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Öğe Evaluation of epicardial adipose tissue and carotid intima-media thickness as a marker of atherosclerosis in patients with inflammatory bowel disease(ARÁN EDICIONES, S.L., 2021) Ekmen, Nergiz; Can, Güray; Yozgat, Ahmet; Can, Hatice; Bayraktar, Muhammed Fatih; Demirkol, Muhammed Emin; Kayhan, Meral Akdoğan; Sasani, HadiBackground and aim: this study aimed to compare carotid intima media (CIMT) and epicardial adipose tissue (EAT) measurements, which are considered as markers for the detection of early atherosclerosis in healthy controls and inflammatory bowel disease (IBD) cases. Methods: a total of 60 IBD patients (25 Crohn’s disease and 35 ulcerative colitis) and 60 healthy patients (as a control group) were included in the study. The measurements of CIMT and EAT were performed using echocardiography and ultrasonography, respectively. Statistical analysis was used to determine the relationship between the parameters. Results: the thickness of bilateral (right and left) CIMT and EAT were significantly higher in IBD than in the control group (p < 0.05). There was a positive correlation between EAT and bilateral (right and left) CIMT in IBD patients (p < 0.05). Conclusion: IBD is associated with an increased thickness of EAT and CIMT. Chronic inflammation in IBD may increase the risk of atherosclerotic heart disease. Thus, only measur ing the thickness of EAT and CIMT can be used as an objec tive, easy, simple, affordable, non-invasive and accessible assessment method in order to screen for this riskÖğe Is there any link between atrial arrhythmias and inflammatory bowel disease?(Wolters Kluwer Medknow Publications, 2021) Can, Güray; Can, Hatice; Bayraktar, Muhammet Fatih; Demirkol, Muhammed Emin; Kayhan, Meral Akdoğan; Sasani, Hadi; Ekmen, NergizBackground: Inflammation plays an important role in the development of cardiovascular disease, including atherosclerosis and arrhythmia. The aim of this study was to evaluate atrial conduction times (ACTs) in patients with inflammatory bowel disease (IBD) in which systemic chronic inflammation is evident. Methods: In this cross-sectional, prospective, single-center study, 79 IBD patients (51 ulcerative colitis; 28 Crohn's disease) and 70 healthy controls were included. Atrial electromechanical properties were measured by recording simultaneous surface electrocardiography (ECG) with transthoracic echocardiography (ECHO) and tissue Doppler imaging methods. The relationship between age, disease duration, and ACT was evaluated. Results: There were significantly increased conduction durations of lateral-PA (time interval from the onset of the P-wave on surface ECG to the beginning of the late diastolic wave), septal-PA, tricuspid-PA, and interatrial-electromechanical delay (IA-EMD), right intraatrial EMD, and left intraatrial (LI-EMD) durations in IBD patients (P < 0.001). In IBD patients, there was a positive correlation with age, lateral PA, septal PA, tricuspid PA, IA-EMD, and LI-EMD (P < 0.05). A positive correlation was found between disease duration and only lateral PA and tricuspid PA (P < 0.05). Conclusion: In IBD patients, prolonged ACT consists a potential risk for severe atrial arrhythmias. ECG and ECHO screening can be useful in identifying risk groups in IBD patients and taking precautions for future cardiac complications.Öğe Preliminary examination of the relations between disease stage, illness perceptions, coping strategies, and psychological morbidity in chronic hepatitis B and C guided by the Common-Sense Model of Illness(Lippincott Williams & Wilkins, 2021) Ekmen, Nergiz; Can, Güray; Can, HaticeBackground and aims Chronic viral hepatitis (CVH) has a spectrum from asymptomatic disease to cirrhosis and hepatocellular carcinoma. In our study, we aimed to establish the relations between disease stage, illness perception, coping strategies and psychological morbidity in CVH. Methods A total of 182 patients with chronic hepatitis B (CHB) (n = 136) and chronic hepatitis C (CHC) (n = 46) were enrolled. Illness perceptions were measured with the Brief Illness Perceptions Questionnaire. Coping strategies were measured with the Carver Brief Coping Questionnaire. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale. Relations were evaluated by structural equation modeling (SEM). Results In CHB, combining the questionnaire data using SEM resulted in a final model with an excellent fit [chi(2) (2) = 0.00, P = 1.000, chi(2)/N = 0.00, root mean square error of approximation (RMSEA) < 0.001, comparative fit index (CFI) = 1.000, goodness-of-fit index (GFI) = 1.000]. Disease stage had a significant direct influence on illness perceptions (beta = 0.23, P = 0.006). Illness perceptions had a significant direct influence on emotional coping strategy, depression and anxiety (beta = 0.20, P = 0.019; beta = 0.33, P < 0.001; beta = 0.59, P < 0.001, respectively). While the use of emotional coping strategies was associated significantly (P = 0.01) with the presence of anxiety, problem-focused coping strategy was associated with depression (P = 0.004). In CHC, SEM resulted in a final model with an excellent fit [chi(2) (2) = 0.078, P = 0.962, chi(2)/N = 0.039, RMSEA<0.001, CFI = 1.000, GFI = 0.999]. Disease stage did not have a significant direct influence on illness perceptions (P > 0.05). Illness perceptions had a significant direct influence on depression and anxiety (beta = 0.27, P = 0.023; beta = 0.44, P < 0.001, respectively). Conclusion The psychological consequences of the disease vary depending on the person's perception of illness and coping strategies.Öğe Social stigmatization in Turkish patients with chronic hepatitis B and C(Ediciones Doyma, S.L., 2021) Yozgat, Ahmet; Can, Güray; Can, Hatice; Ekmen, Nergiz; Akyol, Taner; Kasapoğlu, Benan; Kekilli, MuratBackground and aim: Viral hepatitis is the most important cause of chronic hepatitis worldwide. Stigmatization is defined as a feeling of rejection and isolation of patients by society due to illness. There are no studies on chronic viral hepatitis in the literature in English, which has its own religious and socio-cultural structure. In our study, we aimed to investigate the presence of social stigmatism and psychosocial effects on patients with different stages of chronic viral hepatitis B and C. Methods: Forty-five patients with chronic hepatitis C and 114 patients with chronic hepatitis B were enrolled in the study. Berger's scale was used for stigmatization, composed of 40 four-point Likert items that have four subscales: personalized stigma, disclosure, negative self-image, and public attitude. Stigma score ranges between one and four. Stigma is accepted as present if the overall score is above two. Results: Overall the mean stigma scores were 1.97 ± 0.58 and 2.14 ± 0.57 for chronic hepatitis B and C, respectively. There was stigma in 47.4% of the patients with chronic hepatitis B, and 60% of the patients with chronic hepatitis C. Being male was the risk factor on overall stigma, disclosure and public attitude in chronic hepatitis C. Living in an urban setting was the risk factor on negative self-image in chronic hepatitis C and on personalized stigma and disclosure in chronic hepatitis B. Conclusions: To the best of our knowledge, this is the first study that provides qualitative information about chronic hepatitis-related stigma. Stigmatization is a major problem in Turkey and worldwide. We believe that increasing the knowledge of the patients and society by teaching about the transmission routes of the disease and focusing on vaccination studies will prevent stigmatization.
