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Öğe Akut miyokard infarktüs geçiren hastalarda travma sonrası stres bozukluğu belirtileri(2015) Semiz, Murat; Erdem, Fatma; Erdem, Alim; Tuman, Taha Can; Oran, Meral Demir; Kayka, Nefise; Yıldırım, OsmanAmaç: Bu çalışmanın amacı akut miyokard infarktüs (AMİ) geçiren hastalarda depresyon, anksiyete ve travma sonrası stres bozukluğu (TSSB) belirtilerini araştırmaktır. Çalışmamızda ruhsal belirtilerin klinik bulgular ile ilişkisi de incelenmiştir. Yöntem : Bu çalışmaya AMİ geçirdikten bir ay sonra kardiyoloji polikliniğine kontrol amaçlı gelen 50 hasta alınmıştı r. Hastalara sosyodemografik form, Hastane Ankiyete -Depresyon (HAD) ve Travma Sonrası Stres Bozukluğu Kontrol Listesi (Sivil Sürümü) (PTSB -CL) ölçekleri doldurtulmuştur. AMİ sonrası TSSB belirtilerine yol açabilecek bedensel, fiziksel veya ruhsal olay yaşa yan hastalar çalışmaya alınmamıştır. Bulgular: Hastaların anksiyete ölçeğinin ortalama puanı 8.7±4.3 olarak bulundu. Anksiyete ölçeğinin kesme puanına göre değerlendirme yapıldığında; hastaların % 26’sının anksiyete bozukluğu olabileceği gösterildi. Depres yon ölçeğinin ortalama puanı 7.2±3.6 idi ve ölçeğin kesme puanına göre hastaların % 36’sında (n=18) depresif bozukluk olabileceği saptandı. PCL -C ölçeğinin ortalama puanı 22.1±5.1 idi. Hastaların % 24’ü PCL -C ölçeğine göre kesme puanının üzerinde bir değerdeydi ve bu hastalarda TSSB olasılığı düşünüldü. Sonuç : Bu çalışmada AMİ geçiren hastalarda yüksek oranda TSSB belirtileri saptanmıştır. Hastanede yatış süresi ve taburculuk sonrası anjina şikayetleri TSSB belirtileri ile ilişkili bulunmuştur. AMİ geçiren hastalarda depresif bulguların yanı sıra TSSB belirtilerine de dikkat edilmesi gerektiğini düşünmekteyiz.Öğe Assessment of relation between neutrophil lympocyte, platelet lympocyte ratios and epicardial fat thickness in patients with ankylosing spondylitis(Medical Association of Zenica-Doboj Canton, 2016) Boyraz, İsmail; Çağlar, Sabri Onur; Erdem, Fatma; Yazıcı, Mehmet; Yazıcı, Selma; Koç, BünyaminAim To investigate whether there is a relation between neutrophil-lymphocyte (N/L) and platelet- lymphocyte (P/L) ratios and epicardial adipose tissue (EAT) thickness in patients with ankylosing spondylitis (AS). Methods Thirty patients diagnosed with ankylosing spondylitis and 25 healthy people (controls) were included in the study. Age, gender, body mass index (BMI), height, hemogram, sedimentation, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, CRP, hepatic and renal function tests, lipid profile of the all patients were recorded. Data related to duration of the disease, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) values of the cases in the patient group were obtained. A cardiologist measured EAT thickness by ECHO in both patient and control groups. Results In the patient group, mean BASDAI and BASFI scores were 2.48±2.21 and 1.5±2.07, respectively. Age, gender, BMI values did not show statistically significant difference between the patient and the control groups. N/L and P/L ratios did not change significantly in the patient group having higher EAT, BASFI values and taking anti-TNF compared to the control group. Conclusion In patients with AS, EAT measurements, which are related to inflammatory response increase, can be used for monitoring of the risk of development of cardiac disease. We could not find the relation between EAT and N/L, P/L ratios in terms of evaluation of inflammatory response. © 2016, Medical Association of Zenica-Doboj Canton. All rights reserved.Öğe Benefit of metformin in COPD: an effect on autonomic nervous system?