Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Migraine and Subclinical Atherosclerosis: Endothelial Dysfunction Biomarkers and Carotid Intima-Media Thickness: A Case-Control Study(2019) Avci, Aynur Yilmaz; Akkucuk, Mehmet Husamettin; Torun, Ebru; Arikan, Serap; Can, Ufuk; Tekindal, Mustafa Agah; https://orcid.org/0000-0001-9004-9382; https://orcid.org/0000-0003-4569-1143; https://orcid.org/0000-0001-5752-3812; https://orcid.org/0000-0001-8689-417X; https://orcid.org/0000-0002-4060-7048; 30645751; F-6770-2019; AAJ-2828-2021; AAJ-1289-2021; AAJ-2999-2021; U-9270-2018Background Migraine is a common neurovascular disease associated with vascular risks, especially in young adult females, but the mechanism underlying these associations remains unknown. This study evaluated the relationships between plasma endothelial dysfunction biomarkers and carotid intima-media thickness (IMT) in young adult females with migraine. Methods This case-control study included 148 female patients (age range: 18-50years). Migraine was diagnosed according to the International Headache Society-IIIb criteria. Endothelial dysfunction biomarkers, such as von Willebrand factor (vWF), C-reactive protein (CRP), homocysteine, total nitrate/nitrite concentration, and thiobarbituric acid-reactive substances (TBARS), were evaluated in plasma. Carotid IMT was measured by a radiologist with sonography. Results The CRP, TBARS, vWF, and IMT levels were increased in the migraine compared with the control group (p<0.001, p=0.02, p<0.001, and p<0.001, respectively). After adjusting for confounders, multiple linear regression analysis revealed that systolic arterial blood pressure, CRP, vWF, TBARS, and right and left internal carotid artery (ICA) IMT were independently positively correlated with migraine (p<0.01, p=0.004, p=0.023, p=0.024, p=0.032, and p=0.048, respectively). Multiple logistic regression analysis revealed that right ICA IMT was independently associated with ergotamine and triptan and left ICA IMT was independently associated with ergotamine (p=0.013, p=0.026, and p=0.017, respectively). In addition, significant correlations were found between LDL lipoprotein and carotid IMT in the migraine group (p<0.05). Conclusions Carotid IMT enhancement and elevated TBARS, vWF, and CRP levels in migraine subjects during a migraine attack could be regarded as consequences of migraine attack pathophysiology. The independent associations between triptan and ergotamine consumption and enhanced carotid IMT suggest that repeated use of these vasoconstrictive antimigraine agents may have additional effects on carotid IMT.Item Does measles immunization lead to immunization for COVID-19? Case series(2021) Akkucuk, Mehmet Husamettin; Akalin, Nalan; Gulalp, Betul; https://orcid.org/0000-0003-4569-1143; https://orcid.org/0000-0002-2045-2771; AAJ-2828-2021; P-6931-2016There are many studies on protective, preventive and treatment methods for about Covid-19 pandemic, which affects the whole world.The results of epidemiological studies also guide these researches. The studies of the scientists who are struggling with this pandemic worldwide reveal that the incidence of covid-19 is low in the child age group and the disease survived more mildly in childhood. There is an opinion about the reason why covid-19 disease is seen less frequently and milder in pediatric patients, that active immunization created with childhood vaccines. For this reason, we compared the Rubeola immunoglobulin levels formed aganist the measles vector, one of the childhood vaccines which has antigenic similarity with the SARS-CoV family, in patients diagnosed with covid-19 in our hospital and Rubeola immunoglobulin levels of screening performed in healthy individuals before pandemi. As a result , we found the measles IgG levels were statistically significantly higher in patients diagnosed with measles IgG covid-19 compared to the control group. According to this result, this significant increase in level after being infected with SARS-CoV2 in patients with measles immunization may have positive effects on the course of the disease. In addition. we saw that all our Covid-19 patients with high measles antibody recovered without serious mortality and morbidity , despite their age, gender and chronic diseases. Therefore , considering the completion process of vaccination studies, we think that measles vaccination can be applied to risky groups without contraindications to reduce the existing destructive effects of the disease.Item False Positive Computed Tomography Imaging for