ABSTRACT Introduction: Diabetes mellitus (DM) in patients undergoing cardiac transcatheter or surgical interventions usually is correlated with poor outcomes. Transcatheter aortic valve implantation (TAVI) has been developed as a therapy choice for inoperable, high-, or intermediate-risk surgical patients with severe aortic stenosis (AS). Objective: To evaluate the impact of DM and hemoglobin A1c (HbA1c) on outcomes and survival after TAVI. Methods: Five hundred and fifty-two symptomatic severe AS patients who underwent TAVI, of whom 164 (29.7%) had DM, were included in this retrospective study. Follow-up was performed after 30 days, six months, and annually. Results: The device success and risks of procedural-related complications were similar between patients with and without DM, except for acute kidney injury, which was more frequent in the DM group (2.4% vs. 0%, P=0.021). In-hospital and first-year mortality were similar between the groups (4.9% vs. 3.6%, P=0.490 and 15.0% vs. 11.2%, P=0.282, respectively). There was a statistical difference between HbA1c ≥ 6.5 and HbA1c ≤ 6.49 groups in total mortality (34.4% vs. 15.8%, P<0.001, respectively). The only independent predictors were Society of Thoracic Surgeons score (hazard ratio [HR] 1.28, 95% confidence interval [CI] 1.09-1.51; P=0.003) and HbA1c level ≥ 6.5 (HR 10.78, 95% CI 2.58-21.50; P=0.003) in multivariable logistic regression analysis. Conclusion: In this study, we conclude that DM was not correlated with an increased mortality risk or complication rates after TAVI. Also, it was shown that mortality was higher in patients with HbA1c ≥ 6.5, and it was an independent predictor for long-term mortality. Introduction (DM TAVI (TAVI inoperable high, high , high- intermediaterisk intermediate AS. . (AS) Objective Ac A c HbAc HbA (HbA1c Methods fiftytwo fifty two 16 29.7% 297 29 7 (29.7% study Followup Follow up 3 days months annually Results proceduralrelated procedural related injury 2.4% 24 2 4 (2.4 vs 0 0% P=0.021. P0021 P P=0.021 021 P=0.021) Inhospital hospital firstyear first year 4.9% 49 9 (4.9 36 6 3.6% P0490 490 P=0.49 150 15 15.0 112 11 11.2% P0282 282 P=0.282 respectively. respectively respectively) 65 5 6. 649 6.4 34.4% 344 34 (34.4 158 8 15.8% P0001 001 P<0.001 hazard HR [HR 128 1 28 1.28 95 [CI 1.091.51 109151 1.09 1.51 09 51 1.09-1.51 P=0.003 P0003 003 1078 10 78 10.78 2.5821.50 2582150 2.58 21.50 58 21 50 2.58-21.50 analysis Conclusion Also longterm long term (AS 29.7 (29.7 2.4 (2. P002 P=0.02 02 4.9 (4. 3.6 P049 P=0.4 15. 11.2 P028 P=0.28 64 34.4 (34. 15.8 P000 00 P<0.00 12 1.2 091 1.091.5 10915 109 1.0 151 1.5 1.09-1.5 P=0.00 107 10.7 5821 2.5821.5 258215 258 2.5 2150 21.5 2.58-21.5 29. (29. 2. (2 P00 P=0.0 4. (4 3. P04 P=0. 11. P02 P=0.2 34. (34 P<0.0 1. 1.091. 1091 1.09-1. 10. 582 2.5821. 25821 25 215 21. 2.58-21. (29 ( P0 P=0 (3 P<0. 1.091 1.09-1 2.5821 2582 2.58-21 P= P<0 1.09- 2.582 2.58-2 P< 2.58-

