Yazar "Tamer, Ali" seçeneğine göre listele

Listeleniyor 1 - 20 / 42
  • Küçük Resim
    Öğe
    Abdominal actinomycosis: A case report mimicking colon tumor
    (Turkiye Klinikleri, 2006) Tamer, Ali; Gündüz, Yasemin; Karabay, Oğuz; İka, Hüseyin; Aksel, Ferda
    Actinomyces spp., cause a chronic suppurative, granulomatous disease which is characterized clinically by extensive abscess formation, recurrent draining sinuses and fistulae and histologically by the presence of the so-called sulphur granules. Colonic actinomycosis is relatively rare, and its diagnosis is difficult. In this paper, we present a patient operated due to abdominal mass and diagnosed as transverse colon actinomycosis postoperatively, and discuss this case by reviewing the literature. Copyright © 2006 by Türkiye Klinikleri.
  • Küçük Resim
    Öğe
    Abdominal actinomycosis: a report of two cases
    (Acta Medical Belgica, 2006) Tamer, Ali; Gündüz, Yasemin; Karabay, Oğuz; Mert, Ali
    Actinomyces spp. cause a chronic suppurative, gramilomatous disease which is characterized clinically by extensive abscess formation, recurrent draining of sinuses and fistulae and histologically by the presence of the so-called "sulphur granules". Colonic actinomycosis is a relatively rare infection and its diagnosis is difficult. We report the case of a female patient who was operated on for ovarian cyst and the case of another female patient operated on for a mass in the transverse colon. In both cases the pathology of the excised tissues revealed actinomycosis. Actinomycosis must be considered in the differential diagnosis of patients who present with abdominal pain, fever, leucocytosis and intestinal wall thickness and/or abdominal mass.
  • Küçük Resim Yok
    Öğe
    The abnormalities in the coagulation factory in patients with essential hypertension and relationship between the coagulation abnormalities and end organ damage
    (2005) Çelebi, Harika; Karaca, Ilgın; İlkay, Erdoǧan; Tamer, Ali; Koç, Zuhal
    Hypertension is one of the important health problems in the world due to its high incidence and the fact that it causes mortality and morbidity. Mortality and morbidity in hypertensive patients are caused by damage of the target organ. Hypertensive patients are found to have impairments in coagulation mechanism in comparison to normotensive people. The relation between coagulation abnormalities in hypertensives and damage of the target organ is debatable. In this study we investigated coagulation abnormalities in hypertensive patients and the relation between the possible abnormality and target organ damage. Prothrombin time, partial thromboplastin time, fibrinogen, D-dimer and antithrombin III were measured in 50 essential hypertension patients and 50 normotensive controls. Target organ damage was assessed by clinical evaluation and laboratory tests including measurement of creatine clearance, proteinuria, ophthalmoscopy, electrocardiography, echocardiography, and ultrasound examination of major arteries. Plasma fibrinogen and D-dimer levels were significantly greater in hypertensives than normotensive controls. Antitrombin III level was significantly lower in hypertensives than controls. Hypertensive patients had greater body mass index and triglyceride and LDL cholesterol levels and lower HDL cholesterol than controls. The difference in terms of impairment of coagulation parameters was not statistically significant between hypertensive cases with target organ damage and hypertensive cases without target organ damage. Elevated plasma levels of fibrinogen, D-dimer and lower level of AT III in patients with essential hypertension may contribute to the development of atherosclerotic disease. Copyright © Hellenic Society of Haematology.
