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Bora E, Eyuboglu MS, Cesim E, Demir M, Yalincetin B, Ermis C, Özbek Uzman S, Sut E, Demirlek C, Verim B, Baykara B, İnal N, Akdede BB. Social cognition and neurocognition in first-episode bipolar disorder and psychosis: The effect of negative and attenuated positive symptoms. J Affect Disord 2024; 351:356-363. [PMID: 38290586 DOI: 10.1016/j.jad.2024.01.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/13/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Schizophrenia and bipolar disorder are associated with neurocognitive and social-cognitive impairments. To date very few studies investigated social cognition in first-episode bipolar disorder (FEBD). Our main aim was to investigate the differences in social cognition and neurocognition between FEBD and first-episode psychosis (FEP). Another aim was to investigate neurocognitive correlates of negative symptoms and attenuated psychotic symptoms in FEBD. METHODS This study included 55 FEBD, 64 FEP and 43 healthy controls. A comprehensive neuropsychological battery assessing social cognition, processing speed, verbal and visual memory, working memory, sustained attention, and executive functions was administered to all participants. RESULTS Both FEBD and FEP were associated with widespread deficits in all neurocognitive domains and social cognition. Both FEP (d = -1.19) and FEBP (d = -0.88) were also impaired in social cognition. In FEP, effect sizes (Cohen's d) of neurocognitive deficits ranged from -0.71 to -1.56. FEBD was also associated with relatively milder but similar neurocognitive deficits (d = -0.61 to-1.17). FEBD group performed significantly better than FEP group in verbal and visual memory, processing speed, and executive function domains (d = -0.40 to-0.52). Negative symptoms and social functioning were associated with neuropsychological impairment in both groups. The severity of attenuated psychotic symptoms was associated with poorer verbal memory in FEBD (r = -0.39, p < 0.01). LIMITATIONS The cross-sectional nature of the current study is the main limitation. CONCLUSIONS Neurocognitive and social-cognitive deficits are evident in both FEBD and FEP. In FEBD, more severe memory deficits might be markers of clinical overlap and shared neurobiological vulnerability with psychotic disorders.
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Affiliation(s)
- E Bora
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia.
| | - M S Eyuboglu
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - E Cesim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - M Demir
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - B Yalincetin
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - C Ermis
- Queen Silvia Children's Hospital, Department Child and Adolescent Psychiatry, Gothenburg, Sweden
| | - S Özbek Uzman
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - E Sut
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - C Demirlek
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - B Verim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - B Baykara
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - N İnal
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - B B Akdede
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
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Bayrak HC, Adiguzel IF, Demir M, Tarlacık AO. Tranexamic Acid and Tourniquet: Which Combination Reduces Blood Loss Most Effectively? Niger J Clin Pract 2024; 27:521-527. [PMID: 38679776 DOI: 10.4103/njcp.njcp_3_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 02/27/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Blood loss during and after total knee arthroplasty (TKA) can lead to substantial morbidity and the need for blood transfusions. There are several methods to minimize blood loss and decrease transfusion rates in patients undergoing TKA. Tranexamic acid, an antifibrinolytic agent with known efficacy for achieving these goals, is combined with tourniquets to reduce bleeding in arthroplasty surgeries. Our study investigated the effects of various combinations of tranexamic acid and tourniquet use on bleeding in knee arthroplasty in 558 patients. AIM We aimed to determine the method that would provide the least blood loss and transfusion need in knee arthroplasty surgery. METHODS Between January 2018 and December 2022, 558 patients aged between 55 and 85 years underwent TKA surgery for grade 4 gonarthrosis in our clinic, and their decrease in hemoglobin value and whether they were transfused or not were analyzed. The patients were divided into four groups based on use of tranexamic acid and tourniquet. Demographic variables and patient data (body mass index, INR values, and preoperative hemoglobin values) were recorded. RESULTS There were 558 patients with a mean age of 68.19 (67 ± 6.949) years. In group 1, tranexamic acid was not used in 128 patients and tourniquet was used only during cementation; in group 2, in 132 patients, tranexamic acid was not used and tourniquet was used throughout the surgery; in group 3, in 158 patients, tranexamic acid was used and tourniquet was used throughout the surgery; in group 4, in 140 patients, tranexamic acid was used and tourniquet was used only during cementation. The decrease in hemoglobin value and transfusion rate was lowest in group 3 and highest in group 1. Besides, there was a greater decrease in hemoglobin value in group 2 than in group 4 and the transfusion rate was similar. CONCLUSIONS This clinical study showed that using tranexamic acid and a tourniquet throughout surgery significantly reduced the decrease in hemoglobin value and the need for transfusion.
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Affiliation(s)
- H C Bayrak
- Department of Orthopaedics and Traumatology, Eskisehir Yunus Emre State Hospital, Eskisehir, Turkey
| | - I F Adiguzel
- Department of Orthopaedics and Traumatology, Ankara Etlik City Hospital, Ankara, Turkey
| | - M Demir
- Department of Orthopaedics and Traumatology, Tokat Zile State Hospital, Tokat, Turkey
| | - A O Tarlacık
- Department of Orthopaedics and Traumatology, Eskisehir City Hospital, Eskişehir, Turkey
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Bora E, Eyuboglu MS, Cesim E, Demir M, Yalincetin B, Ermis C, Özbek Uzman S, Sut E, Demirlek C, Verim B, Baykara B, Akay A, İnal N, Akdede BB. Neurocognition and social cognition in youth and young adults at ultra-high-risk for psychosis and bipolar disorder. Schizophr Res 2024; 266:58-65. [PMID: 38368706 DOI: 10.1016/j.schres.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 02/01/2024] [Accepted: 02/11/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Schizophrenia and bipolar disorder are associated with significant deficits in neurocognition and social cognition. Unlike the studies in chronic stages of these disorders, very limited information is available regarding neurocognitive and social-cognitive impairment before the onset of bipolar disorder. Our main aim was to investigate the differences in neurocognition and social cognition between individuals at ultra-high risk for psychosis (UHR-P) and bipolar disorder (UHR-BD). METHODS This study included 152 help-seeking individuals identified as UHR-P (n = 78) and UHR-BD (n = 74), who were compared with a healthy control group (n = 43). A comprehensive neuropsychological battery was administered to all participants. RESULTS UHR-P was associated with widespread deficits in all neurocognitive and social-cognitive domains. Effect sizes (Cohen's d) of these deficits ranged from -0.57 to -1.34. UHR-BD was associated with significant deficits in processing speed, executive functions, sustained attention and social cognition (d = -0.48 to-0.70, p < 0.05). UHR-P performed significantly worse than UHR-BD in social cognition, processing speed, verbal memory and executive function domains (d = -0.39 to-0.64, p < 0.05). Negative symptoms were associated with impaired social cognition in the UHR-P group and verbal memory deficits in the UHR-BD group. Cognitive impairment was associated with functional impairment in both groups. CONCLUSIONS While UHR-P is associated with more widespread cognitive impairment, deficits in processing speed, executive functions, sustained attention and social cognition might be common features of both UHR groups. In early intervention services, cognition should be considered as a target for assessment and intervention not only for individuals at high risk for psychosis but also for bipolar disorder.
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Affiliation(s)
- E Bora
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia.
| | - M S Eyuboglu
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - E Cesim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - M Demir
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - B Yalincetin
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - C Ermis
- Queen Silvia Children's Hospital, Department Child and Adolescent Psychiatry, Gothenburg, Sweden
| | - S Özbek Uzman
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - E Sut
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - C Demirlek
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - B Verim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - B Baykara
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - A Akay
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - N İnal
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - B B Akdede
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
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Demir M, Balkiz Soyal Ö, Aytaç BG. Assessment of Optic Nerve Sheath Diameter in Patients Undergoing Endoscopic Retrograde Cholangiopancreatography: A Prospective, Randomized, Controlled Double-Blinded Comparison of Propofol and Ketofol Anesthesia. Niger J Clin Pract 2024; 27:22-28. [PMID: 38317031 DOI: 10.4103/njcp.njcp_876_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 12/17/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND ERCP is an endoscopic procedure for the diagnosis and treatment of biliopancreatic system diseases. An increase in intra-abdominal pressure due to the insufflation of air to the intestinal lumen may be transmitted to ICP through the course of ERCP. In this prospective, randomized, controlled double-blinded study, we aimed to assess the ICP change using ultrasonography measurement of ONSD in patients undergoing ERCP comparing the effects of propofol and ketofol anesthesia. MATERIAL/METHODS One hundred and nine patients undergoing ERCP under propofol or ketofol anesthesia were enrolled in the study. Ultrasonography measurement of ONSD was performed before (T0) and immediately after induction of anesthesia (T1), during sphincterotomy (T2), at the end of procedure (T3), and after the patient is fully awake (T4). RESULTS Comparison of ONSD values and ONSD alteration between groups showed no statistically significant difference (P > 0.05). Both groups showed significantly greater changes from T0 to T2 compared with values from T0 to T1, T3, and T4, respectively (P = 0,000). T0 to T3 alteration was also significantly greater than T0 to T1 and T4 change in both groups (P = 0,000). CONCLUSIONS ERCP procedure increases intracranial pressure most prominently during sphincterotomy both under propofol or ketofol anesthesia. Further studies are needed to investigate the impact of this phenomenon on adverse clinical outcomes.
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Affiliation(s)
- M Demir
- Anesthesiology Department, Kars Kağızman State Hospital, Kars, Turkey
| | - Ö Balkiz Soyal
- Anesthesiology Department, Ankara City Hospital, Anesthesiology and Reanimation Clinic, Ankara, Turkey
| | - B G Aytaç
- Anesthesiology Department, Ankara City Hospital, Anesthesiology and Reanimation Clinic, Ankara, Turkey
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Demir M, Altinoz E, Koca O, Elbe H, Onal MO, Bicer Y, Karayakali M. Antioxidant and anti-inflammatory potential of crocin on the doxorubicin mediated hepatotoxicity in Wistar rats. Tissue Cell 2023; 84:102182. [PMID: 37523948 DOI: 10.1016/j.tice.2023.102182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023]
Abstract
Doxorubicin (DXR) is widely used in cancer treatment. However, it has not yet been possible to prevent the side effects of DXR. The aim of this study was to investigate the hepatoprotective effect of crocin against DXR used in cancer treatment. For this reason; forty Wistar rats (male-250-300 g) were allocated into four groups (n = 10/group): Control, Crocin, DXR and DXR+Crocin. Control and Crocin groups were administered saline and crocin (40 mg/kg, i.p) for 15 days, respectively. DXR group, cumulative dose 12 mg/kg DXR, was administered for 12 days via 48 h intervals in six injections (2 mg/kg each, i.p). DXR+Crocin group, crocin (40 mg/kg-i.p) was administered for 15 days, and DXR was given as in the DXR group. The results revealed that serum liver markers (alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP) increased significantly after DXR administration but recovered after crocin therapy. In addition, lipid peroxidation (MDA), and inflammatory cytokine (TNF-α) increased after DXR application and the antioxidative defense system (GSH, SOD, CAT) significantly decreased and re-achieved by crocin treatment. Our results conclude that crocin treatment was related to ameliorated hepatocellular architecture and reduced hepatic oxidative stress and inflammation in rats with DXR-induced hepatotoxicity.
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Affiliation(s)
- M Demir
- Department of Physiology, Faculty of Medicine, Karabuk University, Karabuk, Turkey.
| | - E Altinoz
- Department of Medical Biochemistry, Faculty of Medicine, Karabuk University, Karabuk, Turkey
| | - O Koca
- Department of Biochemistry, Karabuk University Education and Research Hospital, Karabuk, Turkey
| | - H Elbe
- Department of Histology and Embryology, Faculty of Medicine, Mugla Sıtkı Kocman University, Mugla, Turkey
| | - M O Onal
- Department of Histology and Embryology, Faculty of Medicine, Mugla Sıtkı Kocman University, Mugla, Turkey
| | - Y Bicer
- Department of Medical Biochemistry, Faculty of Medicine, Karabuk University, Karabuk, Turkey
| | - M Karayakali
- Department of Medical Biochemistry, Faculty of Medicine, Karabuk University, Karabuk, Turkey
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Sagir S, Seker U, Pekince Ozoner M, Yuksel M, Demir M. Oxidative stress, apoptosis, inflammation, and proliferation modulator function of visnagin provide gonadoprotective activity in testicular ischemia-reperfusion injury. Eur Rev Med Pharmacol Sci 2023; 27:9968-9977. [PMID: 37916367 DOI: 10.26355/eurrev_202310_34176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
OBJECTIVE: Visnagin (Vis) is a compound found in the flowers and seeds of the Ammi visnaga plant with promising antioxidant and anti-inflammatory properties. We aimed to investigate the dose-dependent gonadoprotective effects of visnagin in rats while considering oxidative stress, apoptosis, and inflammation-related protein expression levels. MATERIALS AND METHODS: Twenty-eight adult rats were divided into four groups of seven animals each; control, ischemia/reperfusion (I/R), I/R+30Vis, and I/R+60Vis. Animals in control received no surgical application and were sacrificed at the end of the experiment. The rats in I/R, I/R + Vis30, and I/R + Vis60 were exposed to testicular ischemia and the animals in I/R + Vis30, and I/R + Vis60 groups received either 30 or 60 mg/kg visnagin intraperitoneal. At the end of the experiment, testis tissues were used for the measurement of oxidative stress, apoptosis, and inflammation. RESULTS: Our microscopic examinations indicated that I/R resulted in testicular degenerations and morphological alterations, which were improved in visnagin-treated animals. The biochemical analyses demonstrated that oxidative stress in the I/R group increased significantly (p<0.05) compared to the control group. The immunohistochemical examinations showed that pro-apoptotic Bax and Caspase 3 expressions, and pro-inflammatory tumor necrosis factor-alpha (TNF-α) levels were significantly up-regulated (p<0.05) but proliferating nuclear antigen (PCNA) levels in I/R group was significantly (p<0.001) down-regulated compared to the control group. CONCLUSIONS: Ischemia leading to testicular torsion is a reproductive health-affecting problem, and current surgical treatment methods might be insufficient to recover the testis due to the accumulation of reactive oxygen species (ROS). Our observations indicate that visnagin is a potential co-modality along with the surgical interventions for the recovery of ischemia encountered testis, but we believe the requirement of more detailed studies to explore the underlying signaling pathways and the strength of visnagin against testicular ischemia-reperfusion injury. Graphical Abstract https://www.europeanreview.org/wp/wp-content/uploads/GRAB.jpg.
