The Effect of Cold Saline Irrigation of Dissection Planes in Rhinoplasty on Postoperative Edema and Ecchymosis.

BACKGROUND: Periorbital edema and ecchymosis are frequently encountered after rhinoplasty and may be distressing to patients. Cold therapy is frequently employed in rhinoplasty to reduce postoperative edema and ecchymosis. PURPOSE: The aim of this study was to evaluate the effect of cold saline irrigation (CSI) of dissection planes in rhinoplasty on postoperative edema and ecchymosis. STUDY DESIGN, SETTING, SAMPLE: The investigators designed a retrospective cohort study. The data of patients who underwent rhinoplasty in our clinic between January 2021 and January 2023 were scanned. Patients who underwent primary open rhinoplasty from the same surgeon and standard rhinoplasty steps were applied in the same way and order were included in the study. Patients who had systemic diseases and previous nose surgery, and patients whose photographs could not be accessed from the photograph archive were excluded. PREDICTOR VARIABLE: According to whether CSI was applied to the dissection plans during rhinoplasty, the patients were divided into the CSI group and the control group (without CSI). MAIN OUTCOME VARIABLES: Patients' grades of periorbital edema and ecchymosis were the main outcome variables. The differences of outcome variables were compared between the 2 groups. COVARIATES: Demographics (age, sex), and surgical detail (duration of surgery) were collected as covariates. ANALYSES: The numerical variables were compared between the two groups using the student's t-test and Mann-Whitney U test, whereas the categorical variables were compared using Pearson's χ2 and Fisher's exact tests. P < .05 was considered statistically significant. RESULTS: Among the 167 patients who met the inclusion criteria, 60 patients were randomly selected, 30 patients in each group. No statistically significant difference was found between the two groups in terms of age (P = .45) and sex (P = .27). The mean ecchymosis grade was statistically significant lower in the CSI group than in the control group for all evaluation times (P < .05). Similarly, the mean edema grade was statistically significant lower in the CSI group than in the control group for all evaluation times, with the exception of the 10th and 15th day (P < .05). CONCLUSION AND RELEVANCE: CSI of the dissection planes in rhinoplasty reduced the development of periorbital edema and ecchymosis. This procedure is straightforward, inexpensive, and effective.

Comparison of Anticancer, Antioxidant, Enzyme Inhibitory Effects and Phytochemical Contents between Edible Lettuce (Lactuca sativa) and A New Wild Species (Lactuca anatolica).

In this study, the bioactive components, enzyme inhibitory, antioxidant and anticancer potentials of edible (L. sativa) and a new species (L. anatolica) of Lactuca were evaluated and compared. The quantitative analyzes of the bioactive components of L. sativa (LS) and L. anatolica (LA) were analyzed quantitatively by GC-MS and Orbitrab HPLC-HRMS. Antioxidant, enzyme inhibitory and anticancer properties were analyzed by various assays. In general, LA exhibited more stronger antioxidant properties compared to LS. The extracts showed similar inhibitory effects on these enzymes. It was determined that LS was dominant in terms of linoleic acid (23.71%), while LA contained a high level of α-linolenic acid (31.70%). LA and LS inhibited the viability of A549 and MCF-7 cells in a dose-dependent manner. IC50 values for LA, LS and cisplatin were determined as 120.3, 197.5, 4.3 µg/mL in A549 cell line and 286.2, 472.8, 7.2 µg/mL in MCF-7 cell line, respectively. It was revealed that LA and LS treatment at 50 µg/mL concentrations in A549 cells completely suppressed the colony forming capacity, and treatment with IC50 doses inhibited cell migration, and triggered apoptosis by regulating caspase-3, cPARP, p53 and p21. The findings of this study suggested that these species have significant pharmacological potential.

Incidence and Risk Factors of Acute Kidney Injury in Pediatric Liver Transplant Patients: A Retrospective Study.

