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Öğe AİBÜ Tıp Fakültesi Hastanesi'nde görev yapan hemşirelerin sağlık sorunları ve yaşam alışkanlıklarının değerlendirilmesi(2005) Alçelik, Aytekin; Deniz, Fatih; Yeşildal, Nuray; Mayda, Atilla Senih; Şerifi, Berna AyaktaAmaçlar: Hemşirelik özveri, sabır ve fizikselsel dayanıklılık gerektiren bir meslektir. Hemşireler hastalara daha fazla faydalı olabilmek için kendi fizikselsel ve ruhsal sağlıklarını korumak durumundadırlar. A.İ.B.Ü. Düzce Tıp Fak. hemşirelerinin sağlık sorunlarını, yaşam alışkanlıklarını ve beslenme durumlarını değerlendirmek amacıyla kesitsel tipte bir çalışma yapılmıştır. Gereç-yöntem: Yetmiş dokuz hemşireye araştırmacılar tarafından hazırlanan anket formları doldurtulmuş, verilerin analizi bir istatistik paket programı ile yapılmıştır. Bulgular: Grubun yaş ortalaması 23.5 ± 0.2 yıl olarak saptanmıştır. “Yaşamınızdan memnun musunuz?” sorusuna grubun %39.7'si "fena değil", % 36.8’i “memnunum” yanıtını vermişlerdir. Araştırma grubunun fiziksel aktivitesi incelendiğinde %65.7'sinin herhangi bir fiziksel aktivitede bulunmadıkları saptanmıştır. Yeme alışkanlıkları incelendiğinde %80.9'unun öğün atladığı saptanmıştır. Araştırma grubunda en sık belirtilen sağlık sorunları %52.9 bel ağrısı, %48.5 sırt ağrısı, %48.5 mide ağrısı, %38.2 omuz ağrısı, ve %38.2 boyun ağrısıdır. Grubun %26.5'inin Hepatit B'ye karşı aşısız olduğu bildirilmiştir. Sonuç: Sağlık sorunlarının azaltılması için işyeri işçi sağlığı ve iş güvenliği birimi kurulmalıdır. Hemşirelere mesleki riskler ve stres yönetimi hakkında hizmet içi eğitim verilmelidir.Öğe Aqueous humour and serum concentration of asymmetric dimethyl arginine in pseudoexfoliation syndrome(Bmj Publishing Group, 2012) Tosun, Mehmet; Erdurmuş, Mesut; Buğdaycı, Güler; Çelebi, Serdal; Alçelik, AytekinObjective Asymmetric dimethyl arginine (ADMA) is the major endogenous inhibitor of nitric oxide synthase. ADMA is related to endothelial dysfunction and is an independent cardiovascular risk factor. This study aimed to evaluate the concentration of ADMA in aqueous humour and serum samples of patients with pseudoexfoliation (PEX) syndrome. Materials and Methods 21 cataract patients with PEX syndrome (PEX group) and 18 cataract patients without PEX syndrome (control group) were enrolled in the study. ADMA was measured in the aqueous humour and serum of the PEX and control groups. ELISA was used to determine the ADMA concentration. Results Mean aqueous humour ADMA concentration in the PEX group was 0.39 +/- 0.07 mu mol/l and in the control group was 0.34 +/- 0.06 mu mol/l. Mean serum ADMA concentration in the PEX group was 0.5660.21 mu mol/l and in the control group was 0.4460.12 mu mol/l. ADMA concentration of aqueous humour in the PEX group was significantly higher than the control group (p=0.026). Similarly, ADMA concentration of serum in the PEX group was significantly higher than the control group (p=0.039). Conclusions The findings of the present study could suggest that ADMA might play a role in the aetiopathogenesis of PEX syndrome. Higher aqueous and serum levels of ADMA might be potential evidence of endothelial dysfunction in PEX syndrome.Öğe Association between nasal polyps and mean platelet volume(Univ West Indies Faculty Medical Sciences, 2017) Aktaş, Gülali; Alçelik, Aytekin; Şit, Mustafa; Şavlı, HalukThe Editor Sir, We have previously reported that mean platelet volume (MPV) is decreased in nasal polyp patients compared to control subjects (1). First of all, we agree with Erdur et al that MPV has not been fully elucidated as an inflammatory marker in certain circumstances. The biological and prognostic value of MPV is still controversial (2) and needs to be validated with prospective randomized controlled trials. However, this retrospective study could be the first step to larger studies aimed at observing the relationship between MPV and inflammation. We also accept that results of MPV studies represent the probability and not the absolute consequences. Methodologies of many studies in literature that observed association between MPV and inflammation are quite similarÖğe Association between omentin levels and insulin resistance in pregnancy(Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh, 2014) Aktaş, Gülali; Alçelik, Aytekin; Özlü, Tülay; Tosun, Mehmet; Tekçe, Buket Kın; Savlı, Haluk; Tekçe, HikmetAims: Omentin is a new adipokine secreted mainly from visceral