Do novel oral anticoagulant drugs used in patients with nonvalvular atrial fibrillation act only as anticoagulants?

OBJECTIVE

Although inflammation has an important role in the pathogenesis of atrial fibrillation (AF), the effect of novel oral anticoagulants (NOAC) used to reduce the risk of ischemic stroke and embolism on inflammation remains unknown. In this study, we aimed to investigate the effects of NOAC, which have been shown to have anticoagulant properties, on inflammation and platelet reactivation, which have an important role in the pathogenesis of AF.

PATIENTS AND METHODS

A total of 530 patients, including 380 patients with nonvalvular AF using NOAC and 150 patients with nonvalvular AF who did not use any NOAC were included in the study. Neutrophil-to-lymphocyte ratio (NLR) was calculated as the ratio of absolute neutrophil count to absolute lymphocyte count. Mean platelet volume (MPV), red cell distribution width (RDW), and neutrophil-to-lymphocyte ratio (NLR) values of both groups were assessed both on admission and at three-month follow-up.

RESULTS

When the complete blood count (CBC) changes of the groups included in the study were compared, the RDW, MPV, and NLR values showed a greater decrease in the NOAC group compared to the non-NOAC group (p=0.000 for all).

CONCLUSIONS

The results indicated that the NOAC used in anticoagulation treatment do not only act as anticoagulants but also reduce inflammation and platelet reactivation, which have an important role in the pathogenesis of AF and thromboembolism.

Evaluation of Coronary Flow Level with Mots-C in Patients with STEMI Undergoing Primary PCI

BACKGROUND

The protective effects of mitochondrial open reading frame of the 12S rRNA-c (MOTS-C) on cardiovascular diseases have been shown in numerous studies. However, there is little documentation of the relationship between MOTS-C and coronary blood flow in ST-segment elevation myocardial infarction (STEMI).

OBJECTIVE

We aimed to investigate the role of MOTS-C, which is known to have cytoprotective properties in the pathogenesis of the no-reflow phenomenon, by comparing the coronary flow rate and MOTS-C levels in patients with STEMI submitted to primary PCI.

METHODS

52 patients with STEMI and 42 patients without stenosis >50% in the coronary arteries were included in the study. The STEMI group was divided into two groups according to post-PCI TIMI (Thrombolysis In Myocardial Infarction) flow grade:(i) No-reflow: grade 0, 1, and 2 and (ii) grade 3(angiographic success). A p value of <0.05 was considered significant.

RESULTS

MOTS-C levels were significantly lower in the STEMI group compared to the control group (91.9 ± 8.9 pg/mL vs. 171.8±12.5 pg/mL, p<0.001). In addition, the Receiver Operating Characteristics (ROC) curve analysis indicated that serum MOTS-C levels had a diagnostic value in predicting no-reflow (Area Under the ROC curve [AUC]:0.95, 95% CI:0.856-0.993, p<0.001). A MOTS-C ≥84.15 pg/mL measured at admission was shown to have 95.3% sensitivity and 88.9% specificity in predicting no-reflow.

CONCLUSION

MOTS-C is a strong and independent predictor of no-reflow and in-hospital MACE in patients with STEMI. It was also noted that low MOTS-C levels may be an important prognostic marker of and may have a role in the pathogenesis of STEMI.

MOTS-c as a predictor of coronary lesions and complexity in patients with stable coronary artery disease

OBJECTIVE

Atherosclerosis plays a major role in the development of coronary artery disease (CAD). It has been shown that mitochondrial open-reading-frame of the twelve S rRNA-c (MOTS-c), a mitochondrial-derived peptide, has preventive effects on atherosclerosis. The aim of this study was to determine the relationship between MOTS-c levels and CAD presence and severity using SYNTAX score (SS) in patients with stable angina pectoris.

PATIENTS AND METHODS

Ninety-two consecutive patients with stable coronary artery disease (CAD+) and ninety-two consecutive patients with normal coronary artery (CAD-) were included. Presence and severity of coronary artery disease were determined using the SS.

RESULTS

We observed that the MOTS-c levels was lower in the CAD group (111±13 vs. 161±23, p<0.001). The MOTS-c levels were also found to be significant independent predictors for CAD in multiple regression analysis (p<0.001). A MOTS-c levels ≥130.9 had 80.3% sensitivity and 73.2% specificity (area under the curve [AUC]: 0.858, 95% CI: 0.895-0.999, p<0.001) for predicting CAD.

CONCLUSIONS

The authors revealed that there is a strong correlation between MOTS-c levels and CAD. Therefore, MOTS-c may help identify patients with CAD, thus allowing for early preventive treatment.