Background: Acute kidney injury (AKI) significantly contributes to the mortality and morbidity rates among pediatric liver transplant (LT) recipients. Objective: Our study aimed to assess the potential factors contributing to AKI in pediatric LT patients and to analyze the impact of AKI on postoperative mortality and hospitalization duration. Materials and methods: About 235 pediatric LT patients under the age of 18 between the years 2015 and 2021 were evaluated retrospectively. The relationship between preoperative and intraoperative variables of the patients and AKI developed when the early postoperative period was assessed. Results: A correlation was found between the patients' preoperative age, albumin levels, and AKI. AKI was found to be associated with the duration of surgery and intraoperative blood transfusion. Conclusion: Our findings revealed that the severity of AKI in pediatric LT patients is linked to extended surgical durations and increased blood transfusions resulting from hemodynamically compromised blood loss. Furthermore, independent risk factors for AKI were identified as prolonged warm ischemia and the overall duration of the operation. How to cite this article: Demiroz D, Colak YZ, Ozdes OO, Ucar M, Ali Erdogan M, Toprak HI, et al. Incidence and Risk Factors of Acute Kidney Injury in Pediatric Liver Transplant Patients: A Retrospective Study. Indian J Crit Care Med 2024;28(1):75-79.

The association between total cholesterol and cognitive impairment in chronic obstructive pulmonary disease patients.

AIM: Chronic obstructive pulmonary disease (COPD) is primarily a respiratory system disorder associated with extrapulmonary conditions. Cognitive impairment (CoI) is very common among COPD patients This study sought to investigate the association between CoI and clinical parameters, inflammatory markers and lipid profiles in a COPD patient population. METHODS: The study population included 111 stable COPD patients. COPD was diagnosed according to Global Initiative for Chronic Obstructive Lung Disease guideline. Total complete blood count test and biochemical measurements including lipid profile were performed. Afterwards, all patients underwent neuropsychological assessment including Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index and Montreal Cognitive Assessment (MoCA) tests. RESULTS: The patients were categorized into two groups according to their MoCA test score: MoCA score ≤ 21 (CoI) (n = 69) and MoCA score > 21 (normal cognition) (n = 42). Total cholesterol (TC) levels were significantly lower in patients with CoI compared to patients with normal cognition. Inflammation related parameters including C-reactive protein were similar among groups. Multivariate logistic regression analysis yielded education, HADS score and TC (OR:1.02, 95% CI:1.00-1.04, p = 0.025) as independent predictors of MoCA score. CONCLUSION: TC independently associates with CoI in COPD patients. There is comparable inflammatory status in COPD patients with CoI compared to COPD patients with normal cognition.

Design, synthesis, α-glucosidase inhibition, pharmacokinetic, and cytotoxic studies of new indole-carbohydrazide-phenoxy-N-phenylacetamide derivatives.

A new series of indole-carbohydrazide-phenoxy-N-phenylacetamide derivatives 7a-l were designed, synthesized, and screened for their α-glucosidase inhibitory abilities and cytotoxic effects. The results obtained in the α-glucosidase inhibition assay indicated that most of the synthesized derivatives displayed good to moderate inhibitory abilities (Ki values ranging from 14.65 ± 2.54 to 37.466 ± 6.46 µM) when compared with the standard drug acarbose (Ki = 42.38 ± 5.73 µM). Among them, 2-mehoxy-phenoxy derivatives 7l and 7h with 4-nitro and 4-chloro substituents on the phenyl ring of the N-phenylacetamide moiety, respectively, displayed the most inhibition effects. The inhibitory mechanism of these compounds was investigated by molecular docking studies. The in vitro cytotoxicity assay showed that only one compound, 2-methoxy-phenoxy derivative 7k with a 4-bromo substituent on the phenyl ring of the N-phenylacetamide moiety, exhibited moderate cytotoxicity against the human non-small-cell lung cancer cell line A549 and the rest of the compounds show almost no cytotoxicity. Further cytotoxic evaluations were also performed on compound 7k. The in silico pharmacokinetic study predicted that the selected compounds 7l and 7h are likely to be orally active.

Evaluation of Sleep Quality, Work Stress and Related Factors in Hospital Office Workers.

