The association of the platelet-to-lymphocyte ratio with mitral annular calcification.

OBJECTIVES: Mitral annular calcification (MAC) and atherosclerosis are similar in regard to risk factors and pathogenesis. Increased platelet-to-lymphocyte ratio (PLR) has been shown to be associated with atherosclerotic diseases in previous studies. In this study, we aimed to show the association of PLR levels with the presence of MAC. DESIGN: A total of 1060 patients [n = 704 MAC (+), and n = 356 MAC (-)] who were admitted to our cardiology department were enrolled between January 2014 and December 2014. Demographic, clinical, and laboratory parameters of all participants were recorded. PLR was calculated from the complete blood count. RESULTS: The MAC (+) group comprised of those older in age and having a higher rate of hypertension. The mean PLR value was also significantly higher in the MAC (+) group, as compared to that in the MAC (-) group (129.1 ± 32.2 vs 103.5 ± 23.8, p < 0.001). There was a statistically significant and positive correlation between the neutrophil-to-lymphocyte ratio (NLR) and PLR (r = 0.644, p < 0.001). Age, hypertension, mean platelet volume, NLR, and PLR (OR: 1.109, 95% CI: 1.101-1.123, p < 0.001) were independently associated with the presence of MAC. CONCLUSIONS: Our results demonstrated that the PLR was significantly increased in patients with MAC, and that the PLR was independently associated with the presence of MAC.

[The relationship between mitral annular calcification and red cell distribution width: a cross-sectional study]. / Mitral anülüs kalsifikasyonu ile kirmizi kan hücresi dagilim genisligi iliskisi: Kesitsel bir çalisma.

OBJECTIVE: Mitral annular calcification (MAC) and atherosclerosis are similar in regard to risk factors and pathogenesis. Increased red blood cell distribution width (RDW) has been shown to be associated with atherosclerotic diseases. However, no data evaluating the association of MAC with RDW has been available. The aim of this cross-sectional study was to investigate the relationship between MAC and RDW among patients with various cardiovascular risk factors. METHODS: A total of 623 patients (MAC-positive group: n=413; control group: n=210) admitted to our cardiology outpatient clinics were enrolled between March and November 2014. Demographic, clinical, and laboratory parameters of all participants were recorded. RDW was analyzed from complete blood samples of study participants. RESULTS: Patients in MAC-positive group showed older age and higher rate of hypertension. Mean RDW value was significantly higher in MAC-positive group, compared to control group (15.3±1.4% vs. 13.9±1.4%, p<0.001). In Pearson correlation analysis, statistically significant and positive correlation was determined between neutrophil-lymphocyte ratio and RDW (r=0.284, p<0.001). In multivariate logistic regression analysis, age (OR: 1.041, p<0.001), hypertension (OR: 1.540, p=0.039), and RDW (OR: 5.351, p<0.001) were determined as independent predictors of MAC. CONCLUSION: RDW levels were significantly increased in patients with MAC, and RDW was determined as an independent predictor for presence of MAC. Therefore, increased RDW can be used as a marker of continuing inflammatory process in MAC patients.

Predictors of Bullying Perpetration and Bullying Victimization Among Semi-Professional Team Sport Players in North Cyprus.

This study explores the influence of individual and relational predictors on bullying perpetration/victimization among semi-professional team sport players in North Cyprus. Three variables reflect on an individual's level characteristics (e.g., gender, age, and nationality), and another one, representing the relational level factor (e.g., negative coaching behavior). The current paper obtained data from athletes through convenient sampling technique and online survey utilization. A total of 190 sports players with an average age of 24.77 (SD = 4.52) participated. All participants were club athletes from 16 diverse nations, competing in four different sports disciplines: football, volleyball, handball, and basketball. Hierarchical regression analysis was implemented to evaluate the above underlying linkages. It was found that age, nationality, and the coach's negative personal rapport significantly predicted bullying victimization dynamics among athletes. Bullying perpetration was only predicted by negative personal rapport with the coach but not by any of the individual level predictors. The moderation analysis showed that negative personal rapport with the coach significantly predicted the level of bullying victimization, the age and the nationality of the athlete moderated the relationship between the negative personal rapport and bullying victimization. In other words, the negative personal rapport had a higher effect on bullying victimization for the younger athletes and for international ones. Such findings have the potential to shape the base for further ongoing works, which could underline the critical demand for more emphasis and analysis of nationality, gender, age, and coach's negative rapport on bullying perpetration or victimization. The significance of the study's findings, its limits, and potential paths for further interpersonal violence research are addressed.