The CHA2DS2-VASc risk score predicts successful endovascular treatment in patients with acute ischemic stroke

OBJECTIVES

Acute ischemic stroke is a common cause of mortality and morbidity worldwide. Percutaneous endovascular intervention is an important treatment method in ischemic stroke. Endovascular procedure success is associated with the clinical outcome of the patients. The CHA2DS2-VASC score is an important score used to determine the risk of ischemic stroke in patients with atrial fibrillation. In our study, we aimed to evaluate the relationship between procedure success and CHA2DS2-VASC score in patients with acute ischemic stroke who underwent endovascular intervention.

MATERIALS AND METHODS

A total of 102 consecutive patients who underwent endovascular intervention with acute ischemic stroke were included in the study. The admission CHA2DS2-VASc scores of the patients were recorded. After the procedure, the relationship between the TICI score and the CHA2DS2-VASc score was evaluated.

RESULTS

CHA2DS2-VASc score was significantly higher in the group that resulted in unsuccessful endovascular intervention (2.78 ± 1.44, 5.02 ± 1.77 p < .001). Receiver-operating characteristics analysis revealed the cutoff value of CHA2DS2-VASc score ≥3 as a predictor of unsuccessful intervention with 76,6% sensitivity and 83,3% specificity, positive predictive value 50%, negative predictive value 84,6% (area under the curve [AUC]: 0.827,95% CI: 0.739-0.895, p < .001). In the multivariate analysis; atrial fibrillation ([β] = 4.201; [CI]: 1.251-14.103, p = .020), CHA2DS2-VASc score ([β] = 0.053; [CI]: 0.004-0.750, p = .030) were found independent predictors for unsuccessful intervention treatment.

CONCLUSIONS

In our study, we showed that the CHA2DS2-VASc score is associated with the success of endovascular intervention in patients with acute ischemic stroke who underwent percutaneous endovascular treatment.

The CHA2DS2-VASc Risk Score Predicts Total Occlusion in Infarct-Related Arteries in Patients With Non-ST Elevation Myocardial Infarction

Early detection of total coronary artery occlusion (TO) in non-ST elevation myocardial infarction (NSTEMI) patients may be beneficial since invasive treatments are initiated more rapidly in appropriate patients. Previous studies have shown that the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke, vascular disease, age between 65 and 74 years, female gender) score is associated with thrombus burden in acute coronary syndromes. We investigated the association between the CHA2DS2-VASc risk score and TO in patients with NSTEMI who underwent coronary angiography. TIMI (thrombolysis in myocardial infarction) flow 0 was defined as TO and TIMI flow 1-3 was defined as non-total occlusion (non-TO). The NSTEMI patients (n = 400) included were separated into two groups: those with (n = 138) and without (n = 262) TO. We observed that the CHA2DS2-VASc score was higher in the TO group (3.86 ± 2.32 vs 2.15 ± 1.79, P <.001). The Global Registry of Acute Coronary Events (GRACE) score (P = .002) and the CHA2DS2-VASc score (P < .001) were also found to be significant independent predictors for total occlusion in multiple regression analysis. A CHA2DS2-VASc score ≥3 had 68.1% sensitivity and 64.0% specificity (area under the curve (AUC): 0.657, 95% CI: 0.585-0.725, P < .001) for predicting TO. The CHA2DS2-VASc score was an effective tool that predicted TO in patients with NSTEMI.

Public libraries on Facebook: content analysis of Turkish public libraries' posts

Purpose

The study aims to analyze the posts shared by public libraries in Turkey on their official Facebook pages. The targets of the study are to detect content categories shared by the libraries and to describe user interaction of libraries on the basis of their posted content.

Design/methodology/approach

The study examined data relating to 23,027 posts shared by 116 public libraries through descriptive and content analyses. The content analysis on the posts identified general topic and sub-topics through both machine-tagging and checks by the authors. Turkish word parsing applications and stop lists were employed in the designation of sub-categories. In this process, word clusters were identified to allow for the designation of sub-topic headings through the use of the Latent Dirichlet Allocation (LDA) technique.

Findings

The present study identified that a significant portion of the 116 public libraries in Turkey with official Facebook pages had started to use this platform in the year 2017. According to the findings, the user interaction of libraries generally occurs in the form of likes. Analyses on the topic categories of the posts established that a remarkable number of public libraries in Turkey targeted users from pre-school children to young adults.

Originality/value

The study contributes to the existing body of literature as one of the first research studies describing the current situation concerning public libraries in Turkey through the analysis of the content they generate on Facebook pages.