BACKGROUND:  Occupational factors, working conditions, age, gender, exercise, acquired habits, and stress affect a person's sleep quality. The aim of this study was to investigate sleep quality, work stress, and related factors among office workers in a hospital. METHODS:  This cross-sectional study was conducted with office workers actively working in a hospital. A questionnaire consisting of a sociodemographic data form, the Pittsburgh Sleep Quality Index (PSQI), and Swedish Workload-Control-Support Scale were used to assess the participants.    Results: The mean of PSQI score was 4.32±2.40 and 27.2% of the participants had poor sleep quality. In the multivariate backward stepwise logistic regression analysis, it was found that shift workers were 1.73 times (95% CI: 1.02-2.91) more likely to have poor sleep quality, and a one-unit increase in work stress score increased the risk of having poor sleep quality by 2.59 times (95% CI: 1.37-4.87). An increase in age was found to decrease the risk of poor sleep quality in workers (OR =0.95; 95% CI: 0.93-0.98). CONCLUSION:  This study suggests that reducing workload and increasing work control as well as enhancing social support will be effective in preventing sleep disturbances. It is important, however, in terms of providing guidance for hospital employees in planning future measures to improve working conditions.

Quercetin and Luteolin Improve the Anticancer Effects of 5-Fluorouracil in Human Colorectal Adenocarcinoma In Vitro Model: A Mechanistic Insight.

The aim of this study was to investigate the antitumor effects of quercetin and luteolin combined with 5-Fluorouracil (5-FU) in HT-29 human colorectal cancer cells. Cell viability induced by quercetin, luteolin and combination of these compounds with 5-FU were determined by MTT assay, also Cell death detection Elisa assay and fluorescence microscopy were performed to investigate apoptotic effects. Hu-VEGF Elisa assay was employed to determine the effects of treatments on angiogenesis. Western blot and qRT-PCR analysis were performed to investigate effects on p53, Bax, Bcl-2, p38 MAPK, mTOR, PTEN, and Akt proteins and genes. The results indicated that quercetin, luteolin and combinations of these compounds with 5-FU inhibited the growth of HT 29 cells. Compared to the control, apoptosis were triggered 8.1 and 10.1 fold in HT-29 cells, that treated with quercetin + 5-FU and luteolin + 5-FU, respectively. VEGF amount significantly decreased by combined treatments. qRT-PCR and western blot results demonstrated that quercetin, luteolin and the combinations of these flavonoids with 5-FU, modulate the apoptotic pathways in HT-29 cells. The increase in p53, Bax, p38 MAPK, and PTEN gene expression levels compared to the control group was 1.71, 1.42, 3.26, and 3.29-fold with 5-FU + L treatment, respectively, while this increase was 8.43, 1.65, 3.55, and 3.54-fold with 5-FU + Q treatment, respectively. In addition, when the anti-apoptotic Bcl-2, mTOR, and Akt gene expression levels were normalized as 1 in the control group, they were 0.28, 0.41, and 0.22 with 5-FU + L treatment, and 0.32, 0.46, and 0.39, respectively, with 5-FU + Q treatment. These findings suggested that quercetin and luteolin synergistically enhanced the anticancer effect of 5-FU in HT 29 cells and may therefore minimize the toxic effects of 5-FU in the clinical treatment of colorectal cancer.

Does Rocuroinum Dose Adjusted Due to Lean Body Weight Provide Adequate Intubation Conditions?: A Prospective Observational Study.

Methods: This is a prospective, observational study. Patients between the ages of 18 and 65 with BMI of 18.5-34.9, who are expected to be under general anesthesia for less than 6 hours, were divided into 3 groups according to their BMI (Group 1 BMI = 18.5-24.9, Group 2 BMI = 25-29.9, Group 3 BMI = 30-34.9). These groups were randomly divided into 2 subgroups: Groups LBW; 1 LBW, 2 LBW, and 3 LBW were given rocuronium intubation dosages based on their LBW while control groups; 1K, 2K, and 3K were given 0.6 mg/kg rocuronium according to their total body weight. The data on the duration of action of rocuronium and its effects on the endotracheal intubation conditions were evaluated. Results: In Group 1, T1 time was found to be significantly longer (p=0.001). Intubation score and the use of additional rocuronium dose were found to be significantly higher in Group 1 LBW than in Group 1K (p=0.001). In Group 1, an additional rocuronium dose was needed to achieve optimal intubation conditions for subgroup 1 LBW. Rocuronium duration of action was found to be significantly longer in control groups 2 and 3, that received TBW-based dosage. Conclusion: In adult patients with a BMI of 18.5 and 24.9 BMI, we report optimal intubation conditions with the LBW-adjusted rocuronium dosage. This trial is registered with NCT05476952.