adipose tissue. Serum omentin is found to be reduced in patients with impaired glucose tolerance, type 2 diabetes mellitus, obesity and insulin resistant states. Despite the fact that pregnancy is also characterized with hyperinsulinemia, literature is lacking about data of omentin levels and its association with insulin resistance in pregnant women. We aimed to evaluate the association of omentin levels and insulin resistance in pregnant women and to compare these levels with those of non-pregnant, nondiabetic women. Methods: Uncomplicated pregnant women who admit to our outpatient clinics for routine follow-up were included in the study group. Non-pregnant women without diabetes mellitus were served as control group. Fasting glucose, insulin, omentin levels and HOMA IR were recorded. SPSS 15.0 for Windows was used for statistical analysis. Results: There were 36 pregnant women in the study group and 37 healthy, non-pregnant women in the control group. Serum omentin and fasting glucose levels were significantly decreased and fasting insulin was significantly increased in the study group compared to control group. Conclusion: Omentin might be an indicator of insulin resistance in pregnant women. Larger prospective studies are needed to claim whether omentin can have a clinical use for diagnosis of gestational diabetes mellitus.Öğe The association of binge eating disorder with glycemic control in patients with type 2 diabetes [Tip 2 diyabet hastalarında tıkınırcasına yeme bozukluğu ve glisemik kontrol arasındaki ilişki](Türkiye Klinikleri, 2011) Canan, Fatih; Güngör, Adem; Önder, Elif; Celbek, Gökhan; Aydın, Yusuf; Alçelik, AytekinObjective: Our aim was to assess the prevalence of binge eating disorder (BED) in individuals with type 2 diabetes and to investigate whether a comorbidity with BED would affect glycemic control in these patients. Materials and Methods: Eighty-two type 2 diabetic patients were enrolled. The participants were assessed for eating disorders by a psychiatrist. Blood samples were drawn and HbA1c and other biochemical parameters were measured. Results: Of the 82 subjects, 27 (34.1%) met the criteria for BED. No other types of eating disorders were detected. HbA1c was significantly higher in individuals with BED (p<0.05). Conclusion: Our findings reveal that BED is highly prevalent among type 2 diabetic patients and it impairs glycemic control. Thus, patients with type 2 diabetes should be assessed carefully for eating disorders.Öğe The Association of Omentin Levels in Non-Diabetic Postmenopausal Women with Bone Mineral Density and Total Body Composition(2015) Özlü, Tülay; Sarman, Hakan; Alçelik, Aytekin; Işık, Cengiz; Yazıcı, Selma; Tosun, Mehmet; Caglar, HilalObjectives: Positive relation between body mass and bone mineral density (BMD) is thought to be due to weight bearing effect. However, adipose tissue derived adipokines may have important effects on bone. Obese women have decreased levels of omentin in circulation which is related with adverse metabolic events. The hypothesis was that performed in this study, we aimed to study the association of omentin levels with body composition and BMD in non-diabetic postmenopausal women. Methods: Postmenopausal women aged 40 to 70 years, scheduled for BMD testing were prospectively evaluated. Patients with known diabetes, chronic renal failure, chronic liver disease, malabsorption, inflammatory bowel disease, <40 and >70 years of age were excluded. BMD and body composition were measured by DXA (GE-Lunar DPX pro). Fasting blood samples were obtained for analysis of complete blood count, glucose, creatinine, lipid profile and omentin. Statistical analyses were performed by using SPSS version 18 for windows. P<0.05 was considered statistically significant. Results: Mean age of the patients in the osteoporosis group was higher than that of the control group (59.1±7.6 vs 53.3±5.7, p<0.05). Mean omentin level was higher in osteoporosis group than in osteopenia and control groups (479.7±141.6 vs 342.3±173.6 and 346.8±127.2, p<0.05). Total body fat mass, muscle mass and the T score of lumbar spine had a negative correlation with omentin levels (r=-0.252, -0.276, -0.344, p<0.05). Conclusions: Body composition does not seem to effect omentin levels. Women with a lower BMI have increased omentin levels. Higher omentin levels are associated with lower T scores at the lumbar spine.