Relationships between sleep, quality of life and anxiety in patients undergoing cardiac surgeries / Relaciones entre sueño, calidad de vida y ansiedad en pacientes sometidos a cirugías cardíacas / Relações entre sono, qualidade de vida e ansiedade em pacientes sujeitos a cirurgias cardíacas

Objective: the objective of this study is to examine the relationships between sleep, quality of life and anxiety in patients undergoing cardiac surgeries during the preoperative period, at discharge, two weeks after discharge and three months after discharge. Method: this study had a prospective, descriptive and correlational design and was conducted in a single center. The sample consisted of 68 patients who had undergone cardiac surgeries. The data were collected using an Information Form, the State-Trait Anxiety Inventory, the Richard-Campbell Sleep Questionnaire and the Nottingham Health Profile. Results: the patients' sleep quality increased from moderate to good at each measurement moment after the surgeries, when compared to sleep quality measured at their first hospitalization. While the state anxiety scores decreased at discharge and 2 weeks after the initial hospitalization, they increased to a moderate level 3 months after discharge. There was no significant relationship between anxiety levels and sleep quality at any measurement moment. Additionally, the patients' quality of life was significantly improved 2 weeks and 3 months after discharge. Conclusion: The results of this study showed that the sleep quality of patients who had undergone cardiac surgeries was improved during the postoperative period, and that this improvement exerted a positive effect on their quality of life.

Objetivo: el objetivo de este estudio es examinar las relaciones entre el sueño, la calidad de vida y la ansiedad en pacientes sometidos a cirugías cardíacas durante el período preoperatorio, al momento del alta hospitalaria, y dos semanas y tres meses después del alta. Método: este estudio tuvo un diseño prospectivo, descriptivo y correlacional y se realizó en un único centro. La muestra estuvo compuesta por 68 pacientes que habían sido sometidos a cirugías cardíacas. Los datos se recolectaron por medio de un Formulario de Información y a través de los siguientes instrumentos: State-Trait Anxiety Inventory , Richard-Campbell Sleep Questionnaire y Nottingham Health Profile . Resultados: la calidad del sueño de los pacientes mejoró de moderada a buena en cada medición después de las cirugías, en comparación con la evaluada al momento de la primera internación. Si bien las puntuaciones de ansiedad rasgo disminuyeron al momento del alta hospitalaria y 2 semanas después de la internación inicial, aumentaron al nivel moderado 3 meses después del alta. No se registró ninguna relación significativa entre niveles de ansiedad y calidad del sueño en ninguna de las mediciones. Además, la calidad de vida de los pacientes mejoró significativamente 2 semanas y 3 meses después del alta hospitalaria. Conclusión: los resultados de este estudio demostraron que la calidad de sueño de los pacientes sometidos a cirugías cardíacas mejoró durante el período postoperatorio, además de que esta mejora ejerció un efecto positivo sobre su calidad de vida.

Objetivo: o objetivo deste estudo é examinar as relações entre sono, qualidade de vida e ansiedade em pacientes sujeitos a cirurgias cardíacas durante o período pré-operatório, na alta, duas semanas após a alta e três meses após a alta. Método: este estudo teve um projeto prospectivo, descritivo e correlacional e foi realizado em um único centro. A amostra foi composta por 68 pacientes sujeitos a cirurgias cardíacas. Os dados foram coletados por meio de um Formulário de Informações, do State-Trait Anxiety Inventory , do Richard-Campbell Sleep Questionnaire e do Nottingham Health Profile . Resultados: a qualidade de sono dos pacientes aumentou de moderada para boa em cada momento de medição após as cirurgias, quando comparada à qualidade de sono medida em sua primeira internação. Embora a pontuação de ansiedade-estado tenha diminuído na alta e duas semanas após a internação inicial, ela aumentou para um nível moderado três meses após a alta. Não houve relação significativa entre os níveis de ansiedade e a qualidade do sono em nenhum momento de medição. Além disso, a qualidade de vida dos pacientes melhorou significativamente duas semanas e três meses após a alta. Conclusão: os resultados desse estudo mostraram que a qualidade de sono dos pacientes sujeitos a cirurgias cardíacas melhorou durante o período pós-operatório, e que essa melhora exerceu um efeito positivo em sua qualidade de vida.