Efficacy of Intravenous Ibuprofen and Intravenous Paracetamol in Multimodal Pain Management of Postoperative Pain After Percutaneous Nephrolithotomy.

PURPOSE: Many different techniques, including multimodal analgesia, have been used for the management of postoperative pain after Percutaneous nephrolithotomy (PCNL). Ketorolac, intravenous (IV) paracetamol, rofecoxib, and IV ibuprofen have been used as a part of a multimodal analgesic approach in different surgical procedures. However, the efficacy of IV ibuprofen has not been well elucidated in adult patients undergoing elective PCNL. The aim of the study was to examine the efficacy of IV ibuprofen compared to IV paracetamol after elective PCNL. DESIGN: This was a prospective randomized clinic study. METHODS: The study was conducted with 50 patients scheduled for PNCL between the ages of 18 and 65. IV ibuprofen 800 mg infusion was used for Group I, and 1 g IV paracetamol infusion Group P. IV tramadol infusion was administered with a Patient Controlled Analgesia device for postoperative analgesia. The primary outcome was 24-hour tramadol consumption. Secondary outcomes were pain intensity and side effects of the drugs. All outcomes were recorded in the 30th minute in the PACU and in 2, 4, 6, 12, 24 hours postoperatively. FINDINGS: Total postoperative tramadol consumption was significantly lower in Group I compared with Group P (P = .031). There was also a significant decrease in the cumulative tramadol consumption between the two groups in the 2nd and 24th hours (P < .012). In all measurement periods, pain intensity, sedation score, nausea and vomiting, itching, additional analgesia, and satisfaction with pain management were similar between the two groups. CONCLUSION: IV ibuprofen, used as a part of multimodal tramadol-based analgesia reduced tramadol consumption compared with IV paracetamol in the first 24 hours postoperatively after elective PCNL. The IV ibuprofen-tramadol combination seems appeared superior to a paracetamol-tramadol combination.

Proven Food-Induced Acute Urticaria and Predictive Factors for Definitive Diagnosis in Childhood.

BACKGROUND: Urticaria can be the only sign of a food allergy or can be seen together with other signs and symptoms of a food allergy. OBJECTIVE: To determine the demographic, etiologic, and clinical features of food-induced acute urticaria in childhood. METHODS: Patients suspected of food-induced acute urticaria were included in this prospective cross-sectional multicenter study. RESULTS: Two hundred twenty-nine urticaria cases were included in this study. Seventeen patients who did not meet the inclusion criteria of the study were excluded. Of the 212 included cases, 179 (84.4%) were diagnosed with definitive food-induced acute urticaria. The most common foods causing acute urticaria were cow's milk, hen's eggs, and nuts in 56.4, 35.2, and 19% of cases, respectively. The positive predictive value of a history of milk-induced acute urticaria together with a milk-specific IgE >5 kU/L for cow's milk-induced acute urticaria was 92% (95% CI: 81-96%). A history of cow's milk-induced and/or hen's egg-induced acute urticaria was consistent with a definitive diagnosis of food-induced urticaria (Chen's kappa: 0.664 and 0.627 for milk and eggs, respectively). Urticaria activity scores were higher in patients with food-induced acute urticaria (p = 0.002). CONCLUSION: Cow's milk, hen's eggs, and nuts were the most common allergens in the etiology of childhood food-induced acute urticaria. Although the urticaria activity score provides guidance for diagnosis, an oral food challenge is often essential for the definitive diagnosis of a patient with a history of food-induced acute urticaria.