Öğe Asymetric dimethyl arginine level as a cardiovascular risk factor in patiens with hyperthyroidism(Editura Acad Romane, 2012) Alçelik, Aytekin; Özhan, Hakan; Alçelik, Ayşegül Gürses; Yalçın, Sübhan; Aydın, YusufIntroduction. Thyroid diseases may cause endothelial dysfunction. Asymmetric dimethylarginine (ADMA) levels in patients with thyroid dysfunction were analyzed by few studies. Aim. We aimed to compare ADMA levels in patients with hyperthyroidism in a cohort free of cardiovascular risk associates such as diabetes or chronic renal failure with further comparison with healthy control subjects. Materials and methods. The study took place in Duzce University Medical Faculty, Cardiology and Internal Medicine Department during the year 2010. The study group consisted of patients with hyperthyroidism (overt and subclinical). The patients with renal failure, diabetes and severe hypertension were excluded. Results. Mean ADMA level was 1.04 +/- 0.43 mu mol/L in the hyperthyroid group and 0.68 +/- 0.21 mu mol/L in the control group (p <= 0.001). The comparison of patients with hyperthyroidism according to the etiology (three groups as Graves', multinodular goiter and thyroiditis) did not show any significant difference. Conclusion. Asymmetric dimethylarginine increases in patients with hyperthyroidism regardless of the etiology. The increase of ADMA levels is independent of known major cardiovascular risk factors. It may reflect the possible counteraction of endothelial dysfunction in the pathogenesis of atherosclerosis in hyperthyroidism beyond the known cardiovascular risk factors.Öğe Atrial conduction time and atrial mechanical function in patients with impaired fasting glucose(Springer, 2012) Ayhan, Selim; Öztürk, Serkan; Alçelik, Aytekin; Özlü, Mehmet Fatih; Erdem, Alim; Memioğlu, Tolga; Özdemir, Mesut; Yazıcı, MehmetProlonging atrial conduction time, as measured by tissue Doppler imaging (TDI), is an independent predictor of new onset or recurrent atrial fibrillation (AF). We investigated atrial conduction time and cardiac mechanical function in patients with impaired fasting glucose (IFG) using echocardiography. Thirty patients with IFG (19 males and 11 females; age, 46.9 +/- 9.5 years) and 30 control subjects (18 males and 12 females; age, 46.7 +/- 8.2 years) were included. Atrial conduction time was determined from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septal), and lateral tricuspid annulus (PA tricuspid) by TDI. Inter- and intra-atrial electromechanical delays (EMDs) were calculated. Left atrial (LA) volumes were determined according to the biplane area-length method. LA mechanical function parameters were calculated. LA passive emptying volume and LA passive emptying fraction decreased significantly in patients with IFG as compared with control subjects (p < 0.001 and p < 0.001, respectively). PA lateral and PA septal durations were significantly higher in patients with IFG than in the control group. However, no difference in PA tricuspid duration was observed between the two groups. Inter- and intra-atrial EMDs were significantly higher in patients with IFG as compared with the control subjects (median [interquartile range], 34.0 [17.0] vs. 17.0 [4.0], p < 0.001 and 15.0 [8.5] vs. 7.5 [2.0], p < 0.001, respectively). Positive correlations were detected between both inter- and intra-atrial EMD and glucose levels (r = 0.76, p < 0.001 and r = 0.68, p < 0.001, respectively). Additionally, a multiple linear regression analysis revealed that glucose levels were independently associated with inter-atrial EMD (beta = 0.753, p < 0.001). We showed that IFG was associated with inter- and intra-atrial EMD. Our findings suggest that IFG is an etiological factor for the development of AF.Öğe Cardiac autonomic function in healthy young smokers(Sage Publications Inc, 2015) Erdem, Alim; Ayhan, Suzi Selim; Öztürk, Serkan; Özlü, Mehmet Fatih; Alçelik, Aytekin; Tosun, Mehmet; Gümüştekin, Kenan; Yazıcı, MehmetThe present study examined the heart rate turbulence (HRT) and heart rate variability (HRV) parameters in healthy young smokers (<40years) to assess the effects of smoking on cardiac autonomic function. The study included 75 smokers with a history of habitual smoking for at least 1year (41 males and 34 females; mean age, 29.3 +/- 7.3years) and 30 nonsmokers (hospital staff; 16 males and 14 females; mean age, 29.0 +/- 6.1years). Addiction to smoking was evaluated using the modified Fagerstrom test for