Surgical and Histopathological Results in Carotid Body Tumors.

OBJECTIVE: The possible relationships between the histopathological findings of carotid body tumors and age, gender, tumor diameter, and Shamblin classification were investigated. In addition, preoperative embolization status, development of neurological complications, need for vascular reconstruction, hemoglobin change, and discharge time were examined and the effects of these variables on each other were analyzed. METHODS: Between 2008 and 2022, 46 cases who underwent carotid body tumor excision were examined retrospectively. The cases were followed for an average of 81 months postoperatively. Histopathological materials were reexamined and the effect of categorical variables was analyzed. RESULTS: Mean tumor diameter was 3.55 ± 1.26 cm, mean discharge time was 3.91 ± 2.37 days, and mean hemoglobin change was 1.86 ± 1.25. Neurological complications developed in 13% of cases. The amount of hemoglobin change was significantly (p = 0.003) higher in those who developed neurological complications, whereas the tumor diameter and discharge time were found to be insignificantly higher. Surgical complications requiring vascular repair occurred in 10.8% of cases. Tumor diameter (p = 0.017) and hemoglobin change (p = 0.046) were significantly higher in these patients. There were significant correlations between higher Shamblin classification and tumor diameter, discharge time, postoperative hemoglobin value, and number of surgical and neurological complications. No significant difference was found between Ki-67, capsular invasion, mitosis, pleomorphism, prominent nucleoli, mean island diameter, and tendency of islands to merge with categorical variables. CONCLUSION: As the tumor diameter increases, the operation becomes more difficult and the postoperative complication rate increases. We think that subadventitial and capsular removal of the tumor is effective in preventing recurrence. To reach a histopathological conclusion, a larger series of studies including tumors with high Ki-67 and mitosis rates, large size, and one or more of the criteria for necrosis are needed.

Preoperative monocytosis is predictable at diagnosis for RT-PCR negative COVID-19 paediatric cardiac surgery patients.

Other markers investigated in this population have gained importance in the diagnosis of the disease since the course of COVID-19 disease is atypical in the paediatric population and PCR may be misleading. The leukocyte profile is one of these biochemical tests. Children did not have lymphopenia in hemogram count, whereas relatively neutropenia and monocytosis were detected, unlike the adult population. The reason why children do not have lymphopenia is thought to be due to the fact that the thymus is more active in the first years of life.Two-hundred and four patients operated in our paediatric cardiac surgery clinic from 11March, 2020 to 1 April, 2021 were retrospectively examined and 11 patients with preoperative asymptomatic and PCR (-), but with PCR (+) in the post-operative period (patients with incubation period or false PCR negativity) were included in our study. Patients requiring emergency operation and operated from PCR (+) patients in the preoperative period were excluded from the study.The neutrophil ratio in the lymphocytic series of 7 patients out of 11 patients was slightly below the normal range in the preoperative period, the lymphocyte ratio of 3 patients was slightly above the normal range, and the relative monocyte ratio of 10 patients was slightly above the normal range.We think that evaluating the leukocyte profile combined with RT-PCR will give more accurate results in the diagnosis of incubation period and false RT-PCR negative patients. In addition, we believe that the algorithms for non-complex paediatric cardiac surgery procedures and timing in the paediatric population with a better course of COVID-19 disease with a positive post-operative course.

Infection profile of patients with extracorporeal membrane oxygenation in paediatric cardiac surgery ICU.