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Affiliation(s)
- S Sagir
- Department of Urology, Faculty of Medicine, Mardin Artuklu University, Mardin, Turkey.
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Demir M, Şahan MH. Evaluation of the relationship between trochlear and patellar morphology and patellar chondromalacia with magnetic resonance imaging. Acta Orthop Belg 2023; 89:409-416. [PMID: 37935222 DOI: 10.52628/89.3.11782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
It was aimed to investigate the relationship between magnetic resonance imaging (MRI) measurements of trochlear and patellar morphology and grade 3-4 patellar chondromalacia. Grade 3-4 patellar chondromalacia group, and an age- and sex-matched control group with normal patellar joint cartilage were comprised. For trochlear morphology evaluation in MRI; sulcus angle, trochlear angle, lateral trochlear inclination angle and medial trochlear inclination angle were measured. For patellar morphology evaluation; patella trochlear ratio, insall-salvati ratio, modified Insall- Salvati ratio and Blackburne-Peel ratio were measured. Obtained measurements were statistically analyzed according to demographic characteristics. One hundred and twenty-five patients with chondromalacia and 125 controls participated. The sulcus angle and the trochlear angle were significantly higher in the patellar chondromalacia group (p<0.05). The lateral trochlear inclination angle was significantly less in the patellar chondromalacia group (p=0.011). There was no significant difference between the groups in terms of medial trochlear inclination angle (p=0.520). There was no significant difference between the groups in terms of patella-trochlear ratio (p=0.617). Insall-Salvati ratio was significantly higher in the patellar chondromalacia group (p=0.003). Modified Insall-Salvati ratio was significantly lower in the patellar chondromalacia group (p=0.001). The rate of Blackburne-Peel was significantly higher in the patellar chondromalacia group (p=0.004). Measurements of sulcus angle, trochlear angle, lateral trochlear inclination angle, Insall-Salvati ratio, modified Insall-Salvati ratio, Blackburne-Peel ratio have diagnostic value for grade 3-4 chondromalacia.
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Karaçalılar M, Demir M. A novel predictor in patients undergoing heart valve surgery: systemic inflammation response index: a single center cross-sectional study. Eur Rev Med Pharmacol Sci 2023; 27:1016-1022. [PMID: 36808347 DOI: 10.26355/eurrev_202302_31196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE Inflammation plays a pivotal role in heart valve disease (HVD). This study aimed at evaluating the prognostic value of systemic inflammation response index (SIRI) after valve replacement surgery. SUBJECTS AND METHODS The study enrolled 90 patients who underwent valve replacement surgery. SIRI was calculated using laboratory data on admission. Receiver operating characteristic (ROC) analysis was used to calculate the optimal cutoff values of SIRI for predicting mortality. Univariable and multivariable COX analysis was used to assess the relationship of SIRI with clinical outcomes. RESULTS 5-year mortality rate was higher in SIRI ≥1.55 group than SIRI <1.55 group [16 (38.1%) vs. 9 (18.8%)]. In receiver operating characteristic analysis, the optimal cutoff values for SIRI were 1.55 (area under the curve 0.654, p: 0.025). Univariable analysis revealed that SIRI [OR: 1.41, 95%CI (1.13-1.75), p<0.001] was an independent predictor of 5-years mortality. Multivariable analysis revealed that glomerular filtration rate (GFR) [OR: 0.98, 95%CI (0.97-0.99)] was an independent predictor of 5-years mortality. CONCLUSIONS Although SIRI is a preferable parameter for the detection of long-term mortality, it failed to predict in-hospital and 1-year mortality. Larger multi-center studies are needed to investigate effect of SIRI on prognosis.
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Affiliation(s)
- M Karaçalılar
- Department of Cardiovascular Surgery, Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey.
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Özbek M, Akıl MA, Demir M, Arık B, Demir F, Akıl E. Prognostic importance of nutritional assessment in patients with acute ischemic stroke undergoing endovascular thrombectomy. Eur Rev Med Pharmacol Sci 2023; 27:960-968. [PMID: 36808342 DOI: 10.26355/eurrev_202302_31189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE The prevalence of malnutrition in patients with acute ischemic stroke (AIS) can range from 8% to 34%. It has been shown that prognostic nutritional index (PNI) and control nutritional status (CONUT) scores can provide an opportunity to make prognostic predictions in some disease groups. Previous studies have shown a close relationship between malnutrition scores and stroke prognosis. We evaluated the effect of nutritional scores on in-hospital and long-term mortality in AIS patients undergoing endovascular therapy (EVT). PATIENTS AND METHODS 219 patients who underwent EVT for the AIS were included in this retrospective design and cross-sectional study. The primary endpoint of the study was accepted as all-cause death including in-hospital death, 1-year death, and 3-years death. RESULTS A total of 57 patients died in the hospital. In-hospital mortality rate was higher in the high CONUT group [36 (49.3%), 10 (13.7%), 11 (15.1%), p<0.001]. A total of 78 patients died within one year, and 1-year mortality was higher in the high CONUT group [43 (58.9%), 21 (28.8), 14 (19.2), p<0.001]. At the end of the 3-year follow-up, 90 patients had died, and the 3-year mortality rate was significantly higher in groups with a high CONUT score than in those with a low CONUT score (p<0.001). CONCLUSIONS A higher CONUT score, calculated easily by simple scoring with parameters studied from peripheral blood before the EVT procedure, is an independent predictor of in-hospital, 1-year, and 3-years all-cause mortality.
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Affiliation(s)
- M Özbek
- Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
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Sarier M, Demir M, Emek M, Özgen A, Turgut H, Özdemir C. Association between selective serotonin and serotonin-noradrenaline reuptake inhibitor therapy and hematuria. Nord J Psychiatry 2023; 77:31-35. [PMID: 35243962 DOI: 10.1080/08039488.2022.2047224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) are used as first-line treatment for many psychiatric diseases, especially major depressive disorder. However, an important side effect of these drugs is the risk of bleeding due to platelet dysfunction. The aim of this study was to determine the frequency of hematuria in patients using SSRI/SNRIs and to compare with a control group. METHODS This study included patients who were followed up and treated with SSRI/SNRI in the psychiatric outpatient clinic of the Antalya Medical Park Hospital between 1 January 2021 and 31 March 2021 and a control group comprising patients who presented to the medical check-up outpatient clinic between the same dates. Complete urinalysis was performed for all patients and the results were compared between the groups. RESULTS Each group included 100 patients with a female/male ratio of 1. The mean age was 41.45 ± 13.47 (16-74) years in the study group and 40.51 ± 13.75 (20-70) years in the control group (p = 0.519). Mean duration of SSRI/SNRI use in the study group was 13.35 ± 1.32 (1-64) months. The prevalence of hematuria was 17% in the SSRI/SNRI group and 6% in the control group (p = 0.015). All cases of hematuria were microscopic hematuria. CONCLUSION Hematuria is significantly more common in patients receiving SSRI/SNRI treatment. The use of SSRI/SNRI should also be taken into account when investigating the etiology of hematuria.
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Affiliation(s)
- Mehmet Sarier
- Department of Urology, Istinye University, Istanbul, Turkey.,Department of Urology, Medical Park Hospital, Antalya, Turkey
| | - Meltem Demir
- Vocational School of Health Services, Antalya Bilim University, Turkey
| | - Mestan Emek
- Department of Public Health, Akdeniz University, Antalya, Turkey
| | - Ali Özgen
- Department of Pschiatry, Medical Park Hospital, Antalya, Turkey
| | - Hasan Turgut
- Faculty of Health Science, Avrasya University, Trabzon, Turkey
| | - Candan Özdemir
- Department of Neurology, Medical park Hospital, Antalya, Turkey
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Acar N, Demir M, Aki Z, Ozakin E, Canaki M. 395 Is Lower Extremity Venography Necessary in Pulmonary Embolism CT Imaging? Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Roeb E, Canbay A, Bantel H, Bojunga J, de Laffolie J, Demir M, Denzer UW, Geier A, Hofmann WP, Hudert C, Karlas T, Krawczyk M, Longerich T, Luedde T, Roden M, Schattenberg J, Sterneck M, Tannapfel A, Lorenz P, Tacke F. Aktualisierte S2k-Leitlinie nicht-alkoholische Fettlebererkrankung der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – April 2022 – AWMF-Registernummer: 021–025. Z Gastroenterol 2022; 60:1346-1421. [PMID: 36100202 DOI: 10.1055/a-1880-2283] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- E Roeb
- Gastroenterologie, Medizinische Klinik II, Universitätsklinikum Gießen und Marburg, Gießen, Deutschland
| | - A Canbay
- Medizinische Klinik, Universitätsklinikum Knappschaftskrankenhaus Bochum, Bochum, Deutschland
| | - H Bantel
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover (MHH), Hannover, Deutschland
| | - J Bojunga
- Medizinische Klinik I Gastroent., Hepat., Pneum., Endokrin., Universitätsklinikum Frankfurt, Frankfurt, Deutschland
| | - J de Laffolie
- Allgemeinpädiatrie und Neonatologie, Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Gießen und Marburg, Gießen, Deutschland
| | - M Demir
- Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum und Campus Charité Mitte, Berlin, Deutschland
| | - U W Denzer
- Klinik für Gastroenterologie und Endokrinologie, Universitätsklinikum Gießen und Marburg, Marburg, Deutschland
| | - A Geier
- Medizinische Klinik und Poliklinik II, Schwerpunkt Hepatologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - W P Hofmann
- Gastroenterologie am Bayerischen Platz - Medizinisches Versorgungszentrum, Berlin, Deutschland
| | - C Hudert
- Klinik für Pädiatrie m. S. Gastroenterologie, Nephrologie und Stoffwechselmedizin, Charité Campus Virchow-Klinikum - Universitätsmedizin Berlin, Berlin, Deutschland
| | - T Karlas
- Klinik und Poliklinik für Onkologie, Gastroenterologie, Hepatologie, Pneumologie und Infektiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - M Krawczyk
- Klinik für Innere Medizin II, Gastroent., Hepat., Endokrin., Diabet., Ern.med., Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | - T Longerich
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - T Luedde
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - M Roden
- Klinik für Endokrinologie und Diabetologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - J Schattenberg
- I. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Mainz, Deutschland
| | - M Sterneck
- Klinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Universitätsklinikum Hamburg, Hamburg, Deutschland
| | - A Tannapfel
- Institut für Pathologie, Ruhr-Universität Bochum, Bochum, Deutschland
| | - P Lorenz
- Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS), Berlin, Deutschland
| | - F Tacke
- Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum und Campus Charité Mitte, Berlin, Deutschland
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Özbek M, Zihni Bilik M, Demir M, Arik B, Şimşek H, Ertaş F, Toprak N. Global longitudinal strain score predicts all cause death in patients with chronic total occlusion with preserved ejection fraction. Eur Rev Med Pharmacol Sci 2022; 26:6251-6258. [PMID: 36111926 DOI: 10.26355/eurrev_202209_29648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Change in LVEF is one of the most important indicators of prognosis in CTO cases. Studies in patients with CTO have shown improvement in LVEF approximately at 3 and 6 months after successful PCI. It has been shown that LV global longitudinal strain (GLS) starts to improve even 1 day after CTO-PCI. We aimed at investigating the effect of subclinical echocardiographic involvement on all-cause mortality in the group with CTO and preserved ejection fraction by evaluating the LV GLS score. PATIENTS AND METHODS Patients with LVEF ≥ 50% were considered to have preserved ejection fraction and were included in the study. The endpoint of the study was all-cause death. For this retrospective study, 1,171 patients with coronary angiography who had had CTO in any of their vessels were screened. RESULTS A total of 86 consecutive patients were reviewed in the study. The optimum GLS score cut-off value (≥ 14.18) for predicting mortality was determined using receiver operating characteristic (ROC) curve analysis (AUC: 0.897, sensitivity 87.5%, specificity 81.5% p<0.001). At a mean follow-up of 49 months, a significant difference was found between the two groups in all-cause mortality determined by the GLS score [2 (3.4%) vs. 14 (51.9%), p<0.001]. A significant difference in mortality was observed between the group with a low GLS score and the group with a high GLS score, according to Kaplan-Meier analysis. The effect of GLS score in predicting all-cause mortality was demonstrated in multivariate cox regression analysis (Low GLS score; OR: 6.36 95%CI (1.039-39.013), p=0.045). Cox regression multivariate analysis and the effect of GLS score in predicting mortality were observed [Low GLS score; OR: 6.368 95%CI (1.039-39.013), p=0.045]. CONCLUSIONS As a predictor, GLS may be a valuable marker of cardiac subclinical dysfunction for all caused mortality in CTO patients.