nicotine-dependence index (NDI). HRT, HRV, basic clinical and echocardiographic, and Holter test parameters were compared between groups. No significant differences between the two groups were found in the basic clinical and echocardiographic variables. Turbulence onset (TO) was significantly higher in the smoking group than in the controls, and turbulence slope was significantly lower in the smokers, than in the controls (p<0.05). Standard deviation of all normal-to-normal (NN) interval index (SDNNI) was the only HRV parameter that was significantly different between the smoking and control groups (p<0.05). The NDI was positively correlated with the TO (p<0.05). Smoking impairs the baroregulatory function in healthy young smokers, particularly the HRT parameters and SDNNI. Our findings highlight the importance of complete smoking cessation.Öğe Coronary artery ectasia is associated with atrial electrical and mechanical dysfunction: an observational study(2012) Öztürk, Serkan; Özyaşar, Mehmet; Ayhan, Selim Suzi; Özlü, Mehmet Fatih; Erdem, Alim; Alçelik, Aytekin; Öztürk, SelçukAmaç: Bizim çalışmamızın amacı, izole koroner arter ektazisi (İKAE) olan hastalarda total atriyal ileti süresi ve sol atriyal (SA) mekanik fonksiyonların araştırılmasıdır. Yöntemler: Enine-kesitli gözlemsel bu çalışmaya, herhangi bir darlığı olmayan 60 İKAE’li hasta alındı. Kontrol grubu yaş ve cinsiyet açısından eşleştirilen 40 bireyden oluşturuldu. Sol atriyal mekanik fonksiyonlar disk metoduyla apikal dört boşluktan ölçüldü. Sol atriyal mekanik fonksiyon parametreleri hesaplandı. P dalga dispersiyonu yüzey elektrokardiyografisinden (EKG) ölçüldü. Total atriyal ileti süresi, yüzey EKG’sinde P dalgasının başından, doku Doppler ile mitral lateral duvardan ölçülen A’ dalgasının tepesine kadar olan zaman aralığı olarak ölçüldü. İstatistiksel analizde; Student t, Mann-Whitney U, Pearson ve Spearman korelasyonu ve çoklu doğrusal regresyon analizi kullanıldı. Bulgular: Klinik ve laboratuvar bulgular açısından gruplar benzerdi. Her iki grupta Vmaks ve SA total boşalma oranı benzerdi (31.9±6.5 karşı 29.0±7.3 mL/$m^{2}$, p=0.082 ve 20.0±5.2 vs. 19.9±5.1 mL/$m^{2}$, p=0.821). Ancak, SA pasif boşalma hacmi ve SA pasif boşalma oranı İKAE hastalarında anlamlı olarak azalmıştı (11.1±3.2 karşı 13.5±3.8 mL/$m^{2}$, p=0.005 ve 35.2±7.2 karşı 47.8±9.4 mL/$m^{2}$, p<0.001). Fakat SA aktif boşalma hacmi ve SA aktif boşalma oranı İKAE hastalarında anlamlı olarak artmıştı (9.1±2.6 karşı 6.4±3.0 mL/$m^{2}$, p< 0.001 ve 45.3±8.1 karşı 40.7±6.7mL/$m^{2}$, p=0.002). Total atriyal ileti süresi İKAE grubunda normal gruba göre anlamlı olarak daha uzun ölçüldü (131.8±5.7 karşı 114.4±9.1 ms, p<0.001). Çoklu doğrusal regresyon analizinde ektazik segment sayısı total atriyal ileti süresinin bağımsız bir faktörü olarak tespit edildi (?=0.581, %95 GA=4.046-6.295, p<0.001). Sonuç: Bu çalışma İKAE’li hastalarda SA elektriksel ve mekanik fonksiyonlarının bozulduğunu gösteren ilk çalışmadır. Bozulmuş olan SA fonksiyonları kardiyak aritmiler, azalmış kardiyak atım hacmi ve kalp yetersizliği ile ilişkili olabilir. (Anadolu Kardiyol Derg 2012; 12: 637-43)Öğe Could red cell distribution width be a marker in Hashimoto's Thyroiditis?(Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh, 2014) Aktaş, Gülali; Şit, Mustafa; Dikbaş, Oğuz; Tekçe, Buket Kin; Savlı, Haluk; Tekçe, Hikmet; Alçelik, AytekinAims: Hashimoto's Thyroiditis (HT) is the most common autoimmune thyroiditis worldwide and characterized with lymphomonocytic inflammation of the thyroid gland. Red cell distribution width (RDW) reflects erythrocyte anisocytosis and besides it increases in iron deficiency anemia, recent studies reported that RDW was also associated with conditions characterized with overt or subclinical infl ammation. We aimed to answer whether RDW increased in Hashimoto's thyroiditis. Methods: Patients with HT admitted to outpatient clinic of our hospital were included to the study. Patients with anemia (especially iron deficiency), diabetes mellitus, chronic inflammatory disease and on medication that may affect hemogram results (e.g., aspirin) excluded from the study. Patient characteristics, thyroid stimulating hormone (TSH), Free T3 (FT3), Free T4 (FT4), Anti-thyroid peroxidase (Anti-TPO), Anti-Thyroglobulin (Anti-TG), leukocyte count (WBC), Hemoglobin (Hb), Hematocrit (Htc), mean corpuscular volume (MCV), RDW and platelet count (PLT) values of the study cohort were obtained from computerized database of our institution. Results: There was no significant difference between study and control groups in terms of WBC, Hb, Htc, MCV, PLT, PDW and FT3 levels. However, FT4 level was significantly lower and TSH was significantly higher in study group compared to controls. RDW was significantly increased in study group compared to control group. Conclusion: We suggest that elevated RDW values in patients without iron deficiency anemia may require further evaluation for HT, especially in female population.