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Özderya A, Şahin S, Koşmaz T, Maz MA, Yerlikaya MG, Akyüz AR, Sayın MR, Erkan H. Can HALP score predict post-contrast acute kidney injury and 6-year mortality in patients undergoing endovascular abdominal aneurysm repair? Vascular 2024:17085381241246905. [PMID: 38607832 DOI: 10.1177/17085381241246905] [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: 04/14/2024]
Abstract
BACKGROUND The aim of this study is to investigate the relationship between HALP score and post-contrast acute kidney injury (PC-AKI) and average 6-year mortality in patients undergoing endovascular abdominal aortic aneurysm repair (EVAR). METHODS 125 patients who underwent EVAR between January 2015 and December 2020 were included in our study. HALP score was calculated with the formula "hemoglobin × albumin × lymphocyte count/platelet count." In the first phase of the study, two groups were developed: those who developed PC-AKI and those who did not. In the second stage, statistical analysis was performed by creating two groups: average 6-year mortality and survivors group. RESULTS HALP score was found to be lower in the PC-AKI group [26.12 (14-61.54) versus 40.53 (7.22-103.61); p < .001]. Low HALP score was found to be both a dependent and independent predictor of the development of PC-AKI (p = .019). HALP score was also found to be lower in the mortality group compared to the survivors [28.97 (12.6-103.61) versus 40.81 (7.22-99) p = .004]. Low HALP score was found to be only a dependent predictor of mortality. The development of PC-AKI was found to be an independent predictor of mortality (p = .042). CONCLUSIONS The HALP score, which can be calculated with a simple formula, can be used to predict PC-AKI and medium-long-term mortality in EVAR patients.
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Affiliation(s)
- Ahmet Özderya
- Department of Cardiology, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Sinan Şahin
- Department of Cardiology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Tolga Koşmaz
- Department of Cardiology, University of Health Sciences Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey
| | - Mehmet Ali Maz
- Department of Cardiology, University of Health Sciences Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey
| | - Murat Gökhan Yerlikaya
- Department of Cardiology, University of Health Sciences Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey
| | - Ali Rıza Akyüz
- Department of Cardiology, University of Health Sciences Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey
| | - Muhammet Raşit Sayın
- Department of Cardiology, University of Health Sciences Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey
| | - Hakan Erkan
- Department of Cardiology, University of Health Science Bursa City Hospital, Bursa, Turkey
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Subaşi S, Dere Ö, Şahin S, Gökdoğan Ç, Kayilioğlu I, Yazkan C, Özcan Ö. Analysis of factors on voice quality in thyroidectomy patients. Eur Rev Med Pharmacol Sci 2024; 28:2701-2709. [PMID: 38639510 DOI: 10.26355/eurrev_202404_35899] [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: 04/20/2024]
Abstract
OBJECTIVE Vocal cord paralysis (VCP) is a serious complication in thyroidectomy operations; however, its management remains unclear. The present study evaluated the voice parameters of patients who underwent surgery using Intraoperative Neurophysiologic Monitoring (IONM). PATIENTS AND METHODS A total of 52 patients (41 females and 11 males) who underwent a total thyroidectomy operation were evaluated using objective and subjective voice analysis examinations before and after surgery. Acoustic parameters, such as Fundamental Frequency (F0), Shimmer, Jitter, Noise-to-Harmonic ratio (NHR), and aerodynamic parameters, including S/Z ratio and maximum phonation time (MPT), were analyzed. Objective findings, including the VHI-10 (Voice Handicap Index) and V-RQOL (Voice-Related Quality of Life), were also analyzed. The relationship between voice parameters and IONM values was investigated. RESULTS The objective analysis (acoustic and aerodynamic parameters) showed no difference (p>0.05). However, the subjective analysis, which involved the VHI-10 and V-RQOL measures, revealed a significant difference before and after the operation (p<0.05). The Spearman correlation analysis showed that the NHR postoperative 1st-month parameter negatively correlated (rho=-0.317, p<0.059), while the F0 postoperative 6th-month parameter positively correlated (rho=0.347) with the amplitude difference before and after dissection (Right R2-R1 difference) for the right RLN measured in IONM. CONCLUSIONS Patients who are planning to undergo a thyroidectomy procedure should undergo voice assessment during both the preoperative and postoperative periods. IONM could improve voice quality outcomes.
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Affiliation(s)
- S Subaşi
- Department of General Surgery, Mugla Training and Research Hospital, Mugla, Turkey.
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Şahin S, Ata Korkmaz HA. Delayed Aortic Dissection after Transcatheter Aortic Valve Implantation. Turk Kardiyol Dern Ars 2023; 51:577-579. [PMID: 38164774 DOI: 10.5543/tkda.2023.26783] [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] [Indexed: 01/03/2024] Open
Abstract
Transcatheter aortic valve implantation (TAVI) offers functional improvement for high-risk patients with aortic stenosis. Vascular complications after TAVI are known to occur frequently. Among them, aortic dissection is a rare but life-threatening vascular complication. We present a case of delayed aortic dissection following a successful TAVI.
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Affiliation(s)
- Sinan Şahin
- Department of Cardiology, University of Health Sciences, Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application Center, Trabzon, Türkiye
| | - Hatice Ayça Ata Korkmaz
- Department of Cardiology, University of Health Sciences, Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application Center, Trabzon, Türkiye
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Kargı T, Ekşi M, Karadağ S, Evren I, Hacıislamoğlu A, Polat H, Arikan Y, Özlü DN, Atar FA, Şahin S, Taşçı AI. Optimal patient position for percutaneous nephrolithotomy in horseshoe kidneys: Traditional prone or supine? Actas Urol Esp 2022; 46:565-571. [PMID: 35491387 DOI: 10.1016/j.acuroe.2022.03.008] [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: 09/20/2021] [Accepted: 10/21/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Although it was stated that supine percutaneous nephrolithotomy (PCNL) was associated with relatively shorter surgical times and comparable success and complication rates, there is no consensus in the current literature concerning the safety and efficacy of supine PCNL in patients with horseshoe kidneys. We aimed to compare supine and prone PCNL regarding safety and efficacy in patients with horseshoe kidneys. METHODS Data of the patients with horseshoe kidneys who underwent PCNL for renal stones larger than 2 cm between January 2010 and May 2021 were retrospectively reviewed. The study patients were categorized as Group 1 (i.e., supine PCNL-SPCNL) and Group 2 (i.e., prone PCNL-PPCNL). Both groups were compared regarding demographic, clinical, and surgical data. RESULTS Sixty-five patients were included. Among these patients, 31 (47.7%) were in Group 1, while 34 (52.3%) were in Group 2. Both groups were statistically similar in terms of demographic data, stone characteristics, perioperative parameters, and complication rates (p > 0.05). There was no statistical difference in terms of additional treatment rates, stone-free rates in the postoperative second-day and third-month evaluations (p > 0.05). Mean surgical time was significantly longer in Group 2 (113 ± 17.1 min) than in Group 1 (90.6 ± 11.3 min) (p = 0.000). CONCLUSION Although it is traditionally performed in the prone position, the supine approach is as safe and effective as the prone approach. In addition, the supine approach is associated with significantly shorter surgical times.
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Affiliation(s)
- T Kargı
- Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey
| | - M Ekşi
- Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey
| | - S Karadağ
- Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey
| | - I Evren
- Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey
| | - A Hacıislamoğlu
- Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey
| | - H Polat
- Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey
| | - Y Arikan
- Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey
| | - D N Özlü
- Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey.
| | - F A Atar
- Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey
| | - S Şahin
- Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey
| | - A I Taşçı
- Departamento de Urología, Bakirkoy Hospital de Formación e Investigación Sadi Konuk, Universidad de Ciencias de la Salud, Istanbul, Turkey
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Kavak Eren G, Ertan F, Şahin S, Atasever Akkas E, Karakaya E. PO-1671 Total Marrow and Lymphoid Irradiation via Arc IMRT and Helical Tomotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03635-0] [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: 10/18/2022]
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Ekşi M, Fakir A, Evren İ, Şam E, Arıkan Y, Kargı T, Hacıislamoğlu A, Yavuzsan A, Şahin S, Taşçı A. Prediction of infective complications after retrograde intrarenal surgery using machine learning algorithms. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00155-0] [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: 10/18/2022] Open
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Akkaş F, Culha MG, Ayten A, Danacıoğlu YO, Yildiz Ö, İnci E, Guner E, Şahin S. A novel model using computed tomography parameters to predict shock wave lithotripsy success in ureteral stones at different locations. Actas Urol Esp 2022; 46:114-121. [PMID: 35184987 DOI: 10.1016/j.acuroe.2021.01.011] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/13/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To combine non-contrast computerized tomography (NCCT)-based parameters with stone and patient characteristics that are already known to affect shock wave lithotripsy (SWL) success and assess this novel model's effectiveness in predicting SWL success for single ureteral stones in different locations. MATERIALS AND METHODS Data of patients treated by SWL for a single ureteral stone between January 2017 and January 2019 were retrospectively reviewed. Demographic parameters of patients and stone characteristics were combined with NCCT-based parameters. NCCT-based parameters included the presence or absence of hydronephrosis, perinephric stranding, periureteral edema, diameter of the proximal ureter, ureteral wall thickness (UWT) at ureteral stone site. The logistic regression method was used for the development of a useful predictive model. Subsequently, the receiver operating curve was used to determine cut-off levels, and a scoring system was developed for prediction of SWL success. RESULTS Stone-free rate was 77,1% (267/346) in the entire cohort. Univariate analysis revealed that age, stone volume, density, perinephric stranding, diameter of proximal ureter, and UWT, were associated with SWL success. In multivariate analysis, proximal ureteral stone location, stone volume, density, and UWT were independent predictors of SWL success. The formula used during logistic regression analysis was: 1/[1 + exp {-8.856 + 0.008 (stone volume) + 0.002 (stone density) + 0.673 (UWT) + 1026 (proximal ureteral stone)}]. The scores of 0, 1, 2, 3 and 4 were associated with 97,8%, 83,4%, 60,8%, 33,2% and 11,1% success rates, respectively, in the prediction model based on these parameters. CONCLUSION We conclude that our model can facilitate decision-making for SWL treatment of ureteral stones in different locations.