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Affiliation(s)
- M Özbek
- Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
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Proietti M, Romiti GF, Vitolo M, Harrison SL, Lane DA, Fauchier L, Marin F, Näbauer M, Potpara TS, Dan GA, Maggioni AP, Cesari M, Boriani G, Lip GYH, Ekmekçiu U, Paparisto V, Tase M, Gjergo H, Dragoti J, Goda A, Ciutea M, Ahadi N, el Husseini Z, Raepers M, Leroy J, Haushan P, Jourdan A, Lepiece C, Desteghe L, Vijgen J, Koopman P, Van Genechten G, Heidbuchel H, Boussy T, De Coninck M, Van Eeckhoutte H, Bouckaert N, Friart A, Boreux J, Arend C, Evrard P, Stefan L, Hoffer E, Herzet J, Massoz M, Celentano C, Sprynger M, Pierard L, Melon P, Van Hauwaert B, Kuppens C, Faes D, Van Lier D, Van Dorpe A, Gerardy A, Deceuninck O, Xhaet O, Dormal F, Ballant E, Blommaert D, Yakova D, Hristov M, Yncheva T, Stancheva N, Tisheva S, Tokmakova M, Nikolov F, Gencheva D, Shalganov T, Kunev B, Stoyanov M, Marchov D, Gelev V, Traykov V, Kisheva A, Tsvyatkov H, Shtereva R, Bakalska-Georgieva S, Slavcheva S, Yotov Y, Kubíčková M, Marni Joensen A, Gammelmark A, Hvilsted Rasmussen L, Dinesen P, Riahi S, Krogh Venø S, Sorensen B, Korsgaard A, Andersen K, Fragtrup Hellum C, Svenningsen A, Nyvad O, Wiggers P, May O, Aarup A, Graversen B, Jensen L, Andersen M, Svejgaard M, Vester S, Hansen S, Lynggaard V, Ciudad M, Vettus R, Muda P, Maestre A, Castaño S, Cheggour S, Poulard J, Mouquet V, Leparrée S, Bouet J, Taieb J, Doucy A, Duquenne H, Furber A, Dupuis J, Rautureau J, Font M, Damiano P, Lacrimini M, Abalea J, Boismal S, Menez T, Mansourati J, Range G, Gorka H, Laure C, Vassalière C, Elbaz N, Lellouche N, Djouadi K, Roubille F, Dietz D, Davy J, Granier M, Winum P, Leperchois-Jacquey C, Kassim H, Marijon E, Le Heuzey J, Fedida J, Maupain C, Himbert C, Gandjbakhch E, Hidden-Lucet F, Duthoit G, Badenco N, Chastre T, Waintraub X, Oudihat M, Lacoste J, Stephan C, Bader H, Delarche N, Giry L, Arnaud D, Lopez C, Boury F, Brunello I, Lefèvre M, Mingam R, Haissaguerre M, Le Bidan M, Pavin D, Le Moal V, Leclercq C, Piot O, Beitar T, Martel I, Schmid A, Sadki N, Romeyer-Bouchard C, Da Costa A, Arnault I, Boyer M, Piat C, Fauchier L, Lozance N, Nastevska S, Doneva A, Fortomaroska Milevska B, Sheshoski B, Petroska K, Taneska N, Bakrecheski N, Lazarovska K, Jovevska S, Ristovski V, Antovski A, Lazarova E, Kotlar I, Taleski J, Poposka L, Kedev S, Zlatanovik N, Jordanova S, Bajraktarova Proseva T, Doncovska S, Maisuradze D, Esakia A, Sagirashvili E, Lartsuliani K, Natelashvili N, Gumberidze N, Gvenetadze R, Etsadashvili K, Gotonelia N, Kuridze N, Papiashvili G, Menabde I, Glöggler S, Napp A, Lebherz C, Romero H, Schmitz K, Berger M, Zink M, Köster S, Sachse J, Vonderhagen E, Soiron G, Mischke K, Reith R, Schneider M, Rieker W, Boscher D, Taschareck A, Beer A, Oster D, Ritter O, Adamczewski J, Walter S, Frommhold A, Luckner E, Richter J, Schellner M, Landgraf S, Bartholome S, Naumann R, Schoeler J, Westermeier D, William F, Wilhelm K, Maerkl M, Oekinghaus R, Denart M, Kriete M, Tebbe U, Scheibner T, Gruber M, Gerlach A, Beckendorf C, Anneken L, Arnold M, Lengerer S, Bal Z, Uecker C, Förtsch H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, Holst Hansen C, Engset I, Atar D, Dyduch-Fejklowicz B, Koba E, Cichocka M, Sokal A, Kubicius A, Pruchniewicz E, Kowalik-Sztylc A, Czapla W, Mróz I, Kozlowski M, Pawlowski T, Tendera M, Winiarska-Filipek A, Fidyk A, Slowikowski A, Haberka M, Lachor-Broda M, Biedron M, Gasior Z, Kołodziej M, Janion M, Gorczyca-Michta I, Wozakowska-Kaplon B, Stasiak M, Jakubowski P, Ciurus T, Drozdz J, Simiera M, Zajac P, Wcislo T, Zycinski P, Kasprzak J, Olejnik A, Harc-Dyl E, Miarka J, Pasieka M, Ziemińska-Łuć M, Bujak W, Śliwiński A, Grech A, Morka J, Petrykowska K, Prasał M, Hordyński G, Feusette P, Lipski P, Wester A, Streb W, Romanek J, Woźniak P, Chlebuś M, Szafarz P, Stanik W, Zakrzewski M, Kaźmierczak J, Przybylska A, Skorek E, Błaszczyk H, Stępień M, Szabowski S, Krysiak W, Szymańska M, Karasiński J, Blicharz J, Skura M, Hałas K, Michalczyk L, Orski Z, Krzyżanowski K, Skrobowski A, Zieliński L, Tomaszewska-Kiecana M, Dłużniewski M, Kiliszek M, Peller M, Budnik M, Balsam P, Opolski G, Tymińska A, Ozierański K, Wancerz A, Borowiec A, Majos E, Dabrowski R, Szwed H, Musialik-Lydka A, Leopold-Jadczyk A, Jedrzejczyk-Patej E, Koziel M, Lenarczyk R, Mazurek M, Kalarus Z, Krzemien-Wolska K, Starosta P, Nowalany-Kozielska E, Orzechowska A, Szpot M, Staszel M, Almeida S, Pereira H, Brandão Alves L, Miranda R, Ribeiro L, Costa F, Morgado F, Carmo P, Galvao Santos P, Bernardo R, Adragão P, Ferreira da Silva G, Peres M, Alves M, Leal M, Cordeiro A, Magalhães P, Fontes P, Leão S, Delgado A, Costa A, Marmelo B, Rodrigues B, Moreira D, Santos J, Santos L, Terchet A, Darabantiu D, Mercea S, Turcin Halka V, Pop Moldovan A, Gabor A, Doka B, Catanescu G, Rus H, Oboroceanu L, Bobescu E, Popescu R, Dan A, Buzea A, Daha I, Dan G, Neuhoff I, Baluta M, Ploesteanu R, Dumitrache N, Vintila M, Daraban A, Japie C, Badila E, Tewelde H, Hostiuc M, Frunza S, Tintea E, Bartos D, Ciobanu A, Popescu I, Toma N, Gherghinescu C, Cretu D, Patrascu N, Stoicescu C, Udroiu C, Bicescu G, Vintila V, Vinereanu D, Cinteza M, Rimbas R, Grecu M, Cozma A, Boros F, Ille M, Tica O, Tor R, Corina A, Jeewooth A, Maria B, Georgiana C, Natalia C, Alin D, Dinu-Andrei D, Livia M, Daniela R, Larisa R, Umaar S, Tamara T, Ioachim Popescu M, Nistor D, Sus I, Coborosanu O, Alina-Ramona N, Dan R, Petrescu L, Ionescu G, Popescu I, Vacarescu C, Goanta E, Mangea M, Ionac A, Mornos C, Cozma D, Pescariu S, Solodovnicova E, Soldatova I, Shutova J, Tjuleneva L, Zubova T, Uskov V, Obukhov D, Rusanova G, Soldatova I, Isakova N, Odinsova S, Arhipova T, Kazakevich E, Serdechnaya E, Zavyalova O, Novikova T, Riabaia I, Zhigalov S, Drozdova E, Luchkina I, Monogarova Y, Hegya D, Rodionova L, Rodionova L, Nevzorova V, Soldatova I, Lusanova O, Arandjelovic A, Toncev D, Milanov M, Sekularac N, Zdravkovic M, Hinic S, Dimkovic S, Acimovic T, Saric J, Polovina M, Potpara T, Vujisic-Tesic B, Nedeljkovic M, Zlatar M, Asanin M, Vasic V, Popovic Z, Djikic D, Sipic M, Peric V, Dejanovic B, Milosevic N, Stevanovic A, Andric A, Pencic B, Pavlovic-Kleut M, Celic V, Pavlovic M, Petrovic M, Vuleta M, Petrovic N, Simovic S, Savovic Z, Milanov S, Davidovic G, Iric-Cupic V, Simonovic D, Stojanovic M, Stojanovic S, Mitic V, Ilic V, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Markovic S, Kovacevic S, García Fernandez A, Perez Cabeza A, Anguita M, Tercedor Sanchez L, Mau E, Loayssa J, Ayarra M, Carpintero M, Roldán Rabadan I, Leal M, Gil Ortega M, Tello Montoliu A, Orenes Piñero E, Manzano Fernández S, Marín F, Romero Aniorte A, Veliz Martínez A, Quintana Giner M, Ballesteros G, Palacio M, Alcalde O, García-Bolao I, Bertomeu Gonzalez V, Otero-Raviña F, García Seara J, Gonzalez Juanatey J, Dayal N, Maziarski P, Gentil-Baron P, Shah D, Koç M, Onrat E, Dural IE, Yilmaz K, Özin B, Tan Kurklu S, Atmaca Y, Canpolat U, Tokgozoglu L, Dolu AK, Demirtas B, Sahin D, Ozcan Celebi O, Diker E, Gagirci G, Turk UO, Ari H, Polat N, Toprak N, Sucu M, Akin Serdar O, Taha Alper A, Kepez A, Yuksel Y, Uzunselvi A, Yuksel S, Sahin M, Kayapinar O, Ozcan T, Kaya H, Yilmaz MB, Kutlu M, Demir M, Gibbs C, Kaminskiene S, Bryce M, Skinner A, Belcher G, Hunt J, Stancombe L, Holbrook B, Peters C, Tettersell S, Shantsila A, Lane D, Senoo K, Proietti M, Russell K, Domingos P, Hussain S, Partridge J, Haynes R, Bahadur S, Brown R, McMahon S, Y H Lip G, McDonald J, Balachandran K, Singh R, Garg S, Desai H, Davies K, Goddard W, Galasko G, Rahman I, Chua Y, Payne O, Preston S, Brennan O, Pedley L, Whiteside C, Dickinson C, Brown J, Jones K, Benham L, Brady R, Buchanan L, Ashton A, Crowther H, Fairlamb H, Thornthwaite S, Relph C, McSkeane A, Poultney U, Kelsall N, Rice P, Wilson T, Wrigley M, Kaba R, Patel T, Young E, Law J, Runnett C, Thomas H, McKie H, Fuller J, Pick S, Sharp A, Hunt A, Thorpe K, Hardman C, Cusack E, Adams L, Hough M, Keenan S, Bowring A, Watts J, Zaman J, Goffin K, Nutt H, Beerachee Y, Featherstone J, Mills C, Pearson J, Stephenson L, Grant S, Wilson A, Hawksworth C, Alam I, Robinson M, Ryan S, Egdell R, Gibson E, Holland M, Leonard D, Mishra B, Ahmad S, Randall H, Hill J, Reid L, George M, McKinley S, Brockway L, Milligan W, Sobolewska J, Muir J, Tuckis L, Winstanley L, Jacob P, Kaye S, Morby L, Jan A, Sewell T, Boos C, Wadams B, Cope C, Jefferey P, Andrews N, Getty A, Suttling A, Turner C, Hudson K, Austin R, Howe S, Iqbal R, Gandhi N, Brophy K, Mirza P, Willard E, Collins S, Ndlovu N, Subkovas E, Karthikeyan V, Waggett L, Wood A, Bolger A, Stockport J, Evans L, Harman E, Starling J, Williams L, Saul V, Sinha M, Bell L, Tudgay S, Kemp S, Brown J, Frost L, Ingram T, Loughlin A, Adams C, Adams M, Hurford F, Owen C, Miller C, Donaldson D, Tivenan H, Button H, Nasser A, Jhagra O, Stidolph B, Brown C, Livingstone C, Duffy M, Madgwick P, Roberts P, Greenwood E, Fletcher L, Beveridge M, Earles S, McKenzie D, Beacock D, Dayer M, Seddon M, Greenwell D, Luxton F, Venn F, Mills H, Rewbury J, James K, Roberts K, Tonks L, Felmeden D, Taggu W, Summerhayes A, Hughes D, Sutton J, Felmeden L, Khan M, Walker E, Norris L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Akıl MA, Oylumlu M, Oylumlu M, Demir M, Ozbek M, Polat N, Acet H, Bilik MZ. Predictive value of lymphocyte to monocyte ratio for cardiac syndrome X. Eur Rev Med Pharmacol Sci 2022; 26:4303-4308. [PMID: 35776031 DOI: 10.26355/eurrev_202206_29069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Cardiac syndrome X (CSX) is typically described with ischemia in stress tests in addition to angina-like chest pain and without stenosis in coronary angiography. We aimed at determining the relationship between LMR and CSX. PATIENTS AND METHODS We retrospectively collected patients with CSX between January 2016 and December 2019. Patients with typical angina-like chest pain, normal 12-lead electrocardiography at rest, a positive response to the exercise test (> 0.1 mV ST-segment depression at 80 ms after the J point in two or more contiguous leads) or ischemia on myocardial perfusion scintigraphy and normal coronary angiography were included in the study as CSX patients. RESULTS This study consisted of 116 patients with CSX and 153 control groups. The mean age of the patients with CSX was 52.7±9.7 years, and the mean age of the control group was 53.7±10.6 years (p= 0.416). The patients with CSX were more likely to have higher monocyte counts and LMR. According to the Pearson correlation test, the CRP value negatively correlated with the LMR. In multivariate logistic regression analysis, LMR remained a significant predictor of CSX. In ROC analysis, LMR < 4.1 had 64% sensitivity and 50% specificity (ROC area under curve: 0.587, 95% CI: 0.519-0.655, p=0.015) in accurately predicting a CSX diagnosis. CONCLUSIONS We showed that lower LMR levels were associated with the presence of CSX.