AIM: We investigated the risk of increased nosocomial infections and the associated pathogens in patients who underwent paediatric cardiovascular surgery and were put on extracorporeal membrane oxygenation support. We studied the duration of extracorporeal membrane oxygenation use and other variables that may be associated with increased nosocomial infection risk. METHODS: Patients who were treated with an extracorporeal membrane oxygenation in paediatric cardiovascular surgery ICU between 2010 and 2020 were included in this retrospective study. We analysed the site of infection and microbiological profile of infections occurring in these patients according to CDC and National Healthcare Safety Network criteria. RESULTS: The onset of infection development in patients after extracorporeal membrane oxygenation was found to be median 8 (3-15, 25-75 IQR) days in the whole group, and median 11 (3-16, 25-75 IQR) days in those who developed infection without being put on extracorporeal membrane oxygenation. When patients were divided into those with and without infection, duration of ICU was found to be 19 (16-28, IQR 25-75) days in patients with infection vs. 8 (2-16, IQR 25-75; p: <0.001) days in patients without infection. Duration of extracorporeal membrane oxygenation support was found to be 14 (10-25, IQR 25-75) days in patients with infection versus 5 (2-10, IQR 25-75; p: <0.001) days in patients without infection and total hospital stay was 26 (18-33, IQR 25-75) days in patients with infection versus 8 (2-23, IQR 25-75) days in those without infection. A total of 24 patients out of the 70 patients experienced 32 infectious episodes during extracorporeal membrane oxygenation support. Culture-positive infections were detected at a single site in 19 patients, and multiple sites in 5 patients. CONCLUSION: We propose that prolonged extracorporeal membrane oxygenation support is associated with an increased risk of infection. Although extracorporeal membrane oxygenation is a life-saving treatment method, prolonged extracorporeal membrane oxygenation may increase the development of infectious complications and the associated mortality and morbidity of the patient.

PENTRAXIN 3 LEVELS CORRELATE WELL WITH DISEASE SEVERITY AT ADMISSION IN COVID-19 PATIENTS.

Pentraxin 3 (PTX3), a long pentraxin, is not only released from dendritic cells and neutrophils but also from epithelial and endothelial cells such as alveolar epithelium. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) initially activates the innate immune system, causing a complex immune response. Clinical and experimental studies suggest that PTX3, a locally and systemically secreted marker, can be used as a predictor of the severity and mortality in respiratory infections. In the current study, serum PTX3 levels in patients hospitalized with COVID-19 were found to be significantly increased at admission and showed significant association with the disease severity.

Contribution of Current Comorbid Conditions to Carotid Artery Stenosis in Patients Undergoing Coronary Artery Bypass and Stroke Distribution in Carotid Artery Stenosis Groups.

OBJECTIVE: The aim of this study was to contribute to the issue of "Who should we perform Doppler ultrasonography on?" and determine the contribution of comorbid diseases to the development of carotid artery stenosis (CAS) and preoperative CAS by examining comorbid diseases in patients undergoing coronary artery bypass graft operation (CABG) and also discussing the effect of carotid stenosis levels on postoperative stroke. METHOD: Between 2011-2015, a total of 921 patients who underwent cardiac surgery retrospectively were examined. Of these, 594 CABG patients aged 60 and over who underwent preoperative carotid Doppler examination were analyzed. RESULTS: Sixty-five percent of patients were male, and 35% were female. The mean age was 69.3 years. Sixty-nine percent of patients were in the 0-29% stenosis group, 12.9% in the 30-49% group, 14.6% in the 50-69% group, 3% in the 70-99% group, and 0.3% in the 100% occlusion group. Peripheral artery disease (PAD), age, gender, and diabetes mellitus (DM) were found to have significant (P < 0.05) effects on the occurrence of CAS. CAS increased by 0.9% with an increase of one year in age, 10.8% with the presence of PAD, 3% with male sex, 3.8% with presence of chronic obstructive pulmonery disease (COPD), 1.9% with presence of left main coronary disease (LMCAD), and 0.9% with presence of hypertension. In the decision tree analysis, the rate of 50% and above CAS in the presence of PAH + DM and age older than 65 years was 62.5%. Cerebrovascular accident (CVA) distribution was 2.1% in the 0-29% group, 2.5% in the 30-49% group, 4.5% in the 50-69% group, and 11.1% in the 70-99% group. Postoperative CVA was not observed in 10 patients who underwent carotid endarterectomy (CE). Postoperative CVA developed in six patients with 50% or more stenosis who did not undergo CE. CONCLUSION: For the preoperative detection of CAS in patients undergoing CABG, the association of advanced age, PAD, DM, male gender, COPD, LMCAD, and hypertension risk factors should be considered. We suggest that carotid screening should be performed in those over 65 years of age and with PAD+DM. Studies with large populations are needed to observe the effects of aortic atherosclerosis load, surgical procedure, and unilateral/bilateral CAS presence on the development of stroke in patients with severe CAS and postoperative CVA.

Relationship Between Cardiac Surgery and Acute Ischemic Stroke: An Examination in Terms of Clinical, Radiological, and Functional Outcomes and Possible Pathophysiological Mechanisms.

