Biomedical subjects

Selim Kilic

Publications and source records attributed to Selim Kilic.

35 records · Page 2Linked to original sources

PubMed2005

The comparative effects of telmisartan and ramipril on P-wave dispersion in hypertensive patients: a randomized clinical study.

BACKGROUND: Prolongation of P-wave times and increase of P-wave dispersion (PWD) were shown to be independent predictors of atrial fibrillation (AF). Angiotensin II receptor blockers (AARBs) and angiotensin-converting enzyme inhibitors (ACEIs) have beneficial effects on atrial conduction times. However, there are not enough data about the comparative effects of those drugs on PWD. HYPOTHESIS: We aimed to compare the effects of telmisartan and ramipril on PWD after 6-month treatment in hypertensive patients. METHODS: In all, 100 newly diagnosed hypertensive patients were enrolled in the study and were randomly assigned to two groups. Group 1 and Group 2 each consisted of 50 patients, taking daily doses of 80 mg telmisartan and 10 mg ramipril, respectively. Twelve-lead surface electrocardiograms (ECG) were recorded from all patients before and after 6-month drug therapy. The P-wave duration (Pdur) measurements were calculated from the 12-lead surface ECG. RESULTS: When pretreatment PWD and Pmaximum values were compared with post-treatment values, a statistically significant decrease was found in both groups after 6 months (Group 1 and 2; p < 0.001 for PWD and Pmaximum). P-wave dispersion and Pmaximum values after treatment in Group 1 were statistically significantly lower than those in Group 2 after the 6-month treatment period (p = 0.01 for PWD; p = 0.008 for Pmaximum). CONCLUSIONS: Telmisartan has a much greater lowering effect on PWD and Pmaximum values than ramipril. This finding may be important in the prevention of AF in hypertensive patients.

Angiotensin II Type 1 Receptor Blockers↗

PubMed2005

Impaired coronary collateral vessel development in patients with proliferative diabetic retinopathy.

BACKGROUND: Diabetic patients have been reported to have impaired coronary collateral vessel growth, although they have excessive neovascularization in the retina. HYPOTHESIS: This study was designed to compare coronary collateral circulation (CCC) in patients with proliferative diabetic retinopathy (PDR) with that in patients without DR. METHODS: Ninety diabetic patients with chronic total occlusion in at least one major epicardial coronary artery were enrolled in the study. Groups 1 and 2 consisted of 48 patients without DR and 42 patients with PDR, respectively. Coronary collateral circulation (CCC) was analyzed according to the Rentrop system. Each group was also divided into two subgroups according to poor and good CCC. Serum vascular endothelial growth factor (VEGF) levels were measured using the enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: The mean Rentrop collateral score was higher in Group 1 than in Group 2 (2.39 +/- 1.07 vs. 1.76 +/- 0.76, respectively, p < 0.001). When the two groups were compared with respect to poor and good CCC, poor CCC was higher in patients with PDR (64 vs. 36%, respectively, p = 0.01). Serum VEGF levels were higher in patients with PDR than in those without DR (219 +/- 99 vs. 139 +/- 98 pg/ml, p < 0.001); however, patients with poor and good CCC had similar VEGF levels. CONCLUSIONS: We have shown that patients with PDR have a lower coronary collateral score than patients without DR. Also, serum VEGF was significantly higher in patients with PDR than in those without DR. These findings have suggested that diabetes mellitus may have a different action on retinal and coronary circulation.

Aged↗

PubMed2005

Preoperative methylene blue administration in patients at high risk for vasoplegic syndrome during cardiac surgery.