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Affiliation(s)
- M A Akıl
- Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
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16
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Ekin T, Kis M, Gungoren F, Atici A, Kunak AÜ, Mutlu D, Katkat F, Demir M, Sarac İ, Soydan E, Karaduman M, Bekar L, Boyuk F, Adiyaman MS, Zoghi M. Awareness and knowledge of pneumococcal vaccination in cardiology outpatient clinics and impact of physicians' recommendation on vaccination rates. Eur J Prev Cardiol 2022. [PMCID: PMC9384017 DOI: 10.1093/eurjpc/zwac056.170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Although there is not enough data on pneumococcal vaccination status in patients with cardiovascular disease and or risk factors in our country, it is known that vaccination rates are quite low in the current data.
Purpose
We aimed to evaluate the awareness of pneumococcal vaccination (PCV13, PPSV23) in general cardiology outpatient clinics and impact of physician’s recommendation (with educational brochures) on vaccination rate.
Methods
Awareness of vaccination, before COVID-19 pandemic, was measured in patients admitting to cardiology outpatient clinics from 40 center of our country by a questionnaire contained 19 questions. The demographics (including gender, age, educational level, awareness vaccination level) and comorbidities were obtained. The vaccination rates were calculated within 3-months follow-up from the admitting of patient to cardiology clinics.
Results
The 403 (18.2%) of patients with previous pneumococcal vaccination were excluded from the study. The mean age of study population (n=1808) was 61.9±12.1 years and 55.4% were male. The 58.7% had coronary artery disease, hypertension (74.1%) was the most common risk factor and 32.7% of the patients had never been vaccinated although they had information about vaccination before. The 98.5% were referred to family medicine (n=1412, 78.1%) or vaccination outpatient clinics (n=370, 20.5%) and the vaccination rate was 62.1% during the follow-up period. The differences between vaccinated and not-vaccinated patients are presented in Table 1.
The physician’s recommendation was positively correlated with vaccination intention and behavior in our participants. Multivariate logistic regression analysis showed a significant between vaccination and female sex [OR=1.55 (95% CI=1.25–1.92), p<0.001], higher education level [OR=1.49 (95% CI=1.15-1.92), p=0.002] patients’ knowledge [OR=1.93 (95% CI=1.56-2.40), p<0.001], and their physician’s recommendation [OR=5.12 (95% CI=1.92-13.68), p=0.001].
Conclusion
To our knowledge this is the first report about the awareness pneumococcal vaccination rates and impact of physician’s recommendation in patients with cardiovascular disease by high study population. These findings suggest providing information on the benefits of vaccination by physician’s and educational advice was significantly associated with an increase vaccination rate and have a key role.
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Affiliation(s)
- T Ekin
- Sorgun State Hospital, Cardiology, Yozgat, Turkey
| | - M Kis
- Dokuz Eylul University, Cardiology, Izmir, Turkey
| | | | - A Atici
- Medeniyet University, Istanbul, Turkey
| | - AÜ Kunak
- Medstar Hospital, Antalya, Turkey
| | - D Mutlu
- Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - F Katkat
- Istanbul Education and Research Hospital, Istanbul, Turkey
| | - M Demir
- Kutahya Health Sciences University, Kutahya, Turkey
| | - İ Sarac
- Regional Training and Research Hospital, Erzurum, Turkey
| | | | | | - L Bekar
- HITIT UNIVERSITY, Corum, Turkey
| | - F Boyuk
- Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - MS Adiyaman
- Gazi Yasargil Research Hospital, Diyarbakir, Turkey
| | - M Zoghi
- Ege University, Izmir, Turkey
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Sarier M, Demir M, Emek M, Turgut H. Hematuria frequency and association with abnormal urological findings in medical check-up patients. Niger J Clin Pract 2022; 25:310-314. [PMID: 35295054 DOI: 10.4103/njcp.njcp_1509_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aims and Background Hematuria is one of the most common findings in urology. The management of hematuria detected in routine medical check-ups is also important in this respect. The aim of this study was to determine the frequency of hematuria in patients undergoing medical check-ups and evaluate its association with abnormal urological findings in laboratory tests and imaging. Patients and Methods Asymptomatic patients who presented to the check-up clinic between January 1 and December 31, 2020, were included. All patients underwent a complete laboratory workup and total abdominal ultrasound (TAUS). The distribution of hematuria by sex and age and the relationship between hematuria and abnormal urological findings in the laboratory tests and TAUS were calculated. Results The mean age of the 2,077 check-up patients was 45.8 ± 12.8 years. The female to male ratio was 1.07:1, and there was no significant difference in age between the sexes (P = 0.655). Microscopic hematuria was detected in 15.9% of the patients. The frequency of hematuria was 10.8% in men and 20.7% in women (P < 0.001). Men with hematuria were significantly older than men without hematuria (P = 0.033), whereas hematuria was not associated with age in women (P = 0.521). When its relationship between abnormal urological findings was evaluated, hematuria had a sensitivity of 21.70% (95% confidence interval [CI]: 18.84, 24.86) and a specificity of 87.11% (95% CI: 85.23, 88.79). Conclusion The frequency of hematuria in check-up patients was remarkable, at 15.9%. Hematuria in women is more common and unrelated to age, unlike in men. Hematuria had a high specificity but low sensitivity for urological abnormal findings.
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Affiliation(s)
- M Sarier
- Department of Urology, Istinye University, Istanbul; Department of Urology, Medical Park Hospital, Antalya, Turkey
| | - M Demir
- Faculty of Health Sciences, Bilim University, Antalya, Turkey
| | - M Emek
- Department of Public Health, Akdeniz University, Antalya, Turkey
| | - H Turgut
- Faculty of Health Science, Avrasya University, Trabzon, Turkey
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18
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Sarier M, Demir M, Emek M, Usta SS, Soylu A, Konuk EY, Turgut H. Comparison of spermiograms of infertile men before and during the COVID-19 pandemic. Rev Assoc Med Bras (1992) 2022; 68:191-195. [PMID: 35239880 DOI: 10.1590/1806-9282.20210935] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 11/21/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Since the start of the COVID-19 pandemic, there has been interest in the impact of both SARS-CoV-2 infection and pandemic-induced social restrictions on male reproductive health. This study aimed to evaluate the spermiogram values of men who presented for infertility during the pandemic compared with the previous 2 years. METHODS Patients who presented to a urology outpatient clinic for the first time due to infertility were included. The patients' age, semen volume, and spermiogram results were recorded. Based on the presentation date, the patients were divided into prepandemic group 1 (March 2018-February 2019), prepandemic group 2 (March 2019-February 2020), and pandemic group (March 2020-February 2021) for comparison. RESULTS A total of 594 patients were included. There was no significant difference between the three groups in terms of the number of patients who presented for infertility (207, 190, and 197 patients, respectively; p=0.691). The mean age was 36.6±7.2 in the prepandemic group 1, 35.5±7.1 in the prepandemic group 2, and 33.1±6.3 in the pandemic group. Patients who presented during the pandemic were significantly younger (p<0.001). There were no differences between the groups in terms of semen volume (p=0.910) or rates of normospermia and pathological spermiogram findings (p=0.222). CONCLUSIONS In the first year of the COVID-19 pandemic, there was no significant difference in the number of patients who presented for infertility or in their spermiogram results compared with 2018 and 2019. However, it is noteworthy that the patients were significantly younger during the pandemic than in the previous 2 years.
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Affiliation(s)
- Mehmet Sarier
- Istinye University, Department of Urology - Istanbul, Turkey.,Medical Park Hospital, Department of Urology - Antalya, Turkey
| | - Meltem Demir
- Antalya Bilim University, Faculty of Health Science - Antalya, Turkey
| | - Mestan Emek
- Akdeniz University, Department of Public Health - Antalya, Turkey
| | - Sibel Sürmen Usta
- Medical Park Hospital, Department of Obstetrics and Gynaecology - Antalya, Turkey
| | - Ahmet Soylu
- Atlas University, Department of Urology - Istanbul, Turkey
| | | | - Hasan Turgut
- Avrasya University, Faculty of Health Science - Trabzon, Turkey
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Tutuncu A, Camci S, Karakus A, Bursa N, Kinik M, Zengin I, Severgun K, Demir M, Ari H. A novel intermediate coronary artery stenosis severity method: Fluoroscopy-Assisted Measurement of Coronary Volume Ratio (The FLAME FFR Trial). Eur Rev Med Pharmacol Sci 2022; 26:1101-1107. [PMID: 35253164 DOI: 10.26355/eurrev_202202_28099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The fluoroscopy-assisted coronary volume measurement (FLASH) algorithm, based on contrast passage time and vessel size, is a simple and non-invasive method of assessing coronary blood volume. The present study evaluated the diagnostic performance of FLASH flow ratio-derived fractional flow reserve (FFRFLAME) compared to wire-based FFR (FFRWB). PATIENTS AND METHODS FFRFLAME was defined as the ratio of FLASH at baseline to maximal hyperemia. Forty-eight patients with one intermediate coronary lesion (30-70% by angiographic visual estimation) were enrolled in this cross-sectional study. FFRFLAME and FFRWB measurements were collected in each patient. Intravenous administration of adenosine was used to achieve maximal hyperemia. The Pearson correlation coefficient and receiver operating characteristic analysis were performed to determine the predictive accuracy of FFRFLAME. RESULTS The average age of the patients was 58 years, and 43% (21 of 48) were female. The predominant vessel assessed was the left anterior descending artery system (87.5%). The mean FFRWB was 0.91 ± 0.05 at baseline and 0.83 ± 0.07 at the hyperaemic level, with 27% (13 of 48) of patients having an FFRWB of ≤0.80. For each patient, the mean FFRFLAME was 0.668 ± 0.17. The mean FFRFLAME was 0.85 ± 0.16 for patients having an FFRWB of ≤0.80. A strong relationship existed between FFRFLAME and FFRWB (Pearson's r = - 0.765 p<0.001). The optimal cutoff value of the functional significance of coronary artery stenosis for FFRFLAME was determined to be > 0.84 (AUC: 0.899, 84% sensitivity and 97% specificity) when the FFRWB cutoff value for significant lesions was ≤ 0.80. CONCLUSIONS FFRFLAME, applied to coronary angiography without the need for an invasive pressure wire, can be a beneficial index for appropriate lesion selection in coronary artery diseases.
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Affiliation(s)
- A Tutuncu
- Department of Cardiology, University of Health Sciences, Bursa Postgraduate Hospital Bursa, Turkey.
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Tekin I, Demir M, Özdem S. Effect of different storage solutions on oxidative stress in human saphenous vein grafts. J Cardiothorac Surg 2022; 17:7. [PMID: 35034655 PMCID: PMC8762896 DOI: 10.1186/s13019-022-01752-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ischemia-reperfusion injury of saphenous vein grafts (SVG) during coronary artery bypass grafting surgery negatively impacts endothelial integrity and functionality and is associated with vein graft failure. The aim of this study was to evaluate the level of oxidative stress in human SVG segments following ischemic storage in three intraoperative graft storage solutions: saline (S), autologous heparinized blood (HB) and DuraGraft (DG). METHODS 3 mm tissue rings derived from surplus SVG segments from 50 patients were stored at room temperature for 30 min in DG, S or HB. Total oxidative status (TOS) and total antioxidant status (TAS) levels were determined from which the oxidative stress index (OSI: TOS/TAS ratio) was calculated. A p-value < 0.017 was considered significant implementing a Bonferroni correction. RESULTS TOS values were significantly lower for DG stored samples in comparison to both S and HB; there was no difference between S and HB (DG: 32.6 ± 1.8, S: 39.6 ± 2.8 and HB: 40.6 ± 2.4 µmol H2O2 eqv.; DG vs. S and DG vs. HB p < 0.0001, S vs. HB p = 0.047). TAS was higher for both DG and HB in comparison to S (DG: 8.9 ± 0.9, S: 6.9 ± 1.0 and HB: 8.6 ± 0.9 mmol Trolox eqv.; DG vs S p < 0.0001, DG vs. HB p = 0.263, S vs. HB p < 0.0001). OSI differed between all groups with the lowest value for DG (DG: 3.7 ± 0.2, S: 5.8 ± 0.4 and HB: 4.7 ± 0.2 µmol H2O2 eqv./mmol Trolox eqv.; all p < 0.0001). CONCLUSIONS Saphenous veins grafts stored in DuraGraft had a lower oxidative level, higher antioxidant level and a lower oxidative stress index in comparison to saphenous vein grafts stored in saline or heparinized blood. ClinicalTrials.gov Identifier NCT02922088.