  • Küçük Resim Yok
    Öğe
    Akut viral hepatit'te N-asetilsistein tedavisi
    (2003) Gündüz, Hüseyin; Tabak, Ö. Fehmi; Tamer, Ali; Özaras, Reşat; Mert, Ali
    Amaç: Akut viral hepatit (AVH) sık, uzun seyirli ve seyrek olmayarak ciddi sorunlara yol açabilen önemli bir hastalıktır. Ülkemizin de aralarında bulunduğu gelişmekte olan ülkeler için bir toplum sağlığı sorunu niteliğindedir AVH olgularında hastalık süresini kısaltabilen bir tedaviye gereksinim açık iken bu alandaki boşluk henüz doldurulabilmiş değildir. Çalışmamızın amacı hücre içi glutatyon miktarını arttırarak potansiyel toksik ajanlar olan serbest oksijen radikalleri ile reaksiyona girip hücresel bütünlüğü koruyabilen N-asetilsistein (NAS)in AVH tedavisindeki etkisini araştırmaktır. Gereç ve Yöntem: Bu amaçla AVH tanısıyla yatırılarak izlenen hastalari iki gruba ayırıp çalışma grubunda günde üç kez 200 mg (600 mg/gün), oral NAS; kontrol grubunda ise plasebo kapsüller uyguladık. Hastaların çalışmaya dahil edilmelerinden itibaren serum total ve direkt bilirubin, ALT, AST, alkali fosfataz, albümin ve globulin seviyeleri, protrombin aktiviteleri haftada iki kere ölçüldü. Bu izlem serum total bilirubin seviyesinin 2 mg/dl'ye, ALT düzeyinin 100 U/L'nin altına inmesine kadar sürdürülerek hastalar taburcu edildi. Bulgular: İ.Ü Cerrahpaşa Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Enfeksiyon Hastalıkları Bilim Dalı'na AVH tanısıyla yatırılan 41 olgu çalışmaya alındı. Olguların 13 (%31.7)'ü kadın, 28 (%68.3)'i erkekti. Tüm olgularda ortanca yaş 24 (sınırlar:15-52) olup A tipinde ortanca yaş 17 (sınırlar:16-28), B tipinde ise ortanca yaş 26 (sınırlar:15-52) bulundu. Çalışma grubunda ortanca yaş 23 (sınırlar:15-48) kontrol grubunda ise ortanca yaş 24 (sınırlar:16-52) bulundu. HAV ile enfekte hastaların yaşı belirgin olarak küçüktü. Olguların serolojik ayırımında A tipi 9 (%22), B tipi 32 (%78) olguda bulundu. Çalışma grubunda A tipi 4 (%20), B tipi 16 (%80), kontrol grubunda ise A tipi 5 (%23.7), B tipi 16 (%76.4) idi. ALT nin normale dönüş süresi çalışma grubunda 19.7±6.9 gün (A tipi 11.2±6.1 gün, B tipinde 21.8±6.1gün), kontrol grubunda ise 20.4±6.5 gün (A tipi 16±7.4 gün, B tipi 21.8 ±6.7 gün) bulundu. Total bilirubin'in normale dönüş süresi çalışma grubunda 13.7±8.5 gün (A tipi 7.9± 4.9 gün, B tipi 15.2±8.6 gün), kontrol grubunda ise 16.9±7.8 gün (A tipi 12±6.3 gün, B tipi 18.4 ± 8.1 gün) olarak bulundu. Sonuç: NAS kullandığımız hastaların ALT ve total bilirubin değerlerinin normale dönme süresi dolayısıyla hastanede yatış süresi kısalmamış veya olumsuz yönde etkilenip uzamamıştır. Bu bulguların ikterli AVH'in tedavisi için NAS'in önerilemeyeceği sonucu çıkartılabilmektedir. Ayrıca bu ilacın AVH olgularında zararlı olmadığı da anlaşılmıştır.
  • Küçük Resim
    Öğe
    Albendazole versus metronidazole treatment of adult giardiasis: An open randomized clinical study
    (WJG Press, 2004) Karabay, Oguz; Tamer, Ali; Gündüz, Hüseyin; Kayaş, Derya; Arınç, Hüseyin; Çelebi, Harika
    Aim: To investigate the efficacy and tolerability of albendazole and metranidazole treatment in giardiasis. Methods: The open comparative randomized trial was carried out prospectively from December 1999 to July 2001 in Duzce City of Turkey. The diagnosis was based on the presence of signs and symptoms compatible with giardiasis including a positive stool examination of giardia cysts or trophozoite. Metranidazole group consisted of 29 patients and was given metranidazole 500 mg, three times a day for 5 d and albendazole group was consisted of 28 patients and was given albendazole 400 mg/d for 5 d. Results: There were no significant differences in demographical and therapeutical effects and patient's compliance between both groups. But side effects were seen more in metranidazole group than in albendazole group. Conclusion: Albendazole is as effective as metranidazole in adults' giardiasis. Albendazole has less side effect potentials than metranidazole in the treatment of giardiasis. Copyright © 2004 by The WJG Press.
  • Küçük Resim Yok
    Öğe
    Aort darlığında plazma homosistein yüksekliği koroner arter hastalığı varlığını gösterebilir mi?