BACKGROUND: Angiotensin-converting enzyme inhibitors, calcium channel blockers, and preoperative intravenous heparin use are independent risk factors for vasoplegic syndrome after cardiac surgery. We prospectively studied whether preoperative methylene blue administration would prevent the vasoplegic syndrome in these high-risk patients. METHODS: One hundred patients scheduled for coronary artery bypass graft surgery who were at high risk for vasoplegia because they were preoperatively using angiotensin-converting enzyme inhibitors, calcium channel blockers, and heparin were randomly assigned to either receive preoperative methylene blue (group 1, n = 50) or not receive it (group 2, controls, n = 50). Methylene blue (1% solution) was administered intravenously at a dose of 2 mg/kg for more than 30 minutes, beginning in the intensive care unit 1 hour before surgery. RESULTS: Although similar in terms of all demographic and operative variables, the two groups differed significantly in terms of vasoplegic syndrome incidence (0% in group 1[0 of 50] vs 26% in group 2 [13 of 50]; p < 0.001). In 6 patients, the vasoplegic syndrome was refractory to norepinephrine. Four of these patients survived; the other 2 had vasoplegic syndromes that were refractory to aggressive vasopressor therapy, and they ultimately died of multiorgan failure. Stroke occurred in 1 patient. The two study groups also differed significantly in terms of average intensive care unit stay (1.2 +/- 0.5 days in group 1 vs 2.1 +/- 1.2 days in group 2; p < 0.001) and average hospital stay (6.1 +/- 1.7 days in group 1 vs 8.4 +/- 2.0 days in group 2; p < 0.001). CONCLUSIONS: Our results suggest that preoperative methylene blue administration reduces the incidence and severity of vasoplegic syndrome in high-risk patients, thus ensuring adequate systemic vascular resistance in both operative and postoperative periods and shortening both intensive care unit and hospital stays.

Aged↗

PubMed2005

The efficacy and tolerability of doxycycline and mefloquine in malaria prophylaxis of the ISAF troops in Afghanistan.

OBJECTIVES: Afghanistan is one of the endemic regions of chloroquine resistant P. falciparum. Mefloquine and doxycycline are among the recommended prophylactic regimes. The aim of the study was to compare the efficacy and tolerability of the two regimes on the Turkish soldiers settled in Kabul, Afghanistan. METHODS: A total number of 1400 soldiers were subjected to prophylactic regimes with either doxycycline 100 mg/day (n=986) or mefloquine 250 mg/week (n=414). Prophylaxis lasted about 12 weeks. The side effects and compliances were investigated by questionnaires. All soldiers were monitored up to 6 months after returning home. RESULTS: No malaria case was observed and there was no severe side effect in either group. The total side effects in doxycycline group were significantly higher (P<0.001). The compliance of mefloquine takers was better than the doxycycline takers (P<0.05). CONCLUSIONS: The tolerability of the mefloquine regime is better than the doxycycline regime in malaria prophylaxis.

Adult↗

PubMed2005

Prostate cancer and adiponectin.

OBJECTIVES: To search for any relation between plasma adiponectin levels and the cellular differentiation or progression of prostate cancer (PCa). PCa is becoming an increasingly important public health problem, particularly for those countries with a trend toward an aging population. Because insulin resistance in the setting of obesity is associated with the development of PCa, we hypothesized that decreased adiponectin levels might underlie the association between PCa and obesity/insulin resistance. METHODS: In this study, we investigated plasma adiponectin levels in 30 patients with PCa, 41 subjects with benign prostatic obstruction, and 36 healthy individuals. The body mass index and age of the groups were similar. Patients with PCa were stratified into two groups according to the spread of the disease as organ-confined and advanced disease and into three groups according to grade (low, intermediate, and high grade determined by a Gleason sum of less than 5, between 5 and 7, and more than 7, respectively). RESULTS: Plasma adiponectin levels were significantly lower in the PCa group than in the benign prostatic obstruction group or controls (P < 0.001 for both). Additionally, the plasma adiponectin levels were significantly lower in the advanced disease group than in the organ-confined PCa group (P = 0.012). Significant negative associations were found between plasma adiponectin levels and prostate-specific antigen levels or biopsy Gleason scores in the PCa group. The plasma adiponectin levels of those with high-grade PCa were also significantly lower than those for both the low-grade and intermediate-grade groups (P < 0.001 for both). CONCLUSIONS: The results of the present study imply that plasma adiponectin levels are not only lower in patients with PCa but are also negatively associated with the histologic grade and disease stage. Future prospective studies are recommended to establish any causal relation between PCa and plasma adiponectin levels.