(Informa Healthcare, 2015) Yaşar, Zehra; Erdem, Fatma; Talay, FahrettinTo the Editors: With great interest we read the recent article by Hitchings et al. on the safety of metformin in patients with type-2 diabetes mellitus and COPD (1). They found that in patients at high risk for lactate accumulation, metformin therapy was associated with a minor elevation of lactate concentration of doubtful clinical signifi cance. An additional fi nding was that metformin was associated with a longer survival, which was diffi cult to interpret because of possible unmeasured confounders. We would like to propose a mechanism of metformin by which metformin may have a benefi cial eff ect in terms of survival of COPD patients. Studies have shown that alterations in autonomic nervous system are present in COPD, with or without arterial COPD (2–6), which may contribution to the severity of disease and survival. Metformin is an anti-diabetic agent that has been shown to reduce insulin resistance and hyperglycemia, and also reduce the incidence of diabetes (7). Studies have also shown that metformin has benefi cial eff ects on autonomic control (8,9) and can improve cardiac sympathovagal balance in obese patients with type-2 diabetes (8). We think it can be hypothesized that the preceding eff ects of metformin on the autonomic nervous system might have played a role in the survival data reported by Hitchings et al.(1).Öğe Coexistence of Ectasia and Myocardial Bridge on the Same Coronary Artery Segment(2015) Çağlar, Sabri Onur; Erdem, Fatma; Alçelık, AysegülCoronary artery ectasia (CAE) is the dilatation of coronary artery segment just about 1.5 times than normal adjacent segment. Myocardial bridge (MB) is rare congenital anomaly of coronary arteries, characterized by systolic compression of the vessel segment. In this article, we report on a case of the coexistence of CAE and MB in the same segment of left anterior descending artery (LAD) in an 82 year old patient with acute coronary syndrome.Öğe Contribution of fragmented QRS on myocardial perfusion imaging in the assessment of functionally significant coronary artery stenoses(Verduci Publisher, 2016) Çalışkan, Billur; Korkmaz, Ayşe Nurdan; Erdem, FatmaOBJECTIVE: The evaluation of the functional significance of coronary artery stenosis is of great clinical importance in patient management or for decisions concerning coronary intervention. Recently, fragmented QRS (fQRS) on electrocardiography (ECG) has been introduced as a predictor of myocardial scarring as well as myocardial ischaemia in coronary artery disease. We aimed to investigate any additive value of fQRS to myocardial perfusion SPECT in evaluating the functional significance of the intermediate degree of coronary stenosis. PATIENTS AND METHODS: Patients who were referred for myocardial perfusion imaging (MPI) to evaluate the functional significance of intermediate (40-70%) coronary artery stenosis were analyzed retrospectively; 102 patients were included in the study. ECG records were evaluated to detect fQRS. MPI was interpreted visually and semiquantitatively by two nuclear medicine physicians blinded to the electro-cardiographic findings. Summed stress scores (SSS), summed rest scores and summed difference scores (SDS) were calculated according to the 17-segment model. RESULTS: The mean age of the patients was 62.56 +/- 9.5 years, and 64 were males (62.7%). Ischaemia was detected in 30 patients, and the frequency of fQRS was significantly higher in patients with ischaemia than in patients with normal perfusion (54.8% vs. 23.8%, respectively; p<0.001). Myocardial scarring was detected in 15 patients, 7 of whom had coexistent myocardial ischaemia. fQRS was positively correlated with the SSS (r=374, p=0.001), SDS (r=0.460, p=0.001) and summed motion score (r=0.228, p=0.024). fQRS was an independent predictor of myocardial ischemia in multivariate analyses (OR=11.181; CI=3.900-32.057; p<0.001). CONCLUSIONS: The presence of fQRS on ECG is associated with myocardial ischaemia in patients who had an intermediate degree of coronary stenosis.