Cataloguing practices at university libraries

Purpose

This study aims to analyse current practices and cooperation between the Turkish university libraries related to cataloguing processes and present cataloguing librarians’ evaluations about clarity and comprehensiveness of the given information in library catalogues.

Design/methodology/approach

In line with the literature review, a Web-based questionnaire was developed concerning the cataloguing practices implemented at university libraries in Turkey. The questionnaire was submitted to 316 cataloguing librarians. In all, 104 cataloguing librarians from 61 different libraries responded to the survey. The collected data were analysed through descriptive statistics. The responses given to some open-ended questions were assessed with respective expressions presented verbatim in the study and some of them visualised via VOSViewer software.

Findings

The findings reflect that analysed university libraries implement different cataloguing processes. It is seen that some libraries use the necessary systems and services related to cataloguing and classification while others use individual solutions without using such systems and services. Findings reveal that there is cooperation between the analysed libraries about sharing catalogue records. In this regard, it is understood that cataloguing librarians mostly prefer transferring catalogue records from the catalogues of university libraries they trusted. Findings also indicate that analysed librarians think that the descriptive information provided via Online Public Access Catalogues are in moderate level in terms of clarity and comprehensibility.

Originality/value

The study contributes to the existing literature of a limited number of relevant studies by establishing the baseline pertaining to cataloguing processes undertaken at university libraries in Turkey.

Information as an organizational asset: assessment of a public organization’s capabilities in Turkey

This study aims to establish the importance for institutions to assess their information assets as a value in the context of such matters as increased competitive advantage, improved managerial processes, and adaptation to new managerial approaches. In line with this purpose, the study addresses the effects of the evaluation of information assets. Within the scope of the study, a checklist about organizational information assets (such as emails, web content and physical records and electronic records) was developed and it was applied to a large-scale public institution with decision-making authorities with respect to general health policies and practices of Turkey. The study reached findings pertaining to the practices undertaken for information assets within a large-scale public institution at the decision-making level in the field of health in Turkey. At this point, the institution was identified to be able to cover the basic level of records management to a significant extent, but to suffer from shortcomings in sophisticated information management and collaborative practices. On the basis of this observation, the institution was emphasised to be in need of improvements concerning human resources and decision-making practices. The study results also reflect the importance of the assessments for information assets held by institutions.

Kounis syndrome due to hirudotherapy (leech therapy) in emergency department; a case report

Kounis Syndrome is the development of acute coronary syndrome (ACS) because of allergic reactions; allergens, such as foods, insect venom, iodine contrast agent or drugs can cause this syndrome. Hirudotherapy (leech therapy) is increasingly used as a useful therapeutic option in a variety of medical and surgical procedures, and potential complications related to this therapy include Aeromonas species infections, bleeding, anemia and allergic reactions. Here, we present a patient diagnosed as Type 1 Kounis Syndrome after using hirudotherapy for her knee aches. 41-year-old woman admitted to emergency department with sudden onset of face edema, shortness of breath and chest pain complaints and diagnosed as an allergic reaction and anaphylaxis due to leech therapy. Kounis Syndrome should be considered in acute coronary syndrome patients who were admitted to emergency department with anaphylaxis clinic.

Military jet pilots have higher p-wave dispersions compared to the transport aircraft aircrew

OBJECTIVES

For the purpose of flight safety military aircrew must be healthy. P-wave dispersion (PWD) is the p-wave length difference in an electrocardiographic (ECG) examination and represents the risk of developing atrial fibrillation. In the study we aimed at investigating PWD in healthy military aircrew who reported for periodical examinations.

MATERIAL AND METHODS

Seventy-five asymptomatic military aircrew were enrolled in the study. All the subjects underwent physical, radiologic and biochemical examinations, and a 12-lead electrocardiography. P-wave dispersions were calculated.

RESULTS

The mean age of the study participants was 36.15±8.97 years and the mean p-wave duration was 100.8±12 ms in the whole group. Forty-seven subjects were non-pilot aircrew, and 28 were pilots. Thirteen study subjects were serving in jets, 49 in helicopters, and 13 were transport aircraft pilots. Thirty-six of the helicopter and 11 of the transport aircraft aircrew were non-pilot aircrew. P-wave dispersion was the lowest in the transport aircraft aircrew, and the highest in jet pilots. P-wave dispersions were similar in the pilots and non-pilot aircrew. Twenty-three study subjects were overweight, 19 had thyroiditis, 26 had hepatosteatosis, 4 had hyperbilirubinemia, 2 had hypertension, and 5 had hyperlipidemia. The PWD was significantly associated with thyroid-stimulating hormone (TSH) levels. Serum uric acid levels were associated with p-wave durations. Serum TSH levels were the most important predictor of PWD.