The Predictive Value of R Wave Peak Time to Detect Thrombus Burden in St-segment Elevation Myocardial Infarction: A Retrospective Cohort Study in a Tertiary Medical Center

Abstract Background: Patients with higher thrombus burden have higher procedural complications and more long-term adverse cardiac events. Detecting patients with high thrombus burden (HTB) before coronary intervention could help avoid procedural complications. Objective: The research aimed to analyze the R wave peak time (RWPT) on the electrocardiogram to predict thrombus burden before coronary angiography in patients with acute ST-segment elevation myocardial infarction (STEMI). Materials and Methods: A total of 159 patients with STEMI were included in the study conducted at a tertiary medical center. The thrombolysis in myocardial infarction (TIMI) thrombus scale was applied to assess the thrombus burden. TIMI thrombus grades 0, 1, 2, and 3 were accepted as low; 4 and 5 had HTB. RWPT was measured from the beginning of the QRS complex to the R-peak from the leads pointing to the infarct-related artery. Results: Patients were divided into two groups according to their angiographically defined thrombus burden as low and high. The low thrombus burden group (LTB) comprised fifty-four patients, whereas the HTB group comprised 105 patients. In the LTB group, RWPT was 47.96 ± 9.17 ms, and in the HTB group was 53.58 ± 8.92 ms; it was significantly longer (p < 0.01). Receiver operating characteristic analysis showed that a cut-off value of preprocedural RWPT of > 46.5 ms predicted the occurrence of HTB with a sensitivity and specificity of 87.62% and 51.85%, respectively (AUC 0.682, 95% CI 0.590-0.774, p < 0.001). Conclusion: The present study evaluated the relationship between the RWPT and thrombus burden in STEMI patients. Based on the results, RWPT is an independent predictor of HTB.

Protective effects of Urtica dioica L. seed extract on liver tissue injury and antioxidant capacity in irradiated rats

Radiotherapy is often used for the treatment of cancer. However, it causes some side effects in patients. This study aimed to determine the hepatoprotective effects of Urtica dioica L. seed-extract (UDSE) in radiation-induced liver injury. Thirty-two male rats were randomly divided into 4 groups (n=8): control(C) group: no action was taken; radiation (R) group: irradiation was administrated at 5Gy single-fraction, radiation with UDSE(R+UDSE) group: irradiation was administrated at 5 Gy single-fraction and animals were fed pellets with 30 mL UDSE/kg; UDSE group: animals were fed pellets with 30 mL UDSE/kg. All of the experiments were performed in all of the groups over 10 days. Malondialdehyde (MDA) and reduced-glutathione (GSH) levels and superoxide-dismutase (SOD), catalase (CAT), glutathione-peroxidase (GSH-Px), aspartate-transaminase (AST), and alanine-aminotransferase (ALT) activities were determined. Histopathological findings were also evaluated in liver tissues. SOD, CAT and GSH-Px activities and GSH levels in the serum and liver were significantly increased, while MDA levels decreased in the R+UDSE group compared with the R group (P<0.05). Moreover, AST and ALT serum activities in the R+UDSE group were lower than those in the R group (P<0.05). In addition, radiation induced degenerative/necrotic changes in the R group were significantly compensated in the R+UDSE group. The results showed that radiation increased oxidative stress and decreased antioxidant capacity, as well as degeneration in the liver. However, UDSE attenuated these degenerative changes.

In vitro Antiproliferative and inhibition of oxidative DNA damage activities of n-butanol extract of Limonium bonduelli from Algeria

