Background: This study aimed to investigate the incidence of postoperative atrial fibrillation (POAF) in patients undergoing off-pump versus on-pump coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB). Methods: A total of 3,197 consecutive patients (1,816 males, 1,381 females; mean age: 60.8 ± 9.8 years) with preoperative sinus rhythm who underwent CABG at a cardiovascular surgery clinic between November 2009 and March 2014 retrospectively were analyzed. Of the patients, 1,680 underwent on-pump and 1,517 underwent off-pump cardiac surgery. Data, including demographic characteristics, preoperative risk factors, preoperative medications, laboratory test results, postoperative data and complications, and mortality and morbidity rates, were recorded. Results: According to the multivariate analysis, the type of operation, number of anastomoses, right coronary artery or right coronary posterior descending artery graft, vasopressor therapy (epinephrine, norepinephrine), operation duration, age >60 years, hypertension, length of hospital stay >4 days, and obstructive sleep apnea syndrome (OSAS) were the independent predictors of POAF after CABG. Our study results suggest that on-pump CABG under CPB is correlated with POAF. Conclusion: We recommend using off-pump CABG in select cases to minimize the risk of POAF.

Aim: Fullerenol, a water-soluble C60-fullerene, has been demonstrated to scavenge free radicals in vitro and in vivo. The aim of the study was to investigate the effects of fullerenol C60 on lower skeletal muscles in a rat model of ischemia/reperfusion (I/R).Methods: After approval of the ethics committee, 30 Wistar Albino rat were divided into 5 groups with six animals per each as follows: Control (C), diabetes (D), diabetes+fullerenol C60 (DF), diabetes+I/R (group DIR) and diabetes I/R+fullerenol C60 (DIR-F) groups. Streptozotocin was administered to the rats to induce diabetes at a dose of 55 mg/kg. Four weeks after the onset of diabetes, rats were subjected to 2 hours of ischemia and 2 hours of reperfusion. At the end of the reperfusion period, skeletal muscle samples were taken from the lower extremity in all groups for histopathological and immunohistopathological examinations. Results: Myositis and endothelial caspase 3 enzyme activities were high in all groups, particularly DIR. Compared to C, DF and DIR-F groups, inflammation and myositis were significantly higher in the DIR group (P=0.001, P=0.006, P=0.001, respectively, and P=0.001, P=0.022, P=0.001, respectively). Vascular dilatation and congestion were significantly more prominent in all groups compared to the control group (P=0.001 for all).Conclusion: Our results confirm that fullerenol C60 has protective effects against skeletal muscle damage resulting from I/R in diabetic rats. Future studies conducted to evaluate these effects may help illuminate the action mechanism of fullerenol C60 and pathophysiology underlying the tissue damage related to I/R injury.

N-acetylcysteine (NAC) is an antioxidant which works as a free radical scavenger and antiapoptotic agent. N-acetylcysteine-amide (NACA) is a modified form of NAC containing an amide group instead of a carboxyl group of NAC. Our study aims to investigate the effectiveness of these two substances on erythrocyte deformability and oxidative stress in muscle tissue. Materials and Methods. A total of 24 Wistar albino rats were used in our study. The animals were randomly divided into five groups as control (n: 6), ischemia (n: 6), NAC (n: 6), and NACA (n: 6). In the ischemia, NAC, and NACA groups, 120min of ischemia and 120min of reperfusion were achieved by placing nontraumatic vascular clamps across the abdominal aorta. The NAC and NACA groups were administered an injection 30 min before ischemia (100mg/kg NAC; 100mg/kg NACA; intravenous). Blood samples were taken from the animals at the end of the ischemic period. The lower extremity gastrocnemius muscle was isolated and stored at 80 degrees to assess the total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values and was analyzed. Results. The erythrocyte deformability index was found to be statistically significantly lower in rats treated with NAC and NACA before ischemia-reperfusion compared to the groups that received only ischemia-reperfusion. In addition, no statistically significant difference was found between the control group and the NAC and NACA groups. The groups receiving NAC and NACA before ischemia exhibited higher total antioxidative status and lower total oxidative status while the oxidative stress index was also lower. Conclusion. The results of our study demonstrated the protective effects of NAC and NACA on erythrocyte deformability and oxidative damage in skeletal muscle in lower extremity ischemia-reperfusion. NAC and NACA exhibited similar protective effects on oxidative damage and erythrocyte deformability.

Ejmi Eurasian Journal of Medical Investigation

Ischemia-reperfusion (IR) injury significantly reduces erythrocyte deformability, leading to increased oxidative stress, inflammation, and impaired microvascular perfusion. This study aimed to examine the protective effects of hydroxytyrosol (HT), a powerful antioxidant derived from olives, on erythrocyte deformability and related oxidative stress markers in a rat model of hind limb ischemia-reperfusion injury. Twenty-four rats were randomly divided into four groups: Sham, HT-Sham, ischemia-reperfusion (IR), and IR treated with HT (IR-HT). HT was administered intraperitoneally at a dose of 10 mg/kg prior to ischemia induction. Following reperfusion, biochemical parameters, including malondialdehyde (MDA), superoxide dismutase (SOD), endothelial nitric oxide synthase (eNOS), erythrocyte deformability, and morphology, were evaluated. HT administration significantly improved erythrocyte deformability, decreased MDA levels, increased SOD activity, and moderated eNOS expression in the IR-HT group compared to the untreated IR group (p<0.001). Morphological analysis demonstrated substantial preservation of erythrocyte integrity, with fewer pathological changes such as echinocytes and dacrocytes. This study provides preliminary insights into the protective mechanisms of HT, highlighting its therapeutic potential in reducing erythrocyte dysfunction and oxidative damage during ischemia-reperfusion events. Further research exploring comprehensive signaling pathways and long-term clinical outcomes is advisable..

Ejmi Eurasian Journal of Medical Investigation