Öğe The effect of adenoidectomy operation made on patients with adenoid hypertrophy on cardiovascular risk reduction(Lippincott Williams & Wilkins, 2015) Şereflican, Murat; Yurttaş, Veysel; Erdem, FatmaÖğe The effect of mean platelet volume on the patients with nasal polyps(Univ West Indies Faculty Medical Sciences, 2016) Erdur, Ömer; Şereflican, Murat; Yurttaş, Veysel; Erdem, FatmaThe Editor, Sir, With great eagerness, we have read the study in your journal entitled “Mean platelet volume in nasal polyps” by Aktas et al (1). We would like to make some comments about this study. In recent years, many studies, which state there is a significant relation between the decrease of mean platelet volume (MPV) and inflammatory burden of several diseases, have been published (2–4). Besides this, some studies that search for the relation between nasal polyps and MPV have been reported (1, 5). In the results of these studies, there are conflicting comments about the effect of MPV value to nasal polyps. Although a good number of assertive results have been announced in these studies, sufficient usage area of MPV value measurement has not occurred in the follow-up and treatment of patients clinically as there is no fully standardized method of this parameter.Öğe Effect of perioperative inadvertent hypothermia on the ECG parameters in patients undergoing transurethral resection(Verduci Publisher, 2016) Bayır, Hakan; Yıldız, İsa; Erdem, Fatma; Tekelioğlu, Ümit Yaşar; Özyalvaçlı, Mehmet Emin; Bilgi, MuratOBJECTIVE: Perioperative inadvertent hypothermia (PIH) (core body temperature to < 36 degrees C) is a common event during surgery. PIH may result from multiple factors. Elderly urology patients are at greater risk than other patients for hypothermia. PIH may cause adverse postoperative cardiac clinical manifestations. Our study aimed to determine the effects of postoperative alteration of core body temperature on the ECG parameters in patients undergoing transurethral resection. PATIENTS AND METHODS: Fifty-nine patients, 40-83 years of age, who were scheduled for elective Transurethral Resection Prostate and/or Bladder (TUR-P and/or TUR-B) were enrolled in the study. Patients with operation times more than 30 minutes were included. Core temperatures were measured and standard 12-lead ECG readings were taken before surgery and immediately upon arrival in the postanesthesia care unit. RESULTS: 59 patients were included this study. Prevalence of PIH (< 36 degrees C) was (57.6%). The postoperative temperature was found to be significantly lower than the preoperative of all patients (preop 36.46 +/- 0.39; postop 35.68 +/- 0.59, paired sample t-test, p<0.001). Also in all patients, postoperative QTc dispersions were found to be significantly longer than the preoperative QTc dispersions (preop 59.66 +/- 32.69; postop 74.57 +/- 37.47 ms, p<0.05). When we divided the patients; hypothermic and normothermic, postoperative QTc dispersions were significantly different between two groups (68.23 +/- 33.43 ms, and 83.20 +/- 41.50 ms; p=0.009). CONCLUSIONS: The prevalence of inadvertent intraoperative hypothermia in patients undergoing transurethral resection is relatively high. QTc dispersion of mild hypothermic patients was significantly longer than normothermic patients'.