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Affiliation(s)
- Ilker Tekin
- Department of Cardiovascular Surgery, Manavgat Government Hospital, Manavgat, Turkey. .,Department of Cardiovascular Surgery, Faculty of Medicine, Bahçeşehir University, İstanbul, Turkey.
| | - Meltem Demir
- Department of Biochemistry, Medicalpark Hospital Complex, Antalya, Turkey.,Faculty of Health Science, Bilim University, Antalya, Turkey
| | - Sebahat Özdem
- Department of Medical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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Aktas B, Degirmenciler R, Durmaz C, Taban H, Guven D, Guner G, Yildirim H, Demir M, Kertmen N, Arık Z, Dizdar O, Aksoy S. 173P What to expect from NCCN BRCA testing criteria: A retrospective cohort analysis. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ongun H, Demir M. Mortality Caused by Late-onset Sepsis in Very Low Birth Weight Infants: Risk Analysis and the Performance of Diagnostic Tools. J Coll Physicians Surg Pak 2021; 30:611-616. [PMID: 32703346 DOI: 10.29271/jcpsp.2020.06.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/26/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To assess the risk on late-onset sepsis attributed mortality in very low birth weight (VLBW) infants. Study Design: Observational study. PLACE AND DURATION OF STUDY Level-III Neonatal Intensive Care Unit, İstinye University, Antalya Medical Park Hospital, Turkey, between January 2014 and December 2018. METHODOLOGY Perinatal characteristics and clinical features of 198 septic preterm neonates were evaluated to predict sepsis-attributed mortality. ROC analysis was employed to drive optimal-cutoffs for laboratory parameters and logistic regression to calculate mortality risk factors using SPSS version-22 and MedCalc software. RESULTS Mean gestational age was 28.91 ±2.67 weeks. Umbilical catheterisation was the principal risk factor for culture-positive sepsis (OR 2.860, 95%CI: 1.232-6.639). Outborn infants were more likely to deliver surfactant and longer intubation (p=0.013, and p=0.005, respectively), manifested frequent BPD (p=0.014), and at greater risk of proven sepsis and mortality (OR: 1.796, 95%CI: 1.011-3.191; OR: 1.950, 95%CI: 1.002-3.794). Low Apgar scores necrotising enterocolitis (NEC) and prolonged intubation were independent risk factors for mortality (OR: 13.840, 95%CI: 6.384-30.005; OR: 5.410, 95%CI: 2.113-13.849; OR: 10.037, 95%CI: 4.700-21.434). An increase in high-sensitivity C-reactive protein (hsCRP)-ratio >6.08-fold afforded good sensitivity and specificity (AUC: 0.914; sensitivity: 89.36%, specificity: 86.09%). Logistic regression of various combinations has shown a >6.08-fold change in hsCRP-ratio over 24-hours and platelet counts <88x109/L optimally predicted mortality (OR: 27.983, 95%CI: 9.704-80.697). CONCLUSION Low Apgar scores, NEC and prolonged intubation are independent risk factors for mortality of VLBW infants. Birth in level III-IV NICUs featuring special neonatal care, avoidance of prolonged intubation, and timely prediction of fatal sepsis using hsCRP ratio and platelets could prevent sepsis-related mortality. Key Words: Sepsis, Very low birth weight, Infant formality, Apgar score.
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Affiliation(s)
- Hakan Ongun
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Istinye University Antalya Medical Park Hospital, Antalya, Turkey
| | - Meltem Demir
- Department of Medical Biochemistry, Faculty of Medicine, İstinye University, Antalya, Turkey
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Oner A, Tufek E, Yezer I, Birol A, Demir M, Er S, Demirkol DO. High generation dendrimer decorated poly-Ɛ-caprolactone/polyacrylic acid electrospun nanofibers for the design of a bioelectrochemical sensing surface. REACT FUNCT POLYM 2021. [DOI: 10.1016/j.reactfunctpolym.2021.104853] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Abstract
Objective The present study aimed to investigate the potential of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and mean platelet volume (MPV) as prognostic markers in tinnitus patients at inflammatory process. Methods This study consisted of 216 subjects (124 males and 92 females), Routine laboratory CBC test results were calculated in this study. All the patients were divided into three groups according to their hearing thresholds: a high frequency hearing loss-tinnitus group (HFHL-TN) consisted of 55 subjects, an hearing loss in all frequencies tinnitus group (AFHL-TN) consisted of 53 subjects and a normal hearing-tinnitus group (NH-TN) consisted of 51 subjects. The control group (CNT) included 57 age-and sex-matched healthy subjects. Results NLR, PLR and MPV were observed in the HFHL-TN group when compared to AFHL-TN, NH-TN and CNT group (P < 0.001). An increase in NLR was observed in the AFHL-TN group compared with the CNT group (P = 0.004). The PLR value of the HFHL-TN group was significantly higher than that of the AFHL-TN (P = 0.028) and NH-TN,CNTgroup (P < 0001). The PLR value of the HFHL-TN group was significantly higher than that of the AFHL-TN (p=0.028) and NH-TN, CNT group (P < 0001). MPV values in HFHL-TN group was slightly higher AFHL-TN group and significantly higher than NH-TN (P = 0.025) and CNT (P < 0.001) group. Conclusion Our results confirm that elevated NLR, PLR and MPV values has been suggested to be a useful inflammatuar prognostic biomarker of tinnitus patients.
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Affiliation(s)
- M Demir
- Department of Clinical Biochemistry, Istinye University, Istanbul, Turkey
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Akbas I, Kocak AO, Celik BK, Menekse TS, Demir M, Gur STA, Kerget B, Cakir Z. Performance of integrated pulmonary index for pulmonary embolism in dyspneic patients. BRATISL MED J 2021; 122:65-70. [PMID: 33393323 DOI: 10.4149/bll_2021_008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the diagnostic capacity of integrated pulmonary index (IPI) in predicting the pulmonary embolism (PE) in patients admitted to emergency departments (ED) with dyspnea. BACKGROUND The acute dyspnea is one of the most common chief complaints in EDs. PE is a potentially fatal disease and the delay in specific therapy increases the worst outcomes. METHODS This study is a prospective methodological study, in which we evaluated the diagnostic performance of the IPI in predicting PE in patients admitted to ED with dyspnea. ROC analysis was used for estimating the accuracy of IPI and OCRS. RESULTS Of the 144 patients included in the study, there were 20 (13.9 %) PE patients. In the ROC analysis, the best cut-off point for IPI was ≤ 2. For this cut-off point, the sensitivity and specificity of IPI were 100.0 % and 96.0 %, respectively. Besides, the accuracy of IPI was 96.5 % with a +LR of 24.8 and a -LR of 0.0. CONCLUSION IPI was a potential candidate for evaluating the respiratory status, and a limiting tool to prevent unnecessary diagnostic tests and save time in determining the treatment course in dyspneic patients at ED (Tab. 5, Fig. 3, Ref. 34).
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Ongun H, Demir M. Family-centered lactation counseling and breastfeeding in preterm infants upon neonatal intensive care discharge. J Clin Neonatol 2021. [DOI: 10.4103/jcn.jcn_167_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Susam LA, Alan HY, Yilmaz A, Erol A, Inci CI, Akinci FC, Akkus B, Demir M, Emirhan ME, Faydasicok O, Gudekli E. COSMIC RADIATION EXPOSURE CALCULATIONS FOR INTERNATIONAL AND DOMESTIC FLIGHTS DEPARTS FROM ISTANBUL AND ANKARA. Radiat Prot Dosimetry 2020; 192:61-68. [PMID: 33300563 DOI: 10.1093/rpd/ncaa182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 06/12/2023]
Abstract
In this study, cosmic radiation doses were calculated for domestic and international flights departing from Istanbul and furthermore for domestic flights departing from Ankara using a software program called CARI-7A and also a mathematical method approach. Main parameters for calculating cosmic radiation are vertical cut-off rigidity, flight duration, latitude-longitude and altitude of the flight. Our calculation results agree with the measurements for domestic and international flights departing from Istanbul and Ankara.
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Affiliation(s)
- L Amon Susam
- Department of Physics, Istanbul University, Vezneciler, Istanbul 34134 , Turkey
| | - H Yilmaz Alan
- Institute of Accelerator Technologies, Ankara University, Ankara, Turkey
| | - A Yilmaz
- Department of Physics, Istanbul University, Vezneciler, Istanbul 34134 , Turkey
| | - A Erol
- Department of Physics, Istanbul University, Vezneciler, Istanbul 34134 , Turkey
| | - C I Inci
- Department of Physics, Istanbul University, Vezneciler, Istanbul 34134 , Turkey
| | - F C Akinci
- Department of Physics, Istanbul University, Vezneciler, Istanbul 34134 , Turkey
| | - B Akkus
- Department of Physics, Istanbul University, Vezneciler, Istanbul 34134 , Turkey
| | - M Demir
- Cerrahpasa Faculty of Medicine, Department of Nuclear Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - M E Emirhan
- Department of Physics, Istanbul University, Vezneciler, Istanbul 34134 , Turkey
| | - O Faydasicok
- Department of Mathematics, Istanbul University, Vezneciler, Istanbul 34134, Turkey
| | - E Gudekli
- Department of Physics, Istanbul University, Vezneciler, Istanbul 34134 , Turkey
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Ongun H, Demirezen S, Demir M. Developing necrotizing enterocolitis: retrospective analysis of 1428 preterm infants at a level-III neonatal intensive care unit over a four years period. ARCH ARGENT PEDIATR 2020; 118:405-410. [PMID: 33231048 DOI: 10.5546/aap.2020.eng.405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/03/2020] [Indexed: 11/12/2022]
Abstract
AIM To investigate NEC frequency in premature infants and assess risk factors associated with disease-onset and progression to intestinal perforation. METHODS Retrospective cohort in preterm neonates hospitalized between 2015 and 2018. Perinatal characteristics, clinical features, nutritional data and laboratory outcome were analyzed using SPSS-23 statistical package. Logistic regression was performed to analyze associated risk factors. RESULTS In 1428 neonates, the rate of developing NEC was 18.28 %. Conception with assisted reproductive technology, cesearean section and postnatal-steroids were associated with NEC (OR: 4.056, 95 % CI: 2.810-5.854, OR: 1.961, 95 % CI: 1.321-2.910, OR: 6.422; 95 % CI: 4.327-9.530). Timing of first enteral feeding was associated to developing NEC, but not to intestinal perforation (p < 0.001, p = 0.604). Forty-seven of 261 NEC patients (18 %) have developed intestinal perforation. Antenatal steroids showed to reduce severe consequences (p = 0.001). Timing of first enteral feeding and hemodynamically significant PDA were predisposing factors for NEC and low 5-minutes Apgar score for intestinal perforation. (OR: 6.515; 95 % CI: 5.011-8.470; OR: 4.715; 95 % CI: 2.717-8.183; OR: 2.748; 95 % CI: 1.100-6.866). Mortality was 9 %. Developing NEC increased risk of mortality by 2.192 times (95 % CI: 1.469- 3.271); in intestinal perforation, mortality risk increased to 11.527 (95 % CI: 6.293-21.115). CONCLUSION NEC frequency was 18.28 %. Intestinal perforation occurred in 18 % of NEC patients. PDA and delay in first enteral nutrition were predisposing factors for acquiring NEC and low 5-minutes Apgar scores for intestinal perforation.
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Affiliation(s)
- Hakan Ongun
- Division of Neonatology, Department of Pediatrics, Istinye University Faculty of Medicine, Medical Park Hospital, Antalya, Turkey.
| | - Selim Demirezen
- Department of Pediatric Surgery, Istinye University Faculty of Medicine, Medical Park Hospital, Antalya, Turkey
| | - Meltem Demir
- Department of Medical Biochemistry, Istinye University Faculty of Medicine, Medical Park Hospital, Antalya, Turkey
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Kenangil G, Demir M, Tur EK, Domac FM. Alexithymia, depression, and cognition in patients with Parkinson's disease. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cengiz O, Kivrak A, Yegen M, Demir M. Sevoflurane induced diffuse alveolar haemorrhage in a young patient after orthopedic surgery: A case report. Niger J Clin Pract 2020; 23:120-122. [PMID: 31929218 DOI: 10.4103/njcp.njcp_51_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We present a very rare case of Sevoflurane Induced Diffuse Alveolar Haemorrhage in a young male patient with a closed tibial fracture after direct trauma to the right cruris. The patient was operated for tibial fracture, but diffuse alveolar haemorrhage developed after sevoflurane inhalation in the postoperative period following general anesthesia. Diffuse alveolar haemorrhage (DAH) is associated with inhalation injury from halogenated gases and reported as a unique entity in the literature that practicing clinicians should be aware of and consider in post-operative cases of acute respiratory distress. As DAH usually presents with symptoms the presence of hemoptysis, anemia, dyspnoea and radiological alveolar infiltrates, rapid detection of the aetiology and initiation of cause-directed treatment are of great importance on survival.