Longitudinal Associations among Machiavellianism, Popularity Goals, and Adolescents' Cyberbullying Involvement: The Role of Gender.

Drawing on the social-ecological perspective, this longitudinal study investigated the potential moderating effect of gender in the relationships among Machiavellianism, popularity goals, and cyberbullying involvement (i.e. victimization, perpetration) among adolescents from China, Cyprus, India, and the United States. There were 2,452 adolescents (Mage = 14.85; SD = .53; 13-16 years old; 49.1% girls) from China, Cyprus, India, and the United States included in this study. They completed surveys on Machiavellianism, popularity goals, and cyberbullying victimization and perpetration during the fall of 2014 (Time 1). One year later, during the fall of 2015, adolescents completed surveys on cyberbullying victimization and perpetration. Findings revealed that Machiavellianism and popularity goals were both associated positively with Time 2 cyberbullying victimization and perpetration for all adolescents. The associations between Machiavellianism and Time 2 cyberbullying perpetration and between popularity goals and Time 2 cyberbullying perpetration were stronger for Chinese and Indian boys than girls. Opposite patterns were found for popularity goals and Time 2 cyberbullying perpetration for adolescents from the United States. Gender did not moderate any of the associations for Cypriot adolescents or for Time 2 cyberbullying victimization. The social-ecological perspective provides a useful understanding of how various contexts influence bullying.

Coping with Public and Private Face-to-Face and Cyber Victimization among Adolescents in Six Countries: Roles of Severity and Country.

This study investigated the role of medium (face-to-face, cyber) and publicity (public, private) in adolescents' perceptions of severity and coping strategies (i.e., avoidant, ignoring, helplessness, social support seeking, retaliation) for victimization, while accounting for gender and cultural values. There were 3432 adolescents (ages 11-15, 49% girls) in this study; they were from China, Cyprus, the Czech Republic, India, Japan, and the United States. Adolescents completed questionnaires on individualism and collectivism, and ratings of coping strategies and severity for public face-to-face victimization, private face-to-face victimization, public cyber victimization, and private cyber victimization. Findings revealed similarities in adolescents' coping strategies based on perceptions of severity, publicity, and medium for some coping strategies (i.e., social support seeking, retaliation) but differential associations for other coping strategies (i.e., avoidance, helplessness, ignoring). The results of this study are important for prevention and intervention efforts because they underscore the importance of teaching effective coping strategies to adolescents, and to consider how perceptions of severity, publicity, and medium might influence the implementation of these coping strategies.

Retrosternal Deformations after Coronary Artery Bypass Surgery Using Statistical Shape Analysis.

INTRODUCTION: In this study, we aimed to evaluate the anatomical deformations of the major vascular structures in the retrosternal area caused by adhesions following coronary artery bypass grafting (CABG). METHODS: This single-center, retrospective study included a total of 40 patients with a previous CABG who were admitted to our emergency unit for any reason and underwent a contrast-enhanced chest computed tomography (patient group) and 40 patients without previous cardiac surgery (control group) between January 2018 and November 2019. The retrosternal area was compared between the groups using the statistical shape analysis method. The distance between the sternum and the ascending aorta and pulmonary artery was measured and anatomical deformations of the retrosternal area were examined. RESULTS: There was a statistically significant difference in the anatomical structures of the retrosternal area between the patient and control groups (P<0.001). The distance from the midsternal line to the highest point of the pulmonary artery was statistically significantly shorter in the patient group, compared to the control group (P=0.013). The distance from the sternum to the ascending aorta was also shorter in the patient group, although it did not reach statistical significance (P>0.05). CONCLUSIONS: Our study results showed narrowing of the retrosternal area following CABG and a shorter distance from the sternum to the pulmonary artery than the ascending aorta. Based on these findings, surgeons should be cautious about possible injuries in patients requiring cardiac surgery with repeated median sternotomy.