AIM: The aim is to discuss the clinical characteristics, time, anatomical vascular distribution, radiological features, functional outcomes after stroke and possible pathophysiological mechanisms of acute ischemic stroke (AIS) that develop after cardiac surgery. METHOD: A total of 3,474 patients, who underwent cardiac surgery between 2015-2020, retrospectively were analyzed. Forty-nine patients, who developed AIS and had brain CT and diffusion MR images during hospitalization, were included in the study. RESULTS: AIS distribution was at 53% CABG, 12.2% isolated mitral valve, 8.1% isolated aortic valve, and 26.5% combined surgical procedures. Patients with a ≤2 days (P = 0.03) preop preparation time and body surface area (BSA) of <1.85 m2 (P = 0.02) had a high discharge rate. While newly developing AF was low in the early stroke group, it was higher in the late stroke group (P = 0.02). A history of previous cerebrovascular events was found in 3.3% of the patients. Postoperative new AIS was detected in 7.8% of those with a history of cerebrovascular events. Total anterior circulation infarction (TACI) case rate was 8.1%, partial anterior circulation infarction (PACI) 12.2%, posterior circulation infarction (POCI) 24.4%, cortical border zone infarction (CBZI) 30.6%, combined POCI + CBZI 12.2%, multiple territorial infarcts (MTI) 10.2%, and lacunar circulation infarction (LACI) rate was 2%. The modified Rankin Scale means following AIS was 3.45. The worst Rankin score was 5.75 in CABG+MVR cases; it was found to be 5 in the valve + ascending aorta case and 5 in the five bypass cases. CONCLUSION: Calculation of cerebrovascular reserve with extra/intracranial vascular imaging is important in patients with multiple risk factors, whose association with stroke has been determined before cardiac surgery. We believe that cardiovascular surgery and neurology multidisciplinary prospective randomized studies should be conducted to obtain pre-, peri- and post-procedural risk calculation scales, according to cardiac surgery type and to reshape surgical procedures accordingly.

Predictive Value of Neutrophil-to-Lymphocyte, Aspartate-to-Alanine Aminotransferase, Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratios in Severity and Side of Carotid Artery Stenosis: Are Those Significant?

BACKGROUND: Atherosclerosis is a chronic disease that leads to mortality and morbidity by affecting arterial vascular structures. Carotid artery is one of these arterial structures and occlusive disease of carotid artery may cause stroke or cranial ischemic infarction. Inflammation plays a role in the atherosclerotic process. In this study, we aimed to discuss the relationship between the severity and side of carotid artery occlusion and novel inflammatory parameters include platelet-to-lymphocyte, neutrophil-to- lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios. METHODS: One-hundred-fifteen patients who had carotid artery stenosis between 50%-99% and 115 healthy subjects with no carotid artery stenosis or additional disease were included in the study. The relationship between the side and degree of the lesion and platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios were studied in the patient group. The patients with carotid artery stenosis and the healthy subjects were compared, in the terms of same parameters. Data were evaluated statistically. RESULTS: There were no statistically significant differences between the groups, in the terms of platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to-alanine aminotransferase ratios and the degree of stenosis. There was no statistically significant difference between the sides of the lesions and the parameters above except lymphocyte-to-monocyte ratio. It was statistically significantly higher in left-sided lesions. Aspartate-to- alanine aminotransferase and neutrophil-to-lymphocyte ratios were markedly higher in the patient group, when compared to controls. CONCLUSION: Platelet-to-lymphocyte, neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and aspartate-to- alanine aminotransferase ratios are inexpensive, easy, fast, and reproducible parameters that can be used in determining the prediction of carotid artery stenosis.

Retinal and choroidal vascular structures are affected in axial spondyloarthritis: an optical coherence tomography study.