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Affiliation(s)
- O Cengiz
- Kartal Dr. Lütfi Kırdar Training and Research Hospital, Orthopedics and Traumatology Clinic, İstanbul, Turkey
| | - A Kivrak
- Orthopedics and Traumatology Clinic, Muş State Hospital, Muş, Turkey
| | - M Yegen
- Anesthesiology and Reanimation Clinic, Muş State Hospital, Muş, Turkey
| | - M Demir
- Department of Chest Diseases, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
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Sarier M, Sepin N, Keles Y, Imir L, Emek M, Demir M, Kukul E, Soylu A. Is There any Association between Urothelial Carcinoma of the Bladder and Human Papillomavirus? A Case-Control Study. Urol Int 2019; 104:81-86. [PMID: 31067561 DOI: 10.1159/000500467] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/12/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Human papillomavirus (HPV) is a well-known oncogenic virus associated with anogenital carcinomas. Despite the anatomical proximity of the bladder and the anogenital region, the relationship between HPV and urothelial carcinoma of the bladder (UCB) is still a controversial issue. This study aimed to test the urethral swabs and first-void urine samples of patients with UCB for HPV-Deoxyribonucleic acid (DNA) using polymerase chain reaction (PCR) assay and to compare the results with a control group. MATERIALS AND METHODS Sixty-nine patients who were diagnosed with UCB between January and December 2018 were included in this case-control study. Sixty-nine patients who visited the urology outpatient clinic for non-oncological reasons within the study period were designated as the control group. Urethral swab and first-void morning urine samples were collected from each patient. HPV-DNA presence was investigated using a PCR kit that can detect a total of 22 HPV genotypes, of which 18 are high-risk and 3 are low-risk genotypes. RESULTS The mean age of the patients included in the study was 63.2 ± 12.6 years and the male to female ratio was 5.3. HPV-DNA was detected in 28.9% (20/69) of the patients in the case group and in 8.7% (6/69) of the patients in the control group. HPV-DNA positivity was significantly higher in the case group (OR 4.24; 95% CI 1.63-12.34). No statistically significant relationship was found between HPV-DNA positivity and tumor grade (p = 0.36). CONCLUSION A statistically significant relationship exists between HPV infection and UCB, regardless of the tumor grade.
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Affiliation(s)
- Mehmet Sarier
- Department of Urology, University of Istinye, Istanbul, Turkey, .,Department of Urology, Medical Park Hospital, Antalya, Turkey,
| | - Nevgun Sepin
- Department of Clinical Microbiology and Infectious Disease, Education and Research Hospital, Antalya, Turkey
| | - Yildiz Keles
- Department of Radiation Oncology, Medical Park Hospital, Antalya, Turkey
| | - Levent Imir
- Department of Molecular Microbiology, Gelisim Medical Laboratories, Istanbul, Turkey
| | - Mestan Emek
- Provincial Health Directorate, Antalya, Turkey
| | - Meltem Demir
- Department of Clinical Biochemistry, University of Istinye, Istanbul, Turkey
| | - Erdal Kukul
- Department of Urology, Medical Park Hospital, Antalya, Turkey
| | - Ahmet Soylu
- Department of Urology, Gozde Academy Hospital, Malatya, Turkey
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Demir M, Yilmaz U, Colak C, Cigremis Y, Ozyalin F, Tekedereli I, Sandal S. Is there a new pathway relationship between melatonin and FEZ1 in experimental rat model of Alzheimer’s disease? BRATISL MED J 2019; 120:70-77. [DOI: 10.4149/bll_2019_011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Yoldas A, Demir M, İlgun R, Dayan MO. Blind mole rat (Spalax leucodon) masseter muscle: structure, homology, diversification and nomenclature. Folia Morphol (Warsz) 2018; 78:419-424. [PMID: 30371935 DOI: 10.5603/fm.a2018.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/22/2018] [Accepted: 09/23/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND It is well known that rodents are defined by a unique masticatory apparatus. The present study describes the design and structure of the masseter muscle of the blind mole rat (Spalax leucodon). The blind mole rat, which emer- ged 5.3-3.4 million years ago during the Late Pliocene period, is a subterranean, hypoxia-tolerant and cancer-resistant rodent. Yet, despite these impressive cha- racteristics, no information exists on their masticatory musculature. MATERIALS AND METHODS Fifteen adult blind mole rats were used in this study. Dissections were performed to investigate the anatomical characteristics of the masseter muscle. RESULTS The muscle was comprised of three different parts: the superficial mas- seter, the deep masseter and the zygomaticomandibularis muscle. The superficial masseter originated from the facial fossa at the ventral side of the infraorbital foramen. The deep masseter was separated into anterior and posterior parts. The anterior part of the zygomaticomandibularis muscle arose from the snout and passed through the infraorbital foramen to connect on the mandible. CONCLUSIONS The construction of the deep masseter and zygomaticomandibularis muscles were of the Myomorpha type. Further studies are needed to reveal features such as muscle biomechanics, muscle types.
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Affiliation(s)
- A Yoldas
- Department of Anatomy, Faculty of Medicine, Kahramanmaras University, Kahramanmaras, Turkey.
| | - M Demir
- Department of Anatomy, Faculty of Medicine, Kahramanmaras University, Kahramanmaras, Turkey
| | - R İlgun
- Department of Anatomy, Faculty of Veterinary Medicine, Aksaray University, Aksaray, Turkey
| | - M O Dayan
- Department of Anatomy, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
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34
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Sarier M, Sepin N, Duman I, Demir M, Hizel A, Göktaş Ş, Emek M, Kukul E, Soylu A. Microscopy of Gram-stained urethral smear in the diagnosis of urethritis: Which threshold value should be selected? Andrologia 2018; 50:e13143. [PMID: 30238498 DOI: 10.1111/and.13143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/08/2018] [Accepted: 08/14/2018] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to investigate the sensitivity of GSS in the diagnosis of urethritis in patients who present to the outpatient clinic with symptoms of urethritis. Sixty-three male patients who presented to our outpatient clinic with symptoms of urethritis between January and March 2018 were evaluated. Urethral smear samples obtained from patients were evaluated both by GSS examination and by Real-time Multiplex Polymerase Chain Reaction (rt-MPCR) assay. The sensitivity and specificity of GSS in detecting gonococcal urethritis (GU) and nongonococcal urethritis (NGU) were calculated for threshold values of ≥5 and ≥2 PMNL/HPF. The mean age was 33.2 ± 7.1 years. According to the rt-MPCR results, 14 patients had GU and 27 patients had NGU. A threshold value of ≥5 PMNL/HPF in the GSS demonstrated 92.9% sensitivity in the diagnosis of GU and 55.6% sensitivity in the diagnosis of NGU. A threshold value of ≥2 PMNL/HPF reached 100% sensitivity for GU and 92.6% sensitivity for NGU. A cut-off value of ≥5 PMNL/HPF in the GSS has low sensitivity in the diagnosis of NGU. On the other hand, a threshold value of ≥2 PMNL/HPF seems to have higher sensitivity in the diagnosis of both GU and NGU.
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Affiliation(s)
- Mehmet Sarier
- Department of Urology, Medical Park Hospital, Antalya, Turkey
| | - Nevgun Sepin
- Department of Clinical Microbiology and Infectious Disease Training and Research Hospital, Antalya, Turkey
| | - Ibrahim Duman
- Department of Urology, Medical Park Hospital, Antalya, Turkey
| | - Meltem Demir
- Department of Clinical Microbiology, Medical Park Hospital, Antalya, Turkey
| | - Aydan Hizel
- Department of Clinical Biochemistry, Medical Park Hospital, Antalya, Turkey
| | - Şafak Göktaş
- Department of Clinical Microbiology and Infectious Disease, Gelisim Laboratories, Istanbul, Turkey
| | - Mestan Emek
- Department of Public Health, Public Health Directorate, Antalya, Turkey
| | - Erdal Kukul
- Department of Urology, Medical Park Hospital, Antalya, Turkey
| | - Ahmet Soylu
- Department of Urology, Gözde Hospital, Malatya, Turkey
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Sarier M, Duman I, Kilic S, Yuksel Y, Demir M, Aslan M, Yucetin L, Tekin S, Yavuz AH, Emek M. Comparative Results of Transurethral Incision with Transurethral Resection of The Prostate in Renal Transplant Recipients with Benign Prostate Hyperplasia. Urol J 2018; 15:209-213. [PMID: 29464680 DOI: 10.22037/uj.v0i0.4074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study is to compare the results of transurethral incision of the prostate (TUIP) and transurethral resection of the prostate (TURP) for the surgical treatment of benign prostate hyperplasia (BPH) in patients with renal transplantation. MATERIALS AND METHODS Between April 2009 and May 2016, BPH patients with renal transplants whose prostate volumes were less than 30 cm3 were treated surgically. Forty-seven patients received TURP and 32 received TUIP. The patients' age, duration of dialysis, duration between transplant and TURP/TUIP, preoperative and postoperative serum creatinine (SCr), International Prostate Symptom Score (IPSS), maximum flow rate (Qmax) and postvoidresidual volume (PVR) were recorded. At 1-,6- and 12-month follow-up, early and long-term complications were assessed. Results were evaluated retrospectively. RESULTS In both groups, SCr, PVR and IPSS decreased significantly after the operation, while Qmax increased significantly (P < .001). There was no difference between the two groups in terms of increase in Qmax and decrease in IPSS, SCr and PVR (P = .89, P = .27, P = .08, and P = .27). Among postoperative complications, urinary tract infection (UTIs) and retrograde ejaculation (RE) rates were higher in the TURP group than the TUIP group (12.7% versus 6.2% and 68.1% versus 25%,respectively), whereas urethral strictures were more prevalent in the TUIP group (12.5% versus 6.3%). CONCLUSION For the treatment of BPH in renal transplant patients with a prostate volume less than 30 cm3, bothTUIP and TURP are safe and effective.
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Affiliation(s)
- Mehmet Sarier
- Department of Urology Kemerburgaz University Istanbul 34170 Turkey.
| | - Ibrahim Duman
- Department of Urology Kemerburgaz University Istanbul 34170 Turkey
| | - Suleyman Kilic
- Department of Urology Liv Hospital Istinye University Istanbul 34120 Turkey
| | - Yucel Yuksel
- Department of Transplantation Unit Medical Park Hospital Antalya 07100 Turkey
| | - Meltem Demir
- Department of Clinical Biochemistry Kemerburgaz University Istanbul 34170 Turkey
| | - Mesut Aslan
- Department of Transplantation Unit Medical Park Hospital Antalya 07100 Turkey
| | - Levent Yucetin
- Department of Transplantation Unit Medical Park Hospital Antalya 07100 Turkey
| | - Sabri Tekin
- Department of Surgery Kemerburgaz University Istanbul 34170 Turkey
| | | | - Mestan Emek
- Public Health Diroctorate, Antalya 07140 Turkey
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Sarier M, Demir M, Goktas S, Duman I, Buyukkinaci M, Yuksel Y, Tekin S, Yavuz AH, Sengul A. Results of Real-time Multiplex Polymerase Chain Reaction Assay in Renal Transplant Recipients With Sterile Pyuria. Transplant Proc 2018; 49:1307-1311. [PMID: 28735999 DOI: 10.1016/j.transproceed.2017.02.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/07/2017] [Indexed: 12/17/2022]
Abstract
Urinary tract infections are a major cause of morbidity and hospitalization after renal transplantation. Patients treated with immunosuppressive drugs suffer not only from common uropathogens but also from opportunistic infections caused by unusual uropathogens. Sterile pyuria is associated with numerous infectious agents including viruses, fungi, and atypical or fastidious organisms. The objective of this study was to investigate the pathogens using real-time multiplex polymerase chain reaction (rtMPCR) assay in sterile pyuria of renal transplant recipients. In this prospective controlled study, pathogen detection was performed with rtMPCR assay on October 2016 in 60 patients with sterile pyuria who had undergone kidney transplantation. A total of 40 renal transplant patients were determined as the control group. Male-to-female ratio was same. The mean age of the subjects with sterile pyuria was 45.7 ± 12.1 (25-74). The mean duration after transplantation was 28.8 ± 3.97 (3-102) months. Pathogens were detected with rtMPCR in 61.7% of sterile pyuria group. This rate was significantly higher compared with the control group (P < .001). Two or more different pathogens were found in 13 (21.7%) patients in sterile pyuria group. The pathogens found included cytomegalovirus in 10 patients (19%), Gardnerella vaginalis and obligate anaerobes in 20 patients (38%), Ureaplasma spp in 17 patients (33%), Candida spp in 2 patients (4%), Mycoplasma hominis in one patient (2%), herpes simplex virus-2 in one patient (2%), and Trichomonas vaginalis in one patient (2%). Sterile pyuria may indicate the presence of genitourinary pathogens that cannot be detected with conventional urine culture method in renal transplantation patients. rtMPCR is an accurate and convenient method for detection of multiple potential pathogens of sterile pyuria in renal transplant patients.
