Object No definitive treatment for spinal cord injuries (SCIs) exists, and more research is required. The use of agmatine [4-(aminobutyl)-guanidine-NH2-CH2-CH2-CH2-CH2-NH-C(-NH2)(=NH)], a guanidinium compound formed by decarboxylation of l-arginine by arginine decarboxylase, is a neurotransmitter–neuromodulator with both N-methyl-d-aspartate receptor (NMDAR)–antagonizing and nitric oxide synthase (NOS)–inhibiting activities. The purpose of this study was to demonstrate the dose-dependent activity of agmatine, an inducible NOS (iNOS) inhibitor and selective NMDAR antagonist, on biochemical and functional recovery in an experimental rat SCI model. Methods This study involved 40 Wistar albino male rats. The rats were subjected to sleep–awake cycles for 7 days before surgery. In each group, general anesthesia was induced by a 60-mg/kg ketamine injection. For the surgical SCI model, a Yas¸argil aneurysm clip was placed in the spinal cord. The study was conducted in the following four main groups: Group I (control group) laminectomy only; Group II, trauma-only group and SCI; Group III, laminectomy, SCI and agmatine 50 mg/kg for 10 days; and Group IV, laminectomy, SCI, and agmatine 100 mg/kg for 10 days. On Day 1, no statistical difference was observed in any group (p < 0.005, analysis of variance [ANOVA] and the Fisher protected least significant difference [PLSD]). On Day 2, no statistical difference was noted among Groups II, III, and IV (p = 0.27, p = 0.42, and p = 0.76, respectively; ANOVA and Fisher PLSD). Beginning on Day 3, recovery in Groups III and IV differed significantly from that in Group II (p < 0.005, ANOVA and Fisher PLSD), and a statistically significant difference between Groups III and IV was observed, which also was present on Days 5, 7, and 10 (p = 0.003, p = 0.0024, and p = 0.0036, respectively; ANOVA and Fisher PLSD). Several observations were noteworthy: motor function scores were reduced significantly in the spinal cord–injured rats compared with the controls (p < 0.005); on Day 1, the agreement of motor function scores in rats in each SCI group indicated that the traumatic event had been replicated equally across all groups (p = 0.59, p = 0.59, and p = 0.28); a statistically significant difference in motor function scores developed on Day 3 between the rats subjected to trauma alone (Group II) and those treated with agmatine (Groups III and IV) (p < 0.005); and no statistically significant intergroup difference in motor function existed at any postinjury interval between the 50- and 100-mg/kg/day agmatine–treated rats (p > 0.005). Conclusions Agmatine administration following SCI was shown to reduce NO levels significantly. No statistically significant intergroup difference in the reduction of NO levels was found between rats treated with 50- and 100-mg/kg/day doses of agmatine. Administration of a 100-mg/kg/day dose of agmatine reduced the NO levels to those measured in controls. The authors conclude that with additional studies into the role of agmatine, this drug may be helpful in the treatment of patients with SCIs.

Bu çalışmada Türk Kalp ve Damar Cerrahisi Derneği'nin en geniş katılımlı ulusal kongrelerinde sunulan sözlü bildirilerin literatüre katkısı araştırıldı. Ça lış ma pla nı: Mayıs 2018 tarihinde iki yılda bir düzenlenen 12, 13. ve 14. kongrelerde sözlü olarak sunulan toplam 675 bildiri PubMed ve Google Akademik veri tabanlarında tarandı. Bildiriler gönderildikleri kurum, bilimsel dergilerde yayımlanma durumu, hakemli derginin türü ve yayımlanma yılı açısından incelendi. Bul gu lar: 675 sözlü bildirinin, %69.1'i klinik çalışma, %18.8'i olgu sunumu ve %12.1'i deneysel araştırma idi. Kabul edilen bildirilerin %47.3'ü üniversite hastanelerinden, %36.1'i eğitim ve araştırma hastanelerinden ve %16.6'sı diğer karma kurumlardan gönderildi. Bildirilerin toplam 279'u (%41.3) makale olarak bilimsel bir dergide yayımlandı. Yayımlanma oranı açısından kurumlar arasında anlamlı bir fark olmakla birlikte (p= 0.04), üniversite hastaneleri en yüksek orana sahipti. Bildirilerin bilimsel bir dergide yayımlanma süresi ortalama 16.7±9.1 (dağılım, 4-60) ay idi. So nuç: Türk Kalp ve Damar Cerrahisi Derneği'nin son üç kongresinde sunulan bildirilerin yayına dönüşme oranı, diğer uzmanlık alanlarına ait ulusal kongrelerinde bildirilen literatür sonuçlarına göre daha yüksek, ancak uluslararası kongrelere kıyasla daha düşüktür. Uluslararası bildiriler ile aynı düzeye ulaşmak için bu oranın artırılması ve araştırmacıları yayına teşvik edici yöntemlerin geliştirilmesi gerektiğine inanmaktayız.