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Affiliation(s)
- F Akkaş
- University of Health Sciences, Erzurum Regional Training and Research Hospital, Department of Urology, Erzurum, Turkey.
| | - M G Culha
- University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu Training and Research Hospital, Department of Urology, Istanbul, Turkey
| | - A Ayten
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Urology, Istanbul, Turkey
| | - Y O Danacıoğlu
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Urology, Istanbul, Turkey
| | - Ö Yildiz
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Radiology, Istanbul, Turkey
| | - E İnci
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Radiology, Istanbul, Turkey
| | - E Guner
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Urology, Istanbul, Turkey
| | - S Şahin
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Urology, Istanbul, Turkey
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Akkaş F, Culha M, Ayten A, Danacioğlu Y, Yildiz Ö, İnci E, Guner E, Şahin S. Modelo novedoso basado en los parámetros de la tomografía para predecir el éxito de la litotricia por ondas de choque en los cálculos ureterales de diferentes localizaciones. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2021.01.008] [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: 10/19/2022]
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Şahin S, Ertekin E, Şahin T, Özsunar Y. Evaluation of normal-appearing white matter with perfusion and diffusion MRI in patients with treated glioblastoma. MAGMA 2022; 35:153-162. [PMID: 34951690 DOI: 10.1007/s10334-021-00990-5] [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] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE We tried to reveal how the normal appearing white matter (NAWM) was affected in patients with glioblastoma treated with chemo-radiotherapy (CRT) in the period following the treatment, by multiparametric MRI. MATERIALS AND METHODS 43 multiparametric MRI examinations of 17 patients with glioblastoma treated with CRT were examined. A total of six different series or maps were analyzed in the examinations: Apparent Diffusion Coefficient (ADC) and Fractional Anisotropy (FA) maps, Gradient Echo (GRE) sequence, Dynamic susceptibility contrast (DSC) and Arterial spin labeling (ASL) perfusion sequences. Each sequence in each examination was examined in detail with 14 Region of Interest (ROI) measurements. The obtained values were proportioned to the contralateral NAWM values and the results were recorded as normalized values. Time dependent changes of normalized values were statistically analyzed. RESULTS The most prominent changes in follow-up imaging occurred in the perilesional region. In perilesional NAWM, we found a decrease in normalized FA (nFA), rCBV (nrCBV), rCBF (nrCBF), ASL (nASL)values (p < 0.005) in the first 3 months after treatment, followed by a plateau and an increase approaching pretreatment values, although it did not reach. Similar but milder findings were present in other NAWM areas. In perilesional NAWM, nrCBV values were found to be positively high correlated with nrCBF and nASL, and negatively high correlated with nADC values (r: 0.963, 0.736, - 0.973, respectively). We also found high correlations between the mean values of nrCBV, nrCBF, nASL in other NAWM areas (r: 0.891, 0.864, respectively). DISCUSSION We showed that both DSC and ASL perfusion values decreased correlatively in the first 3 months and showed a plateau after 1 year in patients with glioblastoma treated with CRT, unlike the literature. Although it was not as evident as perfusion MRI, it was observed that the ADC values also showed a plateau pattern following the increase in the first 3 months. Further studies are needed to explain late pathophysiological changes. Because of the high correlation, our results support ASL perfusion instead of contrast enhanced perfusion methods.
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Affiliation(s)
- Sinan Şahin
- Department of Radiology, Adnan Menderes University, Aydın, Turkey
| | - Ersen Ertekin
- Department of Radiology, Adnan Menderes University, Aydın, Turkey.
| | - Tuna Şahin
- Department of Radiology, Adnan Menderes University, Aydın, Turkey
| | - Yelda Özsunar
- Department of Radiology, Adnan Menderes University, Aydın, Turkey
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Eroglu M, Helvacioglu C, Eser AÇ, Sayıcı D, Arınkan A, Şahin S. What are the factors affecting IVF success in women with hypogonadotropic hypogonadism? Eur Rev Med Pharmacol Sci 2021; 25:7750-7753. [PMID: 34982436 DOI: 10.26355/eurrev_202112_27621] [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 This study aimed to investigate in vitro fertilization (IVF) outcomes in women with hypogonadotropic hypogonadism (HH) and unexplained infertility and investigate factors affecting the pregnancy rate among HH patients. MATERIALS AND METHODS This retrospective cohort study was conducted at Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Turkey, a tertiary care referral center. The medical records of 143 women who underwent IVF treatment at this hospital between 2015 and 2020 were reviewed. Sixty-three had hypogonadotropic hypogonadism (HH) and 74 had unexplained infertility. Demographics, hormonal profile, IVF cycle characteristics, and pregnancy rates were recorded. The factors affecting the ongoing pregnancy rates were evaluated among HH patients. RESULTS Anti-Mullerian hormone (AMH) levels were lower among women with HH compared to those with unexplained infertility (1.64±1.2 vs. 3.0±2.13). IVF cycle characteristics and ongoing pregnancy outcome (20.28% vs. 22.97%) were similar between the groups; however, the total dose of human menopausal gonadotrophin (HMG) used (5127.74±1845.8 vs. 2035.71±1387.45) was higher in the HH group. Increased estradiol level (2596.35±1085 vs. 1869.9±1203.4), endometrial thickness (10.82±1.74 vs. 8.43±2.33), higher number of total oocytes retrieved (12.14±4.34 vs. 8.43±5.44) were correlated with higher ongoing pregnancy rates among the HH group. CONCLUSIONS IVF success rates were similar between the HH and unexplained infertility groups. Although AMH level was not a prognostic factor for IVF success, higher doses of HMG were needed to achieve pregnancy in the HH group. The factors affecting the ongoing pregnancy rates in the HH group were higher estradiol level, increased endometrial thickness, and a higher number of oocytes retrieved.
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Affiliation(s)
- M Eroglu
- Obstetrics and Gynecology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey.
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Çırakoğlu ÖF, Şahin S, Yılmaz AS. Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis. Istanbul Med J 2021. [DOI: 10.4274/imj.galenos.2021.08365] [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: 12/01/2022] Open
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Ertaş G, Ekmekçi A, Şahin S, Murat A, Bakhshaliyev N, Erer HB, Güvenç TS, Eren M. Epicardial fat thickness assessment by multi-slice computed tomography for predicting cardiac outcomes in patients undergoing transcatheter aortic valve implantation. Cardiovasc J Afr 2021; 33:108-111. [PMID: 34704590 DOI: 10.5830/cvja-2021-043] [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] [Received: 11/17/2020] [Accepted: 09/13/2021] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Chronic inflammation promotes aortic valve calcification. It is known that epicardial fat is a source of inflammation. The aim of this study was to investigate the relationship between epicardial fat thickness, cardiac conduction disorders and outcomes in patients undergoing transcatheter aortic valve implantation (TAVI). METHODS During a three-year period, 45 patients with severe aortic stenosis who underwent TAVI were recruited to the study. Data were collected retrospectively. Epicardial fat was defined as the adipose tissue between the epicardium and the visceral pericardium. Mean epicardial fat thickness was determined by multi-slice computed tomography, which was performed before the procedure. RESULTS The average thickness of epicardial fat was 13.06 ± 3.29 mm. This study failed to reveal a significant correlation between epicardial fat thickness and post-procedural left bundle branch block, right bundle branch block, paravalvular aortic regurgitation and pacemaker implantation rates (p > 0.05). CONCLUSIONS The results of this study failed to show a significant relationship between epicardial fat thickness, cardiac conduction disorders and outcomes, however further studies with larger sample numbers are required to explore the relationship.