A Synchronous Ipsilateral True Superficial Femoral Artery and Profunda Femoris Artery Aneurysm With Rupture: A Case Report and Review of the Literature.

Atherosclerotic true aneurysms of the superficial femoral artery (SFA) and profunda femoris artery (PFA) are rare and difficult to detect. The synchronous presence of SFA and PFA aneurysms is even rarer. Herein, we present a case with ipsilateral true SFA and PFA aneurysms diagnosed with rupture. A review of the international literature is made, and the diagnosis and treatment options of this rare condition are discussed. A 75-year-old male was admitted to our hospital with an aneurysm on the distal SFA and the ipsilateral PFA, as well as a hematoma around the PFA. It was difficult to determine the source of the rupture before surgery, even with proper imaging. Successful ligation of the PFA and an aneurysmectomy followed by a bypass grafting for the SFA were performed. An intraoperative examination revealed that the SFA aneurysm had ruptured. In elderly males with a history of ectasia or aneurysm on the aorta or peripheral arteries, a synchronous aneurysm on the SFA or the PFA should be suspected.

Predicting Outcomes of Penetrating Cardiovascular Injuries at a Rural Center by Different Scoring Systems.

OBJECTIVE: To compare the anatomical and physiological scoring systems and the outcomes of surgical management of penetrating cardiovascular trauma at a rural center. METHODS: Seventy-seven patients underwent emergency surgery at our center between January/2012 and October/2018 due to penetrating cardiovascular trauma. Injury Severity Score (ISS), Revised Trauma Score (RTS), New Injury Severity Score (NISS), and Trauma and Injury Severity Score (TRISS) were calculated. The validation of these risk scores to predict mortality was assessed by the area under the receiver operating characteristic curve analysis. RESULTS: All trauma scores were correlated with mortality. As ISS, NISS, and TRISS values increased and RTS values decreased, the mortality rate increased. The area under the curve (AUC) in the receiver operating characteristic curve analysis was 0.943 for TRISS, 0.915 for RTS, 0.890 for ISS, and 0.896 for NISS (P<0.001 for each). Logistic regression analysis revealed that scores were correlated with mortality (P<0.001 for each). By investigating cardiac injuries alone, only TRISS and RTS results correlated with mortality for cardiac injuries (Mann-Whitney U test, P=0.003 and P=0.01, respectively). The AUC was only statistically significant for TRISS and RTS (AUC=0.929, P<0.05 for both). For vascular injuries, all the scores were significantly correlated with in-hospital mortality (Mann-Whitney U test, P<0.001 for each). TRISS had the highest AUC (AUC=0.946, P<0.001). CONCLUSION: TRISS has the highest predictivity for in-hospital mortality in patients with penetrating cardiovascular trauma.

Telecardiographic measurements for device migration: A useful tool for follow-up.