Adiponectin↗

PubMed2005

The impact of admission C-reactive protein levels on the development of poor myocardial perfusion after primary percutaneous intervention in patients with acute myocardial infarction.

BACKGROUND: Increased preprocedural C-reactive protein (CRP) levels in patients with acute myocardial infarction (MI) undergoing primary percutaneous coronary intervention (PCI) may affect myocardial perfusion. Accordingly, this study was designed to investigate the impact of admission CRP levels on the development of poor myocardial perfusion after PCI in patients with acute MI. METHODS: The study population consisted of 75 patients (62 men, mean age, 61.6+/-6.68 years), who were admitted to our hospital with acute anterior MI and who underwent primary PCI in the left anterior descending coronary artery. All patients underwent stenting following balloon angioplasty. Myocardial perfusion was evaluated by using Thrombolysis In Myocardial Infarction (TIMI) myocardial perfusion grade (TMPG). Patients were divided into two groups according to TMPG after PCI. Group 1 consisted of 25 patients with TMPG 0-1 and group 2 comprised 50 patients with TMPG 2-3. Admission serum high sensitive CRP (hs-CRP) levels were analysed by using nephelometric method. RESULTS: Admission hs-CRP levels, pain to balloon time and white blood cell count (WBC) of patients in group 1 were significantly higher than those of the patients in group 2 (P<0.001; P<0.001; P=0.002, respectively). Univariate analysis identified ejection fraction, pain to balloon time, WBC and hs-CRP levels as the predictors of poor myocardial perfusion. In multivariate logistic regression analysis, hs-CRP levels and pain to balloon time were found to have statistically significant independent association with poor myocardial perfusion. Adjusted odds ratios were calculated as 1.85 for hs-CRP [P=0.003; 95% confidence interval (CI), 1.23-2.80] and 5.49 for pain to balloon time (P=0.04; 95% CI, 1.08-27.84). CONCLUSIONS: On admission, high CRP level in patients with acute MI undergoing primary PCI is likely to be in the causal pathway leading to the development of poor myocardial perfusion, especially when combined with prolonged pain to balloon time.

Aged↗

PubMed2005

The effects of prior use of atorvastatin on coronary blood flow after primary percutaneous coronary intervention in patients presenting with acute myocardial infarction.

BACKGROUND: Statins exert a variety of favourable effects on the vascular system not directly related to their lipid lowering function known as pleiotropic effects. There are not enough data regarding the effects of prior statin use on coronary blood flow after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Accordingly, in the present study, we aimed to investigate the effects of prior statin use on coronary blood flow after primary PCI in patients with AMI using the Thrombolysis In Myocardial Infarction (TIMI) frame count method. METHODS: The study population consisted of 200 patients (161 men; mean age=62+/-7 years) referred to cardiology clinics with AMI who subsequently underwent successful primary PCI. The study population was divided into two groups according to statin use before primary PCI. Group 1 consisted of 98 patients (75 men; mean age=63+/-7 years) not taking statin and group 2 consisted of 102 patients (86 men; mean age=61+/-7 years) taking daily dose of at least 40 mg atorvastatin for at least 6 months. Coronary blood flow was determined by TIMI frame count method using the angiographic images obtained just after PCI and stenting. RESULTS: Only mean TIMI frame count was detected to be significantly lower in patients taking at least 40 mg atorvastatin for at least 6 months compared with that of the patients taking no statin (P<0.001). After confounding variables were controlled for, the mean TIMI frame count of patients in group 2 was significantly lower than that of the patients in group 1 (P=0.001). Pain to balloon time and vessel type were detected as important confounding variables of TIMI frame count after analysis of covariances. CONCLUSIONS: Prior statin use may improve coronary blood flow after PCI in patients with AMI, possibly by its beneficial effects on microvascular function.