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Affiliation(s)
- Gökhan Ertaş
- Department of Cardiology, Memorial Sisli Hospital, Istanbul, Turkey.
| | - Ahmet Ekmekçi
- Department of Cardiology, Medical Park Pendik Hospital, Istanbul, Turkey
| | - Sinan Şahin
- Department of Radiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Murat
- Department of Cardiology, Memorial Sisli Hospital, Istanbul, Turkey
| | - Nijad Bakhshaliyev
- Department of Cardiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Hatice Betül Erer
- Department of Cardiology, Medical Park Pendik Hospital, Istanbul, Turkey
| | - Tolga Sinan Güvenç
- Department of Cardiology, Medical Park Pendik Hospital, Istanbul, Turkey
| | - Mehmet Eren
- Department of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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Akyüz AR, Konuş AH, Çırakoğlu ÖF, Şahin S, Kul S, Korkmaz L. First experiences with a new balloon-expandable Myval transcatheter aortic valve: a preliminary study. Herz 2021; 47:449-455. [PMID: 34643745 PMCID: PMC8512594 DOI: 10.1007/s00059-021-05069-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 08/02/2021] [Accepted: 09/12/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND In the present article, we present our first experiences with a new type of balloon-expandable Myval valve (Meril Life Sciences, Gujarat, India). MATERIALS AND METHODS A total of 25 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) from June 2020 to November 2020 were included in the study. RESULTS The mean age of the study population was 83 (75-87) years; 17 (68%) were female, and 20 (80%) had hypertension. The Society of Thoracic Surgeons (STS) score of the group was 5.4% ± 3.5%. TAVI was performed via the transfemoral route on all patients. In 19 (76%) cases, we started the procedure without predilation. In two (10.5%) cases performed without predilation, the prosthesis did not pass the native valve. We had to implant the valve from the descending aorta in one (4%) patient. We used Prostar XL (Abbott Vascular, Santa Clara, CA, USA) for six (24%) patients and ProGlide (Abbott Vascular) for 19 (76%) patients for vascular closure. Two (8%) in-hospital deaths occurred in our study but there were no deaths in the 30-day and 90-day follow-up. Vascular complications were observed in one (4%) patient. None of the patients in our study had severe paravalvular leak (PVL), while two (8%) patients had moderate PVL. A permanent pacemaker (PPM) was required in two (8%) patients for the indication of complete atrioventricular block. The mean hospital stay for the whole group was 4 (3-7) days. CONCLUSION Based on our experiences, the new balloon-expandable valve Myval is easy to use, efficient, and has only a few negligible drawbacks such as the need for predilation of the sheath. While shaft flexibility may have advantages in some situations including in very tortuous arteries, it may cause some difficulties in alignment of the valves.
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Affiliation(s)
- Ali Rıza Akyüz
- Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey.
| | - Ali Hakan Konuş
- Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey
| | - Ömer Faruk Çırakoğlu
- Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey
| | - Sinan Şahin
- Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey
| | - Selim Kul
- Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey
| | - Levent Korkmaz
- Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Department of Cardiology, University of Health Sciences, Trabzon, Turkey
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Ekşi M, Yavuzsan A, Evren İ, Ayten A, Fakir A, Akkaş F, Bursalı K, Akdağ A, Şahin S, Taşçı A. Testicular salvage: Using machine learning algorithm to develop a more predictive model in testicular torsion. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01514-1] [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: 10/20/2022]
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15
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Ösken A, Akdeniz E, Keskin M, Öz A, Ipek G, Zehir R, Barutça H, Çam N, Şahin S. Estimated Glomerular Filtration Rate as a Predictor of Restenosis After Carotid Stenting Using First-Generation Stents. Angiology 2021; 72:762-769. [PMID: 33966501 DOI: 10.1177/00033197211014684] [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] [Indexed: 12/12/2022]
Abstract
This study evaluated the impact of the baseline estimated glomerular filtration rate (eGFR) on clinical and angiographic outcomes and long-term in-stent restenosis (ISR) rates in patients undergoing elective carotid artery stenting (CAS) procedures. Consecutive patients who underwent CAS were retrospectively enrolled (n = 456). At the end of 3 years of follow-up, patients who had died or were lost follow-up were excluded from the study and a final analysis was performed using data from the remaining 405 patients. The study population (n = 405) was divided into 3 tertiles based on the tertile values of the eGFR level (T1, T2, and T3); then, clinical and procedural characteristics and 3-year ISR rates were compared between the groups. An ISR of 50% was detected in 49 (12%) surviving patients. The 3-year ISR was higher among patients with the lowest eGFR values (T1) by 3.7 times (95% CI: 2.01-11.38) than that among patients with the highest eGFR values (T3). These significant relationships persisted following adjustment for confounders. A lower baseline eGFR level was significantly associated with an increased ISR rate. Decreased renal function may be a predictor of ISR after CAS using first-generation stents.
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Affiliation(s)
- Altuğ Ösken
- Department of Cardiology, 111319Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Evliya Akdeniz
- Department of Cardiology, 111319Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.,Department of Cardiology, Başkent University Faculty of Medicine, Istanbul, Turkey
| | - Muhammed Keskin
- Department of Cardiology, 111319Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.,Department of Cardiology, Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Öz
- Department of Cardiology, 111319Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.,Department of Cardiology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Göktürk Ipek
- Department of Cardiology, 111319Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Regayip Zehir
- Department of Cardiology, 111319Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey.,Department of Cardiology, Kartal Koşuyolu Training and Research Hospital, Istanbul, Turkey
| | - Hakan Barutça
- Department of Radiology, 111319Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Neşe Çam
- Department of Cardiology, 111319Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Sinan Şahin
- Department of Radiology, 111319Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
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16
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Ösken A, Öz A, Keskin M, Akdeniz E, Şahan H, Şişman SB, Çam N, Şahin S. The association between neutrophil-to-lymphocyte ratio and contrast-induced acute kidney injury in patients with carotid artery stenting. Vascular 2021; 29:550-555. [PMID: 33951973 DOI: 10.1177/17085381211012562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/15/2022]
Abstract
OBJECTIVES Contrast-induced acute kidney injury (CI-AKI) is a life-threatening complication that leads to comorbidities and prolonged hospital stay lengths in the setting of peripheral interventions. The presence of some CI-AKI risk factors has already been investigated. In this study, we evaluated the predictors of CI-AKI after carotid artery stenting. METHODS A total of 389 patients with 50% to 99% carotid artery stenosis who underwent carotid artery stenting were included in this study. Patients were grouped according to CI-AKI status. RESULTS CI-AKI developed in 26 (6.6%) patients. Age, baseline creatinine level, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were higher and estimated glomerular filtration rate, haemoglobin and lymphocyte count were lower in CI-AKI patients. In the multivariate regression analysis, the neutrophil-to-lymphocyte ratio triggered a 1.39- to 2.63-fold increase in the risk of CI-AKI onset (p < 0.001). CONCLUSIONS The neutrophil-to-lymphocyte ratio may be a significant predictor of CI-AKI in patients with carotid artery stenting and higher neutrophil-to-lymphocyte ratio values may be independently associated with CI-AKI.
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Affiliation(s)
- Altuğ Ösken
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Centre, Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Öz
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Centre, Training and Research Hospital, Istanbul, Turkey.,Department of Cardiology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Muhammed Keskin
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Centre, Training and Research Hospital, Istanbul, Turkey.,Department of Cardiology, Sultan 2. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Evliya Akdeniz
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Centre, Training and Research Hospital, Istanbul, Turkey.,Department of Cardiology, Başkent University, Faculty of Medicine, Istanbul, Turkey
| | - Hasan Şahan
- Department of Radiology, Siyami Ersek Thoracic and Cardiovascular Surgery Centre, Training and Research Hospital, Istanbul, Turkey
| | - Seviye Bora Şişman
- Department of Radiology, Siyami Ersek Thoracic and Cardiovascular Surgery Centre, Training and Research Hospital, Istanbul, Turkey
| | - Neşe Çam
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Centre, Training and Research Hospital, Istanbul, Turkey
| | - Sinan Şahin
- Department of Radiology, Siyami Ersek Thoracic and Cardiovascular Surgery Centre, Training and Research Hospital, Istanbul, Turkey
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17
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Cirakoglu OF, Karadeniz AG, Akyüz AR, Aydın C, Şahin S, Erkan H. Abdominal Aortic Intima-Media Thickness Predicts Coronary Artery Disease Severity in Patients With Stable Angina Pectoris: A Prospective Study. Angiology 2021; 72:754-761. [PMID: 33663258 DOI: 10.1177/0003319721998853] [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: 11/15/2022]
Abstract
Accurately identifying coronary artery disease (CAD) is the key element in guiding the work-up of patients with suspected angina. Thickening of the arterial wall is a hallmark of atherosclerosis. Therefore, the main purpose of this study was to determine whether abdominal aortic intima-media thickness (AAIMT), which is the earliest zone of atherosclerotic manifestations, has a predictive value in CAD severity. A total of 255 consecutive patients who were referred for invasive coronary angiography due to suspected stable angina pectoris were prospectively included in the study. B-mode ultrasonography was used to determine AAIMT before coronary angiography. Coronary artery disease severity was assessed with the SYNTAX score (SS). A history of hypertension, age, dyslipidemia, and higher AAIMT (odds ratio: 2.570; 95%CI 1.831-3.608; P < .001) were independent predictors of intermediate or high SS. An AAIMT <1.3 mm had a negative predictive value of 98% for the presence of intermediate or high SS and 83% for obstructive CAD. In conclusion, AAIMT showed a significant and independent predictive value for intermediate or high SS. Therefore, AAIMT may be a noninvasive and useful tool for decision-making by cardiologists (eg, to use a more invasive approach).