PURPOSE: The aim of this study is to evaluate the retinal and choroidal structures in r- and nr-axSpA patients using spectral domain optical coherence tomography (SD-OCT) and to compare changes with healthy controls. METHODS: In this cross-sectional study, 70 axSpA patients (50 radiographic- and 20 nr-axSpA) and 50 healthy control subjects were included. Choroidal thickness (ChT), macular thickness, retinal nerve fiber layer (RNFL), and the ganglion cell complex (GCC) were measured by SD-OCT. For ChT values, seven lines at nasal and temporal were drawn at 500-µm intervals, centering the subfoveal sclerochoroidal junction. Analysis of the data was performed with the SPSS program. Mann-Whitney U test was performed for comparison of non-normally distributed continuous data; Student's t test was used for normal distributed data. RESULTS: No significant difference was observed between 70 (66% male; mean age 39.7 ± 10.4 years) axSpA patients (50 radiographic and 20 nr-axSpA) and 50 (mean age 41.2 ± 6.2 years) healthy control subjects (p 0.417). R-axSpA and nr-axSpA groups and control group were similar in terms of spherical equivalent, intraocular pressure, axial length, and body mass index (p 0.574, p 0.874, p 0.918, p 0.344, respectively). While mean macular and GCC thicknesses were significantly lower in the patient group than in the healthy group, there was no significant difference between the two groups in terms of RNFL thickness. CONCLUSION: The present study showed that there was no significant relationship between markers and scores indicating disease activity and ChT, MT, RNFL, and GCC thicknesses. However, an increase in choroidal thickness and involvement of the retinal layers has also been demonstrated in patients with spondyloarthritis. In addition, the relationship between disease activity and retinal layer involvement is remarkable in the r-axSpA group.

Early-Term Outcomes of Off-Pump versus On-Pump Beating-Heart Coronary Artery Bypass Surgery.

BACKGROUND: The current study analyzed and compared early-term outcomes of off-pump versus on-pump beating heart coronary artery bypass surgery. METHODS: From January 2011 to January 2018, a total of 736 patients underwent isolated first-time elective beating-heart coronary artery bypass surgery without the use of aortic cross-clamping and cardioplegic arrest at our institution, and they were included in this study. Data of patients were collected and retrospectively analyzed. Patients were divided into two groups according to the use of cardiopulmonary bypass during the operation, as off-pump group (n = 399) and on-pump beating-heart group (n = 337). Both groups were compared with each other in terms of preoperative, intraoperative, and postoperative data. RESULTS: Groups were statistically similar with regard to baseline clinical characteristics and demographics. When compared with off-pump group, on-pump beating-heart group had a greater number of distal bypass, longer length of hospital stay, and lower postoperative hematocrit level, and received more blood product transfusion. No statistically significant differences were detected between the groups with respect to mortality and postoperative complications except for atrial fibrillation. Atrial fibrillation was significantly frequent in on-pump beating-heart group. CONCLUSION: Our study suggested that off-pump and on-pump beating-heart coronary artery bypass procedures had similar early mortality and major complication rates except for atrial fibrillation. However, it seemed that off-pump procedure was superior to on-pump beating-heart procedure with regard to length of hospital stay, blood product transfusion, and atrial fibrillation development. Further prospective randomized studies with larger patient series are needed to support our research and attain more accurate data.

Proton Conducting Membranes Based on Poly(Ionic Liquids) Having Phosphonium Counter-Cations.

Proton conducting polymeric membranes are highly searched in many different technologies ranging from energy to biosensing. Protic ionic liquids and their polymeric version represent a new family of proton conducting molecules with relatively facile synthesis and excellent properties. In this work, protic poly(ionic liquids) having the most popular phosphonium counter-cations are presented for the first time. The synthesis is carried out through proton transfer reactions or through ion exchange reactions by using commercially available tertiary phosphines. Tributyl-, trioctyl-, and tricyclohexyl-phosphine are selected to form the desired cations. Polystyrene sulfonic acid, poly(2-acrylamido-2-methyl-1-propanesulfonic acid), and lithium poly[(4-styrenesulfonyl) (trifluoromethanesulfonyl)imide] polymers are used to form the polymeric anions. The chemical structure of the protic poly(ionic liquids) is confirmed by spectroscopic characterizations such as Fourier transform infrared and nuclear magnetic resonance spectroscopies. Thermal properties of the polymer are characterized by means of differential scanning calorimetry and thermogravimetric analysis. Polymers exhibit good membrane forming ability as well as high ionic conductivities in the range of 10-8 to 10-3 S cm-1 from 30 to 90 °C.