This study aimed to evaluate the cardiopulmonary function and impairment of exercise endurance in patients with COVID-19 after 3 months of the second wave of the pandemic in Turkey. A total of 51 consecutive COVID-19 survivors, mostly healthcare providers, still working in the emergency room and intensive care units of the hospital after the second wave of Covid 19 pandemia were included in this study. Cardiopulmonary exercise stress test was performed. The median of the exercise time of the COVID-19 survivors, was 10 (4.5–13) minutes and the mean 6.8 ± 1.3 Mets was achieved. The VO2 max of the COVID-19 survivors was 24 ± 4.6 ml kg−1 min−1 which corresponds the 85 ± 10% of the predicted VO2 max value. The VO2WRs value which was reported about 8.5–11 ml min−1 per watt in healthy individuals as normal was found lower in Covid 19 survivors (5.6 ± 1.4). The percentage of the maximum peak VO2 calculated according to the predictable peak VO2 of the COVID-19 survivors, was found significantly lower in male patients (92 ± 9.5% vs 80 ± 8.5%, p: 0.000). Also, there was a positive correlation between the percentage of the maximum predicted VO2 measurements and age (r: 0.320, p: 0000). The peak VO2 values of COVID-19 survivors decreased, and simultaneously, their exercise performance decreased due to peripheral muscle involvement. We believe that COVID-19 significantly affects men and young patients.

fQRS is a simple, inexpensive, and readily available electrocardiographic entity that provides an additional risk stratification level beyond that provided by conventional risk parameters in predicting in-hospital cardiovascular mortality in type 1 AAD.

SummaryObjectiveIn the last decade, the number of elderly patients suffering from aortic valve disease has significantly increased. This study aimed to identify possible factors that could affect surgical and long-term outcomes in the light of a literature review regarding the management of aortic valve disease in the elderly.MethodsBetween January 1990 and December 2012, a total of 114 patients (64 males, 50 females; mean age 76.6 ± 3.6 years; range 70–87 years) with aortic valve replacement (AVR) alone, or combined with coronary artery bypass grafting (CABG) or mitral surgery in our hospital, were retrospectively analysed.ResultsIn-hospital mortality was seen in 19 patients. The major causes of in-hospital mortality were low-cardiac output syndrome in eight patients (42.1%), respiratory insufficiency or infection in six (31.5%), multi-organ failure in four (21%), and stroke in one patient (5.2%). The main postoperative complications included arrhythmia in 26 patients (22.8%), renal failure in 11 (9.6%), respiratory infection in nine (7.9%), and stroke in three patients (2.6%). The mean length of intensive care unit and hospital stays were 6.4 ± 4.3 and 18 ± 12.8 days, respectively. During follow up, late mortality was seen in 28 patients (29.4%). Possible risk factors for long-term mortality were type of prosthesis, EuroSCORE ≥ 15, postoperative pacemaker implantation, respiratory infection, and haemodialysis. Among 65 long-term survivors, their activity level was good in 53 (81.5%) and poor in two.ConclusionsOur study results demonstrated that an individually tailored approach including scheduled surgery increases short- and long-term outcomes of AVR in patients aged ≥ 70 years. In addition, shorter cardiopulmonary bypass time may be more beneficial in this high-risk patient population.