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Affiliation(s)
- Omer Faruk Cirakoglu
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ayşe Gül Karadeniz
- Department of Radiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ali Riza Akyüz
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Cihan Aydın
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Sinan Şahin
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Hakan Erkan
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
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18
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Akyüz AR, Şahin S, Çırakoğlu ÖF, Kul S, Turan T, Erkan H. Relation between fragmented QRS complex and cardio-ankle vascular index in asymptomatic subjects. Clin Exp Hypertens 2021; 43:368-372. [PMID: 33626982 DOI: 10.1080/10641963.2021.1890764] [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: 10/22/2022]
Abstract
OBJECTIVES Stiffness of large arteries has been related to cardiovascular mortality. Cardio-ankle vascular index (CAVI) is a novel marker of arterial stiffness. Herein, we aimed to study the relationship between fragmented QRS (fQRS) in electrocardiogram and CAVI. METHODS Asymptomatic patients with fQRS and without fQRS were enrolled in the study consecutively. The fQRS complexes were analyzed in the 12-lead electrocardiogram. Arterial stiffness was assessed by using cardio ankle vascular index (CAVI). It was measured by a VaSera VS-1000 CAVI instrument. RESULTS CAVI values of the patients with fQRS was significantly higher compared to those without fQRS (8.625 (7.9-9.2) versus 6.65 (6.7-8.4) p < .001). In a univariate analysis, it was revealed that there was a significant correlation between increased CAVI and fQRS, age, and epicardial fat thickness. Multiple binary logistic regression analysis revealed that age [95% confidence interval (CI): 1,068-1.214, p < .001] and fQRS [95% (CI): 1.766-23.117, p: 0.005] were the independent determinants of increased CAVI values. CONCLUSIONS ECG is a widely and readily available, inexpensive, reproducible technique that can be examined by almost every physician. fQRS values in electrocardiogram may provide a significant predictive value for arterial stiffness in asymptomatic subjects.
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Affiliation(s)
- Ali Rıza Akyüz
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Sinan Şahin
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Ömer Faruk Çırakoğlu
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Selim Kul
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Turhan Turan
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Hakan Erkan
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
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19
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Akyüz AR, Özderya A, Şahin S, Kul S, Turan T, Erkan H, Çırakoğlu ÖF, Karal H, Korkmaz L. Relation of p - wave dispersion with presystolic a - wave and aortic valve sclerosis in asymptomatic subjects. Echocardiography 2021; 38:386-393. [PMID: 33617677 DOI: 10.1111/echo.15011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/22/2020] [Revised: 01/22/2021] [Accepted: 02/11/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND P-wave duration and P-wave dispersion (PWD) are thought to be the surrogate marker of devoloping atrial fibrillation (AF). The main purpose of present study was to investigate the association between presystolic wave (PSW), aortic valve sclerosis, and PWD. PATIENTS AND METHODS Patients with sinus rhythm admitted to the cardiology outpatient clinic were consecutively enrolled. Maximum (Pmax) and minimum (Pmin) P-wave duration and PWD were measured. Echocardiography was used to assess the aortic valve morphology and presence of PSW. The patients were divided into two groups according to presence or absence of AVSc and PSW. RESULTS A total of 100 patients were enrolled consecutively. Patients with both PSW and AVSc had higher PWD values compared with those without PSW (42 ± 15 vs 65 ± 20) and AVSc (52 ± 21 vs 69 ± 19). The patients were categorized on the basis of median PWD values. According to univariate analysis, there was significant association between PWD and presence of PSW (P: .004), presence of AVS (P: .011), hypertension (P: .01) interventricular septal thickness (IVST) (P: .026), and posterior wall thickness (PWT) (P: .022). Multivariate logistic regression analyses demonstrated presence of PSW (95% confidence interval (1.058-6.505, P: .037) as an independent determinant of PWD. CONCLUSION Assessment of presystolic A-wave on echocardiography examination may provide important information regarding the atrial conduction velocities that is a electrophysiological cause of AF. While there was a significant association between AVSc and PWD in univariate analysis, this significance disappeared in multivariate analysis.
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Affiliation(s)
- Ali Rıza Akyüz
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Ahmet Özderya
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Sinan Şahin
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Selim Kul
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Turhan Turan
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Hakan Erkan
- Department of Cardiology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Ömer Faruk Çırakoğlu
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Hüseyin Karal
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
| | - Levent Korkmaz
- Department of Cardiology, University of Health Sciences, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
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20
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Cirakoglu OF, Aslan AO, Yilmaz AS, Şahin S, Akyüz AR. Association Between C-Reactive Protein to Albumin Ratio and Left Ventricular Thrombus Formation Following Acute Anterior Myocardial Infarction. Angiology 2020; 71:804-811. [PMID: 32567322 DOI: 10.1177/0003319720933431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Left ventricular thrombus (LVT) is associated with inflammatory response in survivors with anterior ST-elevation myocardial infarction (STEMI). The C-reactive protein to albumin ratio (CAR) has been proposed as a marker of inflammation. However, there is a lack of data with respect to the role of CAR in LVT development. We investigated the relationship between CAR and LVT development in patients with anterior STEMI treated percutaneously; 955 consecutive patients were enrolled and LVT was observed in 126 (13.2%) patients. Clinical, demographic, and laboratory parameters were recorded. The CAR was significantly higher in patients with LVT (12.6 [8.6-16.1] vs 18.1 [11.5-23], P < .001). Other independent predictors for LVT development were lower ejection fraction, the presence of left ventricular apical aneurysm, proximal left anterior descending lesion location, glycoprotein IIb/IIIa inhibitors treatment, >1 diseased arteries, higher total protein level, neutrophil count, and peak creatine kinase myocardial band activity. In conclusion, the CAR may be useful as a simple tool for predicting LVT development among survivors of anterior STEMI.
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Affiliation(s)
- Omer Faruk Cirakoglu
- Department of Cardiology, 420101Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ahmet Oguz Aslan
- Department of Cardiology, 420101Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ahmet Seyda Yilmaz
- Department of Cardiology, Faculty of Medicine, 485660Recep Tayyip Erdogan University, Rize, Turkey
| | - Sinan Şahin
- Department of Cardiology, 420101Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ali Rıza Akyüz
- Department of Cardiology, 420101Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
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21
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Savaş N, Özer N, Onuk S, Şahin S, Güneş Şahin G, Sipahioğlu H, Sungur M, Gündoğan K. SUN-PO026: Prevalence of Refeeding Hypophosphatemia in Patients Feeded by Enteral Nutrition in the Intensive Care Unit: Seven-Day Follow-Up Results After Nutrition. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32661-5] [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: 11/29/2022]
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22
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Velibey Y, Güvenç TS, Şahin S, Çetin Güvenç R, Güzelburç Ö. An unusual cause of pulmonary arterial hypertension: An acquired extracardiac arteriovenous fistula. Turk Kardiyol Dern Ars 2019; 47:419. [PMID: 31311903 DOI: 10.5543/tkda.2019.53999] [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: 11/04/2022] Open
Affiliation(s)
- Yalçın Velibey
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Tolga Sinan Güvenç
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Sinan Şahin
- Department of Radiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Rengin Çetin Güvenç
- Department of Cardiology, Haydarpaşa Training and Research Hospital, Istanbul, Turkey
| | - Özge Güzelburç
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
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23
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Cirakoglu OF, Aslan AO, Akyuz AR, Kul S, Şahin S, Korkmaz L, Sayın MR. The value of syntax score to predict new-onset atrial fibrillation in patients with acute coronary syndrome. Ann Noninvasive Electrocardiol 2019; 24:e12622. [PMID: 30615236 DOI: 10.1111/anec.12622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/01/2018] [Revised: 12/04/2018] [Accepted: 12/16/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND AIM New-onset atrial fibrillation (NOAF) has been associated with poor outcome in patients with acute coronary syndromes (ACS). Also, Syntax score (SS) is a scoring system that is derived from angiographic images and is associated with long-term mortality and major adverse cardiac events. In this study, we aimed to assess the relationship between SS and NOAF with known predictors of atrial fibrillation. METHODS In a prospective, single-center, cross-sectional study, 692 patients who were diagnosed with coronary artery disease for the first time were enrolled consecutively. NOAF was defined as atrial fibrillation, which was documented after hospital admission. SS was calculated by a computer software. Multivariable logistic regression analyzes were used to detect the relationship between variables and NOAF. RESULTS New-onset atrial fibrillation was detected in 82 patients (11.8%). Patients with NOAF had higher SS (22, interquartile range 18.3-25.1, vs. 12, interquartile range 7-19.5, p < 0.001). According to multivariable logistic regression analysis for NOAF, SS were independently and significantly associated (OR, 1.103; 95% confidence interval, 1.047-1.163; p < 0.001). Other independent predictors of NOAF were TIMI flow <3, C reactive protein, left ventricular ejection fraction, left atrial volume index and E/E' ratio. The optimal cut-off value for SS was 18 for the development of NOAF with 82% sensitivity and 68% specificity (area under the curve: 0.795, 95% confidence interval 0.749-0.841, p < 0.001). CONCLUSION Syntax score may be helpful to identify for patients who would develop atrial fibrillation in the setting of ACS.