SUMMARY OBJECTIVE: The aim of this study was to evaluate the prognostic value of whole blood parameters, systemic inflammatory indices, and systemic inflammatory markers in pregnant women with COVID-19. METHODS: In this cross-sectional study, the demographic, clinical, and laboratory data (i.e., whole blood parameters, C-reactive protein, procalcitonin, ferritin, and D-dimer) of 464 pregnant women with COVID-19 who attended a tertiary hospital between January and April 2021 were reviewed. Systemic inflammatory indices (i.e., neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, platelet/neutrophil ratio, and systemic immune inflammation index) were calculated. Asymptomatic and mildly symptomatic pregnant women were classified as Group 1 (n=413), and those with severe disease were classified as Group 2 (n=51). RESULTS: Lymphocyte count and lymphocyte percentage in whole blood parameters were significantly lower (p<0.05), and C-reactive protein, ferritin, and procalcitonin values were higher in Group 2 (p<0.05). Systemic inflammatory indices [neutrophil/lymphocyte ratio (4.7±2.9 (1.1–21.2) vs 7.5±4.7 (2.13–23.2)), platelet/lymphocyte ratio (191.1±104.3 (53.0–807.1) vs 269.5±118.9 (105.0–756.0)), systemic immune inflammation index (1,000±663 (209–5,231) vs 1,630±1,314 (345–7,006))] were found statistically significantly higher in severe disease group (p<0.001). CONCLUSION: Evidence in this study indicates that neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune inflammation index at first admission are simple, rapid, and inexpensive indices in predicting the prognosis of COVID-19 in pregnant women. OBJECTIVE COVID19. COVID19 COVID 19. 19 METHODS crosssectional cross sectional demographic clinical i.e., ie i e (i.e. Creactive C reactive protein ferritin Ddimer D dimer D-dimer 46 COVID-1 202 reviewed neutrophillymphocyte neutrophil plateletlymphocyte platelet plateletneutrophil calculated n=413, n413 n n=413 , 413 (n=413) n=51. n51 n=51 . 51 (n=51) RESULTS p<0.05, p005 p p<0.05 0 05 (p<0.05) p<0.05. 4.7±2.9 4729 4 7 9 (4.7±2. 1.1–21.2 11212 21 (1.1–21.2 7547 5 7.5±4. 2.13–23.2, 213232 2.13–23.2 13 23 (2.13–23.2)) 191.1±104.3 19111043 191 104 3 (191.1±104. 53.0–807.1 5308071 53 807 (53.0–807.1 26951189 269 118 269.5±118. 105.0–756.0, 10507560 105.0–756.0 105 756 (105.0–756.0)) 1,000±663 1000663 000 663 (1,000±66 209–5,231 2095231 209 231 (209–5,231 16301314 630 314 1,630±1,31 345–7,006 3457006 345 006 (345–7,006)) p<0.001. p0001 p<0.001 001 (p<0.001) CONCLUSION simple rapid COVID1 i.e. (i.e COVID- 20 n41 n=41 41 (n=413 n5 n=5 (n=51 p00 p<0.0 (p<0.05 4.7±2. 472 (4.7±2 1.1–21. 1121 (1.1–21. 754 7.5±4 21323 2.13–23. (2.13–23.2) 191.1±104. 1911104 10 (191.1±104 53.0–807. 530807 80 (53.0–807. 2695118 26 11 269.5±118 1050756 105.0–756. 75 (105.0–756.0) 1,000±66 100066 00 66 (1,000±6 209–5,23 209523 (209–5,23 1630131 63 31 1,630±1,3 345–7,00 345700 34 (345–7,006) p000 p<0.00 (p<0.001 i.e n4 n=4 (n=41 n= (n=5 p0 p<0. (p<0.0 4.7±2 47 (4.7± 1.1–21 112 (1.1–21 7.5± 2132 2.13–23 (2.13–23.2 191.1±104 191110 (191.1±10 53.0–807 53080 8 (53.0–807 269511 269.5±11 105075 105.0–756 (105.0–756.0 1,000±6 10006 6 (1,000± 209–5,2 20952 (209–5,2 163013 1,630±1, 345–7,0 34570 (345–7,006 (p<0.00 (n=4 (n= p<0 (p<0. 4.7± (4.7 1.1–2 (1.1–2 7.5 213 2.13–2 (2.13–23. 191.1±10 19111 (191.1±1 53.0–80 5308 (53.0–80 26951 269.5±1 10507 105.0–75 (105.0–756. 1,000± 1000 (1,000 209–5, 2095 (209–5, 16301 1,630±1 345–7, 3457 (345–7,00 (n p< (p<0 4.7 (4. 1.1– (1.1– 7. 2.13– (2.13–23 191.1±1 1911 (191.1± 53.0–8 530 (53.0–8 2695 269.5± 1050 105.0–7 (105.0–756 1,000 100 (1,00 209–5 (209–5 1630 1,630± 345–7 (345–7,0 (p< 4. (4 1.1 (1.1 2.13 (2.13–2 191.1± (191.1 53.0– (53.0– 269.5 105.0– (105.0–75 1,00 (1,0 209– (209– 163 1,630 345– (345–7, (p ( 1. (1. 2.1 (2.13– 191.1 (191. 53.0 (53.0 269. 105.0 (105.0–7 1,0 (1, (209 16 1,63 (345–7 (1 2. (2.13 191. (191 53. (53. 105. (105.0– 1, (20 1,6 (345– (2.1 (19 (53 (105.0 (2 (345 (2. (5 (105. (34 (105 (3 (10