    (2003) Gündüz, Hüseyin; Akdemir, Ramazan; Tamer, Ali; Binak, Emrah; Ayarcan, Yasemin
    Amaç: Kalsifik aort kapak hastalığı tespit edilen hastalardaki kardiyak risk faktörleri koroner arter hastalığı (KAH) ile benzer olup, koroner arter hastalığı prevalansı artmıştır. Son zamanlarda yapılan çalışmalarda; artmış plazma homosistein konsantrasyonunun koroner arter hastalığı için bağımsız bir risk faktörü olduğu, çeşitli mekanizmalarla ateroskleroza yol açarak aterosklerotik damar hastalıklarını ve venöz sistemde trombüs oluşumunu kolaylaştırıcı etki gösterdiği tespit edilmiştir. Fakat aort darlığı olan hastalarda plazma homosistein düzeyinin koroner arter hastalığı varlığı ile ilişkisi araştırılmamıştır. Bu çalışmanın amaçları; orta-ileri aort darlığı olan hastalarda plazma homosistein düzeyininin koroner arter hastalığı varlığını ne şekilde etkilediğini araştırmak ve aort darlığında homosistein düzeyi, koroner arter hastalığı varlığının noninvaziv bir belirleyicisi olabilir mi sorusuna cevap aramaktır. Gereç ve Yöntem: Çalışmaya transtorasik ekokardiyografi ile orta-ileri derecede aort darlığı tespit edilen ve sonrasında koroner anjiyografi yapılan toplam 58 hasta (koroner arter hastalığı olan 30, koroner arter hastalığı olmayan 28 hasta) alındı. Hastaların 12 saatlik açlık sonrası venöz kan örnekleri alınarak serum total kolesterol, LDL ve HDL kolesterol, trigliserid ve ELİSA yöntemiyle homosistein düzeyleri ölçüldü. Bulgular: Koroner arter hastalığı olan hastalarda (17 erkek,13 kadın, ortalama yaş 66±10 yıl) total kolesterol 266±45 mg/dL, trigliserid 194±93 mg/dL, LDL mg/dL 174±44, HDL 45±5 mg/dL, Homosistein düzeyi 13.2±3.1 µmol/l bulundu. Koroner arter hastalığı olmayan hastalarda ise (18 erkek,10 kadın, ortalama yaş 61±12 yıl) total kolesterol 204±38 mg/dL trigliserid 122±73 mg/dL, LDL 132±33 mg/dL, HDL 48±5 mg/dL, homosistein düzeyi 8.3±2.2 µmol/l bulundu. Koroner arter hastalığı olan hastalarda total kolesterol (p<0.01), LDL (p<0.05) ve homosistein düzeyi (p<0.01) anlamlı olarak yüksek bulundu. Sonuç: Bu sonuçlar orta-ileri aort darlığı olan hastalarda plazma homosistein düzeyindeki yüksekliğin koroner arter hastalığı varlığı ile korele olduğunu göstermektedir. Ayrıca aort darlığında koroner arter hastalığı varlığını gösteren bir noninvaziv test olarak araştırılması gerektiğini düşündürtmektedir.
  • Küçük Resim
    Öğe
    Can serum lipid and CRP levels predict the "severity" of aortic valve stenosis?
    (Taylor & Francis Ltd, 2003) Gündüz, Hüseyin; Akdemir, Ramazan; Binak, Emrah; Tamer, Ali; Keser, Nurgül; Uyan, Cihangir
    Background - Results of the studies performed have suggested that hypercholesterolaemia and inflammation are important aetiologic factors in aortic valve stenosis (AVS). However up to now no such data has been obtained to evaluate whether these predictors may still serve as valuable tools to estimate the progression and severity of AVS. If factors contributing to the "progression" of degenerative process can be understood and preventive measures can be taken, both clinical and economical beneficial effects can be achieved. The objective of this study is to investigate the correlation of serum cholesterol, triglyceride and CRP levels with the severity of aortic stenosis echocardiographically evaluated in patients with aortic valve stenosis. Material and methods -Aortic valvular areas of 60 patients (pts) hospitalized in our clinic with suspected AVS were calculated with Doppler echocardiography. Patients were grouped into mild, moderate and advanced AVS, each category containing 20 pts, and then were subclassified regarding those with and without coronary artery disease(CAD). Results -Total cholesterol and CRP levels were found to be 215 +/- 42 mg/dl and 2.0 +/- 1.4 mg/dl; 224 +/- 43 mg/dl and 2.4 +/- 2.1 mg/dl; 225 +/- 55 mg/dl and 2.7 +/- 2.1 mg/dl in pts with mild, moderate and advanced AVS, respectively. A statistically significant difference was not detected among the three groups (p>0.05). When subclasses were classified the levels were found to be much more increased in those patients having additional CAD. Conclusion - We have demonstrated that severity of AVS does not correlate significantly with hypercholesterolaemia and CRP and their levels do not rise in accordance with increasing severity of AVS. Elevations of lipid levels in AVS were found to correlate with the presence of CAD rather than the severity of AVS. So, not in patients with simply AVS but in patients under higher cardiovascular risks, investigation of CRP plus lipid levels might provide benefit with respect to preventive treatment and benefit from cholesterol-lowering drugs can be expected in such kind of patients.