Öğe The effect of septoplasty operation for nasal septum deviation to cardiovascular risk reduction(Lippincott Williams & Wilkins, 2015) Şereflican, Murat; Yurttaş, Veysel; Erdem, FatmaÖğe Effect of smoking and exposure cigarette smoke on cardiac autonomic function of healthy young adults(Wiley-Blackwell, 2015) Benek, Bedri Selim; Arpacık, Yusuf; Erdem, Fatma; Kırboğa, Tuğba; Erdem, Alim; Gümüştekin, KenanÖğe Epicardial fat thickness in patients with rheumatoid arthritis(Makerere Univ, Fac Med, 2015) Erdem, Fatma; Koç, Bünyamin; Sarıkaya, Savaş; Uçar, Mehmet; Yazıcı, Selma; Boyraz, İsmail; Çağlar, Sabri; Özyalvaçlı, Gülzade; Dönmez, İbrahim; Yazıcı, MehmetBackground: Epidemiologic data indicates that rheumatoid arthritis is an independent risk factor for cardiovascular disease. Epicardial adipose tissue is a novel cardio-metabolic risk factor. Our aim was to evaluate epicardial fat thickness (EFT) using echocardiography in patients with rheumatoid arthritis compared to healthy control subjects. Secondly, we investigated relationship between epicardial fat thickness and clinical and echocardiographic parameters in patients with rheumatoid arthritis. Method: The study population included 76 consecutive patients with rheumatoid arthritis (64 female; mean age, 53 +/- 11 years, median disease duration, 7.8 years) and 50 healthy subjects as controls (39 female; mean age, 52 +/- 6 years). All patients underwent echocardiography to assess left ventricular diastolic dysfunction, left ventricular hypertrophy and EFT. All values were compared between groups. Results: EFT was higher in rheumatoid arthritis patients than in healthy controls (0.66 +/- 0.20 vs. 0.54 +/- 0.18; p=0.003). Thickness of Intra Ventricular Septum (IVS) (1.1 +/- 0.06 and 9.8 +/- 0.08; p=0.001) and posterior wall (PW) (0.98 +/- 0.05 and 0.93 +/- 0.08; p=0.015) was higher in patients with rheumatoid arthritis compared to healthy controls. Early diastolic myocardiac peak velocity or late diastolic mitral peak velocity (E/A) ratio was lower in rheumatoid arthritis patients compared to healthy patients (1.1 +/- 0.8 and 1.24 +/- 0.1 p=0.001) as well as, E/e' was higher in Rheumatoid arthritis (RA) patients than healthy patients. (E/e': 8.7 +/- 1.6 and 8.0 +/- 1.4 p=0.020). In patients with rheumatoid arthritis, EFT was positively correlated with hypertension and duration of disease and E/e' (r: 0.10, p: 0.010, r: 0.306, p: 0.004 and r: 0.465 p: 0.007 respectively) and EFT was negatively correlated with E/A (r: -. 262 p: 0.022) Conclusion: To our knowledge, this is the first report about epicardial adipose tissue in rheumatoid arthritis patients. Epicardial fat thickness as an indicator of cardiovascular involvement was higher in rheumatoid arthritis patients.Öğe Evaluation of atrial conduction times, epicardial fat thickness and carotid intima-media thickness in patients with ankylosing spondylitis(Turkish League Against Rheumatism, 2016) Çağlar, Sabri Onur; Boyraz, İsmail; Erdem, Fatma; Yazıcı, Selma; Çağlar, HilalObjectives: This study aims to determine the relationship between atrial electromechanical delay (EMD), carotid intima-media thickness (CIMT), and epicardial fat thickness (EFT) in ankylosing spondylitis (AS), which has a complicated inflammatory nature. Patients and methods: The study population included 42 consecutive patients with AS (28 males, 14 females; mean age 39.3 +/- 8.5 years; range 22 to 60 years) and 40 healthy subjects as controls (24 males, 16 females; mean age 37.2 +/- 8.7 years; range 22 to 60 years) (p>0.05). All patients underwent a standard tissue Doppler echocardiography to assess the left ventricular diastolic dysfunction, atrial EMD, CIMT, and EFT. All values were compared between the groups. Results: Interatrial (29.5 +/- 5.8 ms vs. 17.9 +/- 5.3 ms) left and right intraatrial EMD (18.2 +/- 4.6 ms and 11.7 +/- 3.5 ms vs. 11.9 +/- 3.2 ms and 7.1 +/- 3.2 ms, respectively) intervals were longer in AS patients than in healthy controls (all p<0.001). Left and right CIMT (0.50 +/- 0.11 mm and 0.44 +/- 0.06 mm vs. 0.51 +/- 0.11 mm and 0.43 +/- 0.04 mm, respectively) and EFT (0.73 +/- 0.15 cm and 0.63 +/- 0.07 cm) values were higher in AS patients than in healthy controls (all p<0.01). Conclusion: To our best knowledge, this is the first report evaluating the atrial EMD, CIMT, and EFT values together in AS patients. As indicators of cardiovascular involvement, all parameters were higher in AS patients.