Background and Aim: In oncology patients, central venous port catheter (CVPC) implantation is generally preferred for venous route. However, in this procedure, postoperative pain is often observed. This study aimed to investigate the effectiveness of ultrasound-guided Pecs II block in the management of pain after CVPC placement. Methods: One hundred and eighty-seven patients who underwent CVPC implantation between January 2017 and August 2018 were included in the study. Patients who underwent Pecs II block under ultrasound guidance were called as the Pecs group, and those who underwent local anesthesia (LA) were referred as the LA group. All procedural parameters were analyzed, including demographic characteristics of patients, visual analogue scores (VAS) at 2nd and 24th hours, and postoperative opioid, and non-steroidal anti-inflammatory drug (NSAID) consumption. Results: The postoperative 2nd hour VAS scores were similar in both groups and were lower than the 24th hour VAS scores. VAS scores at the 24th hour in the Pecs group were significantly lower than the LA group (P = 0.001). While the number of fentanyl rescue doses administered in PACU was similar, the total NSAID consumption in the first 24 hours was higher in the LA group than in the Pecs group. Conclusion: In CVPC placement, ultrasound-guided Pecs II block is a more reliable, easily applicable and longer-acting approach than LA infiltration for postoperative analgesia.

Aim: Factor analysis is a statistical approach used mainly in social science scale development systems. The aim of this study was to evaluate the performance of factorial structures formed by laboratory values in predicting mortality in severe COVID-19 patients. Material and Method: The study included 281 patients diagnosed with ‘‘severe coronavirus infection’’ according to the WHO COVID-19 clinical management guideline who were treated in a 13-bed adult tertiary-level critical care unit of a tertiary level hospital. For a total of 23 variables (ALT, AST, BUN, creatinine, Na, K, LDH, CRP, CK, ferritin, D-dimer, INR, TB, Glu, NLR, WBC, fibrinogen, % NEU, PLT, HTC, % LYM, TLC, Alb), laboratory values were collected. A two-step method was used to determine if exploratory factors might be used in place of laboratory variables. First, the ability of individual laboratory variables to predict mortality was obtained by analysis of the receiver operating characteristic (ROC) analysis. Then, the ability of factors created from these variables to predict mortality was measured using ROC analysis. The area under curve (AUC) values were compared between the two conditions. Results: The Kaiser-Meyer-Olkin (KMO) value calculated using factor analysis on the variables was found to be 0.661. The significance level of the Bartlett’s Test was 0.6. A five-factor structure was created based on the Scree Plot. The fifth factor, which included CRP, fibrinogen, and ferritin, was the highest for predicting mortality (AUC: 0.677). According to the individual laboratory variables, the first factor comprising TLC, CK, and NLR, had the most remarkable success (AUC: 0,642). Conclusions: The factor analysis approach can be used to present an alternative perspective for predicting mortality in COVID-19 critical disease. The factor including CRP, fibrinogen, and ferritin predicted mortality at the highest rate in this study.

Chronic venous disease (CVD) is a proqgressive and underestimated condition related to a vicious circle established by venous reflux and endothelial inflammation, leading to vein dilation and histology distortion, including loss of media tone. Sulodexide (SDX) is a drug restoring the glycocalyx that demonstrated endothelial protection and permeability regulation, together with anti-thrombotic and anti-inflammatory roles. In the lab it also exhibited vein contractility function. The aim of the present study was to show the possible role of endothelium and nitric oxide pathway on SDX’s veno-contractile effect on human saphenous veins. The remnants of great saphenous vein (GSV) segments (n = 14) were harvested during coronary artery bypass graft surgery. They were dissected as endothelium-intact (n = 8) and denuded rings (n = 6). First, a viability test was carried out in bath with Krebs–Henseleit solution to investigate a control and basal tension value. After this, cumulative doses of SDX were applied to rings and contraction values were studied in endothelium-intact phenylephrine (PheE, 6 × 10⁻⁷ M) pre-contracted vein rings. Finally, endothelium-intact PheE pre-contacted vein rings were treated by nitric oxide synthase inhibitor Nω-nitro-L-arginine methyl ester (L-NAME, 10⁻⁴ M) for 10 min. Contraction protocol was applied, and contraction values were measured in cumulative doses of SDX. The same protocol was applied to endothelium-denuded vein rings to investigate the effect of SDX. Saphenous vein rings showed an increase in contraction to cumulative doses of SDX. In endothel-intact rings, KCL-induced contraction from 92.6% ± 0.3 to 112.9% ± 0.4 with cumulative SDX doses. However, SDX did not show any veno-contractile effect on endothel-denuded rings. In denuded rings contraction responses measured from 94.9% ± 0.3 to 85.2% ± 0.3 with increasing doses of SDX, indicating no significant change. Nitric oxide synthase inhibitor (L-NAME) prohibited the contraction response of the sulodexide in all dosages, indicating that the contractile function of SDX was mediated by endothelial derived nitric oxide. Results of endothel-intact and denuded rings with L-NAME showed a similar incline with denuded rings with SDX only. The results confirmed SDX’s veno-contractile effect in human samples, by means of nitric oxide synthase pathways involvement.