An easy-to-use nomogram for predicting in-hospital mortality risk in COVID-19: a retrospective cohort study in a university hospital.

BACKGROUND: One-fifth of COVID-19 patients are seriously and critically ill cases and have a worse prognosis than non-severe cases. Although there is no specific treatment available for COVID-19, early recognition and supportive treatment may reduce the mortality. The aim of this study is to develop a functional nomogram that can be used by clinicians to estimate the risk of in-hospital mortality in patients hospitalized and treated for COVID-19 disease, and to compare the accuracy of model predictions with previous nomograms. METHODS: This retrospective study enrolled 709 patients who were over 18 years old and received inpatient treatment for COVID-19 disease. Multivariable Logistic Regression analysis was performed to assess the possible predictors of a fatal outcome. A nomogram was developed with the possible predictors and total point were calculated. RESULTS: Of the 709 patients treated for COVID-19, 75 (11%) died and 634 survived. The elder age, certain comorbidities (cancer, heart failure, chronic renal failure), dyspnea, lower levels of oxygen saturation and hematocrit, higher levels of C-reactive protein, aspartate aminotransferase and ferritin were independent risk factors for mortality. The prediction ability of total points was excellent (Area Under Curve = 0.922). CONCLUSIONS: The nomogram developed in this study can be used by clinicians as a practical and effective tool in mortality risk estimation. So that with early diagnosis and intervention mortality in COVID-19 patients may be reduced.

Fatty acid composition, enzyme inhibitory effect, antioxidant and anticancer activity of extract from Saponaria prostrata WILLD. subsp. anatolica HEDGE.

This study attempts to evaluate the antioxidant, enzyme inhibitory, and anticancer properties as well as fatty acid compositions of endemic Saponaria prostrata WILLD. subsp. anatolica HEDGE. The gas chromatography-mass spectrometry (GC-MS) was used to determine the fatty acid content of methanol: dichloromethane extract from S. prostrata subsp. anatolica (SPA). Enzymatic activity was measured against acetylcholinesterase, butyrylcholinesterase and α-glucosidase. DPPH (2,2-diphenyl-1-picrylhydrazyl) free radical scavenging activity and Ferric reducing antioxidant power assay (FRAP) were conducted to antioxidant properties. The anticancer effect of SPA on human MCF-7 breast cancer and human HCT116 colorectal cancer cell line was evaluated by WST-1 cell viability assay, colony formation assay and wound healing assay. In addition, human VEGF Elisa method was used to determine the anti-angiogenic effect, and the quantitative real-time PCR (qRT-PCR) method on p53, Bax and Bcl-2 mRNA levels were used to evaluate apoptosis. While high amounts of palmitic acid (40.8%), linoleic acid (17.75%) and α-linolenic acid (16.84%) were detected in the SPA, the total amount of unsaturated fatty acid (51.34%) was higher than the total amount of saturated fatty acid (48.66%). SPA displayed the most promising acetylcholinesterase (AChE), butyrylcholinesterase (BuChE) and α-glycosidase (AG) inhibitory activities (AChE: IC50: 18.03 µg/mL, BuChE: IC50: 44.24 µg/mL and AG: IC50: 210.85 µg/mL). The half maximum inhibitory concentration (IC50) of SPA in MCF-7 and HCT116 cells was determined as 259.79 µg/mL and 97.24 µg/mL, respectively. In addition, it was determined that SPA suppresses colony formation and wound closure, and suppresses angiogenesis as well as triggering apoptosis at a significant level. It is true that endemic S. prostrata subsp. anatolica is a potential source of functional food ingredients, but more analytical and in vivo experiments are needed to explore further secondary metabolite diversity and pharmacological properties.

Early therapeutic plasma exchange may improve treatment outcomes in severe acute toxic Hepatitis.