Öğe Evaluation of Atrial Conduction Times, Epicardial Fat Thickness and Carotid Intima-Media Thickness in Patients With Ankylosing Spondylitis(2016) Çağlar, Sabri Onur; Boyraz, Ismail; Erdem, Fatma; Yazici, Selma; Caglar, Hilal; Koç, Bünyamin; Çağlar, EmrahObjectives: This study aims to determine the relationship between atrial electromechanical delay (EMD), carotid intima-media thickness (CIMT), and epicardial fat thickness (EFT) in ankylosing spondylitis (AS), which has a complicated inflammatory nature.Patients and methods: The study population included 42 consecutive patients with AS (28 males, 14 females; mean age 39.3±8.5 years; range 22 to 60 years) and 40 healthy subjects as controls (24 males, 16 females; mean age 37.2±8.7 years; range 22 to 60 years) (p>0.05). All patients underwent a standard tissue Doppler echocardiography to assess the left ventricular diastolic dysfunction, atrial EMD, CIMT, and EFT. All values were compared between the groups.Results: Interatrial (29.5±5.8 ms vs. 17.9±5.3 ms) left and right intraatrial EMD (18.2±4.6 ms and 11.7±3.5 ms vs. 11.9±3.2 ms and 7.1±3.2 ms, respectively) intervals were longer in AS patients than in healthy controls (all p<0.001). Left and right CIMT (0.50±0.11 mm and 0.44±0.06 mm vs. 0.51±0.11 mm and 0.43±0.04 mm, respectively) and EFT (0.73±0.15 cm and 0.63±0.07 cm) values were higher in AS patients than in healthy controls (all p<0.01).Conclusion: To our best knowledge, this is the first report evaluating the atrial EMD, CIMT, and EFT values together in AS patients. As indicators of cardiovascular involvement, all parameters were higher in AS patients.Öğe Evaluation of the effects of 3D mapping ablation on atrial conduction times in patients with paroxysmal atrial fibrillation(Bayrakol Medical Publisher, 2022) Dönmez, İbrahim; Memioğlu, Tolga; Acar, Emrah; Erdem, FatmaAim: Atrial fibrillation (AF) causes structural, electrical, and cellular remodeling in the atrium. Evaluation of intra-and interatrial conduction time, indicates structural and electrical remodeling in the atrium. This study aimed to evaluate the effect of pulmonary vein isolation applied with radiofrequency ablation (RF) therapy on intra-and interatrial conduction time and to investigate the structural and electrically remodeling after treatment.Material and Methods: Fifty-two patients with symptomatic PAF despite at least one antiarrhythmic drug and without structural heart disease were included in the study. Two patients were excluded because of complications developed during and after the operation. Fifty patients (28 female; mean age: 51.68 +/- 11.731; mean left atrial diameter: 36.79 +/- 4.318) who underwent CARTO (R) 3D pulmonary vein isolation applied with the RF ablation system were followed-up. Intra-and inter-atrial electromechanical delay was measured in all patients using tissue doppler echocardiography before and three months after RF ablation.Results: All intra-and interatrial conduction times were significantly decreased 3 months after RF ablation procedure (PA lateral p = 0.022; PA septum p = 0.002; PA tricuspid p = 0.019, interatrial conduction delay p= 0,012, intra-atrial conduction delay p = 0.029).Discussion: The results of our study suggest that providing stable sinus rhythm with RF ablation may slow down, stop or even improve structural remodeling at substrate level secondary to AF even in patients with paroxysmal AF who did not yet develop atrial fibrosis and permanent structural changes.