In recent years, the prevalence of coronary artery disease (CAD) has become one of the leading causes of death around the world. Accurate stenosis detection of coronary arteries is crucial for timely treatment. Cardiologists use visual estimations when reading coronary angiography images to diagnose stenosis. As a result, they face various challenges which include high workloads, long processing times and human error. Computer-aided segmentation and classification of coronary arteries, as to whether stenosis is present or not, significantly reduces the workload of cardiologists and human errors caused by manual processes. Moreover, deep learning techniques have been shown to aid medical experts in diagnosing diseases using biomedical imaging. Thus, this study proposes the use of automatic segmentation of coronary arteries using U-Net, ResUNet-a, UNet++, models and classification using DenseNet201, EfficientNet-B0, Mobilenet-v2, ResNet101 and Xception models. In the case of segmentation, the comparative analysis of the three models has shown that U-Net achieved the highest score with a 0.8467 Dice score and 0.7454 Jaccard Index in comparison with UNet++ and ResUnet-a. Evaluation of the classification model’s performances has shown that DenseNet201 performed better than other pretrained models with 0.9000 accuracy, 0.9833 specificity, 0.9556 PPV, 0.7746 Cohen’s Kappa and 0.9694 Area Under the Curve (AUC).

Background: The distribution of gene variants in the Turkish Cypriot population with coronary artery disease has not been investigated. In this study, we sought to research different genetic variants in the susceptibility to coronary artery disease and to identify possible associations between various clinical parameters and the genes involved in blood coagulation as well as glucose and lipid metabolism among the Turkish Cypriots and compared the results with the respective Turkish patients from Turkey. Methods: A total of 187 individuals with coronary artery disease, namely 87 Turkish Cypriot individuals from Northern Cyprus, and 100 Turkish patients from Turkey, were investigated. The presence of CAD was documented with coronary angiography. The genetic susceptibility to coronary artery disease in the cohorts was studied using the variants FV Leiden (G1691A), Factor V R2 mutation (FVR2)(H1299R), PTH (G20210A), FXIII (V34L), β-Fibrinogen (-455 G>A), PAI-1 (4G/5G), HPA1 (a/b), MTHFR [C677T] and [A1298C], ACE (I/D), Apo B (R3500Q), and Apo E, in addition to the well-known risk factors associated with coronary artery disease.Results: Age, male sex, diabetes mellitus, hyperlipidemia, triglycerides, HDL, and triglyceride/HDL ratio were significantly associated with (P < .05); LDL (P = .05) and total cholesterol (P = .08) was marginally associated with coronary artery disease in the Turkish Cypriot population. The mutations in the MTHFR [C677T] gene variant were marginally higher in the Turkish Cypriot cohort when compared with the Turkish patients from Turkey (P = .06). No significant direct association of any of the gene variants with coronary artery disease in the Turkish Cypriot cohort could be defined. Several of the genetic variants were associated indirectly with the risk factors for coronary artery disease in Turkish Cypriots. MTHFR [A1298C] was found to be marginally associated with low HDL cholesterol (P = .08). MTHFR [C677] wild-type allele was significantly associated with a decreased rate of high LDL cholesterol (P < .05). The HPA-1 a/b variant was significantly associated with an increased rate of high total cholesterol levels (P < .05). Conclusion: Turkish Cypriot patients with coronary artery disease may be more affected by secondary factors, such as diabetes, hypertension, obesity, and sedentary life style when compared with genetic factors, which may be responsible for coronary artery disease.