BACKGROUND AND OBJECTIVES: Acute toxic hepatitis can result in a different clinical course from a completely curable disease to subacute hepatitis, chronic hepatitis, and fulminant hepatitis failure, which is quite mortal. For this purpose, therapeutic plasma exchange (TPE) can be used for improving treatment outcomes by reducing the harmful substances caused with and/or without liver function in acute toxic hepatitis. We aimed to evaluate treatment outcomes in severe acute toxic hepatitis patients who applied early TPE procedure. MATERIALS AND METHODS: A total of 335 patients who received TPE between 2010-2021 were retrospectively screened and 59 (male/female, 30/29; min/max-age, 22-84) patients with acute toxic hepatitis who underwent TPE in the first 24 h were included in the study. TPE was performed in patients who had high total bilirubin level (>10 mg/dL). Laboratory parameters of the patients before and after the TPE procedure, number of patients developed complications of acute toxic hepatitis and mortality rates were evaluated for effectiveness of TPE. RESULTS: Acute toxic hepatitis was associated with hepatotoxic drugs in 44 (74.5 %), herbal medication 6 (10.2 %), mushroom poisoning 6 (10.2 %) and with substance abuse 3 (5.1 %) in patients. When the patients were compared based on INR, liver function tests, ammonia, lactate and Model For End-Stage Liver Disease (MELD) score at baseline, 48 h after TPE (independently of TPE number) and before final state a statistically significant decrease was observed in all parameters (p < 0.05). Fifty three (90 %) of patients improved without complications, the remaining 6 (10 %) patients were diagnosed with fulminant hepatitis. All these remaining patients died before liver transplantation (LTx) could be performed. CONCLUSION: TPE is a safe, tolerable therapy option and early TPE may improve treatment outcomes in severe acute toxic hepatitis.

Treatment of migraine attacks by transcutaneous electrical nerve stimulation in emergency department: A randomize controlled trial.

PURPOSE: The primary purpose of this trial is to evaluate the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) therapy application in the emergency department. METHODS: The patients were divided into 2 groups: a sham group, and a verum group. Patients in the verum group include those who use the device for the first time. Both groups were connected to visually indistinguishable devices. Both groups underwent therapy for a total of 20 min. Using the Visual Analog Scale (VAS), the patients' perceived changes in pain intensity were recorded at the 20th and 120th minutes after initiation therapy. After the 120th minute, patients' individual needs for additional treatment were assessed. Additionally, their self-reported well-being was assessed using a Likert-type verbal scale. RESULTS: In total 151 patients that were admitted to the emergency ward were assessed, with the sham and verum group being assigned 39 patients each from this pool. For the verum group the VAS change from 0 to 120 min was -65 ± 25 and for the sham group it was -9 ± 2 (p < 0.001). Verbal scores in the 120th minute were found to be 1.2 for sham group and 4.5 in the verum group (p < 0.001). Thirty patients (76.92%) in the sham group and 1 (2%) in the verum group had additional analgesic requirement after 120 min. CONCLUSION: TENS therapy is a fast-acting, effective therapy for the treatment of acute migraine in the emergency department.

Prognostic utility of pulmonary artery and ascending aorta diameters derived from computed tomography in COVID-19 patients.

AIM: Chest computed tomography (CT) imaging plays a diagnostic and prognostic role in Coronavirus disease 2019 (COVID-19) patients. This study aimed to investigate and compare predictive capacity of main pulmonary artery diameter (MPA), ascending aorta diameter (AAo), and MPA-to-AAo ratio to determine in-hospital mortality in COVID-19 patients. MATERIALS AND METHODS: This retrospective study included 255 hospitalized severe or critical COVID-19 patients. MPA was measured at the level of pulmonary artery bifurcation perpendicular to the direction of the vessel through transverse axial images and AAo was measured by using the same CT slice at its maximal diameter. MPA-to-AAo ratio was calculated by division of MPA to AAo. RESULTS: Multivariate logistic regression model yielded MPA ≥29.15 mm (OR: 4.95, 95% CI: 2.01-12.2, p = 0.001), MPA (OR: 1.28, 95% CI: 1.13-1.46, p < 0.001), AAo (OR: .90, 95% CI: .81-.99, p = 0.040), and MPA-to-AAo ratio ≥.82 (OR: 4.67, 95% CI: 1.86-11.7, p = 0.001) as independent predictors of in-hospital mortality. Time-dependent multivariate Cox-proportion regression model demonstrated MPA ≥29.15 mm (HR: 1.96, 95% CI: 1.03-3.90, p = 0.047) and MPA (HR: 1.08, 95% CI: 1.01-1.17, p = 0.048) as independent predictors of in-hospital mortality, whereas AAo and MPA-to-AAo ratio did not reach statistical significance. CONCLUSION: Pulmonary artery enlargement strongly predicts in-hospital mortality in hospitalized COVID-19 patients. MPA, which can be calculated easily from chest CT imaging, can be beneficial in the prognostication of these patients.