Öğe Could thrombocyte parameters be an inflammatory marker in the brucellosis?(Medical Association of Zenica-Doboj Canton, 2013) Küçükbayrak, Abdülkadir; Taş,Tekin; Tosun, Mehmet; Aktaş, Gülali; Alçelik, Aytekin; Hakyemez, İsmail Necati; Koçoğlu, EsraAim To investigate links between platelet parameters mean platelet volume (MPV), platelet count (PC), platelet distribution width (PDW), platelet mass (PM) and brucella tube agglutination titers (BSTAT) in patients with brucellosis. Initially, PC, MPV, PM and PDW calculations were compared between periods before and after treatment. The correlation between inlammation markers (erythrocyte sedimentation rate, ESR, white blood cell count, WBC, and C reactive protein, CRP) and platelet parameters was subsequently investigated. Methods This self-controlled study included 40 patients who had positive BSTAT at least at a titer of 1/160. Platelet parameters and inlammation values (CRP, ESR) at the time of positive BSTAT at least at a titer of 1/160 (pre-treatment) were compared with control of the same parameters at the time when BSTAT became negative or when the titers reduced 4 folds (post-treatment). Results Mean platelet volume values (7.90+1.96) were signiicantly elevated in post treatment period when compared to pre treatment (7.58+1.96), (p= 0.023). Post treatment CRP, ESR and PC were signiicantly reduced when compared to pretreatment values (p=0.000, p=0.000 and p=0.025, respectively). In the pretreatment period, a direct correlation between ESR and PC values (r=0.036, p=0.025), and inverse correlations between ESR with MPV (r=-0.337, p=0.038) was found. A dependent predictive factor in multivariate logistic regression analysis for BSTAT was not found. Conclusion We suggest that PC and MPV may be inlammatory markers in brucellosis.Öğe Detection of atrial electrical and mechanical dysfunction in non-dipper pre-hypertensive subjects(Taylor & Francis Inc, 2014) Sarıkaya, Savaş; Şahin, Şafak; Öztürk, Serkan; Akyol, Lütfi; Altunkaş, Fatih; Alçelik, AytekinIntroduction: A relationship between atrial conduction time and hypertension was shown in previous studies. Increased atrial electromechanical intervals used to predict atrial fibrillation by measured tissue Doppler imaging (TDI). So we aimed to search if there was any association between the non-dipping status and atrial electromechanical intervals in pre-hypertensive patients. Methods: Forty-one non-dipper and 33 dipper pre-hypertensive subjects enrolled in the study. Systolic and diastolic blood pressures were measured with a mercury sphygmomanometer. Twenty-four hours blood pressure was measured with cuff-oscillometric method. All patients were evaluated by transthoracic echocardiography. Using tissue Doppler imaging (TDI), atrial electromechanical coupling (PA) was measured from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum) and right ventricular tricuspid annulus (PA tricuspid). Results: Systolic and diastolic blood pressures were significantly higher in subjects with non-dipper phenomenon than dipper ones at night. Twenty-four hours average systolic and diastolic blood pressures were higher in non-dipper pre-hypertensive subjects, but this elevation was not significant. Left and right intraatrial (PA lateral-PA septum and PA septum-PA tricuspid) and interatrial (PA lateral-PA tricuspid) electromechanical coupling intervals were measured significantly higher in non-dipper pre-hypertensive patients (31.3 +/- 3.9 versus 24.1 +/- 2.3, p = 0.001; 19.5 +/- 4.3 versus 13.8 +/- 2.1, p = 0.001; and 11.4 +/- 2.8 versus 8.8 +/- 1.5, p = 0.001). Also, interatrial electromechanical delay was negatively correlated with dipping levels. Conclusion: This study showed that prolonged atrial electromechanical intervals were related non-dipper pattern in pre-hypertensive patients. Prolonged electromechanical intervals may be an early sign of subclinical atrial dysfunction and arrhythmias' in non-dipper pre-hypertensive patients.