Aged↗

PubMed2005

The effect of biofeedback treatment on voiding and urodynamic parameters in children with voiding dysfunction.

PURPOSE: We studied the effects of biofeedback treatment on voiding and urodynamic parameters in children with voiding dysfunction. MATERIALS AND METHODS: We prospectively studied 188 children between June 1998 and November 2003. Biofeedback was performed with a urodynamics processor that enables simultaneous recording of urine flow and electromyography, and visual display of flow/electromyography activity. At the beginning of the study this treatment was performed once weekly. After patients understood the concept and performed homework regularly sessions were scheduled at 3 to 4-week intervals and continued for 6 months. All children were evaluated at 6 months and again at 2 years after completing biofeedback training. RESULTS: The number of the children completing biofeedback was 168 (89.4%). Improvement was obtained in all parameters, ranging from 59.2% to 87.8% at 6 months. Maximum improvement was acquired with flattened voiding in 65 of 74 children (87.8%), whereas the least improvement was acquired with daytime wetting in 58 of 98 children (59.2%). These improvements continued at 2-year followup, and ranged from 53.1% to 87.3%. While the rate of improvement for nocturnal enuresis, staccato voiding, detrusor-sphincter dyssynergia, vesicoureteral reflux and urinary tract infection had increased, the remaining parameters had decreased at 2-year followup. CONCLUSIONS: Biofeedback training is a simple, effective and well tolerated treatment modality in children for various parameters resulting from bladder dysfunction. Motivation and willingness to participate in biofeedback treatment are important selection criteria.

Adolescent↗

PubMed2005

Does coronary artery size really matter?

OBJECTIVE: To evaluate ischemia in right ventricle (RV) in patients with small caliber of right coronary artery (RCA). PATIENTS AND METHODS: The study population consisted of 60 consecutive patients undergoing coronary angiography within 3 months. The patients were divided into three different groups according to lumen diameter of RCA and coronary dominance. Group 1, 2, and 3 consisted of patients with small diameter of RCA, dominant RCA, and dominant circumflex artery, respectively. RV ischemia was assessed by using pulse-wave tissue Doppler sampling obtained from RV free wall close to the lateral tricuspid annulus at the apical four-chamber view during dobutamine stress echocardiography (DSE). RESULTS: When the mean systolic velocity percentages of increase from low to peak dose dobutamine in patients with small RCA were compared to those of other groups, statistically significant difference was found between group 1 and the other groups (P = 0.007 for group 1 vs group 2; P = 0.01 for group 1 vs group 3). The mean systolic velocity at peak dobutamine dose of patients with small caliber of right coronary artery was statistically lower than the other groups (P = 0.001 for group 1 vs group 2, P < 0.001 group 1 vs group 3). CONCLUSIONS: There are a group of patients with small diameter of RCA causing probable ischemia in RV and small caliber of RCA can really matter in these patients.

Analysis of Variance↗

PubMed2005

Effects of primary percutaneous coronary intervention on P wave dispersion.

BACKGROUND: Several studies demonstrated that P wave dispersion (PWD) increased after coronary occlusion. The effect of primary percutaneous coronary intervention (PCI) on PWD needs to be elucidated. METHODS: The study consisted of 125 patients with acute myocardial infarction (110 men, mean age 59.8+/-7.8 years) undergoing primary PCI. The patients were divided into three groups according to thrombolysis in myocardial infarction myocardial perfusion grade (TMPG) after successful PCI. Groups 1 (n=12), 2 (n=9), and 3 (n=104) included the patients with TMPG 0/1, 2, 3, respectively. Electrocardiograms were obtained before and approximately 66+/-18 minutes after PCI. RESULTS: PWD and P(maximum) after PCI were significantly lower than the preintervention values (P<0.001 for both). When PWD and Pmaximum values after PCI were compared among groups, PWD and Pmaximum in groups 1 and 2 were found to be higher than those of group 3 (P<0.001 for PWD and Pmaximum). Atrial fibrillation (AF) occurred in 14 patients. Pmaximum and PWD in patients with AF were higher compared to those of the patients without AF (P<0.001 for both P wave parameters). Also more frequent AF attacks were observed in group 1 compared to group 3 (P<0.001). CONCLUSIONS: PWD and Pmaximum after primary PCI were lower compared to the preintervention values. Prolonged PWD in patients with poor myocardial perfusion can contribute to increased mortality, and also it can can be combined with ST segment resolution to predict clinical reperfusion and might help in predicting AF.