Innovative Poly(Ionic Liquid)s by the Polymerization of Deep Eutectic Monomers.

The incorporation of ionic liquid (IL) chemistry into functional polymers has extended the properties and applications of polyelectrolytes. However, ILs are expensive due to the presence of fluorinated anions or complicated synthetic steps which limit their technological viability. Here, we show a new family of poly(ionic liquid)s (PILs) which are based in cheap and renewable chemicals and involves facile synthetic approaches. Thus, deep eutectic monomers (DEMs) are prepared for the first time by using quaternary ammonium compounds and various hydrogen bond donors such as citric acid, terephthalic acid or an amidoxime. The deep eutectic formation is made through a simple mixing of the ingredients. Differential scanning calorimetry, nuclear magnetic resonance (NMR) and computational studies reveal the formation of the DEMs due to the ionic interactions. The resulting DEMs are liquid which facilitates their polymerization using mild photopolymerization or polycondensation strategies. Spectroscopic characterizations reveal the successful formation of the polymers. By this way, a new family of PILs can be synthesized which can be used for different applications. As an example, the polymers show promising performance as solid CO2 sorbents. Altogether the deep eutectic monomer route can lead to non-toxic, cheap and easy-to-prepare alternatives to current PILs for different applications.

Oropharyngeal Tularemia Outbreak Associated with Drinking Contaminated Tap Water, Turkey, July-September 2013.

In 2013, an oropharyngeal tularemia outbreak in Turkey affected 55 persons. Drinking tap water during the likely exposure period was significantly associated with illness (attack rate 27% vs. 11% among non-tap water drinkers). Findings showed the tap water source had been contaminated by surface water, and the chlorination device malfunctioned.

Poly(ionic liquid)s as phase splitting promoters in aqueous biphasic systems.

Aqueous biphasic systems (ABSs) provide a sustainable and efficient alternative to conventional liquid-liquid extraction techniques with volatile organic solvents, and can be used for the extraction, recovery, and purification of diverse solutes. In this work, and for the first time, ABSs composed of poly(ionic liquid)s (PILs) and inorganic salts were measured at 25 °C and atmospheric pressure. New PILs having pyrrolidinium polycations combined with different counter-anions, namely acetate [Ac](-), trifluoroacetate [TFAc](-), hexanoate [Hex](-), adipate [Adi](-), and citrate [Cit](-) were synthesized, by a simple and environmentally-friendly procedure, and characterized. The effect of the PIL features, namely molecular weight and anionic character, and other experimental variables, such as temperature, on the phase splitting ability was researched. The aptitude of the studied ABS to be implemented as separation technologies was also evaluated through the use of a model biomolecule, tryptophan.

[Evaluation of post-operative flow and diameter changes in brachial and ulnar arteries in coronary artery bypass surgery patients in which the radial artery is used as graft]. / Koroner arter baypas cerrahisinde radiyal arter grefti kullanilan hastalarda ameliyat sonrasi dönemde brakiyal ve ulnar arterlerde meydana gelen akim ve çap degisikliklerinin incelenmesi.

OBJECTIVE: The radial artery is widely used in coronary bypass surgery. In these patients, forearm and hand circulation is provided by the ulnar artery. This study aimed to investigate post-operative changes in flow and diameter in brachial and ulnar arteries in patients undergoing coronary bypass surgery in which the radial artery is used as graft. METHODS: Between September 2007 and September 2008, 20 patients (16 men, 4 women; mean age 57.8 years; range 44 to 70 years) underwent elective coronary bypass surgery at our clinic. The radial artery was used as graft in all cases. Pre-operatively, adequacy of the ulnar artery for forearm circulation was investigated by Allen test and duplex ultrasonography. Basal flow and diameter values of the brachial and ulnar arteries were measured. Control duplex ultrasound measurements were performed at three months post-operatively. Flow and diameter changes in the brachial and ulnar arteries were recorded. RESULTS: Significant increase was shown in ulnar artery flow and diameter values in post-operative measurements. A significant increase was observed in brachial artery diameter, accompanied by a relative decrease in flow value. There were no mortality or ischemic complications in our study. Transient paresthesia as a neurological complication was observed in 4 patients. CONCLUSION: Radial artery use for coronary bypass surgery leads to significant changes in ulnar and brachial arteries. All flow and diameter changes can be detected by color Doppler ultrasonography in the early stages. These adaptation mechanisms show that the radial artery can be safely harvested as graft material.