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Affiliation(s)
- M Sarier
- Department of Urology, Kemerburgaz University Medical Faculty, İstanbul, Turkey.
| | - M Demir
- Department of Biochemistry, Kemerburgaz University Medical Faculty, İstanbul Turkey
| | - S Goktas
- Department of Clinical Microbiology and Infectious Disease, Gelişim Medical Laboratories, İstanbul, Turkey
| | - I Duman
- Department of Urology, Kemerburgaz University Medical Faculty, İstanbul, Turkey
| | - M Buyukkinaci
- Department of Obstetrics and Gynecology, Medical Park Hospital, Antalya, Turkey
| | - Y Yuksel
- Department of Transplantation Unit, Medical Park Hospital, Antalya, Turkey
| | - S Tekin
- Department of Surgery, Kemerburgaz University, İstanbul, Turkey
| | - A H Yavuz
- Department of Transplantation Unit, Medical Park Hospital, Antalya, Turkey
| | - A Sengul
- Department of Clinical Microbiology and Infectious Disease, Medical Park Hospital, Antalya, Turkey
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Ikikardes MF, Deniz A, Celik AI, Kanadasi M, Demir M, Usal A. P460Incidence and predictors of sudden cardiac death after acute myocardial infarction. Europace 2018. [DOI: 10.1093/europace/euy015.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - A Deniz
- Cukurova University, Cardiology, Adana, Turkey
| | - A I Celik
- Bayburt State Hospital, Cardiology, bayburt, Turkey
| | - M Kanadasi
- Cukurova University, Cardiology, Adana, Turkey
| | - M Demir
- Cukurova University, Cardiology, Adana, Turkey
| | - A Usal
- Cukurova University, Cardiology, Adana, Turkey
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Sarıer M, Duman İ, Demir M, Yüksel Y, Emek M, Kukul E. The outcomes of transurethral incision/resection of the prostate (TUIP/TURP) performed early after renal transplantation. Turk J Urol 2018; 44:172-177. [PMID: 29511589 PMCID: PMC5832381 DOI: 10.5152/tud.2018.98404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 12/19/2017] [Indexed: 08/21/2023]
Abstract
OBJECTIVE In the early period after renal transplantation, urinary retention stemming from bladder outlet obstruction (BOO) may directly affect graft success. The aim of this study was to evaluate the early and long-term outcomes of transurethral resection of the prostate (TURP) and transurethral incision of prostate (TUIP) procedures performed in the first month following RT due to BOO. MATERIAL AND METHODS Between February 2009 and March 2016, 38 male patients underwent TURP/TUIP due to BOO within the first 30 days of renal transplantation. The urodynamic and renal function assessment results of all patients were collected during the pre-and postoperative periods. All patients were followed up for a minimum of 12 months for short and long-term complications. The results were evaluated retrospectively. RESULTS The mean age of the patients who underwent operations was 59.2±12 years. The median duration of dialysis was 41 months (range 0-180). Before the operation the mean serum creatinine (sCr) level was 1.8±0.7 mg/dL, the mean total PSA level was 1.6±1.1 ng/mL. Of the voiding parameters, the mean Qmax and Qave were measured as 8.2±4.5 mL/sec and 4.6±2.5 mL/sec, respectively. The median post-micturition residual urine (PMR) was 105 mL (range 10-400). TURP/TUIP operations were performed at a median of 19 days (range 8-30) after renal transplantations. None of the patients experienced major complications. In the early postoperative period, 5 patients (13.1%) developed urinary tract infection. The mean decrease in sCr in the first month following TURP/TUIP was 1.4±0.4 mg/dL (p<0.001). The mean Qmax (22.4±11.1 mL/sec), and Qave (11.7±5.4 mL/sec) increased significantly (p<0.001), while the median PMR (15 mL, range 0-205) decreased significantly (p<0.001). The mean follow-up period after the procedure was 46.8±23.3 months. During the follow-up period, 3 (7.8%) patients suffered from urethral stricture and 2 (5.2%) patients from bladder neck obstruction. CONCLUSION In the surgical treatment of urinary retention arising from BOO in the first month following renal transplantation, TURP/TUIP yield safe and successful results. In addition, regarding the short and long term outcomes, these procedures may be safely performed with low morbidity.
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Affiliation(s)
- Mehmet Sarıer
- Department of Urology, Altınbaş University School of Medicine, İstanbul, Turkey
| | - İbrahim Duman
- Department of Urology, Altınbaş University School of Medicine, İstanbul, Turkey
| | - Meltem Demir
- Department of Clinical Biochemistry, Altınbaş University School of Medicine, İstanbul, Turkey
| | - Yücel Yüksel
- Department of Transplantation Unit, Medical Park Hospital, Antalya Turkey
| | | | - Erdal Kukul
- Department of Urology, Medical Park Hospital, Antalya, Turkey
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Kulali F, Semiz-Oysu A, Demir M, Segmen-Yilmaz M, Bukte Y. Role of diffusion-weighted MR imaging in predicting the grade of nonfunctional pancreatic neuroendocrine tumors. Diagn Interv Imaging 2017; 99:301-309. [PMID: 29258825 DOI: 10.1016/j.diii.2017.10.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 10/14/2017] [Accepted: 10/18/2017] [Indexed: 01/19/2023]
Abstract
PURPOSE The purpose of this study was to describe the magnetic resonance imaging (MRI) findings including diffusion-weighted MRI of nonfunctional pancreatic neuroendocrine tumors (PanNETs) and their hepatic metastases, and investigate the relationships between MRI features and histopathological findings for each grade of PanNETs. MATERIALS AND METHODS A total of 30 patients were included. There were 14 men and 16 women with a mean age of 61.60±11 (SD) years (range: 31-81years). PanNET lesions were analyzed qualitatively (signal intensities, contrast enhancement, lesion margins, presence of metastasis and characteristics of metastases) and quantitatively (signal intensity ratios, contrast enhancement indices and normalized apparent diffusion coefficient [ADC]). The relationships between MRI findings and histopathological findings were evaluated. RESULTS Among 30 nonfunctional PanNETs, 11 were high-grade tumors, 10 were intermediate and 9 were low-grade tumors. All high grade PanNETs showed low to intermediate signal on T2-weighted images and ill-defined borders. All intermediate grade PanNETs had intermediate and 6 low grade PanNETs have high signal on T2-weighted images. Patients with hepatic metastases from high grade PanNETs had cystic component in 8/10 (80%) and wash-out in 7/10 (70%) whereas intermediate grade PanNETs had none (P<0.05). The normalized ADC values of high grade PanNETs was lower than those of intermediate and low grade PanNETs (P<0.05). CONCLUSION The presence of cystic component or contrast wash-out in hepatic metastases correlates with high grade PanNETs. The pre-operative MRI combined with DWI has an important role in grading and surgical planning of PanNETs.
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Affiliation(s)
- F Kulali
- Radiology Department, University of Health Sciences, Umraniye Training and Research Hospital, Adem Yavuz Cad. No:1, Saglik Bilimleri Universitesi Umraniye Egitim ve Arastirma Hastanesi, Radyoloji Klinigi, Umraniye, 34764 Istanbul, Turkey.
| | - A Semiz-Oysu
- Radiology Department, University of Health Sciences, Umraniye Training and Research Hospital, Adem Yavuz Cad. No:1, Saglik Bilimleri Universitesi Umraniye Egitim ve Arastirma Hastanesi, Radyoloji Klinigi, Umraniye, 34764 Istanbul, Turkey
| | - M Demir
- Radiology Department, University of Health Sciences, Umraniye Training and Research Hospital, Adem Yavuz Cad. No:1, Saglik Bilimleri Universitesi Umraniye Egitim ve Arastirma Hastanesi, Radyoloji Klinigi, Umraniye, 34764 Istanbul, Turkey
| | - M Segmen-Yilmaz
- Pathology Department, University of Health Sciences, Umraniye Training and Research Hospital, Adem Yavuz Cad. No:1, Saglik Bilimleri Universitesi Umraniye Egitim ve Arastirma Hastanesi, Radyoloji Klinigi, Umraniye, 34764 Istanbul, Turkey
| | - Y Bukte
- Radiology Department, University of Health Sciences, Umraniye Training and Research Hospital, Adem Yavuz Cad. No:1, Saglik Bilimleri Universitesi Umraniye Egitim ve Arastirma Hastanesi, Radyoloji Klinigi, Umraniye, 34764 Istanbul, Turkey
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Tumer MK, Demir M, Cicek M. Effect of aquaporin 1 and 4 on masticatory muscles degeneration as a result of aging. ACTA ACUST UNITED AC 2017; 118:669-675. [PMID: 29216723 DOI: 10.4149/bll_2017_127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The changes in the mouth structures due to aging cause some structural and functional changes by affecting masticatory muscles over time. The aim of this study was to evaluate the aging-related histopathologic changes and immunohistochemically assessed aquaporin 1 and 4 expressions on masseter and temporal muscles. MATERIAL AND METHODS 14 Balb/c white mice (50-80 g) were used in this study. Group I consisted of young animals (2-month-individuals) (n = 7) and Group II consisted of older animals (18-month-old) (n = 7). After routine histological follow-ups were made, tissues were stained immunohistochemically for aquaporin 1 and aquaporin 4 as well as with hematoxylin-eosin. RESULTS It was seen that while the masseter and temporalis muscle tissues showed a high immunoreactivity (+++) for aquaporin 1 and 4 in young mice, they showed a weak immunoreactivity (+) for aquaporin 1 and 4 in old mice (p = 0.001). In the H-score assessment, aquaporin 1 and 4 immunoreactivity was significantly higher in young mice than in old mice (p = 0.002). CONCLUSIONS Consequently, it was shown that degeneration of the masticatory muscles increased with aging and there was a decrease in intra- and intercellular exchange of substances because of changing aquaporin 1 and aquaporin 4 expressions (Tab. 2, Fig. 4, Ref. 20).
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Demir M, Tumer MK, Çiçek M, Uysal M, Yoldas A, Doganer A. Comparison of type I collagens and MMP-2 proteins in temporomandibular joint of young and old mice. Folia Morphol (Warsz) 2017; 77:329-334. [PMID: 29064547 DOI: 10.5603/fm.a2017.0096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/05/2017] [Accepted: 10/05/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND The effects of ageing on the histopathological changes of tem-poromandibular joint (TMJ) and the existence and age related alterations of immunochemical expressions of type I collagen and matrix metalloproteinase-2 (MMP-2) proteins was aimed to be displayed. MATERIALS AND METHODS In this study, 14 Balb/C type white mice (50- -80 g) were included. Groups were organised as group 1 - 2-month-old young animals (n = 7) and group 2 - 18-month-old old animals (n = 7). Of the paraffin embedded tissues 4-5 μm thick sections were taken and immunohisto-chemical stainings of haematoxylin-eosin, type-1 collagen and MMP-2 were performed. RESULTS Collagen bundles showed sagittal and oblique localisations in the young mice, which were comprised of compact collagen bundle layers positioned alterna-tely. While collagen bundle fragmentation was observed in the disks of old mice, some disk regions showed ruptures. In the old mice a decrease in blood vessels, structural impairments and dilatation in arterioles and venules were detected. In the TMJ tissues of the young mice type I collagen and MMP-2 expressions were increased, while they were decreased in old mice. In the MMP-2 H-score evaluation young mice showed significant increase compared to the old mice. CONCLUSIONS Occurrence of degenerations in the collagen structure of TMJ and decimation in the matrix metalloproteases were observed with age. (Folia Morphol 2018; 77, 2: 329-334).
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Affiliation(s)
| | | | - M Çiçek
- Kahramanmaras Sutcu Imam University, 46000 Kahramanmaras, Turkey.
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Sarier M, Tekin S, Duman İ, Yuksel Y, Demir M, Alptekinkaya F, Guler M, Yavuz AH, Kosar A. Results of transurethral resection of the prostate in renal transplant recipients: a single center experience. World J Urol 2017; 36:99-103. [DOI: 10.1007/s00345-017-2094-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/28/2017] [Indexed: 11/24/2022] Open
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Ozarda Y, Ichihara K, Bakan E, Polat H, Ozturk N, Baygutalp NK, Taneli F, Guvenc Y, Ormen M, Erbayraktar Z, Aksoy N, Sezen H, Demir M, Eskandari G, Polat G, Mete N, Yuksel H, Vatansev H, Gun F, Akin O, Ceylan O, Noyan T, Gozlukaya O, Aliyazicioglu Y, Kahraman S, Dirican M, Tuncer GO, Kimura S, Eker P. A nationwide multicentre study in Turkey for establishing reference intervals of haematological parameters with novel use of a panel of whole blood. Biochem Med (Zagreb) 2017; 27:350-377. [PMID: 28694726 PMCID: PMC5493180 DOI: 10.11613/bm.2017.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/08/2017] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION A nationwide multicentre study was conducted to establish well-defined reference intervals (RIs) of haematological parameters for the Turkish population in consideration of sources of variation in reference values (RVs). MATERIALS AND METHODS K2-EDTA whole blood samples (total of 3363) were collected from 12 laboratories. Sera were also collected for measurements of iron, UIBC, TIBC, and ferritin for use in the latent abnormal values exclusion (LAVE) method. The blood samples were analysed within 2 hours in each laboratory using Cell Dyn and Ruby (Abbott), LH780 (Beckman Coulter), or XT-2000i (Sysmex). A panel of freshly prepared blood from 40 healthy volunteers was measured in common to assess any analyser-dependent bias in the measurements. The SD ratio (SDR) based on ANOVA was used to judge the need for partitioning RVs. RIs were computed by the parametric method with/without applying the LAVE method. RESULTS Analyser-dependent bias was found for basophils (Bas), MCHC, RDW and MPV from the panel test results and thus those RIs were derived for each manufacturer. RIs were determined from all volunteers' results for WBC, neutrophils, lymphocytes, monocytes, eosinophils, MCV, MCH and platelets. Gender-specific RIs were required for RBC, haemoglobin, haematocrit, iron, UIBC and ferritin. Region-specific RIs were required for RBC, haemoglobin, haematocrit, UIBC, and TIBC. CONCLUSIONS With the novel use of a freshly prepared blood panel, manufacturer-specific RIs' were derived for Bas, Bas%, MCHC, RDW and MPV. Regional differences in RIs were observed among the 7 regions of Turkey, which may be attributed to nutritional or environmental factors, including altitude.