Analysis of Variance↗

PubMed2005

Effect of climate on the bacteriology of chronic suppurative otitis media.

OBJECTIVES: We evaluated the correlation between the microbial content of chronic suppurative otitis media (CSOM) and regional climatic parameters. METHODS: We assessed the interrelations between monthly mean records of temperature, maximum temperature, atmospheric pressure, and humidity and the aerobic microbial flora in CSOM. RESULTS: Forty-three bacteria of Enterobacteriaceae, 67 staphylococcal spp, 51 Pseudomonas aeruginosa, 9 Streptococcus pneumoniae, 1 alpha-hemolytic Streptococcus, 1 Enterococcus sp, and 2 Edwardsiella tarda strains were recovered from 173 patients with CSOM. There was a good relationship between enteric bacteria and monthly mean temperature (r = 0.501) and significant colonization rates due to increasing monthly mean temperature (p = .040) and monthly mean maximum temperature values (p = .048). CONCLUSIONS: When the weather warmed, the frequency of isolation of enteric bacteria increased significantly. Temperature changes may affect the enteric bacterial colonization of CSOM.

Atmospheric Pressure↗

PubMed2005

The association of plasma adiponectin levels with hypertensive retinopathy.

OBJECTIVE: Previous studies have demonstrated that low plasma adiponectin concentrations are associated with essential hypertension. It has also recently been shown that adiponectin plays an essential role in the modulation of angiogenesis. These data led us to hypothesize that adiponectin might contribute to end-organ damage in hypertension. METHODS: In the present study we have evaluated the relationship between plasma adiponectin concentrations and hypertensive retinopathy. One hundred and ten patients newly diagnosed with essential hypertension (EHT) (mean age, 46.79+/-5.0 years; body mass index (BMI), 26.47+/-2.23 kg/m(2); male/female ratio, 58/52) and 57 healthy normotensive control subjects (NT) (mean age, 46.84+/-5.4 years; BMI, 26.66+/-2.65 kg/m(2); male/female ratio, 33/24) were enrolled. RESULTS: Plasma adiponectin levels were significantly lower in EHT than in NT (P < 0.001). In addition, adiponectin concentrations were strongly correlated with systolic and diastolic blood pressures in EHT (r = -0.757, P < 0.001; r = -0.761, P < 0.001) while there was no correlation in the NT group. Plasma adiponectin in patients with grade 0 hypertensive retinopathy (n = 52) was significantly higher than that of the patients with grade 1 (n = 30) and 2 (n = 28) hypertensive retinopathy (P < 0.001 for each). Plasma adiponectin in patients with grade 0 hypertensive retinopathy was also significantly lower than that in the NT group (P < 0.001). The estimated threshold of plasma adiponectin concentration for hypertensive retinopathy was 17 microg/ml. This critical adiponectin level served largely to separate patients with retinopathy from those without. CONCLUSION: Our results have shown that plasma adiponectin concentrations decrease progressively with higher grades of hypertensive retinopathy even after correction for other atherogenic risk factors, suggesting that a critical adiponectin level is needed for the development of retinopathy.

Adiponectin↗

PubMed2004

Cardiac reoperation by Carpentier bicaval femoral venous cannula: GATA experience.