  • Küçük Resim Yok
    Öğe
    The cardiac effects of a mobile phone positioned closest to the heart
    (2009) Tamer, Ali; Gündüz, Hüseyin; Özyıldırım, Serkan
    Amaç: Bu çalışmanın amacı cep telefonu (CT) prekordiyal bölgedeyken kalp hızı değişkenliği (KHD), QT ve P-dalga dispersiyonu ve kan basıncı (KB) değerlerini kullanarak kardiyak elektriksel aktiviteye CT’nun etkisini değerlendirmektir. Yöntemler: Bu prospektif çalışmaya 24 sağlıklı gönüllü alındı. İlk aşamada, CT olmaksızın, CT prekordiyal bölgede kalbin üzerinde kapalı, açık ve aranırken modlarında 12 derivasyonlu elektrokardiyografi (EKG) ve KB değerleri kaydedildi. İkinci aşamada; CT olmaksızın ve CT açık ve prekordiyal bölgedeyken 30’ar dakikalık Holter-EKG ve tansiyon-Holter ölçümleri yapıldı. P-dalga ve QT dispersiyonu 12 derivasyonlu EKG kayıtlarından hesaplandı, KHD ise 24-saat Holter kayıtlarından ölçüldü. İstatistiksel analizde, cep telefonu olmaksızın ve CT açık modunda, hemodinami ve KHD parametrelerinin karşılaştırılması için eşleştirilmiş t testi kullanıldı. Cep telefonu olmaksızın, kapalı, açık ve aranırken modlarında, hemodinami ve EKG parametrelerinin karşılaştırılması için tekrarlayan ölçümler için ANOVA testi kullanıldı. Bulgular: Çalışmanın ilk aşamasında; gruplar arasında KB, kalp hızı, P-dalga ve QT dispersiyonu parametreleri açısından anlamlı ilişki tespit edilmedi (p>0.05). İkinci aşamada; 2 grup arasında KB, kalp hızı ve KHD parametreleri arasında anlamlı ilişki saptanmadı (p>0.05). Sonuç: Sağlıklı erişkin bireylerde CT farklı modlarda kalbe en yakın pozisyonda kalp hızı, kan basıncını etklilememekte ve kardiyak otonomik disfonksiyona neden olmamaktadır.
  • Küçük Resim Yok
    Öğe
    A case with adult still's disease who was treated with indomethacin and review of treatment approaches
    (2005) Şahin, Özlem; Karabay, Oǧuz; Parlak, Ali Haydar; Tamer, Ali
    Adult Still's disease (ADS) is a rare condition, usually presenting with high fever accompanied by systemic manifestations. Non steroid anti inflammatory drugs (NSAID) and steroids are used for first-line therapy. In patients that are nonresponsive to this therapy or those that require high dose steroid, disease-modifying antirheumatic drugs such as methotrexate (MTX), gold salts, cyclophosphamide, cyclosporine- A and azathioprine (AZA) can be used. The efficacy of interleukin 1 (IL -1) inhibitors and tumor necrosis factor-alpha (TNF alpha) blockers in chronic inflammatory disease like rheumatoid arthritis, ankylosing spondylitis and juvenile chronic arthritis is pointed. Recently studies show that these agents can be used successfully also in the patients who are resistent for conventional therapy. Here, it is aimed to investigate the new and conventional treatment approaches of ASD in the light of literature via presentation of a 51 year old female case with ASD that was treated with indomethacin.
  • Küçük Resim
    Öğe
    The comparison of dexmedetomidine and midazolam used for sedation of patients during upper endoscopy: A prospective, randomized study
    (Hindawi Ltd, 2007) Demiraran, Yavuz; Korkut, Esin; Tamer, Ali; Yorulmaz, İlknur; Kocaman, Buket; Sezen, Gülbin; Akcan, Yusuf
    The aim of the present prospective, randomized study was to investigate and compare the safety and efficacy of dexmedetomidine versus midazolam in providing sedation for gastroscopy. A total of 50 adult patients (25 patients receiving dexmedetomidine and 25 patients receiving midazolam), 18 to 60 years of age, and rated I and II on the American Society of Anesthesiologists physical status classification system were included. A brief questionnaire was used to collect demographic data; patients were asked to rate anxiety, satisfaction wit care to data and expected discomfort on a visual analogue scale. The following parameters were measured continuously and recorded every minute; heart rate, mean arterial pressure, hemoglobin oxygen saturation and respiratory rate. The two groups were similar with regard to age, body mass index, sex, education, duration of endoscopy, and ethanol or tobacco use. After the procedure, full recovery time, mean arterial pressure, heart rate, respiratory rate and hemoglobin oxygen saturation levels were similar in both groups. Both groups also had low levels of perceived procedural gagging, discomfort and anxiety scores (P > 0.05), and high satisfaction levels (90.1+/-3.0 for dexmedetomidine versus 84.9+/-4.5 for midazolam; P>0.05). Retching and endoscopist satisfaction were significantly different in patient receiving dexmedetomidine versus those receiving midazolam (88.8+/-6.5 versus 73.5+/-16.4, P<0.05; and 20.6+/-4.4 versus 45.2+/-6.0; P<0.001). In the midazolam group, the number of patients who had adverse effects was higher than the dexmedetomidine group (P<0.05). As a result, dexmedetomidine performed as effectively and safely as midazolam when used as a sedative in upper gastroscopy; it was superior to midazolam with regard to retching, rate of side effects and endoscopist satisfaction. It was concluded that dexmedetomidine may be a good alternative to midazolam to sedate patients for upper endoscopy.