Resumo Introdução A concha média e o teto etmoidal são estruturas intranasais e podem apresentar muitas variações anatômicas. Essas estruturas, usadas como marcadores anatômicos durante a cirurgia sinusal funcional, são importantes para evitar complicações e para a feitura adequada da cirurgia. O conhecimento das variações anatômicas aumenta o sucesso cirúrgico e reduz as complicações. Objetivo Investigar a presença de assimetria no teto etmoidal e variações anatômicas em pacientes com e sem concha bolhosa. Método Os prontuários dos pacientes submetidos à tomografia computadorizada de seios paranasais entre 2012 e 2018 foram analisados retrospectivamente. Os pacientes foram divididos em dois grupos, pacientes com e sem concha bolhosa. As diferenças entre os dois grupos em termos de idade, sexo, desvio do septo, deiscência da artéria etmoidal e assimetria do teto etmoidal foram avaliadas. Resultados Os 369 pacientes incluídos em nosso estudo foram divididos em dois grupos: com concha bolhosa e sem concha bolhosa. A média de idade dos pacientes com concha bolhosa foi de 36,1 ± 13,4 (mín-máx: 12-74 anos) e a média de idade dos pacientes sem concha bolhosa foi de 37,5 ± 14,3 (mín-máx: 10-81 anos). As profundidades do teto etmoidal foram comparadas entre os dois grupos, observou-se diferença significante (p < 0,001). Observou-se que a profundidade do teto etmoidal foi maior no grupo com concha bolhosa (p < 0,001). Conclusão O resultado do nosso estudo indica que pacientes com concha média bolhosa tendem a apresentar uma maior profundidade do teto etmoidal.

Abstract Introduction The middle turbinate and ethmoid roof are intranasal structures and may have many anatomical variations. These structures, which serve as anatomical markers during functional sinus surgery, are important for preventing complications and performing a proper surgery. Knowledge of anatomical variations will increase surgical success and reduce complications. Objective We aimed to investigate the presence of asymmetry in the ethmoidal roof and anatomical variation in patients with and without concha bullosa. Methods In this study, the files of patients who underwent paranasal computed tomography between 2012 and 2018 were analyzed retrospectively. The patients were divided into two groups, as patients with and without concha bullosa. Differences between the two groups in terms of age, gender, septum deviation, ethmoid artery dehiscence, ethmoid roof asymmetry were examined. Results The 369 patients included in our study were divided into two groups; those with concha bullosa and those without concha bullosa. The mean age of the patients with concha bullosa was 36.1 ± 13.4 (min-max: 12-74) and the mean age of patients without concha bullosa was 37.5 ± 14.3 (min-max: 10-81). The ethmoid roof depths were compared between the two groups and a significant difference was observed (p < 0.001). The ethmoid roof depth was higher in the group with concha bullosa (p < 0.001). Conclusion The results of our study indicate that the ethmoidal roof tends to be higher in patients with middle concha bullosa.

