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        Serum Irisin Level Can Predict the Severity of Coronary Artery Disease in Patients with Stable Angina

        Tolga Han Efe,Çağrı Yayla,Burak Açar,Göktuğ Ertem,Kadriye Gayretli Yayla,Engin Algül,Sefa Ünal,Murat Bilgin,Tolga Çimen,Özgür Kirbaş,Ekrem Yeter 대한심장학회 2017 Korean Circulation Journal Vol.47 No.1

        Background and Objectives: The recently discovered myokine irisin has a proposed role in adipose tissue metabolism. The aim of this study was to evaluate the relationship between serum irisin level and the coronary artery severity in patients with stable coronary artery disease (CAD). Subjects and Methods: Sixty-three patients who underwent coronary angiography (CA) diagnosed with stable CAD and twenty-six patients with normal coronary artery (NCA) were enrolled in the study. Stable CAD patients were divided into two groups as high synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score (≥23) and lower SYNTAX score (<23). Serum irisin level measurement was carried out using human irisin colorimetric enzyme-linked immunosorbent assay (ELISA) commercial kit (AG-45A-0046EK-KI01, Adipogen, San Diego, CA, USA) as recommended by the manufacturer’s protocol. Results: The patients with stable CAD with a higher SYNTAX score (score ≥23) had significantly lower serum irisin levels (127.91±55.38 ng/mL), as compared the patients with a low SYNTAX score (score <23) (224.69±92.99 ng/mL) and control group (299.54±123.20 ng/mL). Irisin levels showed significant differences between all groups (p<0.001). Conclusion: Serum irisin level is an independent predictor of coronary artery severity in patients with stable CAD.

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        Central line-associated bloodstream infections in the intensive care unit: importance of the care bundle

        Aynur Atilla,Zahide Doğanay,Hale Kefeli Çelik,Leman Tomak,Özgür Günal,S. Sırrı Kılıç 대한마취통증의학회 2016 Korean Journal of Anesthesiology Vol.69 No.6

        Background: The importance and efficacy of a care bundle for preventing central line-associated bloodstream infections (CLABSIs) and infectious complications related to placing a central venous catheter (CVC) in patients in the intensive care unit (ICU). Methods: A care bundle was implemented from July 2013 to June 2014 in a medical ICU and surgical ICU. Data were divided into three periods: the prior period (July 2012–June 2013), the intervention period (July 2013–June 2014; first and second periods), and the post-intervention period (July 2014–December 2014; third period). A care bundle consisting of optimal hand hygiene, skin antisepsis with chlorhexidine (2%) allowing the skin to dry, maximal barrier precautions for inserting a catheter (sterile gloves, gown, mask, and drapes), choice of optimal insertion site, prompt catheter removal, and daily evaluation of the need for the CVC was introduced. Results: The catheterization duration was longer and femoral access was more frequently observed in patients with CLABSIs. CLABSI rates decreased with use of the care bundle. The CLABSI rate in the medical ICU was 6.20/1,000 catheter days during the prior period, 3.88/1,000 catheter days during the intervention period, and 1.05/1,000 catheter days during the third period. The CLABSI rate in the surgical ICU was 8.27/1,000, 4.60/1,000, and 3.73/1,000 catheter days during these three periods, respectively. Conclusions: The choice of an optimal catheter insertion site, use of all barrier precautions, and removal of catheters when they are no longer needed are essential to decrease the CLABSI rate.

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