Cardiac involvement in MRI in young population after COVID-19: A single tertiary center experience.

BACKGROUND: Coronavirus 2019 (COVID-19) causes morbidity and mortality in an increasing number of people worldwide. Although it mainly affects the respiratory system, it influences all organs, including the heart. It is associated with a broad spectrum of widespread cardiovascular problems ranging from mild myocardial injury to fulminant myocarditis. We aimed to evaluate the presence and prevalence of cardiac involvement in asymptomatic or symptomatic patients after they recovered from COVID 19 infection. METHODS: A total of 100 consecutive patients with COVID-19 proven by reverse transcription polymerase chain reaction (RT-PCR), under 40 years of age and without any known additional chronic diseases were analyzed retrospectively for cardiac magnetic resonance (CMR) results and symptoms. RESULTS: Cardiac involvement was detected in 49 out of 100 patients on CMR imaging. In the cardiac involvement group, the number of patients with chest pain and/or dyspnea was 41 (84%), which was statistically significant (p = 0.001). Twenty-four patients (47%) in the without cardiac involvement group were asymptomatic and this was also statistically significant (p = 0.001). LV ejection fraction was statistically significantly lower in the group with cardiac involvement (61% vs 66%, p = 0.001). LV stroke volume and tricuspid annular plane systolic excursion (TAPSE) were statistically significantly lower in patients with cardiac involvement (p = 0.028 and p = 0.019, respectively). CONCLUSION: Based on single center experience, myocardial involvement is common in symptomatic patients after COVID-19. More studies are needed for long-term side effects and clinical results in these patients.

The relationship between calcific severe aortic stenosis and systemic immune-inflammation index.

AIM: Calcific aortic stenosis (AS) is a common valvular disease especially in elderly population. Inflammation plays significant role in the pathophysiological mechanism. Systemic immune-inflammation index (SII) is a novel marker of immune system and inflammation that includes neutrophil, lymphocyte, and platelet cell counts. The aim of this study was to investigate the predictive value of SII in calcific severe AS. MATERIALS AND METHODS: Severe calcific AS patients were categorized into two groups: High flow-high gradient (HFHG) AS (n = 289) and low flow-low gradient AS (n = 79). Control group included 273 patients with similar clinical and demographic characteristics but without AS. SII was calculated as absolute platelet count × absolute neutrophil count/absolute lymphocyte count. RESULTS: SII levels were 525 ± 188, 835 ± 402, and 784 ± 348 in control, HFHG AS, and LFLG AS groups, respectively (P < .001). Correlation analyses revealed significant and positive correlation between SII and mean aortic transvalvular pressure gradient (r = .342, P < .001), and negative and significant correlation between SII and AVA (r = -.461, P < .001). Multivariate analysis performed in separate models demonstrated sex, CAD, LDL, and SII levels (Odds ratio [OR]: 1.004, 95 CI%:1.003-1.004) as independent predictors of severe AS in Model 1. According to Model 2, sex, CAD, LDL, and high SII (>661) (OR:5.78, 95 CI%:3.93-4.89) remained as independent predictors of severe AS. CONCLUSION: SII levels can be useful to predict severe calcific AS patients and significantly correlate with AVA and mean aortic transvalvular pressure gradient.

The Effect of 3D-Printed Custom External Nasal Splint on Edema and Ecchymosis After Rhinoplasty.