Abstract Plants are the main sources of natural antioxidants in the form of phenolic compounds, which help human beings to deal with oxidative stress, caused by free radical damage. For this reason, the present study was carried out to evaluate the antiproliferative, antioxidant and inhibition of oxidative DNA damage activities of n-butanol extract obtained from aerial parts of Limonium bonduelli. The antioxidant potential was determined using 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging and inhibition of lipid peroxidation assay. Antiproliferative activity was evaluated using xCELLigence RTCA instrument on two tumor cell lines; HT-29 (human colon adenocarcinoma) and HeLa (human cervix carcinoma). DNA damage inhibition was evaluated using photolyzing 46966 plasmid. Also, total phenolic and total flavonoid contents were determined using a spectrophotometric method. Total phenolic (343 ± 0.05 µg/mg) and flavonoid (220.5 ± 0.04 µg/mg) were indicated as gallic acid and quercetin equivalents respectively. The extract exhibited significant IC50 values in lipid peroxidation (IC50= 181.18 ± 0.65 µg/mL) and DPPH radical scavenging assays (IC50= 14.92 ± 0.032 µg/mL). The extract also partially protected 46966 plasmid DNA from free radical-mediated oxidative stress in a DNA damage inhibition assay and showed concentration-dependent antiproliferative effects. n-butanol extract of L. bonduelli is a rich source of natural antioxidants and anticancer agents.

Comparison of Transcatheter Aortic Valve Implantationversus Surgical Aortic Valve Replacement to Improve Quality of Life in Patients >70 Years of Age with Severe Aortic Stenosis

Abstract Objective: Transcatheter aortic valve implantation has recently been used in the treatment of severe aortic valve stenosis, particularly in patients with high mortality and morbidity rates for open surgery. The purpose of this study was to compare quality of life in patients over 70 years of age undergoing surgical or transcatheter aortic valve implantation, before the procedure and in the early post-procedural period. Methods: Seventy-nine patients were included in the study, 38 (48.1%) male and 41 (51.9%) female. Mean age of patients was 74.3±5.2 (70-91) years. The surgical aortic valve replacement group consisted of 51 (64.6%) patients and the transcatheter aortic valve replacement group of 28 (35.4%). Quality of life data before the procedure and at the 3rd month postoperatively in patients aged 70 years and older undergoing surgical or transcatheter aortic valve implantation were assessed using the 36-item Short Form Health Survey form. Results: Positive increases in physical task difficulty (13.2±9.8vs. 5.1±7.3) (P=0.001), emotional task difficulty (14.4±11.9 vs.8.5±6.4) (P=0.035), and mental health (0.4±10.4 vs. 9.6±15.1) (P=0.001; P<0.01) scores in patients undergoing transcatheter aortic valve replacement were significantly higher compared to the surgical aortic valve replacement group. No statistically significant difference was determined between the groups in terms of pain, vitality, social function, physical function or general health scores in the preoperative and postoperative periods. Conclusion: The positive increase in quality of life parameters in the transcatheter aortic valve implantation group at the 3rd month postoperatively was significantly higher compared to the surgical aortic valve replacement group.

Left Ventricular Systolic and Diastolic Functions in Patients With Sickle Cell Anemia

The aim of this study was to evaluate the left ventricular systolic and diastolic functions in patients with sickle cell anemia. Fifty-four patients (34 male, 20 female, mean age 22.6 +/- 7.3 years) and 23 healthy persons (12 male, 11 female, mean age 26.7 +/- 6.8 years) were studied. After clinical examination and routine biochemical evaluation by a hematologist, patients with sickle cell anemia were admitted to the study. M-mode and 2-dimensional and Doppler echocardiographic measurements of patients and controls were performed according to criteria of the American Echocardiography Society. The values of the patient groups were compared with the values of normal healthy subjects (controls). Left ventricular systolic and diastolic diameters of sickle cell patients were greater than those of controls (p < 0.001). All of the sickle cell anemia patients had reduced systolic cardiac function (EF: 0.57 +/- 0.1 vs 0.63 +/- 0.06 and FS: 0.30 +/- 0.06 vs 0.34 +/- 0.04, p < 0.02) and abnormal diastolic left ventricular function parameters compared with the control group (IRT: 114 +/- 20 msec vs 65 +/- 7 msec, p < 0.0001; E/A ratio: 1.2 +/- 0.5 vs 1.6 +/- 0.04, p < 0.01). Left ventricular mass (LVM) was greater in patients than in controls (222 +/- 78 g vs 177 +/- 46 g, p < 0.01). Left ventricular systolic and diastolic functions were abnormal in patients with sickle cell anemia, and the left ventricular mass was greater in the patients compared with controls.