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Affiliation(s)
- Omer Faruk Cirakoglu
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ahmet Oğuz Aslan
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey.,Department of Cardiology, Akçaabat Haçkalı Baba State Hospital, Trabzon, Turkey
| | - Ali Riza Akyuz
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Selim Kul
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Sinan Şahin
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Levent Korkmaz
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Muhammet Raşit Sayın
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
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Akyüz AR, Şahin S, Karadeniz A. Case Image: Endovascular coil treatment of a right coronary artery aneurysm related to atherosclerosis. Turk Kardiyol Dern Ars 2018; 46:736. [PMID: 30516535 DOI: 10.5543/tkda.2018.10.5543/tkda.2018.21533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Ali Rıza Akyüz
- Department of Cardiology, University of Health Sciences, Trabzon Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
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25
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Kul S, Dursun İ, Sayın MR, Şahin S, Turan T, Akyüz AR, Korkmaz L, Karadeniz A, Yılmaz AS, Durmuş İ. Presystolic wave is associated with carotid intima media thickness. Echocardiography 2018; 36:237-242. [DOI: 10.1111/echo.14217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/29/2018] [Accepted: 11/01/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Selim Kul
- Department of CardiologyTrabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application CenterSaglik Bilimleri Universitesi (University of Health Sciences) Trabzon Turkey
| | - İhsan Dursun
- Department of CardiologyTrabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application CenterSaglik Bilimleri Universitesi (University of Health Sciences) Trabzon Turkey
| | - Muhammet Raşit Sayın
- Department of CardiologyTrabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application CenterSaglik Bilimleri Universitesi (University of Health Sciences) Trabzon Turkey
| | - Sinan Şahin
- Department of CardiologyTrabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application CenterSaglik Bilimleri Universitesi (University of Health Sciences) Trabzon Turkey
| | - Turhan Turan
- Department of CardiologyTrabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application CenterSaglik Bilimleri Universitesi (University of Health Sciences) Trabzon Turkey
| | - Ali Rıza Akyüz
- Department of CardiologyTrabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application CenterSaglik Bilimleri Universitesi (University of Health Sciences) Trabzon Turkey
| | - Levent Korkmaz
- Department of CardiologyTrabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application CenterSaglik Bilimleri Universitesi (University of Health Sciences) Trabzon Turkey
| | - Ayşegül Karadeniz
- Department of RadiologyTrabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application CenterSaglik Bilimleri Universitesi (University of Health Sciences) Trabzon Turkey
| | - Ahmet Seyda Yılmaz
- Department of CardiologyTrabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application CenterSaglik Bilimleri Universitesi (University of Health Sciences) Trabzon Turkey
| | - İsmet Durmuş
- Department of CardiologyTrabzon Ahi Evren Cardiovascular and Thoracic Surgery Research and Application CenterSaglik Bilimleri Universitesi (University of Health Sciences) Trabzon Turkey
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Yıldız E, Şumnu S, Şahin S. Effects of buckwheat flour, gums and proteins on rheological properties of gluten-free batters and structure of cakes. Quality Assurance and Safety of Crops & Foods 2018. [DOI: 10.3920/qas2017.1221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- E. Yıldız
- Department of Food Engineering, Middle East Technical University, 06800 Ankara, Turkey
| | - S.G. Şumnu
- Department of Food Engineering, Middle East Technical University, 06800 Ankara, Turkey
| | - S. Şahin
- Department of Food Engineering, Middle East Technical University, 06800 Ankara, Turkey
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27
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Velibey Y, Tekkeşin Aİ, Barutca H, Yıldırımtürk Ö, Bozbeyoğlu E, Çakıllı Y, Güzelburç Ö, Bora Şişman S, Çinier G, Şahin S, Alper AT. Association between high on-treatment platelet reactivity to clopidogrel and hepatosteatosis in patients undergoing elective stent implantation. Turk Kardiyol Dern Ars 2018; 46:349-357. [PMID: 30024391 DOI: 10.5543/tkda.2018.67817] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The present study is an investigation of the association between high on-treatment platelet reactivity to clopidogrel (HTPRC) and hepatosteatosis in patients who had elective stent implantation due to coronary artery disease. METHODS A total of 190 consecutive patients who underwent an elective coronary stent implantation due to coronary artery disease were prospectively enrolled in the study. Eligible patients were given a 300 mg loading dose of clopidogrel before percutaneous coronary intervention. All of the patients underwent an ultrasound assessment for fatty liver. The patients were divided into 2 groups according to the detection of HTPRC: patients with HTPRC and patients without HTPRC. RESULTS HTPRC was present in 54.2% (103 of 190 patients) of the total study population. The age and body mass index data were similar between the 2 groups. In all, 111 (58.6%) patients had hepatosteatosis. The HTPRC ratio was statistically higher in female patients (p=0.032). Hepatosteatosis was significantly greater in patients with HTPRC (p<0.001); 84 (81.6%) patients with HTPRC had hepatosteatosis (p=0.001). There was also a statistically significant association between the hepatosteatosis grade and HTPRC (p<0.001). The percentage of HTPRC was greater in patients with ≥grade 2 hepatosteatosis than grade 1 (p<0.001). Logistic regression analysis indicated that hepatosteatosis (odds ratio: 9.403, 95% confidence interval: 4.519-19.566; p<0.001), fasting blood glucose, and hypertension were independent predictors of HTPRC. CONCLUSION To the best of our knowledge, this is the first study to demonstrate a relationship between hepatosteatosis and HTPRC.
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Affiliation(s)
- Yalçın Velibey
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
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Bozkurt H, Özer S, Şahin S, Sönmezgöz E. Internet use patterns and Internet addiction in children and adolescents with obesity. Pediatr Obes 2018; 13:301-306. [PMID: 28371539 DOI: 10.1111/ijpo.12216] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [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: 05/17/2016] [Revised: 10/20/2016] [Accepted: 02/02/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND There are no data regarding the Internet addiction (IA) rates and patterns in youth with obesity. OBJECTIVE This study aimed to explore the prevalence and patterns of IA in children and adolescents with obesity. The relationship between IA and body mass index (BMI) was also investigated. METHODS Study includes 437 children and adolescents with age ranging from 8 to 17 years: 268 with obesity and 169 with healthy controls. The Internet addiction scale (IAS) form was administered to all participants. The obesity group also completed a personal information form including Internet usage habits and goals. Linear regression analysis was utilized to assess the contributions of Internet use habits and goals to BMI in the obesity group and IAS scores to BMI in both groups. RESULTS A total of 24.6% of the obese children and adolescents were diagnosed with IA according to IAS, while 11.2% of healthy peers had IA (p < 0.05). The mean IAS scores for the obesity group and the control group were 53.71 ± 25.04 and 43.42 ± 17.36, respectively (p < 0.05). The IAS scores (t = 3.105) and spending time more than 21 h week-1 on the Internet (t = 3.262) were significantly associated with increased BMI in the obesity group (p < 0.05). Other Internet habits and goals were not associated with BMI (p > 0.05). The IAS scores (t = 8.719) were also found to be associated with increased BMI in the control group (p < 0.05). CONCLUSIONS The present study suggests that obese children and adolescents were found to have higher IA rates than their healthy peers, and the results indicate an association between IA and BMI.
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Affiliation(s)
- H Bozkurt
- Department of Child and Adolescent Psychiatry, Gaziosmanpasa University, Tokat, Turkey
| | - S Özer
- Department of Pediatrics, Gaziosmanpasa University, Tokat, Turkey
| | - S Şahin
- Department of Child and Adolescent Psychiatry, Gaziosmanpasa University, Tokat, Turkey
| | - E Sönmezgöz
- Department of Pediatrics, Gaziosmanpasa University, Tokat, Turkey
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Keskin M, Hayıroğlu Mİ, Uzun AO, Güvenç TS, Şahin S, Kozan Ö. Effect of Nonalcoholic Fatty Liver Disease on In-Hospital and Long-Term Outcomes in Patients With ST-Segment Elevation Myocardial Infarction. Am J Cardiol 2017; 120:1720-1726. [PMID: 28867124 DOI: 10.1016/j.amjcard.2017.07.107] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/16/2017] [Accepted: 07/20/2017] [Indexed: 12/22/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a risk factor for coronary artery disease. We investigated the effect of NAFLD grade on in-hospital and long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI). The study group consisted of 360 patients with STEMI. The patients were classified according to the grade of the NAFLD using ultrasonography. Based on this classification, all patients were divided into 4 subgroups as grade 0 (no fatty liver disease), grade 1, grade 2, and grade 3. Hierarchical logistic regression and Cox proportional regression analysis were used to establish the relation between NAFLD grade and outcomes. In-hospital mortality for grade 0, 1, 2, and 3 NAFLDs were 4.7%, 8.3%, 11.3%, and 33.9%, respectively. Three-year mortality for grade 0, 1, 2, and 3 NAFLDs were 5.6%, 7.8%, 9.5%, and 33.3%, respectively. In the multivariable hierarchical logistic regression analysis, in-hospital mortality risks were higher for patients with grade 3 NAFLD (odds ratio 4.2). In a multivariable Cox proportional regression analysis, the mortality risk was higher for patients with grade 3 NAFLD (hazard ratio 4.0). In conclusion, in patients with STEMI, the presence of NAFLD is associated with unfavorable clinical outcomes. Among these patients, grade 3 NAFLD had the highest mortality rates. The present study supports NAFLD screening in patients with STEMI.