Öğe Detection of atrial electromechanical dysfunction in obesity(Taylor & Francis Ltd, 2015) Erdem, Fatma Hızal; Öztürk, Serkan; Baltacı, Davut; Dönmez, İbrahim; Alçelik, Aytekin; Ayhan, Selim Suzi; Yazıcı, MehmetIntroduction Obesity is associated with atrial fibrillation and is known as an independent risk factor. The aim of our study was to investigate if there was any association between the body mass index and atrial electromechanical intervals in obese and non-obese patients. Methods Seventy patients were enrolled in the study. Body mass index (BMI), functional capacity, and fasting blood sugar were evaluated; then, these patients were divided into two groups, patients who had a BMI >= 30 were known as obese (35 patients) and those who had a BMI <30 were known as non-obese patients. All patients were evaluated by transthoracic echocardiography. LA volumes were measured by the discs method in the apical four-chamber view. LA active and passive emptying volumes and fraction were calculated. Using TDI, atrial electromechanical coupling (PA) was measured from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum), and right ventricular tricuspid annulus (PA tricuspid). Results LA diameter was significantly higher in obese patients (P=0.021). LA passive emptying volume and fraction were significantly decreased in obese patients (P = 0.038 and P = 0.011). LA active emptying volume and fraction were significantly increased in obese patients (P = 0.001 and P = 0.001). Left intraatrial and interatrial electromechanical delay were significantly higher in obese patients (18.9 +/- 3.8 vs 11.9 +/- 2.0, P < 0.001 and 29.5 +/- 4.1 vs 17.9 +/- 2.5, P < 0.001). Also interatrial electromechanical delay correlated positively with BMI. Conclusion This study revealed that delayed atrial electromechanical interval and impaired LA mechanical functions were related to BMI in obese patients. These findings may be an early sign of subclinical atrial dysfunction and arrhythmias in obese patients.Öğe Detection of subclinical atrial dysfunction by two-dimensional echocardiography in patients with overt hyperthyroidism(Elsevier Masson, 2012) Ayhan, Selim; Öztürk, Serkan; Dikbaş, Oğuz; Erdem, Alim; Özlü, Mehmet Fatih; Baltacı, Davut; Alçelik, AytekinBackground. - Hyperthyroidism is an important cardiovascular risk factor in the development of atrial fibrillation and heart failure. Increased atrial electromechanical intervals are used to predict atrial fibrillation, measured by tissue Doppler imaging (TDI). Aims. - To evaluate atrial electromechanical delay (EMD) and left atrial (LA) mechanical function in patients with overt hyperthyroidism. Methods. - Thirty-four patients with overt hyperthyroidism and 34 controls were included. A diagnosis of overt hyperthyroidism was reached with decreased serum thyroid-stimulating hormone (TSH) and increased free T4 (fT4) concentrations. Using TDI, atrial electromechanical coupling (PA) was obtained from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum) and right ventricular tricuspid annulus (PA tricuspid). LA volumes (maximum, minimum and presystolic) were measured by the disks method in apical four-chamber view and indexed to body surface area. LA active and passive emptying volumes and fractions were calculated. Results. - LA diameter was significantly higher in hyperthyroid patients (P = 0.001). LA passive emptying volume and fraction were significantly decreased in hyperthyroid patients (P = 0.038 and P < 0.001). LA active emptying volume and fraction were significantly increased in hyperthyroid patients (P < 0.001 and P < 0.001). Left and right intra-atrial (PA lateral-PA septum and PA septum-PA tricuspid) and interatrial (PA lateral-PA tricuspid) EMDs were significantly higher in hyperthyroid patients (29.2 +/- 4.4 vs 18.1 +/- 2.6, P < 0.001; 18.7 +/- 4.3 vs 10.6 +/- 2.0, P < 0.001; and 10.5 +/- 2.9 vs 7.1 +/- 1.2, P < 0.001, respectively). Stepwise linear regression analysis demonstrated that fT4 and TSH concentrations were independent predictors of interatrial EMD (beta = 0.436, P < 0.001 and beta = -0.310, P = 0.005, respectively). Conclusion. - This study showed prolonged atrial electromechanical intervals and impaired LA mechanical function in patients with overt hyperthyroidism, which may be an early sign of subclinical cardiac involvement and dysrhythmias in overt hyperthyroidism. (c) 2012 Elsevier Masson SAS. All rights reserved.