Coronavirus-2019(2021) Akkucuk, Mehmet Husamettin; Karadas, Mehmet Akif; Seviner, Meltem; Demir, Tayfun Anil; Doganay, Elif Kilicli; 0000-0003-4569-1143; 0000-0002-4719-2535; AAJ-2828-2021; AAJ-1600-2021A 79-year-old female patient presented to the emergency unit with cough and severe shortness of breath. Due to a bilateral multilobular ground glass density result from thoracic tomography, the patient was admitted to intensive care with the preliminary diagnosis of corona virus-2019 (COVID-19), and a continuous positive airway pressure was applied. A polymerase chain reaction (PCR) test was performed, and treatment with hydroxychloroquine and azithromycin was initiated. At the same time, the patient with an arterial blood pressure of 190/100 mm/hg was administered with diuretic treatment to reduce lung congestion. The follow-up computed tomography of the patient showed rapid recovery, and ground glass appearances had completely resolved. The PCR was negative and the patient was diagnosed with acute lung edema. The treatment was prescribed, and the patient was discharged from the hospital. Thoracic tomography findings are useful in early period for COVID-19 diagnosis; however, it may show similar results as other diseases that cause respiratory failure and lead to misleading interpretations.Item Admission Tpe interval predicts reperfusion success in STEMI patients treated with fibrinolytic agents(2020) Coner, Ali; Akinci, Sinan; Akkucuk, Mehmet Husamettin; Altin, Cihan; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0003-4569-1143; 0000-0001-5250-5404; 31974326; AAG-8233-2020; AAJ-2828-2021; AAD-5564-2021Objective: Myocardial infarction is a leading cause of morbidity and mortality. Fibrinolytic administration is still a life-saving choice in ST-segment elevated myocardial infarction (STEMI), but the rate of successful reperfusion can be inconsistent. Failed reperfusion adds additional clinical risks to rescue percutaneous coronary intervention for STEMI patients. The interval between the peak of the T wave and the end of the T wave (Tpe) and the ratio of Tpe and a corrected measurement of the time from the start of the Q wave to the end of the T wave (Tpe/QTc ratio) are relatively new electrocardiogram (ECG) indices and have not yet been tested in STEMI patients treated with fibrinolytic agents. Methods: A total of 177 STEMI patients (mean age: 60.5 +/- 11.1 years; 138 men and 39 women) were enrolled in this retrospective study to evaluate ECG parameters. The Tpe interval and the Tpe/QTc ratio at baseline and at the 90th minute following the administration of fibrinolytic therapy were analyzed. The clinical and ECG findings of successful and failed reperfusion groups were compared. Results: Successful reperfusion was achieved in 119 patients (67.2%). The average Tpe interval on the admission ECG was shorter (91.7 vs. 100.9 milliseconds [ms]) (p<0.001) and shortened more in the successful reperfusion group (9.3 vs. 4.5 ms) (p<0.001). A cut-off value of 89.0 ms for the Tpe interval on the admission ECG was found to be related to reperfusion success with a sensitivity of 90.9%. Conclusion: The Tpe interval was a predictor for reperfusion success in STEMI patients treated with fibrinolytic agents.Item Cervicofacial and Mediastinum Emphysema Following Dental Intervention(2015) Akkucuk, Mehmet Husamettin; Avci, Suat; Torun, Ebru; Gonullu, HaticeMediastinitis is a clinical case with high mortality and morbidity ratio. Thus, defining the causes beforehand is significantly important. A 65-year-old male patient present to the emergency care unit because of symptoms such as swelling of his face and neck. Crepitation is noted during palpation at the right lateral face and neck of patients, indicating that swelling occurred after medical intervention by the dentist using spray. Emphysema is seen on the face, neck, and mediastinum on X-ray and CT scans. Patients were hospitalized, and parenteral antibiotic therapy was applied in case of the possibility of serious infection, which may occur because of the use of air syringe, causing the permeation of oral flora to the neck and mediastinum via buccal mucosal ruptures during the patient's dental surgery. Because swellings disappeared and the patient did not have fever on the third day of hospitalization, the patient was discharged after oral antibiotics therapy. Physicians working at the emergency care unit will always keep in mind the risk of deep neck infections and mediastinitis occurrence that patients presenting with swelling symptoms on the neck and face may have following dental surgery.