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Velibey Y, Tekkeşin Aİ, Alper AT, Şahin S. Case Images: Multimodality imaging in a patient with lead perforation. Turk Kardiyol Dern Ars 2017; 45:298. [PMID: 28429703 DOI: 10.5543/tkda.2016.58701] [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: 11/04/2022] Open
Affiliation(s)
- Yalçın Velibey
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
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Sancar F, Şahin S, Şahin G, Eren N. The Assessment of a Drama Therapy Process for Patients with Severe Psychiatric Patients. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionDrama therapy is a useful therapy method for improving the life quality of psychiatric patients. Drama therapy is a rehearsal of everyday life. In this therapy method, clients actively join the creative process in order to better understand their life experiences.ObjectivesDrama therapy may improve patients’ ego functions, psycho-social and self-expression abilities, problem-solving skills, real-life adaptations and contribute to patient's psychiatric treatment.AimThe main aims were to examine the curative effects of drama group therapy and the effects of drama therapy on functionality in psychiatric patients.MethodThe study was performed at the Istanbul University Faculty of Medicine. Patients were referred from the Psychiatry Polyclinic of this university to Art Therapy and Rehabilitation Program. Drama therapy is an applied drama-based art group therapy. The 10 subjects in our study, ranged from 20 to 50 years old. This therapy group gathered once a week for a ninety minute session. Subjects continued their medical care and received psychotherapy throughout the 24-week study. The therapy plan included an introduction, a warm-up session, a drama therapy work and a sharing session. Patients were assessed in pre and post-treatment with Global Assessment of Functioning and Wilcoxon Signed Ranks Test was used for statistical analysis. Yalom's Group Curative Factors Scale was applied.ResultThere was a significant decrease in loss of functioning (P < .05). In Group Curative Factors, the means of hope, identification, group cohesion and altruism were determined high.ConclusionOur study demonstrates that drama therapy has positive effects on patients with severe psychiatric patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Aslan A, Barutca H, Kocaaslan C, Orman S, Şahin S. Pulsatile Mass Sensation with Intense Abdominal Pain; Atypical Presentation of the Nutcracker Syndrome. Pol J Radiol 2017; 81:507-509. [PMID: 28058069 PMCID: PMC5181552 DOI: 10.12659/pjr.898166] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 04/10/2016] [Indexed: 11/29/2022] Open
Abstract
Background Patients with Nutcracker syndrome generally present with nonspecific abdominal pain, with the left renal vein (LRV) lodged between the aorta and the superior mesenteric artery. In rare cases this can result in atypical gastrointestinal symptoms, making the diagnosis of Nutcracker syndrome challenging. Case Report A 28-year-old female patient presented with complaints of severe abdominal pain and palpable pulsatile abdominal mass located in the left epigastric area. Computed tomography angiography revealed that the LRV was lodged in the aortomesenteric region with a dilated left ovarian vein and pelvic varicose veins. The upper gastrointestinal endoscopy and colonoscopy were normal. The patient was diagnosed as Nutcracker syndrome and discharged to be treated with analgesics. Conclusions Nutcracker syndrome can be seen with atypical gastrointestinal and vascular symptoms. Computed tomography angiography is a reliable and robust technique to prove the diagnosis of nutcracker syndrome.
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Affiliation(s)
- Ahmet Aslan
- Department of Radiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Kadiköy, Istanbul, Turkey; Department of Radiology, Ümraniye Training and Research Hospital, Ümraniye, Istanbul, Turkey (Present)
| | - Hakan Barutca
- Department of Radiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Kadiköy, Istanbul, Turkey
| | - Cemal Kocaaslan
- Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Kadiköy, Istanbul, Turkey
| | - Süleyman Orman
- Department of Gastrointestinal Surgery, Göztepe Training and Research Hospital, Medical School of Istanbul Medeniyet University, Kadiköy, Istanbul, Turkey
| | - Sinan Şahin
- Department of Radiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Kadiköy, Istanbul, Turkey
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Aslan T, Kesim B, Üstün Y, Topçuoğlu HS, Şahin S, Ulusan Ö. Efficacy of manual and mechanical instrumentation techniques for removal of overextended root canal filling material. Niger J Clin Pract 2017; 20:761-766. [PMID: 28656933 DOI: 10.4103/1119-3077.180069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ziyrek M, Şahin S, Özdemir E, Acar Z, Kahraman S. Diagonal earlobe crease associated with increased epicardial adipose tissue and carotid intima media thickness in subjects free of clinical cardiovascular disease. Turk Kardiyol Dern Ars 2016; 44:474-80. [PMID: 27665328 DOI: 10.5543/tkda.2016.37806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Atherosclerotic coronary artery disease is a leading cause of death, worldwide. Diagonal earlobe crease (DELC) has been suggested as a simple, noninvasive marker of cardiovascular disease. Although epicardial adipose tissue (EAT) thickness and carotid intima media thickness (CIMT) are closely related to atherosclerosis, the relation between EAT, CIMT, and DELC had yet to be studied. The present objective was to analyze this association. METHODS Subjects were apparently healthy individuals referred to the cardiology outpatient clinic. A total of 65 subjects with DELC and 65 age- and sex-matched controls without DELC were enrolled. EAT thickness and CIMT were measured and analyzed. RESULTS Epicardial adipose tissue thickness was significantly higher in the DELC group (0.57±0.12 vs. 0.35±0.05; p<0.0001). CIMT was also significantly higher in DELC group (0.85±0.16 vs. 0.60±0.15; p<0.0001). Correlation analysis showed that CIMT was significantly correlated with EAT thickness (r: 0.594; p<0.0001). Linear regression analysis showed that presence of DELC was independently associated with CIMT and EAT thickness. CONCLUSION A significant and independent association between the presence of DELC and increased CIMT and EAT thickness was presently determined, for the first time, in subjects free of clinical cardiovascular disease.
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Affiliation(s)
- Murat Ziyrek
- Department of Cardiology, Silivri State Hospital, İstanbul, Turkey.
| | - Sinan Şahin
- Department of Cardiology, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Emrah Özdemir
- Departmet of Cardiology, Yeniyüzyıl University Faculty of Medicine Gaziosmanpaşa Training and Research Hospital, İstanbul, Turkey
| | - Zeydin Acar
- Department of Cardiology, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Serkan Kahraman
- Department of Cardiology, Silivri State Hospital, İstanbul, Turkey
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Eren N, Şahin S. An evaluation of the difficulties and attitudes mental health professionals experience with people with personality disorders. J Psychiatr Ment Health Nurs 2016; 23:22-36. [PMID: 26272790 DOI: 10.1111/jpm.12257] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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] [Accepted: 06/29/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Working with people with a personality disorder (PD) can arouse strong feelings, and cause difficulties as well as different attitudes among mental health workers (MHWs). While attitudes towards people with PD and the difficulties experienced by MHWs have been previously investigated, the reciprocal relationship between the two has not been thoroughly investigated. AIM/QUESTION This study aims to investigate (1) affective reactions of MHWs to people with personality disorders, (2) the difficulties that MHWs experience while working with these patients, (3) their attitudes towards these patients, and (4) the interaction between these variables. METHOD The data for this study were collected through a Personal Information Questionnaire, the Difficulty of Working with Personality Disorders Scale and the Attitudes towards Patients with Personality Disorders Scale from 332 MHWs from several mental health clinics in Turkey, all of whom were experienced in working with people with PD. RESULTS The results indicate that the participants described 'difficulty in forming a relationship, understanding the client, and establishing cooperation' among the primary reasons of difficulties. This study also shows that there is a strong relationship between MHWs' feelings of boredom/discontent, guilt/pity and a tendency to display positive behaviours/an inability of establishing borders against people with PD. DISCUSSION The findings of this study imply that the level of education, expertise, psychotherapy treatment and clinical supervision of MHWs all affect perceived difficulties and attitudes towards people with PD. It is also noted that among nurses, a higher level of education results in reduced experience of difficulties while working with patients with PD. IMPLICATION FOR PRACTICE The results foreground the need for specific skills to be developed in MHWs through theoretical training, case-focused supervision and receiving personal psychotherapy for MHWs.
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Affiliation(s)
- N Eren
- Social Psychiatry Services, Department of Psychiatry, Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - S Şahin
- Department of Psychiatry, Faculty of Medicine, Istanbul University, İstanbul, Turkey
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Akyüz AR, Ağaç MT, Turan T, Şahin S, Kul S, Korkmaz L, Erkuş ME, Erkan H, Çelik Ş. Xanthelasma Is Associated with an Increased Amount of Epicardial Adipose Tissue. Med Princ Pract 2016; 25:187-90. [PMID: 26488592 PMCID: PMC5588332 DOI: 10.1159/000441846] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 10/20/2015] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE In the present study, we aimed to compare the amount of epicardial adipose tissue in subjects with and without xanthelasma. SUBJECTS AND METHODS Fifty-two subjects with xanthelasma and 52 age- and gender-matched control subjects were enrolled in this study. Epicardial adipose tissue was assessed by measuring epicardial fat thickness (EFT) with echocardiography. Participants were dichotomized according to median EFT, which was 4 mm. The group with EFT >4 mm was defined as the supramedian group. Body mass index (BMI) was calculated by weight (kilograms) divided by height (meters) squared. Conditional logistic regression analysis was performed to find independent factors associated with supramedian EFT (>4 mm). RESULTS Subjects with xanthelasma had higher BMI (31.2 ± 5.6 vs. 28.6 ± 5.7, p = 0.01) and higher levels of total cholesterol (216 ± 54 vs. 181 ± 42 mg/dl, p < 0.001), LDL cholesterol (142 ± 45 vs. 115 ± 36 mg/dl, p = 0.003) and triglycerides (median, 154 vs. 101 mg/dl, p = 0.01) than control subjects. EFT was significantly higher in subjects with xanthelasma than in controls (5.04 ± 2.02 vs. 3.81 ± 2.03 mm, p = 0.002). In the conditional logistic regression analysis, the presence of xanthelasma (OR, 3.55; 95% CI, 1.43-8.78, p = 0.006) and lower HDL cholesterol level (OR, 0.96; 95% CI, 0.92-0.99, p = 0.023) were independently associated with supramedian EFT. CONCLUSION The amount of epicardial adipose tissue found in subjects with xanthelasma was higher than in subjects without xanthelasma. In addition, the presence of xanthelasma was independently associated with supramedian EFT.