Öğe Diabetes mellitus increases plasma cardiothrophin-1 levels independently of heart failure and hypertension(Carbone Editore, 2013) Aktaş, Gülali; Alçelik, Aytekin; Tosun, Mehmet; Öztürk, Serkan; Özlü, Mehmet Fatih; Savlı, Haluk; Yazıcı, MehmetAims: Cardiothrophin-1 (CT-1) is a novel 201 amino acid cytokine that has pleiotropic protective effects in apoptosis, hepatic injury, myocardial infection and contrast nephropathy. CT-1 predicts a variety of disorders including atherosclerosis, heart failure, hypertension and cardiomyopathy. However, CT-1 has not been studied previously in diabetic patients without heart failure. The aim of this study was, therefore, to compare CT-1 levels in diabetic and non-diabetic patients. Methods: Thirty-eight patients with type 2 diabetes mellitus and 32 non-diabetic controls have been enrolled into the study. Subjects with severe hypertension, renal diseases, pregnancy and malignancy were excluded. The statistical analysis was performed with SPSS for Windows version 15.0. Results: There were no significant differences between the diabetic and non-diabetic groups with regard to age, hypertension, serum creatinine, systolic and diastolic blood pressure. Median plasma CT-1 was 9.05 (5.70-24.94) pg/ml in diabetic group and 7.16 (5.53-9.64) pg/ml in non-diabetic group (P<0.001). Conclusion: Plasma CT-1 levels increased in diabetic patients independently of hypertension (HT) and heart failure. Prospective studies with a larger cohort are now needed to observe the effects of CT-1 treatment in a diabetic population.Öğe Effects of the inflammatory response on serum omentin levels in early acute and chronic pancreatitis(Societa Editrice Universo, 2014) Şit, Mustafa; Aktaş, Gülali; Yılmaz, Edip Erdal; Alçelik, Aytekin; Terzi, Elçin Hakan; Tosun, MehmetBackground and Aims: Acute pancreatitis is an acute inflammation of the parenchyma of the pancreas. Several adipokines have been investigated in acute pancreatitis, and these cytokines contribute to inflammation in acute pancreatitis. However, not enough data exist regarding omentin in injuries of the pancreas. Because of a possible common pathogenesis, we aimed to study the association between pancreatic damage and serum omentin levels. Materials and Methods: Twenty-four Sprague Dowley rats weighing 200-250 g were randomly placed into three groups: a sham group (n=8), an acute pancreatitis group (n=8), and a chronic pancreatitis group (n=8). Both rats in the sham group underwent laparotomy, and 0.1 cc of saline solution was injected through the pancreatic canal. On the seventh day, a blood sample was obtained by abdominal aorta puncture, and the pancreas was resected for histological examination. In the acute and chronic pancreatitis groups, 0.1 cc of 4.5% Sodium Taurocholote was injected through the pancreatic canal. Blood samples were obtained and pancreatic resection was performed after 24 hours for the acute pancreatitis group and after 7 days for the chronic pancreatitis group. Results: Serum omentin levels of rats with chronic pancreatitis (49.37±2.82 ng/ml) were increased compared to both acute pancreatitis (37.79±1.24 ng/ml) (p<0.01) and sham rats (22.49±1.4 ng/ml) (p<0.01). In addition, the omentin level of rats with acute pancreatitis was significantly increased compared to the sham group (p<0.01). Conclusion: The elevation in omentin levels in rats in the early stage of pancreatitis was due to the anti-inflammatory effects of omentin; hence, elevated omentin levels improved insulin resistance and caused a significant reduction in glucose levels.Öğe Evaluation of left atrial mechanical functions and atrial conduction abnormalities in patients with clinical hypothyroid(Via Medica, 2012) Öztürk, Serkan; Dikbaş, Oğuz; Özyaşar, Mehmet; Ayhan, Selim; Özlü, Fatih; Erdem, Alim; Yazıcı, Mehmet; Alçelik, Aytekin; Tosun, MehmetBackground: The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical delay and P wave dispersion in hypothyroid patients. Methods: Thirty-four patients with overt hypothyroid and thirty controls were included. A diagnosis of overt hypothyroid was reached with increased serum TSH and decreased free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay (EMD) were measured by tissue Doppler imaging (TDI). P wave dispersion was calculated by 12 lead electrocardiograms. Results: LA diameter were significantly higher