  • Küçük Resim
    Öğe
    Diyalize giren hastalarda önyük azalmasının kapak yetersizliklerine etkisi
    (2005) Arınç, Hüseyin; Gündüz, Hüseyin; Tamer, Ali; Özhan, Hakan; Akdemir, Ramazan; Oğuzhan, Abdurrahman; Uyan, Cihangir
    Amaç: Diyalize giren kronik böbrek yetersizlikli hastaların vücut sıvısındaki artışa bağlı olarak ekokardiyografi sırasında kalp büyüklüğü ve sol ventrikül kitlesine ait ölçümler olduğundan farklı, kapak yetersizliğiyse olduğundan fazla olarak değerlendirilebilmektedir. Çalışmamızda diyalizle birlikte yapılan ultrafiltrasyonun, sol ventrikül ve sol atriyum büyüklüklerine, vena kava inferior çapları ve kollapsibilitesine etkisi ayrıca diyaliz öncesi kapak yetersizliği saptanan hastaların yetersizlik varlığı ve ciddiyetine olan etkisi incelendi. Gereç ve Yöntemler: Bu çalışmaya son dönem böbrek yetmezliği tanısı konmuş, hipervolemisi olan ve hemodiyalizle birlikte ultrafiltrasyon yapılacak 16’sı erkek, 14’ü kadın toplam 30 hasta alındı. Diyalizle birlikte yapılan ultrafiltrasyon öncesi ve sonrası ekokardiyografi ile sol ventrikül diyastolik-sistolik genişlikleri, septum ve arka duvar diyastolik-sistolik kalınlıkları, sol atriyum genişliği, aort çapı ve varsa perikardiyal sıvı ölçümleri yapıldı. Mitral, aort, triküspid ve pulmoner kapak fonksiyonları, varsa kaçak akımları 4 üzerinden derecelendirildi. Vena kava inferior inspiratuar ve ekspiratuar çapları ölçülüp, vena kava inferior çökebilirlik indeksi hesaplandı. Bulgular: Hemodiyaliz sonrası sol atriyum büyüklüğünde, sol ventrikül diyastolik ve sistolik genişliklerinde anlamlı azalma oldu. Hastaların mitral ve triküspid yetersizliği ciddiyetinde belirgin azalma olurken, aort ve pulmoner yetersizlikleri ciddiyetindeyse belirgin azalma saptanmadı. Vena kava inferior inspiryum ve ekspiryumdaki çaplarında anlamlı küçülme, çökebilirliğinde anlamlı artış saptandı. Sonuç: Diyalizde sıvı azaltılmasına bağlı hemodinamik ve ekokardiyografik parametrelerde anlamlı değişiklikler olmaktadır. Özellikle kapak yetersizliklerinin varlığında ve ciddiyetinde azalma olmaktadır.
  • Küçük Resim Yok
    Öğe
    Dose Chronic
    (2006) Karbay, Oğuz; Tamer, Ali; Sahin, İdris; Çelebi, Harika
    Objectives: To determine the prevalence of Staphylococcus aureus nasal carriage in patients with chronic hepatitis B virus infection. Patients and Methods: The prevalence of S. aureus nasal carriage was determined in patients with chronic hepatitis B virus infection and compared with the prevalence of S. aureus nasal carriage among control patients. Results: Between February 2003 and November 2004, 70 chronic hepatitis B patients and 70 control patients were enrolled in the study. S. aureus nasal carriage was shown in 15(12%) of the patients with chronic hepatitis B and 13 (19%) of the control group (P>0.05). There was no difference in nasal colonization between the cases and controls when analysed by age, sex, frequency of skin infection, prior use of antibiotics and hospital admission in the preceding six months. Conclusion: The results of our study show that chronic hepatitis B virus infection is not associated with S. aureus nasal carriage.