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Affiliation(s)
- Ali Rıza Akyüz
- Department of Cardiology, Akçaabat Haçkalı Baba State Hospital, Şanlıurfa, Turkey
- *Ali Rıza Akyüz, MD, Department of Cardiology, Akçaabat Haçkalı Baba State Hospital, Açaabat, TR—61300 Trabzon (Turkey), E-Mail
| | - Mustafa Tarık Ağaç
- Department of Cardiology, Faculty of Medicine, Sakarya University, Sakarya, Şanlıurfa, Turkey
| | - Turhan Turan
- Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Şanlıurfa, Turkey
| | - Sinan Şahin
- Department of Cardiology, Bergama State Hospital, Izmir, Şanlıurfa, Turkey
| | - Selim Kul
- Department of Cardiology, Trabzon Kanuni Training and Research Hospital, Trabzon, Şanlıurfa, Turkey
| | - Levent Korkmaz
- Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Şanlıurfa, Turkey
| | | | - Hakan Erkan
- Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Şanlıurfa, Turkey
| | - Şükrü Çelik
- Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Şanlıurfa, Turkey
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Gün I, Özdamar Ö, Şahin S, Akpak YK, Sofuoğlu K. Is there any effect of oocyte count retrieved in the OPU procedure on pregnancy outcomes? J OBSTET GYNAECOL 2015; 36:416-9. [PMID: 26467556 DOI: 10.3109/01443615.2015.1090416] [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: 11/13/2022]
Abstract
We aimed to investigate whether the number of oocytes retrieved during ovum pick-up has any effect on pregnancy outcomes when using the gonadotropin-releasing hormone or GnRH long agonist or antagonist protocols. A retrospective study was conducted between 2012 and 2014. The patients were grouped according to the number of oocytes retrieved at ovum pick-up; < 10 oocytes (Group 1), 10-14 oocytes (Group 2) and ≥ 15 oocytes (Group 3). Biochemical pregnancy rates were compared among the three groups. Statistical analysis was performed using one-way ANOVA test for continuous variables and chi-square test for categorical variables. In total, 825 treatment cycles were included in the study. Groups 1, 2 and 3 consisted of 514, 206 and 105 patients, respectively. There was no difference among the three groups regarding biochemical pregnancy rates (22.8%, 28.6% and 28.6%; p = 0.166, respectively). The results of our study suggest that the number of eggs retrieved has no effect on pregnancy outcome in assisted reproductive technology treatment.
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Affiliation(s)
- I Gün
- a GATA Haydarpasa Training Hospital , Department of Obstetrics and Gynecology, Division of Assisted Reproduction and Endocrinology , İstanbul , Turkey
| | - Ö Özdamar
- b Gölcük Military Hospital , Department of Obstetrics and Gynecology , Kocaeli , Turkey
| | - S Şahin
- c Zeynep Kamil Women's Health and Hospital , Department of Obstetrics and Gynecology, Division of Assisted Reproduction and Endocrinology , Istanbul , Turkey
| | - Y K Akpak
- d Ankara Mevki Military Hospital , Department of Obstetrics and Gynecology , Ankara , Turkey
| | - K Sofuoğlu
- c Zeynep Kamil Women's Health and Hospital , Department of Obstetrics and Gynecology, Division of Assisted Reproduction and Endocrinology , Istanbul , Turkey
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Ziyrek M, Şahin S, Acar Z, Şen O. The Relationship between Proliferative Scars and Endothelial Function in Surgically Revascularized Patients. Balkan Med J 2015; 32:377-81. [PMID: 26740897 DOI: 10.5152/balkanmedj.2015.15707] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 09/24/2014] [Accepted: 03/02/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Proliferative scars are benign fibrotic proliferations which demonstrate abnormal wound healing in response to skin injuries. As postulated in the "response to injury hypothesis", atherosclerosis is also triggered by an endothelial injury. Keloid and atherosclerotic processes have many pathophysiological and cytological features in common. AIMS In this study, we investigated the relationship between proliferative scars and endothelial function in surgically revascularized patients. We aimed to test the hypothesis that atherosclerosis is a wound healing abnormality. STUDY DESIGN Cross-sectional study. METHODS Consecutive patients who were admitted to the cardiology outpatient clinic with a history of coronary artery bypass grafting operation were evaluated. Thirty-three patients with proliferative scars at the median sternotomy site formed the keloid group, and 36 age- and sex-matched patients with no proliferative scar at the median sternotomy site formed the control group. Endothelial function was evaluated by flow-mediated vasodilatation of the brachial artery via ultrasonograhic examination. RESULTS There is no signicant difference according to the demographic data, biochemical parameters, clinical parameters and number of grafts between keloid and control groups. Endothelial-dependent vasodila-tory response was lower in the keloid group than the control group (9.30±3.5 and 18.68±8.2, respectively; p=0.001). CONCLUSION This study showed that endothalial dysfunction, which is strongly correlated with atherosclerosis, was more prominent in patients with proliferative scars. As proliferative scars and atherosclerosis have many features in common, we might conclude that atherosclerosis is a wound healing abnormality.
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Affiliation(s)
- Murat Ziyrek
- Department of Cardiology, Karadeniz Hospital, Trabzon, Turkey
| | - Sinan Şahin
- Department of Cardiology, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Zeydin Acar
- Department of Cardiology, Karadeniz Hospital, Trabzon, Turkey
| | - Onur Şen
- Department of Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
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Öztürk M, Mercan R, Gök K, Onat A, Kısacık B, Kimyon G, Balkarlı A, Kaya A, Çobankara V, Balcı M, Pamuk ÖN, Çetin G, Sayarlıoğlu M, Şenel S, Tezcan M, Küçük A, Üreten K, Şahin S, Tufan A. AB0914 Management of Gout in Different Clinical Specialties in Turkey. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4644] [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]
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Türkmen S, Şahin S, Koçer N, Peters H, Mundlos S, Tüysüz B. Neuroimaging and clinical characterization of Sotos syndrome. Genet Couns 2015; 26:1-12. [PMID: 26043501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Sotos syndrome is a well-known overgrowth syndrome characterized by excessive growth during childhood, macrocephaly, distinctive facial appearance and learning disability. This disorder is caused by mutations or deletions in NSD1 gene. The aim of this study is to examine the relationship between the neuroimaging and clinical features of children with Sotos syndrome. Six Turkish children with Sotos syndrome were followed up about 3-7 years. The diagnosis was confirmed with molecular genetic analysis. We identified the pathogenic NSD1 mutation including three novel in all patients. All the patients had a characteristic facial gestalt of Sotos syndrome consisting of triangular face with prominent forehead, frontoparietal sparseness of hair and small nose. However, the degree of psychomotor and intellectual development was variable. Severe learning defect and speech delay were remarkable in two patients. The neuroimaging analysis showed abnormalities in four of six patients including bilateral large ventricles, thinning of the corpus callosum and persistent cavum septum pellucidum et vergae. Typical craniofacial appearance is the primary finding for the diagnosis of the disease even in the infantile period. However, the degree of psychomotor and intellectual development is very variable and does not correlate with the neuroimaging findings.
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Özkan H, Osman O, Şahin S, Boz AF. A novel method for pulmonary embolism detection in CTA images. Comput Methods Programs Biomed 2014; 113:757-766. [PMID: 24440133 DOI: 10.1016/j.cmpb.2013.12.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 12/19/2013] [Accepted: 12/20/2013] [Indexed: 06/03/2023]
Abstract
In this paper, we propose a new computer-aided detection (CAD) - based method to detect pulmonary embolism (PE) in computed tomography angiography images (CTAI). Since lung vessel segmentation is the main objective to provide high sensitivity in PE detection, this method performs accurate lung vessel segmentation. To concatenate clogged vessels due to PEs, the starting region of PEs and some reference points (RPs) are determined. These RPs are detected according to the fixed anatomical structures. After lung vessel tree is segmented, the region, intensity, and size of PEs are used to distinguish them. We used the data sets that have heart disease or abnormal tissues because of lung disease except PE in this work. According to the results, 428 of 450 PEs, labeled by the radiologists from 33 patients, have been detected. The sensitivity of the developed system is 95.1% at 14.4 false positive per data set (FP/ds). With this performance, the proposed CAD system is found quite useful to use as a second reader by the radiologists.
