It is well established that a condition of hypercoagulation due to deficiencies of antithrombin III, protein C and protein S may result in thrombo-embolism. To evaluate the possibility of hypercoagulation in acute mesenteric ischemia (AMI); clinical features, ECG changes, drug history, the length of intestine remaining after the resection and mortality of 15 consecutive patients were recorded and plasma levels of antithrombin III, Protein C and protein S were measured. Antihypertensive, antidiabetic and digitalis were the main drugs used by the patients. Atrial fibrillation was the main ECG finding (60%). AMI was attributed to thrombo-embolic phenomena because of atrial fibrillation in these patients. Levels of antithrombin III and protein S were lower in patients without atrial fibrillation compared to those with the condition (mean values 16.18 vs. 18.04 and 87.33 vs. 94.22 respectively) but the difference was not statistically significant. Levels of Protein C were lower and the length of intestine remaining after resection was shorter in patients without, compared to those with, atrial fibrillation (mean values 77.00 vs. 88.66, and 52.5 cm vs. 86.11 cm respectively). The difference was statistically significant (p< 0.05). Postoperative mortality rate was 33.3% (5 patients) and the length of intestine remaining after resection was the main determining factor in the prognosis of the patients. We conclude that a condition of hypercoagulation due to a deficiency of protein C has a significant role in the pathogenesis of AMI especially in patients without atrial fibrillation.

Bu çalışmada, abdominal aortaya açık cerrahi girişim gerçekleştirilen hastalar ile endovasküler girişim gerçekleştirilmiş hastaların postoperatif dönemde ağrılarını ve analjezik ihtiyaçlarını karşılaştırmak amaçlanmıştır. Gereç ve Yöntem: Araştırma Ocak 2014-Aralık 2015 tarihleri arasında merkezimizde abdominal aortaya açık cerrahi ve EVAR uygulanan hastalarda retrospektif olarak yapılmıştır. Çalışmaya 68 hasta dahil edilmiştir. Ancak 7 hasta öldüğü için çalışma dışı bırakılmıştır. 22 hastaya açık cerrahi uygulanırken 39 hastaya EVAR uygulanmıştır. Ağrı değerlendirilmesinde kliniğimizin protokolü olarak yedi yaş üzeri çocuklarda, erişkin ve bilinci açık hastada sayısal/sözlü/vizüel ağrı ölçeği kullanılmaktadır. Bulgular: Araştırma kapsamına alınan hastaların %63.9'una EVAR uygulanırken %36.1'ine açık cerrahi uygulandı. EVAR grubunun yaş ortalaması 67.35±11.05, açık cerrahi grubunun 64.22±13.53 idi. EVAR grubun ağrı skoru 1.35±0.82 iken, açık cerrahi grubunun 4.81±1.32 idi. EVAR uygulanan hastaların ağrı puanları açık cerrahi uygulananlara kıyasla daha düşüktü (p=0.000). EVAR grubunun %59'u, açık cerrahi grubunun ise %90.9'u ağrı kesici kullanmıştır (p=0.009). Sonuç: Ağrı durumları değerlendirildiğinde açık cerrahi işlem uygulanan hastaların EVAR uygulanan hastalara kıyasla ağrılarının daha fazla olduğu görülmüştür. Günümüzde endovasküler girişimler artan sıklıkta uygulanmaktadır. Endovasküler girişimlerin hasta konforu ve özellikle cerrahi işlem sonrası hastaların sıklıkla yakındıkları postoperatif dönem ağrı üzerinde olumlu etkileri vardır.

Background: Atrial fibrillation is a form of arrhythmia that frequently occurs after coronary artery bypass graft surgery. Psychological factors may be involved in the development of atrial fibrillation, although the specific effect of anxiety remains unclear.Purpose: This study was designed to evaluate the relationship between preoperative anxiety levels and atrial fibrillation after coronary artery bypass graft surgery.Methods: This descriptive design study recruited a sample of 126 patients. The data were collected by the researcher using a patient information form and the State-Trait Anxiety Scale.Results: Atrial fibrillation developed in 26.5% of the sample. Those who developed atrial fibrillation had a mean trait anxiety scale score of 40.2 AE 7.8, which is statistically significant. According to the results of logistic regression, it was observed that increased trait anxiety score, increased age, presence of comorbid disease, and noncompliance with respiratory physiotherapy increased the risk of developing atrial fibrillation.Conclusion/Implications for Practice: Preoperative anxiety levels were shown to be a significant factor promoting the development of atrial fibrillation after coronary artery bypass graft surgery. The results support measuring anxiety levels in patients as a standard procedure before performing this surgical procedure.