CONCLUSIONS

When TSH levels were associated with PWD, uric acid levels were associated with p-wave duration in the military aircrew. The jet pilots had higher PWDs. These findings reveal that military jet pilots may have a higher risk of developing atrial fibrillation, and PWD should be recorded during periodical examinations.

Elevated adropin: a candidate diagnostic marker for myocardial infarction in conjunction with troponin-I

Myocardial infarction (MI; "heart attack") can cause injury to or death of heart muscle tissue (myocardium) owing to prolonged ischemia and hypoxia. Troponins and CK-MB are released from heart muscle cells during MI. It has been demonstrated that energy expenditure is regulated by adropin expressed in the endocardium, myocardium, and epicardium. We hypothesized that adropin is released into the bloodstream during myocardial muscle injury caused by MI, so the serum level rises as myocytes die. Therefore, we examined the association between adropin expression and myocardial infarction in isoproterenol-induced myocardial infarction. Rats were randomly allocated to six groups. After treatment they were decapitated and their blood and tissues were collected for adropin measurement. Changes in adropin synthesis in rat heart, kidney and liver tissues in isoproterenol (ISO)-induced MI were demonstrated immunohistochemically. Serum adropin concentrations were measured by ELISA, and troponin-I, CK and CK-MB concentrations by autoanalysis. The results demonstrated that cardiac muscle cells, glomerular, peritubular and renal cortical interstitial cells, hepatocytes and liver sinusoidal cells all synthesize adropin, and synthesis increased 1-24 h after MI except in the liver cells. The findings elucidate the pathogenesis of MI, and the gradual increase in serum adropin could be a novel diagnostic marker and serve as an alternative to troponin-I measurement for diagnosing MI.

Relationship between mean platelet volume elevation and left ventricular mass index in hypertensive patients

Objectives:

To compare the mean platelet volume (MPV; a general marker of platelet activation) in groups of patients with and without hypertension and to analyse its relationship with left ventricular mass index (LVMI).

Methods:

This cross-sectional, observational study enrolled newly diagnosed patients with untreated stage I–II hypertension and healthy control subjects without hypertension. MPV was measured using a haematology analyser. Echocardiography was performed on all of the study participants.

Results:

A total of 50 newly diagnosed patients with hypertension and 50 healthy control subjects were enrolled in the study. The majority of the demographic characteristics and laboratory findings were not significantly different between the two groups. The mean ± SD MPV was significantly higher in the hypertensive group compared with the control group (10.3 ± 1.4 fl versus 9.2 ± 1.8 fl, respectively). The mean ± SD LVMI was significantly higher in the hypertensive group compared with the control group (115.9 ± 23.0 g/m2 versus 95.7 ± 23.4 g/m2, respectively). There was no significant correlation between MPV and LVMI.

Conclusion:

In patients with untreated hypertension, despite elevated MPV levels there was no correlation between LVMI and MPV.

Başlangıcından Bugüne Bilgi Dünyası Dergisi’nin Bibliyometrik Profili

Türkiye’de kütüphanecilik ve bilgibilim alanı literatürünün gelişmesinde Üniversite ve Araştırma Kütüphanecileri Derneği’nin (ÜNAK) resmi yayın organı olan Bilgi Dünyası dergisinin katkısı bilinmektedir. 2000 yılından bu yana Nisan ve Ekim aylarında olmak üzere yılda iki defa yayımlanan Bilgi Dünyası dergisi üniversite ve araştırma kütüphaneleri ile birlikte, bilgibilim, bilgi hizmetleri, bilgi ve belge yönetimine ilişkin sorunları inceleyen ve çözüm önerileri sunan makaleleri yayımlamayı amaçlamaktadır. Çalışmamızda da Bilgi Dünyası dergisinde yayımlanan 104 makale ve 60 görüş bibliyometrik özellikleri açısından analiz edilmektedir. Analiz sonuçlarına göre yayımlandığı ilk yıldan bu yana geçen süre göz önüne alındığında son üç yılda yayımlanan hakemli makale sayısının diğer yıllara oranla daha yüksek oranda olduğu görülmüştür. Makalelerin konu dağılımı olarak ise çoğunlukla bilgi merkezleri ile ilgili olduğu saptanmıştır. Çalışma sonuçlarında Bilgi Dünyası dergisi örneğinden hareketle Türkiye’deki kütüphanecilik alanında yapılan çalışmalara yönelik detaylı bir atıf analizi çalışmasının gerekliliği önerilmektedir.