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Affiliation(s)
- Haydar Özkan
- Fatih Sultan Mehmet Vakıf University, Department of Biomedical Engineering, Istanbul, Turkey.
| | - Onur Osman
- Arel University, Department of Electrical and Electronics Engineering, Istanbul, Turkey
| | - Sinan Şahin
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Radiology, Istanbul, Turkey
| | - Ali Fuat Boz
- Sakarya University Technology Faculty, Department of Electrical and Electronics Engineering, Sakarya, Turkey
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Şenuzun Aykar F, Bilge A, Mermer G, Şahin S. Validity and reliability of the social support scale in chronic diseases–TR (SSCII-TR). Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2013.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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43
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Akyüz AR, Ağaç MT, Turan T, Şahin S, Kul S, Korkmaz L, Erkuş ME, Erkan H, Çelik Ş. Xanthelasma is Associated with Increased Amount of Epicardial Adipose Tissue. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.523] [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: 11/16/2022]
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Şahin S, Ziyrek M, Acar Z, Bilici M, Ağaç MT. Cheloid. Is it a Marker of Response to Endothelial Injury? J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.592] [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: 10/26/2022]
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45
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Ziyrek M, Can F, Civan M, Erdem Ş, Acar Z, Şahin S, Çiftçi Ç. The Association between Coronary Atherosclerotic Burden and Asymmetric Dimethylarginine, Carotis Intima Media Thickness and Endothelial Function. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.097] [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: 11/30/2022]
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Şahin S, Ziyrek M, Bilici M, Korkmaz L, Acar Z. Diagonal Ear Lobe Crease is Associated with Epicardial Adipose Tissue Thickness and Carotid Intima Media Thickness in Subjects Free of Clinical Cardiovascular Disease. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.616] [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: 11/25/2022]
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Abstract
Abstract
The main objective is to study the effects of spectral shifting in an inertial confinement system for kT/shot energy regime on the breeding performance for tritium and for high quality fissile fuel. A protective liquid droplet jet zone of 2 m thickness is used as coolant, energy carrier, and breeder. Flibe as the main constituent is mixed with increased mole-fractions of heavy metal salt (ThF4 or UF4) starting by 2 moles% up to 12 moles%. Spectrum softening within the inertial confinement system reduces the tritium production ratio (TBR) in the protective coolant to a lower level than unity. However, additional tritium production in the 6Li2DT zone of the system increases TBR to values above unity and allows a continuous operation of the power plant with a self-sustained fusion fuel supply. By modest fusion fuel burn efficiencies (40 to 60 %) and with a few mol.% of heavy metal salt in the coolant in form of ThF4 or % UF4, a satisfactory TBR of > 1.05 can be realized. In addition to that, excess fissile fuel of extremely high isotopic purity with a rate of ∼ 1000 kg/year of 233U or 239Pu can be produced. Radiation damage through atomic displacements and helium gas production after a plant operation period of 30 years is very low, namely dpa < 1 and He < 2 ppm, respectively.
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Affiliation(s)
- S. Şahin
- Gazi Üniversitesi, Teknik Egitim Fakültesi, Beşevler-Ankara 06500-TURKEY
| | - H. M. Şahin
- Gazi Üniversitesi, Teknik Egitim Fakültesi, Beşevler-Ankara 06500-TURKEY
| | - K. Yildiz
- Nigde Üniversitesi, Aksaray Mühendislik Fakültesi, Aksaray 68000, Turkey
| | - A. Acir
- Gazi Üniversitesi, Teknik Egitim Fakültesi, Beşevler-Ankara 06500-TURKEY
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Abstract
Abstract
Criticality and burn up behavior of the Fixed Bed Nuclear Reactor (FBNR) are investigated for the mixed fuel 233UO2/ThO2 as an alternative to low enriched 235UO2 fuel. CERMET fuel with a zirconium matrix and cladding has been used throughout the study. The main results of the study can be summarized as follows: Reactor criticality is already achieved by ∼2% 233UO2 with the mixed 233UO2/ThO2 fuel. At higher 233U fractions, reactor criticality rises rapidly and exceeds keff > 1.5 already by 9% 233UO2. With 100% 233UO2, start up criticality can reach keff = 2.0975. Time dependent reactor criticality keff and fuel burn up have been investigated for two different mixed fuel 233UO2/ThO2 compositions, namely: 4% 233UO2 + 96% ThO2 for a reactor power of 40 MWel (120 MWth) and 9% 233UO2 + 91% ThO2 for a reactor power of 70 MWel (210 MWth). Sufficient reactor criticality (keff > 1.06) for continuous operation without fuel change can be sustained during ∼5 and 12 years with 4% and 9% 233UO2 fractions in the mixed fuel, leading to burn ups of ∼36000 and >105000MWD/t, respectively. Thorium based fuel produces no prolific uranium. Plutonium production remains negligible.
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Affiliation(s)
- S. Şahin
- Atılım University, Faculty of Engineering, Department of Mechanical Engineering, 06836 İncek, Gölbaşı, Ankara, Türkiye. E-mail:
| | - A. Acır
- Gazi University, Faculty of Technology, Teknikokullar, Ankara, Türkiye
| | - H. M. Şahin
- Gazi University, Faculty of Technology, Teknikokullar, Ankara, Türkiye
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Abstract
Abstract
Reactor grade (RG) plutonium, accumulated as nuclear waste of commercial reactors can be re-utilized in CANDU reactors. TRISO type fuel can withstand very high fuel burn ups. On the other hand, carbide fuel would have higher neutronic and thermal performance than oxide fuel. In the present work, RG-PuC/ThC TRISO fuels particles are imbedded body-centered cubic (BCC) in a graphite matrix with a volume fraction of 60%. The fuel compacts conform to the dimensions of sintered CANDU fuel compacts are inserted in 37 zircolay rods to build the fuel zone of a bundle. Investigations have been conducted on a conventional CANDU reactor based on GENTILLYII design with 380 fuel bundles in the core. Three mixed fuel composition have been selected for numerical calculation; (1) 10% RG-PuC + 90% ThC; (2) 30% RG-PuC + 70% ThC; (3) 50% RG-PuC + 50% ThC. Initial reactor criticality values for the modes (1), (2) and (3) are calculated as k∞,0 = 1.4848, 1.5756 and 1.627, respectively. Corresponding operation lifetimes are ∼2.7, 8.4, and 15 years and with burn ups of ∼72000, 222000 and 366000 MW.d/tonne, respectively. Higher initial plutonium charge leads to higher burn ups and longer operation periods. In the course of reactor operation, most of the plutonium will be incinerated. At the end of life, remnants of plutonium isotopes would survive; and few amounts of uranium, americium and curium isotopes would be produced.
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Affiliation(s)
- S. Şahin
- Atilim University, Faculty of Engineering, 06836 Incek Gölbasi, Ankara, TÜRKIYE. E-mail: ,
| | - M. J. Khan
- Pakistan Institute of Engineering and Applied Sciences, Islamabad 45650, Pakistan
- Postdoctoral Fellow, Faculty of Technology, Gazi University Teknikokullar, Ankara, TÜRKIYE
| | - R. Ahmed
- Pakistan Institute of Engineering and Applied Sciences, Islamabad 45650, Pakistan
- Postdoctoral Fellow, Faculty of Technology, Gazi University Teknikokullar, Ankara, TÜRKIYE
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Abstract
Abstract
Nuclear waste actinides can be used as a booster fissile fuel material in form of mixed fuel with thorium in a CANDU reactor in order to assure the initial criticality at startup. Two different fuel compositions have been found useful to provide sufficient reactor criticality over a long operation period: 1) 95% thoria (ThO2)+5% minor actinides MAO2 and 2) 90% ThO2+5% MAO2+5% UO2. The latter allows a higher degree of nuclear safeguarding through denaturing the new 233U fuel with 238U. The temporal variation of the criticality k∞ and the burn-up values of the reactor have been calculated by full power operation for a period of 10 years. The criticality starts by k∞>1.3 for both fuel compositions. A sharp decrease of the criticality has been observed in the first year as a consequence of rapid plutonium burnout in the actinide fuel. The criticality becomes quasi constant after the 2nd year and remains close to k∞ = ∼1.06 for ∼10 years. After the 2nd year, the CANDU reactor begins to operate practically as a thorium burner. Very high burn up could be achieved with the same fuel material (up to 200000 MW.D/MT), provided that the fuel rod claddings would be replaced periodically (after every 50000 or 100000 MW.D/MT). The reactor criticality can be maintained until a great fraction of the thorium fuel is burnt up. This would reduce fuel fabrication costs and nuclear waste mass for final disposal per unit energy drastically.
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Affiliation(s)
- S. Şahin
- Gazi Üniversitesi, Teknik Eğitim Fakültesi, Beşevler – Ankara – Turkey. E-mail:
| | - K. Yıldız
- Aksaray Üniversitesi, Mühendislik Fakültesi, Aksaray 68000, Turkey
| | - H. M. Şahin
- Gazi Üniversitesi, Teknik Eğitim Fakültesi, Beşevler – Ankara – Turkey. E-mail:
| | - A. Acır
- Gazi Üniversitesi, Teknik Eğitim Fakültesi, Beşevler – Ankara – Turkey. E-mail:
| | - N. Şahin
- Aksaray Üniversitesi, Mühendislik Fakültesi, Aksaray 68000, Turkey
| | - T. Altınok
- Savunma Bilimleri Enstitüsü, Ankara 06654, Turkey
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