Abstract Objectives: The purpose of the study is to investigate whether there is any relationship between mean argyrophilic nucleolar organizing regions (AgNOR) number and total AgNOR area/total nuclear area (TAA/TNA) ratio and the levels of brain hypoxia after exposure to different acute doses of carbon monoxide (CO) gas. Methods: Each experimental group was exposed to CO gas (concentrations of 1,000, 3,000 and 5,000 ppm). Then, the rats were anesthetized, and blood samples were taken from the right jugular vein for carboxyhemoglobin levels detection. The rats were sacrificed on seventh day. AgNOR staining was applied to brain tissues. TAA/TNA and mean AgNOR number were detected for each nucleus. Results: Significant differences were detected among the all groups for TAA/TNA ratio, mean AgNOR number and carboxyhemoglobin level. According to double comparison of groups, the differences between control and 1000ppm, control and 3000ppm, control and 5000ppm and 1000 and 5000ppm were significant for TAA/TNA ratio. When mean AgNOR number to be considered, significant differences were detected between control and 1000ppm, control and 3000ppm, control and 5000ppm and 1000 and 3000ppm. Conclusion: AgNOR proteins may be used for early detection of the duration, intensity and damage of brain injury caused by CO intoxication. Thus, effective treatment strategies for the prevention of hypoxic conditions may be developed.

Resumen Objetivos: El objetivo del estudio es investigar si existe alguna relación entre el número medio de regiones organizadoras nucleolares argirófilas (AgNOR) y la proporción de área total de AgNOR/área nuclear total (TAA/TNA) y los niveles de hipoxia cerebral en la exposición a diferentes dosis agudas de gas monóxido de carbono (CO). Métodos: Cada grupo experimental fue expuesto a gas CO (concentraciones de 1,000, 3,000 y 5,000 ppm). Luego las ratas fueron anestesiadas, se tomaron muestras de sangre de la vena yugular derecha para la detección de los niveles de carboxihemoglobina. Las ratas se sacrificaron el séptimo día. Se aplicó tinción con AgNOR en los tejidos cerebrales. Se detectaron el TAA/TNA y el número medio de AgNOR para cada núcleo. Resultados: Se detectaron diferencias significativas entre todos los grupos para la relación TAA/TNA, el número medio de AgNOR y el nivel de carboxihemoglobina. Según la doble comparación de grupos, las diferencias entre control y 1,000 ppm, control y 3,000 ppm, control y 5,000 ppm y 1,000 y 5,000 ppm fueron significativas para la relación TAA/TNA. Cuando se consideró el número de AgNOR medio, se detectaron diferencias significativas entre control y 1,000ppm, control y 3,000ppm, control y 5,000 ppm y 1,000 y 3,000 ppm. Conclusión: Las proteínas AgNOR pueden usarse para la detección temprana de la duración, intensidad y daño de la lesión cerebral causada por la intoxicación por CO. Por lo tanto, se pueden desarrollar estrategias de tratamiento efectivas para la prevención de condiciones hipóxicas.

SUMMARY INTRODUCTION: According to recent studies, the rate of atrioventricular block requiring permanent pacing in patients following transcatheter aortic valve implantation varied between 5.7% and 42.5%. Fragmented QRS is a useful marker of myocardial scar and can predict adverse cardiac events. In this study, we examined association between f ragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation. OBJECTIVE: In this study, we examined association between fragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation’ sentence is enough for it. METHODS: We retrospectively analyzed standard 12-lead electrocardiographic recordings of 124 consecutive patients in whom a CoreValve prosthesis was implanted. We examined 12-lead electrocardiogram before and after procedure along with one- and six-month follow-up. We documented QRS fragmentation and postprocedural rhythm disturbances. RESULTS: There was a significant increase in the frequency of left bundle branch block, (21.1 versus 0%, p<0.05) and the incidence of atrioventricular blocks requiring permanent pacing (21.1 versus 0%, p<0.05) following transcatheter aortic valve implantation in patients whose preprocedural electrocardiogram recordings revealed fragmented QRS compared to those without fragmented QRS. Based our collected data, the presence of QRS fragmentation in anterior derivations was the only independent factor associated with postprocedural rhythm disturbances (B-value 0.217; OR 0.805; 95%CI 0.136–4.78; p=0.004). CONCLUSION: Our data showed an increased risk for the development of new-onset left bundle branch block and atrioventricular blocks following transcatheter aortic valve implantation in patients whose baseline electrocardiogram recordings demonstrated QRS fragmentation.