PURPOSE: The aim of this study was to investigate the effects of traditional thermoplastic splints vs a 3D-printed custom external nasal splint designed to apply pressure to the lateral osteotomy lines and neighboring periorbital region on edema and ecchymosis after rhinoplasty. PATIENTS AND METHODS: Forty patients undergoing open rhinoplasty were included in this prospective randomized controlled study. The patients were divided into 2 groups. In the study group, the new 3D-printed custom external nasal splint was used. In the control group, the thermoplastic external nasal splint was used. Periorbital edema and ecchymosis scores were assessed peroperative before external nasal splint application, postoperatively at the 1st and 4th hours, and 1st, 2nd, 5th, 7th, 10th, and 15th days. RESULTS: There were lower scores of ecchymosis and edema in the study group compared to the control group for all the follow-up controls. There was a significant difference between the 2 groups with respect to the occurrence of ecchymosis for all follow-up controls except for the first postoperative hour and the seventh postoperative day (P < .05). Comparison of the 2 groups with respect to the grade of edema showed a significant difference only in the first and fourth postoperative hours (P < .05). CONCLUSIONS: The study detected less edema and ecchymosis scores using this 3D custom external nasal splint, thus creating a new area of use for 3D printers in the field of facial esthetic surgery. New thermoplastic splints of different shapes and sizes can be produced that can compress the osteotomy lines and the neighboring periorbital region.

Food-induced anaphylaxis in early childhood and factors associated with its severity.

Background: Several factors that increase the risk of severe food-induced anaphylaxis have been identified. Objective: We aimed to determine the demographic, etiologic, and clinical features of food-induced anaphylaxis in early childhood and also any other factors associated with severe anaphylaxis. Methods: We carried out a medical chart review of anaphylaxis cases from 16 pediatric allergy and immunology centers in Turkey. Results: The data of 227 patients with 266 food-induced anaphylaxis episodes were included in the study. The median (interquartile range) age of the first anaphylaxis episode was 9 months (6-18 months); 160 of these patients were boys (70.5%). The anaphylaxis episodes were mild in 75 cases (28.2%), moderate in 154 cases (57.9%), and severe in 37 cases (13.9%). The most frequent food allergens involved were cow's milk (47.4%), nuts (16.7%), and hen's egg (15.8%). Epinephrine was administered in only 98 (36.8%) of these anaphylaxis episodes. A logistic regression analysis revealed two statistically significant factors that were independently associated with severe anaphylaxis: the presence of angioedema and hoarseness during the anaphylactic episode. Urticaria was observed less frequently in patients who developed hypotension. In addition, confusion and syncope were associated with 25.9- and 44.6-fold increases, respectively, in the risk of concomitant hypotension. Conclusion: Cow's milk, nuts, and hen's egg caused the majority of mild and moderate-to-severe anaphylaxis episodes. The presence of angioedema and hoarseness in any patient who presents with a history of food-induced anaphylaxis should alert clinicians that the reaction may be severe. In addition, the presence of confusion, syncope, or stridor probably indicates concomitant hypotension.

Assessment of functional and aesthetic outcomes in septorhinoplasty.

PURPOSE: The aim of this study is to review the aesthetic and functional outcomes of septorhinoplasty using questionnaires that have never been collectively used, as well as surgeons' evaluation. MATERIALS AND METHODS: Our study was conducted prospectively among 100 patients who underwent septorhinoplasty operation. We evaluated the effects of septorhinoplasty's functional and aesthetic outcomes on patients' emotional status using a combination of NOSE, ROE, DAS-24, and GBI questionnaires as well as surgeons' evaluations. RESULTS: Our study did not detect any significant difference between preoperative and postoperative levels of patient satisfaction with regard to age, sex, and surgery type and the number of surgeries. Our study, on the other hand, revealed significantly higher postoperative GBI scores among patients with higher preoperative DAS-24 and NOSE scores. However, we showed no significant difference between the preoperative ROE score and postoperative GBI score CONCLUSION: This study demonstrated that septorhinoplasty can not only significantly alter a nose's functional and aesthetic appearance, but it can also boost patient satisfaction.