BACKGROUND: Division of the sternum is primarily a blind procedure in reoperation and carries an increased risk of injury for major cardiac structures in the presence of adhesions between the posterior table and the heart. METHODS: Two hundred patients were randomly divided into two groups. Cardiopulmonary bypass was established through the femoral artery and vein in group 1 (n = 100) patients before sternal reentry. Carpentier dual-stage femoral venous return cannula was used in all group 1 patients. Cardiopulmonary bypass was performed after sternal reentry in group 2 (n = 100) patients. RESULTS: Six severe cardiac injuries developed in group 2. Cardiopulmonary bypass time was 93 +/- 9 minutes in group 1 and 71 +/- 11 minutes in group 2 (p = 0.011), and the operation time was 155 +/- 23 minutes in group 1 and 185 +/- 32 minutes in group 2 (p = 0.024). Inotropic therapy was required in 52 patients in group 1 and 76 patients in group 2 (p = 0.032). Average chest drainage was 450 +/- 135 mL in group 1 and 850 +/- 250 mL in group 2 (p < 0.001). Average fresh whole blood transfusion was 3.3 +/- 1.2 U in group 1 and 5.8 +/- 0.9 U in group 2 (p = 0.033). Average intensive care unit stay was 2.2 +/- 1.3 days in group 1 and 4.5 +/- 2.3 days in group 2 (p = 0.025). Average hospital stay was 7.3 +/- 2.4 days in group 1 and 9.1 +/- 3.1 days for group 2 (p = 0.011). CONCLUSIONS: Cardiopulmonary bypass by bicaval Carpentier femoral venous cannula before resternotomy not only allows adequate cardiopulmonary bypass flow but also significantly reduces the risk of cardiac injury and catastrophic hemorrhage and allows safe reopening. Although this procedure increases cardiopulmonary bypass time, the operation time, bleeding, and blood transfusion requirement are significantly reduced.

Blood Loss, Surgical↗

PubMed2004

Peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonist increases plasma adiponectin levels in type 2 diabetic patients with proteinuria.

Adiponectin appears to be an important modulator for metabolic and vascular diseases. A case-controlled study was designed to measure plasma adiponectin levels and investigate the effects of rosiglitazone on adiponectin levels in type 2 diabetic patients with proteinuria. Sixty-four patients (mean age, 46.1+/-4.6 yr; 30 male, 34 female) and 26 healthy volunteers (mean age, 45.3+/-4.8 yr; 14 male, 12 female) were included. Patients with proteinuria were treated with 4-mg/d rosiglitazone (n=21, 10 males, 11 females) for 4 wk. Adiponectin levels in patients were significantly lower than those of controls (p<0.001). There were significant negative correlations between adiponectin concentrations and insulin levels as well as homeostasis model assessment (HOMA) index in patient's group (r=- 0.538, p<0.001; r=- 0.393, p=0.001, respectively). There was also a significant negative correlation between plasma adiponectin concentrations and the degree of proteinuria (r=- 0.526, p=0.002). Plasma adiponectin levels in patients with proteinuria (n=31; 3.91+/-2.57 microg/mL) were significantly lower than those without proteinuria (n=33; 10.15+/-1.97 microg/mL) (p<0.001). After the treatment period, adiponectin levels significantly increased (p<0.001) and proteinuria, plasma insulin, and HOMA indexes significantly decreased in treatment group (p<0.001, p<0.001, p<0.001, respectively). The results suggest that adiponectin is inversely correlated with proteinuria and treatment with peroxisome proliferator-activated receptor-gamma (PPAR-gamma) agonist rosiglitazone both corrects proteinuria and increases the low adiponectin levels in diabetic patients.

Adipocytes↗

PubMed2004

How medical students use the computer and Internet at a Turkish military medical school.