Öğe An evaluation on the role of MPV on idiopathic sudden hearing loss etiology(Springer, 2015) Şereflican, Murat; Yurttaş, Veysel; Erdem, FatmaÖğe Giant coronary artery and slow flow phenomenon in young patient with acute coronary syndrome(2015) Çağlar, Sabri Onur; Erdem, Fatma; Suzi, Selim Ayhan; Yazıcı, Mehmet[No Abstract Available]Öğe The importance of coronary angiography for ischemic sign confirmation detected by myocardial perfusion scintigraphy(2016) Korkmaz, Ayşe Nurdan; Çalışkan, Billur; Erdem, FatmaTo the Editor, We have read with interest the article titled “Asymmetric dimethylarginine is not a good predictor of ischemia using myocardial perfusion scintigraphy” published in the latest issue of the Turkish Journal of Medical Science, by Erkan et al. (1). We would like to point out some issues related to this article.Öğe In reference to snoring and carotid artery intima-media thickness(Wiley, 2015) Şereflican, Murat; Erdem, Alim; Erdem, FatmaÖğe Is an elevated neutrophil-to-lymphocyte ratio a predictor of metabolic syndrome in patients with chronic obstructive pulmonary disease?(Verduci Publisher, 2015) Yaşar, Zehra; Büyükşirin, Melih; Üçsular, Fatma Demirci; Karğı, Aysel; Erdem, Fatma; Talay, Fahrettin; Kurt, Özlem KarOBJECTIVE: This study aimed to evaluate the diagnostic value of the neutrophil-to-lymphocyte ratio (NLR) in early detection of metabolic syndrome (MetS) in patients with chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: We retrospectively enrolled hospital records of 140 COPD patients and 50 sex and age-matched healthy controls. The diagnostic values of NLR were estimated using the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). RESULTS: In total, 140 patients with COPD of which 63 patients had MetS and 50 healthy subjects were included in the study. We found that the NLR values of the stable COPD patients were significantly higher than those of the controls (p < 0.001). Among patients with COPD, the NLR was significantly higher in patients with than without MetS (p < 0.001). The AUC of the NLR was 0.898 in patients with MetS. The optimal NLR cut-off was 2.56 and was validated in the testing set. For evaluation of MetS, the sensitivity and specificity were 84.1% and 84.4% in patients with COPD under the suggested cut-offs. CONCLUSIONS: The NLR is a simple, effective, and practical predictor of MetS in patients with stable COPD. It has potential value in public health practice for management of patients with COPD.Öğe NORMAL BASINÇLI HİDROSEFALİNİN NEDEN OLDUĞU PAROKSİSMAL ATRİYAL FİBRİLASYON OLGUSU(2015) Çağlar, Sabri Onur; Erdem, Fatma; Türkoğlu, Şule AydınÖZET Atriyal fibrilasyon (AF) klinik pratikte sık görülen bir ritim bozukluğudur. Yaş, diabetes mellitus, hipertansiyon, kalp yetmezliği, sigara, obezite, erkek cinsiyet, miyokard infarktüsü, valvüler kalp hastalığı, pulmoner hastalıklar ve hipertiroidi AF için risk faktörleridir. Mevcut bilgilerimize göre paroksismal AF ile normal basınçlı hidrosefali (NPH)birlikteliği daha önce bildirilmedi. Burada yeni başlangıçlı AF ile NPH birlikteliğini sunuyoruz. 53 yaşında bayan hasta acil sevişe 45 dakika önce başlayan çarpıntı şikayeti ile başvurdu. Çekilen elektrokardiyografi (EKG)’si AF ile uyumluydu. Medikal kardiyoversiyon uygulandı. Medikal kardi- yoversiyon sonrası normal sinüs ritmi(NSR)’ne dönmedi. Daha sonra 100 j ile bifazik elektriksel kardiyoversiyon uygulandı. Elektriksel kardiyoversiyon sonrası NSR elde edildi. Hastanın anamne- zinde bir haftadır olan yürüme güçlüğü mevcuttu. Nöroloji tarafından değerlendirilen hastaya be- yin MR istendi. MR ventrikülomegali ile uyumluydu. 25 ml’lik beyin omurilik sıvısının boşaltılması sonrası hastanın klinik bulguları normale döndü. Bu yüzden hekimler, NPH’ın AF’ye yol açabilece- ğini akılda bulundurmalıdır.
