Abstract Objective: The aims of this study were to determine whether the detection of preoperative clopidogrel resistance in patients undergoing cardiac surgery while using clopidogrel could play a guiding role in the prediction of postoperative excessive bleeding, transfusion requirements, and risks and to provide clinically significant data. Methods: Two hundred and twenty-two patients [median age: 59.4 (38-83) years; 38 females] undergoing emergency and elective coronary artery bypass graft (CABG) surgeries in our clinic were evaluated prospectively. Patients with multiple systemic diseases, other than diabetes mellitus (DM) and hypertension (HT), were excluded. Patients receiving clopidogrel were also evaluated for clopidogrel resistance and grouped according to the results of this test. Assessments of platelet functions were performed by multiplate impedance aggregometry method and adenosine diphosphate test. Results: The use of postoperative fresh blood replacement and platelet transfusion was higher in patients receiving clopidogrel than in those not receiving it (P=0.001, P=0.018). DM, HT, myocardial infarction, and the number of presentation to the emergency room were significantly higher in patients receiving clopidogrel than in those not receiving it (P<0.05). No significant difference was determined between patients with and without clopidogrel resistance regarding the amount of bleeding during and after surgery, erythrocyte suspension and fresh-frozen plasma transfusion rates, preoperative troponin values, ejection fraction values, and length of hospital stays (P>0.05). Conclusion: We think that resistance studies in patients receiving clopidogrel before cardiac surgery are not efficient to predict bleeding and bleeding-related complications in patients undergoing emergency and elective CABG surgeries.

The surface morphology of the ctenidia of Spondylus spinosus Schreibers, 1793 was studied with light and scanning electron microscopy for comparison with the gill structures of other bivalves. The demibranch of S. spinosus is heterorhabdic, with the principal filaments at the descending lamellae and ordinary filaments at the ascending lamellae. The gill lamellae have a prominent gauze-like structure at their distal part, with numerous groups of eight ordinary filaments. They bear ciliary arrays on their frontal surfaces and ostia at their latero-frontal surfaces. Frequent cirral plates form regular interfilamentary junctions. The description of the gill structure of S. spinosus presented here can be used to derive implications for the correlations among the structure, habitat and mode of life of this species. At a particular stage of its adult life, Spondylus spinosus could be used as a subject for biomonitoring studies in natural and experimental environments.