ObjectiveThe incidence of depression and anxiety is higher in patients with acute coronary syndrome. The aim of this study is to determine whether experiencing acute coronary syndrome prior to open heart surgery affects patients in terms of depression, hopelessness, anxiety, fear of death and quality of life.MethodsThe study included 63 patients who underwent coronary bypass surgery between January 2015 and January 2016. The patients were divided into two groups: those diagnosed after acute coronary syndrome (Group 1) and those diagnosed without acute coronary syndrome (Group 2). Beck depression scale, Beck hopelessness scale, Templer death anxiety scale and death depression scale, State-Trait anxiety inventory and WHOQOL-Bref quality of life scale were applied.ResultsThere was no significant difference between the two groups in terms of the total score obtained from Beck depression scale, Beck hopelessness scale - future-related emotions, loss of motivation, future-related expectations subgroups, death anxiety scale, the death depression scale, State-Trait Anxiety Inventory - social and environmental subgroups. The mental quality of life sub-scores of group 2 were significantly higher. The patients in both groups were found to be depressed and hopeless about the future. Anxiety levels were found to be significantly higher in all of the patients in both groups.ConclusionAcute coronary syndrome before coronary artery bypass surgery impairs more the quality of life in mental terms. But unexpectedly there are no differences in terms of depression, hopelessness, anxiety and fear of death.

Carotid endarterectomy results in thinning of the superior peripapillary RNFL thickness. To the best of our knowledge, this is the first study to examine peripapillary RNFL and GCC thicknesses before and after CEA.

Objective: Temporal arteritis is systemic vasculitis of medium and large sized vessels. The lowest incidence rates were reported in Turkey, Japan and Israel. We aimed to investigate the results of patients with biopsy-proven temporal arteritis and those classified according to the American College of Rheumatology criteria from a low-incidence region for temporal arteritis. The results of our study are noteworthy, since there is limited data on pathologic diagnosis of temporal arteritis in Turkey. Method:We studied the medical records, laboratory findings such as erythrocyte sedimentation rate and C-reactive protein levels, biopsy results, and postoperative complications of all the patients operated for temporal artery biopsy at our clinic. We used the computerized laboratory registry that keeps all records of 42 consecutive temporal artery biopsy results from January 2011 to December 2016. Results: The mean age was 66±12.5 years. The most common manifestations on admission were temporal headache, optic neuritis and jaw claudication, respectively. Temporal artery biopsy results confirmed tempoal arteritis in eight out of 42 (19%) patients. There was no statistically significant difference between biopsy-positive and biopsy-negative groups in terms of sex, age, erythrocyte sedimentation rate, C-reactive protein and biopsy length. Conclusion: We were not able to find a correlation between the analysis of biopsy results and clinical evaluation of patients with temporal arteritis. We suggest that diagnosis of temporal arteritis depends on clinical suspicion. Laboratory examination results may not be helpful in accurate diagnosis of tempoal arteritis.

In conclusion, sildenafil and n-acetylcystein may reduce femoral artery endothelium and gastrocnemius muscle injury following lower extremity ischemia/reperfusion.

StreszczenieWstęp: Definicja bólu koncentruje się głównie na uszkodzeniu tkanek i informacjach dotyczących zmian patofizjologicznych. Chorzy doświadczają bólu w odpowiedzi na uszkodzenie tkanki po zabiegu operacyjnym, a jego intensywność po operacji torakochirurgicznej jest duża. Cel pracy: Celem pracy była ocena skuteczności i skutków ubocznych zastosowania w piersiowym odcinku kręgosłupa nadtwardówkowej i przykręgowej blokady w leczeniu bólu po torakotomii. Materiał i metody: W prospektywnym, z podwójnie ślepą próbą badaniu z randomizacją, pacjenci zostali podzieleni na dwie grupy w zależności od sposobu znieczulenia piersiowego odcinka kręgo-słupa: nadtwardówkowego (grupa EPI, n = 30) i przykręgowego [grupa PVB, n = 30]. Po podaniu bolusa 10 ml 0,25% bupiwakainy kontynuowano ciągły wlew leku przez okres 24 godzin w dawce 0,1 ml mL kg -1 h -1 . Analogowa skala wzrokowa została użyta do oceny intensywności bólu w spoczynku (VAS-R) i po kaszlu (VAS-C) wyjściowo (po ekstubacji) oraz w 2., 4., 12. i 24. godzinie po operacji. Oceniano czas stosowania cewnika, dawek morfiny oraz powikłań i skutków ubocznych znieczulenia. Wyniki: Natężenie bólu VAS-R i VAS-C w obydwu grupach było podobne zarówno wyjściowo, jak i w 2., 4., 12. i 24. godzinie po operacji (p > 0,05). W grupie EPI w porównaniu z grupą PVB stwierdzono większą częstość występowania hipotensji i dłuż-szy czas stosowania cewnika (p = 0,038, p < 0,0001). Wnioski: Zarówno technika z użyciem nadtwardówkowego, jak i przykręgowego znieczulenia są skuteczne w leczeniu bólu po torakotomii. Blokada przykręgowa jest techniką prostszą z rzadszym występowaniem hipotensji, dlatego powinna być rozważa-na jako dobra alternatywa dla techniki nadtwardówkowej. Słowa kluczowe: torakotomia, pooperacyjne znieczulenie, piersiowa blokada przykręgowa, piersiowe nadtwardówkowe znieczulenie, powikłanie. Kardiochirurgia i Torakochirurgia Polska 2013; 10 (2) 139 ANAESTHESIOLOGY AND INTENSIVE CARE AbstractIntroduction: The definition of pain focuses mainly on tissue damage and provides information regarding pathophysiological changes in the human being [1]. Patients experience pain as a response to this tissue damage after surgery and the pain intensity after thoracotomies is known to be severe [2]. Aim of the study: Our goal was to investigate the efficacy and adverse effects of thoracic epidural and paravertebral blocks for post-thoracotomy pain management. Material and methods: In a prospective, randomized double blinded study, patients were divided into thoracic epidural (EPI group, n = 30) and paravertebral (PVB group, n = 30) groups. A bolus dose of 10 ml of 0.25% bupivacaine was followed by a continuous infusion of 0.1 ml kg -1 h -1 for a total of 24 hours. A visual analog scale (VAS) was used to evaluate pain at rest (VAS-R) and after coughing (VAS-C) at baseline (after extubation), 2, 4, 12 and 24 hours after surgery. The duration of catheter insertion, morphine consumption, complications and side effects were collected. Results: In comparison of EPI and PVB groups, VAS-R and ...