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Affiliation(s)
- Yesim Ozarda
- Department of Medical Biochemistry, Uludag University School of Medicine, Bursa, Turkey
| | - Kiyoshi Ichihara
- Department of Laboratory Sciences, Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Ebubekir Bakan
- Department of Medical Biochemistry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Harun Polat
- Department of Medical Biochemistry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Nurinnisa Ozturk
- Department of Medical Biochemistry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Nurcan K Baygutalp
- Department of Medical Biochemistry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Fatma Taneli
- Department of Medical Biochemistry, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Yesim Guvenc
- Department of Medical Biochemistry, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Murat Ormen
- Department of Medical Biochemistry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Zubeyde Erbayraktar
- Department of Medical Biochemistry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Nurten Aksoy
- Department of Medical Biochemistry, Harran University School of Medicine, Urfa, Turkey
| | - Hatice Sezen
- Department of Medical Biochemistry, Harran University School of Medicine, Urfa, Turkey
| | - Meltem Demir
- Department of Medical Biochemistry, Medicalpark Hospital, Antalya, Turkey
| | - Gulcin Eskandari
- Department of Medical Biochemistry, Mersin University School of Medicine, Mersin, Turkey
| | - Gurbuz Polat
- Department of Medical Biochemistry, Mersin University School of Medicine, Mersin, Turkey
| | - Nuriye Mete
- Department of Medical Biochemistry, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Hatice Yuksel
- Department of Medical Biochemistry, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Husamettin Vatansev
- Department of Medical Biochemistry, Selçuk University School of Medicine, Konya, Turkey
| | - Fatma Gun
- Department of Medical Biochemistry, Selçuk University School of Medicine, Konya, Turkey
| | - Okhan Akin
- Department of Medical Biochemistry, Keçiören Teaching and Research Hospital, Ankara, Turkey
| | - Ozlem Ceylan
- Department of Medical Biochemistry, Keçiören Teaching and Research Hospital, Ankara, Turkey
| | - Tevfik Noyan
- Department of Medical Biochemistry, Ordu University School of Medicine, Ordu, Turkey
| | - Ozgul Gozlukaya
- Department of Medical Biochemistry, Ordu University School of Medicine, Ordu, Turkey
| | - Yuksel Aliyazicioglu
- Department of Medical Biochemistry, Karadeniz Teknik University School of Medicine, Trabzon, Turkey
| | - Sevim Kahraman
- Department of Medical Biochemistry, Karadeniz Teknik University School of Medicine, Trabzon, Turkey
| | - Melahat Dirican
- Department of Medical Biochemistry, Uludag University School of Medicine, Bursa, Turkey
| | - Gul Ozlem Tuncer
- Department of Medical Biochemistry, Uludag University School of Medicine, Bursa, Turkey
| | - Shogo Kimura
- Department of Laboratory Sciences, Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Pinar Eker
- Department of Medical Biochemistry, Kuzey Laboratories, Fatih Sultan Mehmet Hospital, Istanbul
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Sarier M, Demir M, Duman I, Yuksel Y, Demirbas A. Evaluation of Ureteral Stent Colonization in Live-Donor Renal Transplant Recipients. Transplant Proc 2017; 49:415-419. [DOI: 10.1016/j.transproceed.2017.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Duyuler PT, Duyuler S, Demir M. Impact of myocardial blush grade on Tpe interval and Tpe/QT ratio after successful primary percutaneous coronary intervention in patients with ST elevation myocardial infarction. Eur Rev Med Pharmacol Sci 2017; 21:143-149. [PMID: 28121344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Myocardial perfusion, when assessed by myocardial blush grade (MBG) is an independent predictor of major adverse cardiac outcomes. The terminal part of repolarization, measured as the interval from the peak to the end of the T wave (Tpe), is a relatively novel indicator of ventricular arrhythmias. The relations between MBG and Tpe interval have not been examined before. We aimed to evaluate the relationship between MBG and Tpe and Tpe/QT ratio after successful primary percutaneous coronary intervention (PCI) in acute ST-segment elevation myocardial infarction (STEMI). PATIENTS AND METHODS In this study, 149 consecutive patients with STEMI and underwent primary PCI were included. The Tpe interval was defined as the interval from the peak of T wave to end of T wave, and measurements were performed from precordial leads on ECGs at admission and 90 minutes after revascularization. Patients with no myocardial blush were graded as MBG 0, those with minimal myocardial blush were graded as MBG 1, those with moderate myocardial blush were graded as MBG 2 and patients with normal myocardial blush were graded as MBG 3. RESULTS Comparisons were made between the MBG 0-1, MBG 2 and MBG 3 groups. In all groups, post-procedural Tpe interval were significantly shorter than pre-procedural Tpe intervals (for all groups p<0.001). Post-procedural Tpe interval in MBG 3 group was significantly shorter than MBG 0-1 and MBG 2 groups (Tpe=81±11 ms in MBG 0-1 group, 81±11 ms in MBG 2 group and 72±10 ms in MBG 3 group; p<0.001, for all groups). Post-procedural Tpe/QT ratios decreased in all three MBG groups (p<0.001, for all groups). Tpe/QT ratios were smaller with the increasing MBG (p<0.001). CONCLUSIONS Tpe interval and Tpe/QT ratio are closely associated with MBG after successful primary percutaneous coronary intervention in STEMI.
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Affiliation(s)
- P T Duyuler
- Department of Cardiology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
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Krawczyk M, Rau M, Schattenberg JM, Bantel H, Pathil A, Demir M, Kluwe J, Boettler T, Lammert F, Geier A. Presence of the MBOAT7 rs641738 variant might enhance liver fibrosis in patients with fatty liver: analysis of the German NAFLD CSG cohort. Z Gastroenterol 2016. [DOI: 10.1055/s-0036-1597351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Krawczyk
- Saarland University Medical Center, Department of Medicine II, Homburg, Germany
| | - M Rau
- University Hospital Würzburg, Division of Hepatology, Department of Medicine II, Würzburg, Germany
| | - JM Schattenberg
- Johannes Gutenberg University, Department of Medicine I, University Medical Center Mainz, Mainz, Germany
| | - H Bantel
- Hannover Medical School, Department of Gastroenterology, Hepatology and Endocrinology, Hannover, Germany
| | - A Pathil
- University of Heidelberg, Department of Internal Medicine IV, Gastroenterology and Hepatology, Heidelberg, Germany
| | - M Demir
- University Hospital of Cologne, Clinic for Gastroenterology and Hepatology, Cologne, Germany
| | - J Kluwe
- Hamburg University Medical Center, Department of Medicine I, Hamburg, Germany
| | - T Boettler
- University Hospital Freiburg, Department of Medicine II, Freiburg, Germany
| | - F Lammert
- Saarland University Medical Center, Department of Medicine II, Homburg, Germany
| | - A Geier
- University Hospital Würzburg, Division of Hepatology, Department of Medicine II, Würzburg, Germany
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Schramm C, Scheller I, Franklin J, Demir M, Kuetting F, Nierhoff D, Goeser T, Toex U, Steffen HM. Predicting ADR from PDR and individual adenoma-to-polyp-detection-rate ratio for screening and surveillance colonoscopies: A new approach to quality assessment. United European Gastroenterol J 2016; 5:742-749. [PMID: 28815039 DOI: 10.1177/2050640616675220] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 09/27/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND AND AIMS Adenoma detection rate (ADR) has been established as a quality indicator for screening colonoscopy. Because ADR is cumbersome to obtain in routine practice, polyp detection rate (PDR), polypectomy rate (PR) and adenoma-to-polyp-detection-rate-ratio (APDRR) have been proposed to estimate ADR. This study aimed to evaluate APDRR in order to estimate ADR (ADRest) in different settings. METHODS Average risk screening and surveillance colonoscopies from a community-based private practice and a tertiary academic hospital setting were retrospectively evaluated. APDRR was calculated as averaged group APDRR for all study procedures (APDRR) and for the first half of study procedures of each gastroenterologist (APDRRag) or individually for each gastroenterologist on the basis of his or her first 25, 50 and 100 colonoscopies (APDRRind). ADRest was determined from PDR by using APDRR, APDRRag, and APDRRind, respectively. RESULTS A total of 2717 individuals were analyzed. Using APDRR, significant correlations between ADR and ADRest were observed for the entire (0.944, p < 0.001), proximal (0.854, p < 0.001), and distal (0.977, p < 0.001) colon. These correlations were lost when APDRRag was used to estimate each gastroenterologist's ADR for the second half of his or her included colonoscopies. However, ADR and ADRest correlated significantly with a root-mean-square-error of 6.8% and 5.8% when APDRRind on the basis of each gastroenterologist's first 50 and 100 colonoscopies was used for subsequent colonoscopies. CONCLUSIONS ADR for subsequent colonoscopies of an individual endoscopist can be reliably estimated from PDR by using an individually calculated APDRR. Prospective studies are needed to verify this promising approach in different practice settings.
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Affiliation(s)
- C Schramm
- Department for Gastroenterology and Hepatology, University Hospital of Cologne, Germany
| | - I Scheller
- Practice for Gastroenterology Remscheid, Remscheid, Germany
| | - J Franklin
- Institute for Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany
| | - M Demir
- Department for Gastroenterology and Hepatology, University Hospital of Cologne, Germany
| | - F Kuetting
- Department for Gastroenterology and Hepatology, University Hospital of Cologne, Germany
| | - D Nierhoff
- Department for Gastroenterology and Hepatology, University Hospital of Cologne, Germany
| | - T Goeser
- Department for Gastroenterology and Hepatology, University Hospital of Cologne, Germany
| | - U Toex
- Department for Gastroenterology and Hepatology, University Hospital of Cologne, Germany
| | - H M Steffen
- Department for Gastroenterology and Hepatology, University Hospital of Cologne, Germany
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Demir M, Foerster U, Hoffmann V, Pelc A, Schreiter I, Chang DH, Krug B, Christ H, Steffen HM. Effects of early contrast-enhanced computed tomography on clinical course and complications in patients with acute pancreatitis. Z Gastroenterol 2016; 54:642-6. [PMID: 27429101 DOI: 10.1055/s-0042-101961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the effect of an early contrast-enhanced computed tomography (CECT) on clinical course and complications of acute pancreatitis (AP). MATERIAL AND METHODS 58 patients with AP who had at least one CECT examination were analyzed retrospectively. Laboratory as well as clinical data, and results from the assessment of disease severity (CT severity index (CTSI) and its modified (MCTSI) version) were analyzed. The primary endpoint was the development of severe complications, defined as death, respiratory failure, acute renal failure, and the need for invasive interventions. Patients were divided into two groups: an early group (CECT within the first 48 h after the onset of symptoms, n = 32) and a late group (CECT > 48 h after the onset of symptoms, n = 26). Multivariate regression analysis was performed to identify risk factors for severe complications. RESULTS There were no statistically significant differences between both groups concerning baseline characteristics, CTSI, and MCTSI. Complications occurred more often in the early CECT group (p = 0.008). Multivariate logistic regression analysis identified an early CECT and a severe MCTSI as independent risk factors for the occurrence of severe complications (p = 0.02 and p = 0.002, respectively). CONCLUSION CECT performed within the first 48 h after the onset of symptoms is associated with an unfavorable outcome in AP.
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Affiliation(s)
- M Demir
- Clinic for Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, Germany
| | - U Foerster
- Department of Anesthesiology, Technical University Munich, Germany
| | - V Hoffmann
- Clinic for Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, Germany
| | - A Pelc
- Clinic for Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, Germany
| | - I Schreiter
- Department of Radiology, University Hospital of Cologne, Germany
| | - D-H Chang
- Department of Radiology, University Hospital of Cologne, Germany
| | - B Krug
- Department of Radiology, University Hospital of Cologne, Germany
| | - H Christ
- Institute of Medical Statistics, Informatics and Epidemiology, University Hospital of Cologne, Germany
| | - H M Steffen
- Clinic for Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, Germany
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Parlak Y, Demir M, Cavdar I, Ereees S, Gumuser G, Uysal B, Capa Kaya G, Koç M, Sayit E. Bone marrow radiation dosimetry of high dose 131I treatment in differentiated thyroid carcinoma patients. INT J RADIAT RES 2016. [DOI: 10.18869/acadpub.ijrr.14.2.99] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Demir M, Kurt M, Akçay AB. Fragmented QRS is associated with cirrhotic cardiomyopathy in patients with decompensated cirrhosis. Acta Gastroenterol Belg 2016; 79:191-196. [PMID: 27382936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND AIM It has been reported that the fragmented QRS (fQRS) is related to left ventricular systolic dysfunction and diastolic dysfunction. The aim of this study was to determine the frequency of fragmented QRS (fQRS) in patients with decompensated cirrhosis and to evaluate the relationship between the presence of fQRS and systolic and diastolic dysfunction. METHOD PThe study included consecutive 189 patients with decompensated cirrhosis. fQRS pattern was described as presence of RSR' manifested as existence of additional R wave and notching in either R or S waves in ECG recordings. Conventional echocardiography and tissue doppler echocardiography were performed in all patients. RESULTS The prevalence of fQRS was 31% (59/189) in patients with decompensated cirrhosis. The patients with fQRS had worse diastolic and systolic functions in comparison to the patients without fQRS. In addition, multivariate analysis revealed that the presence of an fQRS, Na levels < 125 mEq/L, the Child-Pugh score and the MELD score were independent predictive factors for mortality (respectively, p < 0.001, p < 0.001, p < 0.001 and p < 0.001). CONCLUSIONS In conclusion,this study showed a relationship between the presence of an fQRS and cardiac dysfunction. In addition, the fQRS appeared to act as an independent predictor of mortality in patients with decompensated cirrhosis. These data suggest that the fQRS may represent a novel noninvasive marker for cardiac involvement and for predicting mortality in patients with decompensated cirrhosis.
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