in patients with overt hypothyroid (p = 0.021). LA passive emptying volume and LA passive emptying fraction were significantly decreased with hypothyroid patients (p = 0.002 and p < 0.001). LA active emptying volume and LA active emptying fraction were significantly increased with hypothyroid patients (p < 0.001 and p < 0.001). Infra- and interatrial EMD, were measured significantly higher in hypothyroid patients (30.6 +/- 6.1 vs 18.0 +/- 2.7, p < 0.001; and 10.6 +/- 3.4 vs 6.9 +/- 1.4, p < 0.001, respectively). P wave dispersion were significantly higher in hypothyroid patients (48.8 +/- 6.2 vs 44.3 +/- 7.2, p = 0.022). In stepwise regression analysis demonstrated that, interatrial EMD and LA active emptying fraction related with TSH and fT4. Conclusions: This study showed that impaired LA mechanical and electromechanical function in hypothyroid patients. TSH and T4 were independent determinant of interatrial EMD and LA active emptying fraction. (Cardiol J 2012; 19, 3: 287-294)Öğe Evaluation of left ventricular systolic asynchrony in patients with subclinical hypothyroidism(Via Medica, 2012) Öztürk, Serkan; Alçelik, Aytekin; Özyaşar, Mehmet; Dikbaş, Oğuz; Ayhan, Selim; Özlü, Fatih; Erdem, Alim; Yazıcı, MehmetBackground: The heart was very sensitive to fluctuating thyroid hormone levels. To assess intra-left ventricular (LV) systolic asynchrony in patients with subclinical thyroid dysfunction. Methods: Fifty patients with subclinical hypothyroidism and 40 controls were included. A diagnosis of subclinical hypothyroidism was reached with increased TSH and normal free T4. All subjects were evaluated by echocardiography. Evaluation of intra-LV systolic asynchrony was performed by tissue synchronization imaging (TSI), and four TSI parameters of systolic asynchrony were calculated. LV asynchrony was defined by these parameters. Results: All of the groups were similar in terms of demographic findings and conventional and Doppler echocardiograpic parameters except peak systolic velocity and early diastolic velocity. LV systolic asynchrony parameters of TSI including; standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any 2 of the 12 LV segments (Ts-12), standard deviation of TS of the 6 basal LV segments (Ts-SD-6), maximal difference in Ts between any of the 6 basal LV segments (Ts-6) were significantly lengthened in patients with subclinical hypothyroidism than controls (p < 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). The prevalence of LV asynchrony was significantly higher in patients with subclinical hypothyroidism than control. Conclusions: Patients with subclinical hypothyroidism present evidence of LV asynchrony by TSI. LV systolic asynchrony could be a warning sign of the early stage in cardiac systolic dysfunction in subclinical hypothyroid patients. (Cardiol J 2012; 19, 4: 374-380)Öğe Evaluation of pregnancy-associated plasma protein-a levels in patients with chronic obstructive pulmonary disease and associations with disease severity(Springer/Plenum Publishers, 2016) Talay, Fahrettin; Tosun, Mehmet; Yaşar, Zehra Asuk; Kurt, Özlem Kar; Karği, Aysel; Öztürk, Serkan; Özlü, Mehmet Fatih; Alçelik, AytekinChronic obstructive pulmonary disease (COPD) represents a systemic disorder characterized by chronic airflow limitation and an increased inflammatory response of the airways. Comorbidities are frequent in COPD and it is crucial to predict these in early stage for adequate management of COPD. Recent studies have reported that elevated levels of pregnancy-associated plasma protein-A (PAPP-A), a zinc-binding metalloproteinase, detected in patients with asthma, lung cancer, and pulmonary embolism and independently associated with cardiovascular events. We aimed to assess serum PAPP-A levels in COPD and the associations between disease severity. The study population consisted of 75 COPD patients and 35 healthy subjects as a control group. PAPP-A levels were measured by using ultrasensitive enzyme-linked immunosorbent assay. Elevated levels of PAPP-A were observed in patients with COPD on comparison with the controls (p = 0.000). The levels in stage 1 (34.73 +/- 22.97) and stage 2 (48.29 +/- 53.35) were significantly higher than stage 3 (20.58 +/- 22.98) and stage 4 (27.36 +/- 21.46) (p = 0.049). Increased PAPP-A levels may be a useful marker in management of COPD that seeks to prevent the development of comorbidities such as adverse cardiovascular diseases.