ABSTRACT Objective Several studies have shown that left ventricular (LV) dysfunction is increased in individuals with diabetes. However, there are scarce data about LV function in prediabetics. This study assessed the early changes in LV diastolic and systolic myocardial function in normotensive prediabetics using tissue Doppler echocardiography (TDE). Subjects and methods We evaluated 94 patients with prediabetes (mean age of 50.8 ± 6.9 years, 78 female) without known cardiovascular diseases and 70 healthy volunteers with similar demographic characteristics. Systolic and diastolic function of the left ventricle was evaluated with transthoracic echocardiography according to the latest consensus recommendations including TDE. Results The mean results of septal and lateral parts of the mitral annulus Pulsed wave TDE showed that myocardial systolic wave (Sm), myocardial early diastolic wave (Em) and Em to atrial peak velocity (Am) ratio were significantly lower whereas early diastolic peak flow velocity (E) to Em ratio, myocardial isovolumetric relaxation time (IVRTm), myocardial isovolumetric contraction time (IVCTm) and myocardial performance index (MPI) values were significantly higher in patients with prediabetes (preDM). In addition, mean left atrium (LA) diameter measured with M-mode echocardiography was significantly higher in prediabetics than controls. Conclusion PreDM is associated with subclinical LV systolic and diastolic dysfunction as evaluated by TDE.

Objetivo Avaliar como a melhora da depressão grave através da psicoterapia afeta a função cognitiva de pacientes com esclerose múltipla (EM) diagnosticados com depressão e disfunção cognitiva. Método Foram aplicados a pacientes com EM o “Brief Repeatable Battery of Neuropsychological Test” e o ınventário de depressão de beck (BDI). Os pacientes com depressão e disfunção cognitiva foram submetidos a psicoterapia de grupo por 3 meses. Depois desse período, foram reaplicados os mesmos testes. Resultados Depressão e disfunção cognitiva foram detectadas conjuntamente em 15 (13,9%) dos pacientes. Embora os pacientes se tivessem recuperado ao fim dos 3 meses de psicoterapia de grupo, somente através do BDI e do “Paced Auditory Test” foi possível detectar uma recuperação significativa. Conclusão Psicoterapia de grupo pode diminuir o comprometimento cognitivo em pacientes com EM.

Objective This study will evaluate how decreasing depression severity via group psychotherapy affects the cognitive function of patients with multiple sclerosis (MS) who are also diagnosed with depression and cognitive dysfunction. Method MS patients completed the Brief Repeatable Battery of Neuropsychological Tests and Beck Depression Inventory (BDI). The group members diagnosed with depression and cognitive dysfunction underwent group psychotherapy for 3 months. Upon completion of psychotherapy, both tests were readministered. Results Depression and cognitive dysfunction were comorbid in 15 (13.9%) of patients. Although improvement was detected at the end of the 3-month group psychotherapy intervention, it was limited to the BDI and the Paced Auditory Test. Conclusion Group psychotherapy might decrease cognitive impairment in MS patients.

OBJECTIVES: Acute ST-elevation myocardial infarction is associated with ventricular dysfunction due to ischemia-induced progressive myocardial damage. The decrease in ventricular compliance causes left atrial dilatation and stretching of the atrial myocardium, which are the main stimuli for the secretion of atrial natriuretic peptide. The aim of this study was to evaluate left atrial dimensions and atrial natriuretic peptide levels in patients early after their first acute ST-elevation myocardial infarction and assess the probable interaction between coronary lesions and these measurements. METHODS: A total of 110 patients with acute myocardial infarction and 50 controls were studied. Plasma atrial natriuretic peptide was measured at admission. Left ventricular function, diameter, and volume index were evaluated using transthoracic echocardiography. Gensini and vessel scores of the patients who underwent coronary angiography were calculated. RESULTS: Plasma atrial natriuretic peptide in the patients with myocardial infarction was increased compared with that in controls (3.90±3.75 vs. 1.35±0.72 nmol/L, p<0.001). Although the left atrial diameter was comparable in patients and controls, the left atrial volume index was increased in patients with acute myocardial infarction (26.5±7.1 vs. 21.3±4.9 mL/m2, p<0.01). Multivariate regression analysis showed a strong independent correlation between the left atrial volume index and the plasma atrial natriuretic peptide level (β = 0.23, p = 0.03). CONCLUSIONS: The left atrial volume index and plasma atrial natriuretic peptide level were correlated in patients with acute myocardial infarction.