Introduction: In this study, we evaluated patient response and haemodynamic parameters in patients with low ejection fraction undergoing coronary bypass surgery with either fentanil or remifentanil in conjunction with etomidate.Material and methods: We evaluated 30 cases of coronary artery surgery, which were divided into two treatment groups (n = 15 each). In group F (fentanil group), the following regimen was employed for anaesthesia induction: 1 mg/kg lidocaine, 0.3 mg/kg etomidate, and, following a 1 µg/kg 60 s bolus dose of fentanil, a 0.1 µg/kg/min fentanil infusion was initiated, after which 0.6 mg/kg rocuronium was administered. In group R (remifentanil group), the following regimen was employed for anaesthesia induction: 1 mg/kg lidocaine, 0.3 mg/kg etomidate and, following a 1 µg/kg 60 s bolus dose of remifentanil, a 0.1 µg/kg/min remifentanil infusion was initiated, after which 0.6 mg/kg rocuronium was administered. Systolic artery pressure, diastolic artery pressure, mean arterial pressure, heart rate, SPO2 (saturation), cardiac output, stroke volume variance, central venous pressure, and systemic vascular resistance values were recorded for all study patients at five minutes before anaesthetic induction (T1), immediately following induction (T2), and immediately following intubation (T3).Results: The demographic values obtained for both groups were similar. We found that remifentanil use was associated with decreased cardiac output and increased fluctuations in both heart rate and mean values of arterial pressure.Conclusions: Although many studies have demonstrated remifentanil to be as safe as fentanil when titrated to an appropriate dose, our study suggests that fentanil may be a more appropriate choice during the induction of anaesthesia in patients with a low ejection fraction.

Pulmonary embolism is a rare complication of abdominoplasty and liposuction that may result in a fatal consequence. A 65-year-old obese woman presented with complaints of shortness of breath, palpitation, and hypotension (90/60 mmHg) seven weeks after abdominoplasty and liposuction. The electrocardiogram showed sinus tachycardia, right axis deviation, and right bundle branch block. The chest X-ray showed atelectatic and focally infiltrated areas, and minimal bilateral pleural effusion. Laboratory findings were normal except for D-dimer level (3500 ng/ml). Echocardiography revealed dilated right heart chambers and a thrombus in the left ventricle. Ejection fraction was normal and pulmonary artery pressure was 50 mmHg. Doppler ultrasound showed no signs of thrombosis. Following the diagnosis of pulmonary thromboembolism, the patient received oxygen therapy and heparin infusion. However, the clinical course did not improve, hemodynamic deterioration continued, and the echocardiographic appearance of the thrombus persisted, so thrombolytic therapy with tissue plasminogen activator was administered, which also resulted in no response. In the end, pulmonary embolectomy was performed and the thrombus was successfully extracted. The patient had an uneventful postoperative course and was discharged on the seventh postoperative day.

Background: We aimed to analyze the association between lipid variables and the extent and severity of coronary artery disease (CAD) in non-diabetic Turkish Cypriots. Methods: Overall, 412 patients (mean (SD) age: 58.8 (10.5) yr, 50.1% male) who underwent diagnostic coronary angiography were included in this single-center, cross-sectional study. The Friesinger index (FI) was used to assess the extent and severity of CAD. The lipid variables [total cholesterol, LDL-c, HDL-c, triglyceride (TG) levels and the TG/HDL-C ratio] were categorized into quartiles and evaluated regarding extensive/severe CAD. Potential risk factors in the Turkish Cypriot cohort were evaluated as predictors of CAD in univariate and multivariate logistic regression models. The population of this study are non-diabetic Turkish Cypriots which are administrated North Cyprus. Results: The mean (SD) Friesinger index was 6.9 (4.4), and 59.0% of the patients exhibited a Friesinger index category of >= 5. In the univariate analysis, extensive/severe CAD was directly related to total triglycerides (P=0.01) and TG/ HDL-c quartiiles (P=0.001) and inversely related to HDL-c quartiles (P=0.001). In the multivariate model, diabetes (OR: 4.9; 95% CI: 1.3 - 19.2; P=0.02), male gender (OR: 3.1; 95% CI: 0.95 - 10.3; P=0.06) and high TG/HDL-c ratio (OR: 2.2; 95% CI: 1.3 - 3.8; P=0.004 in the overall population and OR: 1.9; 95% CI: 1.4 - 2.3; P=0.003 except diabetics) were the significant predictors of CAD. Conclusion: We found a significant relationship between the lipid quartiles and the extent and severity of CAD based on the Friesinger index. Male gender, co-morbid diabetes and the TG/HDL-C ratio also played significant roles in predicting CAD risk in non-diabetic Turkish Cypriots.