  • Küçük Resim Yok
    Öğe
    The effect of decreasing preload on valvular regurgitation in patients undergoing dialysis
    (Turkiye Klinikleri, 2005) Arinç, Hüseyin; Gündüz, Hüseyin; Tamer, Ali; Özhan, Hakan; Akdemir, Ramazan; O?uzhan, Abdurrahman; Uyan, Cihangir
    Objective: In chronic renal patients undergoing dialysis, calculations of left ventricular diameter and mass may be inordinately large and valve regurgitation may be develop to a high degree as a result of volume overload. In our study, we investigated the effect of ultrafiltration on left ventricular and atrial diameters, as well as on the collapsibility of the inferior vena cava and severity of valvular regurgitation present before dialysis. Material and Methods: A total of 30 patients, 16 male and 14 female, with a diagnosis of end-stage renal disease with hypervolemia and scheduled to undergo ultrafiltration in addition to hemodialysis were included in our study. Before and after ultrafiltration, left ventricular diastolic and systolic diameters, interventricular septum and posterior wall diastolic and systolic thicknesses, left atrial and aortic root diameters, and the severity of pericardial effusion, if present, were noted. Mitral, tricuspid, aortic and pulmonary valve functions were measured and, if regurgitation was present, its severity was staged in 4 categories. Inferior vena cava expiratory and inspiratory diameters were measured and a collapsibility index was calculated. Results: There was a significant decrease in left atrial and ventricular diastolic and systolic diameters after hemodialysis. Although the severity of mitral and tricuspid regurgitation decreased significantly, aortic and pulmonary regurgitation was not affected. A significant decrease in IVC expiratory and inspiratory diameters and an increase in collapsibility were noted. Conclusion: Dialysis causes significant changes in hemodynamic and echocardiographic parameters due to a decrease in intravascular fluid. In particular, a decrease in the presence and severity of valvular regurgitation occurs as a result of this procedure. Copyright © 2005 by Türkiye Klinikleri.
  • Küçük Resim
    Öğe
    Effect of reperfusion on p-wave duration and p-wave dispersion in acute myocardial infarction: primary angioplasty versus thrombolytic therapy
    (Blackwell Futura Publishing, Inc, 2005) Akdemir, Ramazan; Özhan, Hakan; Gündüz, Hüseyin; Tamer, Ali; Yazıcı, Mehmet; Erbilen, Enver; Albayrak, Sinan
    Background: Atrial fibrillation (AF) is a common arrhythmia occurring in about 10-20% of patients with acute myocardial infarction (AMI). P-wave dispersion (PWd) and P-wave duration (PWD) have been used to evaluate the discontinuous propagation of sinus impulse and the prolongation of atrial conduction time, respectively. This study was conducted to compare the effects of reperfusion either by thrombolytic therapy or primary angioplasty on P-wave duration and dispersion in patients with acute anterior wall myocardial infarction. Methods: We have evaluated 72 consecutive patients retrospectively (24 women, 48 men; aged 58 +/- 12 years) experiencing acute anterior wall myocardial infarction (AMI) for the first time. Patients were grouped according to the reperfusion therapy received (primary angioplasty (PTCA) versus thrombolytic therapy). Left atrial diameter and left ventricular ejection fraction (LVEF) were determined by echocardiography in all patients. Electrocardiography was recorded from all patients on admission and every day during hospitalization. Maximum (P max) and minimum (P min) P-wave durations and P-wave dispersions were calculated before and after the treatment. Results: There were not any significant differences between the groups regarding age, gender, left ventricular ejection fraction, left atrial diameter and volume, cardiovascular risk factors, and duration from symptom onset to treatment. P-wave dispersions and P-wave durations were significantly decreased after PTCA [Mean P max was 113 +/- 111 ms before and 95 +/- 17 ms after the treatment (P = 0.007)]. Mean PWd was 46 +/- 12 ms before and 29 +/- 10 ms after the treatment (P = 0.001). Also, P max and PWd were significantly lower in PTCA group (for P max 97 +/- 22 ms vs 114 +/- 16 ms and for PWd 31 +/- 13 ms vs 55 +/- 5 ms, respectively). Conclusions: Primary angioplasty reduces the incidence of AF by decreasing P max and P-wave dispersion.
  • Küçük Resim Yok
    Öğe
    Effect of reperfusion on P-wave duration and P-wave dispersion in acute myocardial infarction: Primary angioplasty versus thrombolytic therapy
    (2004) Akdemir, Ramazan; Özhan, Hakan; Gündüz, Hüseyin; Tamer, Ali; Yazici, Mehmet; Erbilen, Enver; Albayrak, Sinan
    Atrial fibrillation is a common arrhythmia occurring in about 10-20% of patients with acute myocardial infarction. P-wave dispersion and P-wave duration have been used to evaluate the discontinuous propagation of sinus impulse and the prolongation of atrial conduction time respectively. This study was conducted to compare the effects of reperfusion either by thrombolytic therapy or primary angioplasty on P wave duration and dispersion in patients with acute anterior wall myocardial infarction. We have retrospectively evaluated 72 consecutive patients (24 women, 48 men; aged 58 ±12 years) experiencing a first acute anterior wall myocardial infarction (AMI). Patients were grouped according to the reperfusion therapy received (primary angioplasty (PTCA) versus thrombolytic therapy). Left atrial diameter and left ventricular ejection fraction (LVEF) were determined by echocardiography in all patients. Electrocardiography was recorded from all patients on admission and on pach day of hospitalization. Maximum (P max) and minimum (P min) P wave durations and P wave dispersions (PWd) were calculated before and after treatment. There were no significant differences between the groups regarding age, gender, left ventricular ejection fraction (LVEF), left atrial diameter and volume, cardiovascular risk factors and duration from symptom onset to treatment. PWd and P wave durations were significantly reduced after PTCA (mean P max was 113±11 ms before and 95±17ms after the treatment [p=0.007]. Mean PWd was 46±12 ms before and 29±10 ms after the treatment (p=0.001). Also, P max and PWd were significantly lower in PTCA group (for P max 97±22 ms versus 114±16 ms and for PWd 31±13 ms versus 55±5 ms, respectively). Primary angioplasty reduces P max and P wave dispersion.
