BackgroundLevosimendan has anti-ischaemic effects, improves myocardial contractility and increases systemic, pulmonary and coronary vasodilatation. These properties suggest potential advantages in high-risk cardiac valve surgery patients where cardioprotection would be valuable. The present study investigated the peri-operative haemodynamic effects of prophylactic levosimendan infusion in cardiac valve surgery patients with low ejection fraction and/or severe pulmonary arterial hypertension.MethodsBetween May 2006 and July 2007, 20 consecutive patients with severe pulmonary arterial hypertension (systolic pulmonary artery pressure ≥ 60 mmHg) and/or low ejection fraction (< 50%) who underwent valve surgery in our clinic were included in the study and randomised into two groups. Levosimendan was administered to 10 patients in group I and not to the 10 patients in the control group. Cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), pulmonary vascular resistance (PVR) and mean pulmonary artery pressure (MPAP) were recorded for each patient preoperatively and for 24 hours following the operation.ResultsCO and CI values were higher in the levosimendan group during the study period (p < 0.05). MPAP and PVR values were significantly lower in the levosimendan group for the 24-hour period (p < 0.05) and SVR values were significantly lower after 24 hours in both groups. When clinical results were considered, no difference in favour of levosimendan was detected regarding the mortality and morbidity rates between the groups.ConclusionLevosimendan improved the haemodynamics in cardiac valve surgery patients with low ejection fraction and/or severe pulmonary arterial hypertension, and facilitated weaning from cardiopulmonary bypass in such high-risk patients when started as a prophylactic agent.

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The present study aims to determine the knowledge level of high school students regarding oral cancer. The present study included students from 20 high schools located in the city center of Kahramanmaras between 1 and 28 April 2015. The students were informed prior to the study and 2759 students who gave written consent were included in the study. The participants were administered a questionnaire that was prepared by the investigators. The questionnaire included 25 questions that were prepared using literature in order to establish the knowledge level of the students about oral cancer, and it was evaluated scoring one point to each question. There were 1711 (62.0 %) female students and 1048 (38.0 %) male students; the mean age was 16.01 ± 1.09 years. The knowledge score of the male students was 7.48 ± 5.15 and the knowledge score of the female students was 7.58 ± 4.96. The knowledge score of the female and male participants was similar (p = 0.605). Of the students, 2107 (76.4 %) stated that they heard the expression of oral cancer before compared to 652 (23.6 %) students stating they did not. The study found that high school students had insufficient levels of knowledge about oral cancer. There was a general lack of knowledge about oral cancer and the risks among these students.

Although primary superficial venous aneurysms of upper extremities are very rare, the treatment of choice is most commonly same as the ones in lower limbs. Simple excision is the best approach in the most of the cases, while sclerotherapy could be preferred in order to obtain better cosmesis or to avoid injuries to surrounding structures.

We found that a significantly high rate of the Maras powder users was Candida carriers. It should be kept in mind that opportunistic infections may be caused by Candida species in Maras powder users especially with immunosuppressive conditions since Candida species are likely to lead to such infections in cases of immunosuppressive diseases.