Leukocytes are reported as crucial not only for plaque activation but also in thrombus formation in acute coronary syndromes (ACSs). Among the markers of inflammation, in coronary artery disease neutrophil-lymphocyte ratio (NLR) has been reported to have the greatest predictive power of poor outcomes. Our aim was to evaluate the association of NLR with coronary thrombus in patients with non-ST-segment elevated ACSs (NST-ACSs). A total of 251 patients were hospitalized with a diagnosis of NST-ACS including non-ST-segment elevated myocardial infarction and unstable angina pectoris. Coronary angiographies were performed. In 167 patients, coronary thrombus was detected. Between the patient groups with and without coronary thrombus, neutrophil count, platelet count, and NLR are significantly increased, and lymphocyte count is significantly decreased in the group with coronary thrombus as compared to patient group without coronary thrombus. Leukocyte count and NLR may give an indication about the presence of coronary thrombus. In NST-ACS, blood parameters may give valuable information about the status of the coronary arteries.
Brucellosis is a systemic infectious disease with a broad spectrum of clinical manifestations. Arthritis is frequently observed in its course and may be one of the main presenting clinical features of the disease. We report a case of brucellar monoarthritis of the knee with a prolonged clinical course despite efficient antibiotic treatment.
Objective: Non-dipper hypertension is associated with increased cardiovascular morbidity and mortality. The purpose of this study was to evaluate the association of non-dipping hypertension with aortic diameter in patients with metabolic syndrome. Materials and Methods:This study included 70 hypertensive patients with metabolic syndrome. These patients were evaluated with 24-h blood pressure Holter monitoring and divided into two groups of 35 patients each. Aortic diameter was measured by M-mode and two-dimensional echocardiography. These parameters were compared between the two groups. Results:In the dipper group, there were 26 female and 9 male patients with a mean age of 55±11 years. In the non-dipper group, there were 25 female and 10 male patients with a mean age of 56±11 years. No significant difference was found between the two groups in terms of basic characteristics. Non-dipper hypertensive patients had a higher thoracic aortic diameter value than dipper patients (35.6±2.4 and 33.23±1.1, p<0.01). Conclusion:These findings suggest that thoracic aortic diameter value is higher in patients with non-dipper hypertension.Key Words: Blood pressure, metabolic syndrome, aortic diameter, echocardiography, non-dipper Özet Amaç: Non-dipper hipertansiyon artmış kardiyovasküler mortalite ve morbidite ile ilişkilidir. Bu çalışmanın amacı metabolik sendromlu hastalarda aort çapı ile non-dipping hipertansiyon ilişkisini değerlen-dirmektir. Gereç ve Yöntem:Çalışmaya metabolik sendromlu 70 hipertansif hasta alındı. Bu hastaların 24 saat kan basıncı ölçümü holter ile değerlen-dirildi ve herbirinde 35 hasta olan iki gruba ayrıldı. Aort çapları M mod ve iki boyutlu ekokardiyografi ile değerlendirildi. Bu paramatreler iki gurup arasında karşılaştırıldı. Bulgular:Dipper gurupta yaş ortalaması 55±11 yıl olan 26 kadın, 9 erkek hasta vardı. Non-dipper gurupta yaş ortalaması 56±11 yıl olan 25 kadın, 10 erkek hasta vardı. Temel özellikler açısından iki gurup arasında anlamlı farklılık yoktu. Non-dipper gurupta torasik aort çapları dipper guruba göre yüksekti (35.6±2.4 and 33.23±1.1, p<0.01).Sonuç: Bu bulgular non-dipper hipertansiyon hastalarında torasik aort çaplarının yüksek olduğunu göstermiştir.Anahtar Kelimeler: Kan basıncı, metabolik sendrom, aort çapı, ekokardiyografi, non-dipper
Background: After coronary artery bypass graft (CABG) operations, acute kidney injury (AKI) appears at 5-30% rates, and this rate increases even more in patients with diabetes mellitus (DM). Prognostic nutritional index (PNI) is known as a valuable parameter that affects cardiovascular surgery outcomes. In this current study, we aimed to investigate the importance of PNI value in predicting AKI after on-pump CABG operations in insulin-dependent diabetic patients. Methods: A total of 254 consecutive patients with insulin-dependent diabetes who underwent on-pump CABG in our clinic between January 2016 and January 2020 retrospectively were included in this study. In the postoperative period, patients were registered as the renal failure group (Group 1), and those who did not develop renal failure were registered as Group 2. Results: A total of 255 patients with DM were included in the study. There were 82 patients in Group 1 and 173 patients in Group 2. There was no difference between the groups, in terms of age, gender, smoking, and hyperlipidemia rates. Hypertension rate significantly was higher in Group 2 (P = .001). In multivariate logistic regression analysis, hypertension (OR: 1.226, 95% CI: 1.114-2.459, P = .026), need for inotropic support (OR: 1.128, 95% CI: 1.070-1.784, P = .033), increased blood product use (OR: 1.291, 95% CI: 1.112-2.156, P = .021) preoperative high creatinine (OR: 3.563, 95% CI: 2.497-5.559, P < .001), and PNI (OR: 1.327, 95% CI: 1.118-2.785, P = .012) were independent predictors of AKI. Conclusion: In our study, we determined PNI value as an independent predictor in predicting acute renal injury occurring after on-pump CABG operations in patients with insulin-dependent DM.
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