  • Küçük Resim
    Öğe
    Effect of reperfusion P-wave duration and P-wave dispersion in acute myocardial infarction: Primary angioplasty versus thrombolytic therapy
    (2004) Akdemir, Ramazan; Özhan, Hakan; Gündüz, Hüseyin; Tamer, Ali; Yazıcı, Mehmet; Erbilen, Enver; Albayrak, Sinan; Bulur, Serkan; Uyan, Cihangir
    Atriyal fibrilasyon akut miyokard enfarktüslü hastalarda %10-20 sıklıkla görülen bir aritmidir. P dalga süreleri ve dispersiyonu sinus noddan çıkan uyarının atriyal yayılımının bozulmasını incelemede kullanılmaktadır. Bu çalışma akut ön duvar miyokard enfarktüsü geçirmiş hastalarda primer anjioplasti ve trombolitik tedavinin P dalga süre ve dispersiyonuna etkisini araştırmaktadır. Akut ön duvar miyokard enfarktüsü geçiren 24 kadın, 48 erkek toplam 72 hasta çalışmaya alındı. Hastalar primer anjioplasti ve trombolitik tedavi almak üzere randomize edildi. Klinik, ekokardiyografik ve EKG değerleri incelendi. Tedavi öncesi ve sonrası P dalga süreleri ve dispersiyonu karşılaştırıldı. Yaş, cinsiyet, sol ventrikül ejeksiyon fraksiyonu, sol atriyum çapları ve kardiyovasküler risk faktörleri açısından karşılaştırıldıklarında her iki grupta anlamlı istatistiksel farklılık bulunmadı. Primer anjioplasti grubunda tedaviden sonar P dalga süreleri ve dispersiyonu anlamlı olarak azalmış ve her iki grup karşılaştırıldığında p max ve dispersiyon azalması anjioplasti grubunda istatistiksel olarak daha fazla saptandı. Primer anjioplasti, P dalga süreleri ve dispersiyonunu trombolitik tedaviye göre anlamlı olarak azaltır.
  • Küçük Resim Yok
    Öğe
    Effectiveness of lamivudine and interferon-? combination therapy versus interferon-? monotherapy for the treatment of HBeAg-negative chronic hepatitis B patients: A randomized clinical trial
    (2005) Karabay, Oğuz; Tamer, Ali; Tahtaci, Mustafa; Vardi, Şeref; Çelebi, Harika
    Results comparing the effectiveness of lamivudine used as monotherapy or in combination with interferon-alpha (IFN-?) in the treatment of chronic hepatitis B are not conclusive. This study compared the effects of IFN-? alone or in combination with lamivudine for the treatment of hepatitis B e antigen (HBeAg)-negative patients with chronic hepatitis B. Participation of patients in the IFN-? monotherapy and combination groups was randomized to a 1:1 ratio. Twenty seven HBeAg-negative patients with chronic hepatitis B received IFN-? (13 patients) at 9 million units 3 times weekly for 24 weeks or IFN-? at 9 million units 3 times weekly for 24 weeks plus lamivudine 100 mg/day (14 patients) daily for 1 year. Hepatitis B virus (HBV) DNA was measured quantitatively by real-time polymerase chain reaction at 0, 6, 12 and 18 months after the start of treatment. Sustained virologic response was defined as non-detectable serum HBV DNA 72 weeks after starting treatment. Sustained biochemical response was defined as normalization of alanine aminotransferase (ALT) values 72 weeks after starting treatment. The baseline characteristics of the 2 treatment groups were similar with respect to age, gender, ALT, HBV DNA levels and histologic diagnosis. Sustained biochemical responses were found at week 72 in 7 patients in each group (54% with IFN-? monotherapy and 50% with combination therapy) [p>0.05]. Sustained virologic responses were found at week 72 in 5 patients (38%) in the monotherapy and 7 patients (50%) in the combination therapy group (p>0.05). Combination therapy was not superior to IFN-? alone for the treatment of chronic hepatitis B. Combination treatment was associated with some disadvantages, such as additional cost. Lamivudine, on the other hand, may be more suitable for patients with cirrhosis, non-responders to IFN-? or in cases with contraindication for IFN-?.