The importance of hematologic indices in the risk stratification of patients with acute decompensated systolic heart failure.

OBJECTIVES: In patients with heart failure, a variety of hemogram parameters are known to be of prognostic significance. This study aimed to investigate which of these parameters is/are useful in predicting one-year all-cause mortality in patients with acute decompensated heart failure (ADHF). STUDY DESIGN: Patients who were hospitalized between September 2012-March 2013 in our hospital with systolic-ADHF with ejection fraction ≤40%, symptoms, and findings of congestion were enrolled retrospectively in the study. The study population was divided into two groups based on one-year-mortality. RESULTS: 119 patients with ADHF (mean-age 67±14 years; 55% male) were enrolled in the study. One-year-mortality occurred in 29% of patients. Hemoglobin levels, platelet, basophil and lymphocyte counts were significantly lower, while red-cell distribution width (RDW) was found to be significantly higher in the one-year-mortality group. Neutrophil, monocyte, and eosinophil counts were similar in the two groups. Furthermore, lower estimated glomerular-filtration-rate (eGFR) and unused angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) were associated with mortality. Age, presence of hypertension, right-ventricular diameter, eGFR, ACE/ARB treatment, hemoglobin levels, RDW and platelet, leukocyte, lymphocyte, basophil, neutrophil, monocyte, and eosinophil-counts were found to have prognostic significance in univariate analysis. In multivariate analysis, decreased platelet, lymphocyte-counts and hemoglobin level on admission and unused ACE/ARB treatment at discharge (p<0.05) were found to be independent factors predicting one-year-mortality. CONCLUSION: Among hematological indices; hemoglobin level, platelet and lymphocyte counts are readily available, useful and inexpensive markers for the prediction of one-year all-cause mortality in ADHF patients.

The prognostic significance of serum albumin in patients with acute decompensated systolic heart failure.

BACKGROUND: Despite improvements in the diagnosis and treatment of heart failure, mortality is still high. It is important to identify high-risk patients. In this study, we investigated whether the serum albumin level is a useful predictor of annual mortality in patients with acute decompensated systolic heart failure (ADSHF). METHODS: One-hundred and thirty-five consecutive patients with a left ventricular ejection fraction ≤ 40% who were hospitalized with the diagnosis of ADSHF were included in this retrospective study. Patients were divided into two groups based on whether or not hypoalbuminaemia was present, and the relationship between hypoalbuminaemia and mortality was evaluated. RESULTS: The mean age of the study population was 67 ± 14 years and 54% of the patients were male. Hypoalbuminaemia was detected in 69.6% of the patients. The systolic blood pressure, haemoglobin levels, lymphocyte count, cholesterol and sodium values were low and the direct bilirubin and CRP levels were elevated in the hypoalbuminaemia group. The one-year mortality was 37% in the hypoalbuminaemia group and 12% in the group with normal albuminaemia (P = 0.003). Multivariate analysis showed that hypoalbuminaemia, decreased haemoglobin levels and increased creatinine values were independent predictors of mortality (P < 0.05). A serum albumin cut-off value of 3.10 g/dl predicted 1-year mortality with a sensitivity of 70% and specificity of 70% in patients with ADSHF disease. CONCLUSION: All-cause annual mortality rates are significantly increased in ADSHF patients with hypoalbuminaemia. The serum albumin level, as well as the creatinine and haemoglobin values, may be helpful biomarkers in this group.

Ionic liquids and cellulose: dissolution, chemical modification and preparation of new cellulosic materials.

Due to its abundance and a wide range of beneficial physical and chemical properties, cellulose has become very popular in order to produce materials for various applications. This review summarizes the recent advances in the development of new cellulose materials and technologies using ionic liquids. Dissolution of cellulose in ionic liquids has been used to develop new processing technologies, cellulose functionalization methods and new cellulose materials including blends, composites, fibers and ion gels.

Survival Prediction of Patients after Heart Attack and Breast Cancer Surgery with a Hybrid Model Built with Particle Swarm Optimization, Stacked AutoEncoders, and the Softmax Classifier.

