TR-Dizin İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4808
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Item Heart failure with non-reduced ejection fraction: Epidemiology, pathophysiology, phenotypes, diagnosis and treatment approaches(2022) Cavusoglu, Yuksel; Celik, Ahmet; Altay, Hakan; Nalban, Sanem; Ozden, Ozge; Temizhan, Ahmet; Ural, Ditek; Unlu, Serkan; Yilmaz, Mehmet Birhan; Zoghi, Mehdi; 35969235Heart failure (HF) has been classified as reduced ejection fraction (HFrEF), mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF) by the recent HF guidelines. In addition, HF with improved ejection fraction has been defined as a subgroup of HFrEF. In HFrEF, diagnostic workup and evidence-based pharmacological and device-based therapies have been well established. However, HFpEF, which comprises almost half of the HF population, represents significant uncertainties regarding its pathophysiology, clinical phenotypes, diagnosis and treatment. Diagnostic criteria of HFpEF have been changed a few times over the years and still remained a matter of debate. New paradigms including a prominent role of co-morbidities. inflammation, endothelial dysfunction have been proposed in its pathophysiology. As a complex, multifactorial syndrome HFpEF consists of many overlapping clinical and hemodynamic phenotypes. In contrast to HFrEF, clinical outcomes of HFpEF have not improved over the last decades due to lack of proven effective therapies. Although HFrEF and HFpEF have different clinical spectrums and proposed pathophysiological mechanisms, there is no clear defining syndrome postulated for HFmrEF. Clinical characteristics and risk factors of HFmrEF overlap with HFrEF and HFpEF. HFmrEF is also referred as a transitional zone for dynamic temporal changes in EF. So. HFpEF and HFmrEF, both namely HF with non-reduced ejection fraction (HF-NEF), have some challenges in the management of HF. The purpose of this paper is to provide a comprehensive review including epidemiology, pathophysiology, clinical presentation and phenotypes of HF-NEF and to guide clinicians for the diagnosis and therapeutic approaches based on the available data in the literature.Item Influenza viruses and SARS-CoV-2 in adult: 'Similarities and differences'(2021) Torun, Serife; Kesim, Cagri; Suner, Aynur; Botan Yildirim, Berna; Ozen, Ozgur; Akcay, Sule; 0000-0002-8964-291X; 0000-0001-7122-4130; 0000-0001-7730-1379; 34957739; AAD-5996-2021; AAN-1681-2021Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causing a global pandemic starting from December 2019, showed a course that resulted in serious mortality in the world. In order to understand SARSCoV-2 better, here we aimed to compare the similar and different characteristics of Influenza viruses occurring in the same season with SARS-CoV-2. Materials and Methods: A total of 144 patients (31 patients with COVID-19, 62 patients with H1N1 influenza, and 51 patients with influenza B) were included in the study. Demographic findings, chronic diseases, laboratory values, chest x-ray, and chest CT findings of the patients were evaluated retrospectively. Results: Median age of the COVID-19 patients and rate of male patients were higher than other patient groups (55 years; p< 0.001) (61% male; p< 0.001). The most common chronic medical conditions were hypertension and diabetes. Platelet numbers and alanine aminotransferase values were significantly higher in COVID-19 patients. Radiologically, bilateral (74.2%) and nonspecific distribution (58.1%), ground-glass opacities with consolidation (51.6%), patchy image (25.8%), ground-glass opacities with interstitial changes (22.6%) and halo sign (22.6%) were quite evident than other groups in COVID-19 patients (p< 0.05). Conclusion: We suggest that due to the higher PLT values observed in COVID-19 patients, initiation of anticoagulant therapy should be considered in the early stage and routine follow-up with d-dimer and fibrinogen should be applied for suspected patients. Moreover, attention should be paid in terms of possible liver toxicity of the drugs to be used in treatment due the higher ALT values observed in COVID-19 patients. Since we did not detect SARS-CoV-2 and influenza viruses concurrently in the same patient, it may be helpful to focus on only one virus in a patient with symptoms, and radiographic differences can be used to differentiate COVID-19 from influenza.Item 2019 Turkish Hypertension Consensus Report(2019) Aydogdu, Sinan; Guler, Kerim; Bayram, Fahri; Altun, Bulent; Derici, Ulver; Abaci, Adnan; Tukek, Tufan; Sabuncu, Tevfik; Arici, Mustafa; Erdem, Yunus; Ozin, Bulent; Sahin, Ibrahim; Erturk, Sehsuvar; Bittigen, Atilla; Tokgozoglu, Lale; 31483311The Turkish Hypertension Consensus Report was prepared for the first time in 2015 to adapt the European and American international guidelines to our clinical practice and to create a practical report that could be a basic reference for all physicians dealing with hypertensive patients. This report, which was prepared by a committee with representation from 5 leading hypertension associations, has been accepted and is widely used. New clinical studies in hypertension literature and updated international guidelines since 2015 have demanded an update of the Turkish Hypertension Consensus Report as well. In this updated 2019 report, blood pressure levels were classified as Normal, Elevated, Stage 1, and Stage 2 hypertension. A new section was added for secondary hypertension. It was specified that drug treatment may be initiated with any 1 or a combination of 4 groups of drugs (diuretics, calcium channel blockers, angiotensin-converting enzyme [ACE] inhibitors, and angiotensin receptor blockers [ARBs]), except a combination of an ACE inhibitor and an ARB. It was emphasized that beta-blockers may be a first choice for hypertension treatment in diseases such as atrial fibrillation, heart failure, and coronary artery disease. The initial recommendation for hypertension treatment is a combination therapy in patients with a blood pressure level >= 150/90 mmHg. Target blood pressure values were redefined according to age and the presence of comorbidities. The hypertension treatment algorithm was renewed; it is proposed that drug therapy can also be initiated with a risk-based approach for the group with an elevated blood pressure (systolic blood pressure: 120-139 mmHg, diastolic blood pressure: 80-89 mmHg). The threshold clinic systolic blood pressure level was reduced from 160 mmHg to >= 150 mmHg for the initiation of drug therapy in individuals 80 years of age or more. The section on the treatment of special groups has now been expanded to include pregnancy and lactation. As in the previous report, in this update, practical recommendations for the most common cases seen in the clinic were the goal, rather than a comprehensive report that addresses all aspects of hypertension. This report has evidence-based recommendations for most patients; however, it should be kept in mind that there may be differences from 1 patient to another and that physicians should take an individualized approach according to a good clinical evaluation.