  • Küçük Resim Yok
    Öğe
    The efficiency of two-dose hepatitis B vaccination in health care workers for immunoprophylaxis
    (Turkiye Klinikleri, 2006) Karabay, Oğuz; Tamer, Ali; Koç İnce, Nevin; Büyükahraz, Nisa; Vardı, Şeref
    Objective: Previous studies showed that 2 dose vaccinations 4 months apart were as effective as 3 dose vaccination schedules. In this study, we aimed to investigate the reliability and efficiency of 2 doses of Hepatitis B vaccine in health care workers. Material and Methods: Two dose and 3 dose vaccination groups who were negative for HBsAg, anti-HBcIgG and anti-HBs were selected among health care workers working in the İzzet Baysal Medical Faculty and were randomized in a 1:1 ratio. The 2 dose group included 36 subjects and 33 subjects were present in the 3 dose group. The 2 dose group was vaccinated with 20 ?g of vaccine at 0 and 4 months and the same dose was administered to the 3 dose group at 0, 1, and 6 months. Geometric Mean Titers (GMT) were calculated by measuring the level of anti-HBs quantitatively 2 months after the last shot in both groups. Results: GMT values of the 2 and 3 dose groups were determined as 314.5 and 599.2 IU/mL, respectively (p< 0.01). While the number of subjects with antibody titers under the protective level (anti-HBs<10 IU/mL) was 11 in the 2 dose group, only 1 patient in the 3 dose group had low antibody levels at the end of the vaccination schedule (p< 0.05). No significant difference was observed in terms of adverse effects between the 2 groups (p> 0.05). Conclusion: Although encouraging results were obtained in recent studies, the 2 dose vaccination schedule at 0 and 4 months used in our study for hepatitis B prophylaxis in health care workers was not as effective as the standard schedule. Thus, larger studies are required. Copyright © 2006 by Türkiye Klinikleri.
  • Küçük Resim
    Öğe
    Evaluation of right ventricular function in patients with thyroid dysfunction
    (Karger, 2006) Arınç, Hüseyin; Gündüz, Hüseyin; Tamer, Ali; Seyfeli, Ergün; Kanat, Mustafa; Özhan, Hakan; Akdemir, Ramazan
    Background: Thyroid gland dysfunction affects the structure and function of the heart. Tissue Doppler echocardiography is a new technique, and it has been used frequently in the evaluation of ventricular function. In the present study, right ventricular function was assessed in patients with overt or subclinical hypothyroidism and hyperthyroidism and in healthy subjects using the tissue Doppler method, and results were compared. Patients and Methods: 20 healthy subjects and 63 patients diagnosed with overt and subclinical hypothyroidism and hyperthyroidism were included in the study. Annular and myocardial systolic peak velocities, early and late diastolic peak velocities, precontraction, total contraction and relaxation times of the right ventricle were recorded by tissue Doppler echocardiography. The results of the patients were compared to those of the controls. Results: Myocardial systolic velocity was significantly higher in patients with hyperthyroidism. Annular and myocardial late diastolic velocities were found to be significantly lower in patients with overt hypothyroidism. Annular precontraction time was increased in patients with overt and subclinical hypothyroidism. Myocardial precontraction time was decreased in patients with hyperthyroidism, and increased in patients with overt hypothyroidism patients. Annular relaxation time was increased in patients with overt hypothyroidism. Conclusions: Right ventricular function is affected in patients with thyroid diseases. The tissue Doppler technique is a suitable tool to detect impairments in right ventricular function. There is a significant correlation between serum thyroid hormone levels and right ventricular velocities and time intervals.
  • Küçük Resim
    Öğe
    Hepatitis B carriage and Brucella seroprevalence in urban and rural areas of Bolu province of Turkey: A prospective epidemiologic study
    (2004) Karabay, Oğuz; Serin, Erdinç; Tamer, Ali; Gökdoğan, Feray; Alpteker, Hacer; Özcan, Arzu; Gündüz, Hüseyin
    In this study, we aimed to investigate the prevalence of hepatitis B surface antigen positivity and antibo dies against Brucella in rural and urban areas of Bolu provin ce of Turkey. Methods: A total of 5,234 people were screened from the urban and rural regions (4084 versus 1150, respecti vely). All sera were evaluated for HBsAg and Brucella antibody. Results: HBsAg, rose bengal and serum tube agglutination po sitivity were found to be 2.85%, 1.0%, 0.46%, respectively, in the urban area, versus 2.6%, 1.7%, 1.1%, respectively, in rural are as (P>0.05). Conclusions: HBsAg seropositivity in Bolu is lo wer than in many other centers in Turkey. Brucella prevalence is 1%, which is higher than that in the Ministry of Health re cords. This shows that the recording system in our country is not very efficient. Similar studies should be carried out in diffe rent regions of our country to determine the actual values, which requires the cooperation of scientific foundations and the Ministry of Health.