The prediction of patient survival is crucial for guiding the treatment process in healthcare. Healthcare professionals rely on analyzing patients' clinical characteristics and findings to determine treatment plans, making accurate predictions essential for efficient resource utilization and optimal patient support during recovery. In this study, a hybrid architecture combining Stacked AutoEncoders, Particle Swarm Optimization, and the Softmax Classifier was developed for predicting patient survival. The architecture was evaluated using the Haberman's Survival dataset and the Echocardiogram dataset from UCI. The results were compared with several Machine Learning methods, including Decision Trees, K-Nearest Neighbors, Support Vector Machines, Neural Networks, Gradient Boosting, and Gradient Bagging applied to the same datasets. The findings indicate that the proposed architecture outperforms other Machine Learning methods in predicting patient survival for both datasets and surpasses the results reported in the literature for the Haberman's Survival dataset. In the light of the findings obtained, the models obtained with the proposed architecture can be used as a decision support system in determining patient care and applied methods.

Comparison of Beating-Heart Technique Versus Aortic Cross-Clamping in Tricuspid Valve Surgery.

OBJECTIVE: Tricuspid valve surgery can be performed on a beating heart or on an arrested heart. We aimed to compare the outcomes of tricuspid valve surgery using these two different approaches. METHODS: Between January 2015 and February 2020, 204 patients who underwent tricuspid valve surgery along with concomitant cardiac surgical procedures were included in the study. Techniques of cross-clamping and beating-heart tricuspid surgery were applied to 103 and 101 patients, respectively. Concomitant valvular and/or coronary interventions were performed under cross clamping in both groups. Results from the preoperative period, immediate postoperative period, and six-month postoperative interval were compared between the groups. RESULTS: There were no differences in demographic characteristics or preoperative grades of tricuspid valve regurgitation between the groups. Duration of mechanical ventilation, and stays in the intensive care unit and hospital were significantly shorter in patients operated on using the beating-heart technique. Additionally, re-exploration surgery and mortality rates were significantly lower in the beating-heart group. Postoperative six-month echocardiography findings related to tricuspid valve regurgitation, maximum and minimum gradients of the tricuspid valve, and pulmonary arterial pressure were also lower in the beating-heart group. CONCLUSION: Beating-heart tricuspid valve surgery may be preferable to the cross-clamping technique to avoid clamp-induced ischemia, which can lead to worsened postoperative outcomes.

Surgical Antimicrobial Prophylaxis Compliance in Turkey: Data from the Prospective, Observational, Multicenter Survey Including 7,978 Surgical Patients.

Background: Surgical antimicrobial prophylaxis (SAP) is the peri-operative administration of antimicrobial agents. Compliance rates vary worldwide from 15% to 84.3%, with studies in Turkey not exceeding 35%. The aim of this multicenter study was to determine the rate of appropriate antibiotic class, timing, and duration as well as discharge prescriptions in Turkey. Thus, we aimed to determine the rate of full compliance with SAP procedures in our country Patients and Methods: This multicenter, prospective, observational, descriptive study was conducted in 47 hospitals from 28 provinces in seven different regions of Turkey. Patients over 18 years of age in all surgical units between June 6, 2022, and June 10, 2022, were included in the study. Results: Of the 7,978 patients included in the study, 332 were excluded from further analyses because of pre-existing infection, and SAP compliance analyses were performed on the remaining 7,646 cases. The antibiotic most commonly used for SAP was cefazolin (n = 4,701; 61.5%), followed by third-generation cephalosporins (n = 596; 7.8%). The most common time to start SAP was within 30 minutes before surgery (n = 2,252; 32.5%), followed by 30 to 60 minutes before surgery (n = 1,638; 23.6%). Surgical antimicrobial prophylaxis duration was <24 hours in 3,516 (50.7%) patients and prolonged until discharge in 1,505 (21.7%) patients. Finally, the actual proportion of patients compliant with SAP was 19% (n = 1,452) after omitting 4,458 (58.3%) patients who were prescribed oral antibiotic agents at discharge as part of a prolonged SAP. Conclusions: Surgical antimicrobial prophylaxis compliance rates are still very low in Turkey. Prolonged duration of SAP and especially high rate of antibiotic prescription at discharge are the main reasons for non-compliance with SAP.