The aim of this study was to determine how medical students use the computer and World Wide Web at a Turkish military medical school and to discuss characteristics related to this computer use. The study was conducted in 2003 in the Department of Public Health at the Gulhane Military Medical School in Ankara, Turkey. A survey developed by the authors was distributed to 508 students, after pretest. Responses were analyzed statistically by using a computer. Most of the students (86.4%) could access a computer and the Internet and all of the computers that were used by students had Internet connections, and a small group (8.9%) had owned their own computers. One-half of the students use notes provided by attending stuff and textbooks as assistant resources for their studies. The most common usage of computers was connecting to the Internet (91.9%), and the most common use of the Internet was e-mail communication (81.6%). The most preferred site category for daily visit was newspaper sites (62.8%). Approximately 44.1% of students visited medical sites when they were surfing. Also, there was a negative correlation between school performance and the time spent for computer and Internet use (-0.056 and -0.034, respectively). It was observed that medical students used the computer and Internet essentially for nonmedical purposes. To encourage students to use the computer and Internet for medical purposes, tutors should use the computer and Internet during their teaching activities, and software companies should produce assistant applications for medical students. Also, medical schools should build interactive World Wide Web sites, e-mail groups, discussion boards, and study areas for medical students.

Computers↗

PubMedDate not supplied

Brachial artery cannulation facilitates lower ministernotomy cardiac surgery.

BACKGROUND: Lower ministernotomy has become a more popular approach for many heart operations. However, cannulation of the ascending aorta may cause serious complications. Femoral and brachial arteries have been used for alternative arterial cannulation sites. MATERIALS AND METHODS: The lower ministernotomy approach was used in 65 patients. Ascending aortic cannulation was performed in group 1 (n = 38), femoral cannulation in group 2 (n = 12), and brachial cannulation in group 3 (n = 15) patients. Brachial artery diameter was measured preoperatively by Doppler ultrasound in the preoperative period. RESULTS: Average cross-clamp time for femoral and brachial artery cannulated patients was significantly shorter than in patients in group 1 (31 +/- 9 and 35 +/- 6 minutes, respectively) (p = 0.034). Total cardiopulmonary bypass (CPB) time was 56 +/- 11 minutes for group 1, 39 +/- 7 minutes for group 2, and 41 +/- 5.4 minutes for group 3 (p = 0.041). Operation time was 112 +/- 24, 88 +/- 12, and 91 +/- 11 minutes for the groups 1, 2, and 3, respectively. There was also statistically significant difference between group 1 and group 3 comparisons with regard to CPB time (p = 0.041). Difficult exposure from many cannulas impedes access and lengthens the operation in group I. Superficial wound infection developed in seven patients in group 1, one patient in group 2, and one patient in group 3. CONCLUSION: Cannulation of the brachial artery is superior to the femoral due to possible infection and lymph leakage with the latter and both are superior to central cannulation when lower ministernotomy is performed. By avoiding the difficulties of central aortic cannula placement the operative time is decreased and possible wound edge is protected as lesser exposure is required.

Adolescent↗

PubMedDate not supplied

The effect of oral prednisolone with chronic obstructive pulmonary disease undergoing coronary artery bypass surgery.

BACKGROUND: Chronic obstructive pulmonary disease is still one of the most important problems in patients undergoing cardiopulmonary bypass. The purpose of this prospective study was to assess the beneficial effects of oral prednisolone on pulmonary functions in patients undergoing cardiopulmonary bypass. METHODS: Forty patients with chronic obstructive pulmonary disease were divided into two groups randomly and were given 20 mg oral prednisolone once daily perioperatively (Group I, n = 20) or identical placebo (Group II, n = 20). FEV(1) values, dates of intensive care unit and hospital stays of the two groups were compared. RESULTS: FEV1 values during the admission to our hospital were similar in each group mean predicted FEV1: 56.7 +/- 5.35% in Group I and 57.2 +/- 4.88% in Group II (p = 0.759). After 10 days of oral prednisolone treatment in Group I, predicted FEV1 values were significantly different between two groups (63.2%+/- 4.24 and 57.9%+/- 4.38) (p = 0.0001). While predicted FEV1 values revealed difference between two groups at the date of discharge (p = 0.0001) the values became similar at the third month (55.6%+/- 4.09 in Group I and 55.45%+/- 3.87 in Group II) (p = 0.897). CONCLUSION: Various types of complications may occur after cardiopulmonary bypass. Oral prednisolone not only decreases the rates of complications (reintubation, intubation times, and rhythm disturbances) but also decreases the cost of cardiac operations according to shorter hospital stays.

Administration, Oral↗