OBJECTIVE: Pump thrombosis in left ventricular assist device (LVAD) patients is an important cause of mortality and morbidity. Inflow cannula migration is a predisposing factor for pump thrombosis. Telecardiographic measurements can be used to follow up apical cannula deviation. In this study, we aimed to evaluate the migration of the inflow cannulas in patients with LVADs using angle measurements on telecardiograms. METHODS: Twenty-three patients who were implanted left ventricular assist devices in our clinic between February 2013 and April 2016 were included in our study. During the first year of follow-up, changes in angle measurements on postoperative 1st, 3rd, 6th, and 12th month telecardiograms were compared against the incidence of device thrombus and serum Lactate Dehydrogenase (LDH) levels. RESULTS: Patients who were diagnosed with device thrombosis had more change in inflow cannula angles than patients without device thrombus (p<0.05 at 6th and 12th months). Patients with higher LDH values had more parallel angular changes at all intervals, and the change in angle was statistically significant at 3rd, 6th and 12th months (p<0.05). CONCLUSION: This study shows that it is possible to track the migration of inflow cannulas in patients with left ventricular heart failure using telecardiograms. The correlation between angle change and LDH levels and embolic events may suggest that telecardiographic follow up of angles may be a useful tool for ventricular assist devices teams for early detection of thrombus.

How Decisiveness, Self-Efficacy, Curiosity and Independent and Interdependent Self-Construals Are Related to Future Hopefulness among Senior Students.

Hope is a future-oriented reasoning that influences psychological assets of individuals. A hopeful standing towards the future can positively influence individual well-being. Different standings in terms of hopefulness may create variations in psychological assets of people. In the current study, we examined the associations of decisiveness, self-efficacy, curiosity and self-construals with hopefulness. A total of 278 senior university students were recruited for the study from Eastern Mediterranean University in Famagusta, North Cyprus. Participants filled six questionnaires; the Beck Hopelessness Scale, the Independent and Interdependent Self-Construal Scale, Multi-Domain Decisiveness Scale, Curiosity and Exploration Inventory II, the Dispositional Hope Scale and the General Self-Efficacy Scale. The data was analyzed by hierarchical multiple regression analysis on SPSS 23 software program. The results indicated that self-efficacy and decisiveness significantly predicted hopefulness, while curiosity did not predict hopefulness and only independent self-construal had the predictive effect on hopefulness. Based on these findings, the emerging adulthood nature of the study sample was discussed, and further recommendations were presented.

Neutrophil-to-lymphocyte ratio for early renal failure under extracorporeal membrane oxygenation support for postcardiotomy shock.

BACKGROUND: This study aims to investigate the relationship between the neutrophil-to-lymphocyte ratio and renal injury in patients under extracorporeal membrane oxygenation support for postcardiotomy shock. METHODS: Between January 2007 and July 2018, a total of 119 patients (38 males, 81 females; mean age 54.4±13.0 years; range, 24 to 74 years) who received extracorporeal membrane oxygenation support for postcardiotomy shock and survived at least 48 hours in our center were retrospectively analyzed. Pre- and postoperative neutrophil-to-lymphocyte ratios, demographic characteristics, renal function parameters, and extracorporeal membrane oxygenationrelated data of the patients were recorded. Occurrence and stages of renal injury was determined using the revised Acute Kidney Injury Network and Kidney Disease Improving Global Outcomes criteria. RESULTS: No significant relationship was found between preoperative neutrophil-to-lymphocyte ratio and renal injury (p>0.05). Postoperative neutrophil-to-lymphocyte ratio was higher in patients who developed renal injury, compared to patients without renal injury (8.68 [0.84-42.00] vs. 4.02 [1.04-21.21], respectively, p=0.004). When patients were grouped for renal injury stage according to the revised Acute Kidney Injury Network (p=0.015) and Kidney Disease Improving Global Outcomes (p=0.006) criteria, the patients with more severe renal injury had higher neutrophil-to-lymphocyte ratio. The receiver operating characteristics analysis revealed a cut-off value of 6.71 for the neutrophil-to-lymphocyte ratio for the detection of renal injury. Patients with a value above 6.71 had an odds ratio of 5.941 for occurrence of renal injury. CONCLUSION: Postoperative, but not preoperative neutrophil-tolymphocyte ratio is associated with presence and severity of renal injury in patients under extracorporeal membrane oxygenation support for postcardiotomy shock. Neutrophil-to-lymphocyte ratio is a simple and inexpensive marker of inflammation in this patient population.