Hospital Practices and Research

Abstract Background: Sudden Cardiac Death (SCD) and Acute Coronary Syndrome (ACS) are major public health concerns, particularly in individuals with a family history of early-onset Coronary Artery Disease (CAD).
Objectives: The impact of family history on ACS and SCD risk remains underexplored.
Methods: This retrospective study included 689 patients diagnosed with ST-Elevation Myocardial Infarction (STEMI) who underwent Primary Percutaneous Coronary Intervention (PPCI) between January 2011 and June 2015. Patients with a parental history of SCD due to Myocardial Infarction (MI) were identified (n = 29, 4.2%). Demographic data, cardiovascular risk factors, and angiographic findings were evaluated.
Results: The median age at STEMI onset in patients with a parental history of SCD was 49 (41.5-52) years, 8.9 years younger than their parents’ age at SCD. Most patients were male (96%) and smokers (83%). Hyperlipidemia was present in 80%, although only 7% had been previously diagnosed. Multi-vessel disease was observed in 80%, and 28% required Coronary Artery Bypass Grafting (CABG). Two patients (7%) died due to cardiogenic shock.
Conclusion: Patients with a parental history of SCD develop STEMI at younger ages. Smoking and low HDL levels were key risk factors. Early screening and preventive measures, including smoking cessation and lipid control, were essential for high-risk individuals. Further studies are needed to explore genetic predisposition and targeted prevention strategies.

Abstract Non-cardiac CT angiograms may be helpful when searching for the etiology of cardiac arrest in out-of-hospital cardiac arrest cases and may be effective in the decision of early percutaneous coronary intervention. We want to share an experience related to this topic. A 51-year-old male patient returned home after travelling by plane from abroad and suddenly collapsed while hugging his relatives at home, followed by cardiac arrest (CPA). CTA showed no obvious pathology in the aorta and pulmonary artery, but the proximal left anterior descending artery (LAD) branching from the left main coronary artery (LMCA) was not contrast enhanced and was thought to be an occluded lesion. The cardiology unit was contacted and the patient was taken to the emergency coronary angiography unit. Coronary angiography revealed a critical stenosis in the proximal LAD. In this case, the patient's heart rate was not suitable for a coronary CT angiography (90 beats/minute), and the option of slowing the heart down was not an option as the patient was unstable and had ROSC after CPA. In addition, no radiologic editing of the images for artifacts due to heart rate was performed. Thoracic aorta angiography is not a standard imaging method for coronary artery lesions. However, in this case, it raised suspicion of coronary artery occlusion and was indicative of an occlusion that could not be detected on ECG.

Abstract Background: Platelets/Lymphocyte Ratio (PLR) has been investigated not only in hematological diseases but also in clinical conditions involving almost all organs and systems including inflammatory, neoplastic, and cardiovascular diseases.
Objectives: This study was planned to perform an analysis of the studies on PLR through the PubMed database, to measure the impact of the relevant studies on the diagnosis of diseases.
Methods: This analysis was performed on 16.01.2021 by searching with the word group "platelet lymphocyte ratio", "platelet lymphocyte ratio" in the PubMed database.
Results: The study included 723 articles, of which 580 (80.2%) were retrospective. It was determined that 420 (58.1%) of the studies were conducted by a single clinical department, 55.6% (n=402) were indexed in SCI/SCI-E index, 56.7% (n=410) were Open Access, and 58.8% (n=425) had significant results related to the clinical condition studied. Most publications were from Turkey (n=239, 33.1%), China (n=211, 29.2%), and Japan (n=55, 7.6%).
Conclusion: The majority of the analyzed studies were retrospective, and were SCI/SCI-E indexed. Their role in malignancy diagnoses was evaluated the most. A total of 59 different clinical conditions were evaluated and "platelet lymphocyte ratio" was found useful in the diagnosis of relevant clinical conditions in 58.8% of the studies. PLR is a value that is significantly associated with the diagnosis and prognosis of many diseases and can be obtained by a simple calculation from a complete blood count.

Abstract Background: There are very few studies in the literature evaluating the effects of mask use on physiological parameters.
Objectives: This study aims to examine physiological changes due to masks in healthcare workers who use respiratory masks for long hours in the emergency room during the pandemic process.
Methods: Cross-sectional and prospective study was carried out with healthcare professionals with an FFP2 type valve mask. The participants’ transcutaneous oxygen saturation, pulse, and respiratory rate were measured before wearing the respirator mask and at 30 and 60 minutes after wearing the mask.
Results: SPO2 values of the participants decreased gradually at 0th, 30th, and 60th minutes and respiratory rate increased gradually at 0th, 30th, and 60th minutes. The statistically significant difference arises from the 0 and 60 minutes values. Higher SPO2 values were found at 0 and 30 minutes in non-smokers. SPO2 value gradually decreased in non-smokers at 0, 30, and 60 minutes, but no significant decrease was observed in non-smokers. Pulse rate was found to be higher at 60th minute compared to 0th minute in non-smokers. No significant difference was found between smokers and non-smokers. The respiratory rate gradually increased in smokers at 0th, 30th, and 60th minutes. SPO2 values were lower at the 60th minute compared to the 0th minute in both women and men. There was no significant difference in pulse rates. Respiratory rate was found to be higher at 60th minute in men than at 0th minute.
Conclusion: It is recommended to follow the physiological parameters and to regulate the working conditions when necessary.