Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Investigation of the Factors Affecting the Mortality of Patients Over 80 Years of Age Diagnosed with Acute Pulmonary Thromboembolism(2023) Sen, Nazan; Yilmaz, Mustafa; 0000-0002-2557-9579; S-6973-2016Introduction: To investigate the factors affecting the 30-day mortality of patients over 80 years of age diagnosed with acute pulmonary thromboembolism.Materials and method: This descriptive, retrospective, and single-center study reviewed the medical records of patients over 80 years of age who were admitted to the hospital with a diagnosis of acute pulmonary thromboembolism between January 1, 2008, and April 30, 2023. The factors associated with mortality in patients who had died were examined. The recorded values of factors considered to be the determinants of 30-day mortality were also determined.Results: This study included 113 patients, with a mean age of 83.7 +/- 2.7 years, and comprised of 68 (60.2%) females. During the one-month follow-up period, 30 patients (26.5%) died of acute pulmonary thromboembolism or related complications. No statistically significant difference in age and gender was observed between the exitus and non-exitus groups (p > 0.05). Moreover, no significant difference was observed between the two groups in terms of hypertension and diabetes (p > 0.05), whereas other comorbidities were statistically significantly higher in the exitus group (p < 0.05). In the linear regression analysis, heart failure (p < 0.001), D-dimer level (p = 0.019), partial arterial oxygen pressure (p < 0.001), systolic pulmonary artery pressure (p < 0.001), and recent history of major surgery (p = 0.021) were found to be factors that affected the mortality.Conclusion: The presence of comorbidities, poor hemodynamic findings, poor oxygenation, high pulmonary artery pressure, and high D-dimer levels may be mortality indicators in acute pulmonary thromboembolism patients over 80 years of age.Item Hematological Parameters Can Predict the Extent of Coronary Artery Disease in Patients with End-Stage Renal Disease(2015) Bal, Zeynep; Bal, Ugur; Okyay, Kaan; Yilmaz, Mustafa; Balcioglu, Serhat; Turgay, Ozge; Hasirci, Senem; Aydinalp, Alp; Yildirir, Aylin; Sezer, Siren; Muderrisoglu, Haldun; 0000-0002-8342-679X; 0000-0001-6134-8826; 0000-0002-6731-4958; 0000-0002-9635-6313; 0000-0002-3761-8782; 0000-0002-9446-2518; 0000-0001-8750-5287; 0000-0002-2557-9579; 26246038; AAK-7805-2021; AAK-7355-2020; GPX-1387-2022; AAG-8233-2020; AAD-5841-2021; AAK-4322-2021; AAZ-5795-2021; A-4947-2018; S-6973-2016Aside from traditional factors (e.g., diabetes, age, and hypertension), some hematological parameters, such as neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width (RDW), and mean platelet volume (MPV), have increasingly been reported as measures of systemic inflammation and atherosclerosis in patients with end-stage renal disease (ESRD). This study aimed to determine whether there is an association between these hematological parameters and the extent of coronary artery disease (CAD) in patients with ESRD. A total of 149 consecutive ESRD patients (66 % males) without established CAD were studied. NLR, RDW, and MPV values in all patients were calculated from the complete blood count before coronary angiography. Angiographic views were assessed by an experienced interventional cardiologist, and the extent of CAD was evaluated by the Gensini score. The patients were divided into quartiles of the Gensini score. Age, time on dialysis, calcium-phosphorus product, C-reactive protein levels, NLR, and MPV were significantly different among the groups (all p < 0.05). The Gensini score was correlated with age, time on dialysis (both p < 0.001), NLR (p = 0.004), and C-reactive protein levels (p = 0.034) and inversely correlated with left ventricular ejection fraction (p = 0.023). Multivariate regression analysis showed that age (p = 0.001), time on dialysis (p < 0.001), NLR (p = 0.001), and MPV (p = 0.005) were independent predictors of the extent of CAD. Aside from the well-known traditional factors, NLR and MPV are independent predictors of the extent of CAD in patients with ESRD.Item Predictive Value of Hematologic Parameters for Detecting Asymptomatic Graft Rejection After Heart Transplant: Preliminary Results(2015) Karacaglar, Emir; Bal, Ugur; Ciftci, Orcun; Turgay, Ozge; Yilmaz, Mustafa; Sade, Elif; Aydinalp, Alp; Sezgin, Atilla; Atar, Ilyas; Muderrisoglu, Haldun; 0000-0002-2557-9579; 0000-0002-9446-2518; 0000-0001-8926-9142; 0000-0002-2538-1642; 0000-0002-3761-8782; 0000-0002-9635-6313; 0000-0002-6731-4958; 0000-0003-3737-8595; 26640937; S-6973-2016; AAK-4322-2021; W-5233-2018; ABI-6723-2020; GPX-1387-2022; AAD-5841-2021; AAG-8233-2020; AAQ-7583-2021Objectives: Hematologic parameters, such as mean platelet volume, red-cell distribution width, and neutrophil-to-lymphocyte ratio, have prognostic value in multiple cardiac conditions such as stable angina pectoris, acute coronary syndromes, and heart failure. However, no previous studies have evaluated the association between hematologic parameters and asymptomatic graft rejection after heart transplant. We evaluated the role of hematologic parameters for detecting asymptomatic graft rejection after heart transplant. Materials and Methods: We retrospectively evaluated medical records of 47 adult patients who underwent orthotopic heart transplant between February 25, 2005, and July 6, 2014, in our hospital, noting their hematologic parameters before each biopsy. Two groups were created according to biopsy results: rejection and no-rejection. Results: We excluded 4 patients who died during the first month posttransplant owing to early complications. We evaluated 422 endomyocardial biopsy results of 43 adult patients (mean age, 43.4 +/- 11.4 y; 14 women). Mean follow-up was 33 months. A total of 109 biopsies performed because of clinical suspicion of rejection were excluded. Redcell distribution width levels were similar between groups (17.2% +/- 2.6% in the rejection group and 17.1% +/- 2.5% in the no-rejection group; P=.856). Neutrophil-to-lymphocyte ratio was similar between groups (7.8 +/- 9.9 in the rejection group and 8.2 +/- 9.7 in the no-rejection group; P=.791). Mean platelet volume levels were significantly lower in the rejection group (8.3 +/- 1.3 fL) than in the no-rejection group (8.8 +/- 1.8 fL) (P=.037) (Table 1). Conclusions: According to our results, only lower mean platelet volume levels were significantly associated with asymptomatic graft rejection in patients with a transplanted heart. More detailed analyses are needed to exclude the effects of immunosuppressant drugs, and further studies are needed to clarify the exact role of hematologic parameters for detecting asymptomatic rejection after heart transplant.Item Investigation of The Relationship Between Asthma and Subclinical Atherosclerosis by Carotid/Femoral Intima Media and Epicardial Fat Thickness Measurement(2018) Yilmaz, Mustafa; Yilmaz, Hatice Eylul Bozkurt; Sen, Nazan; Altin, Cihan; Tekin, Abdullah; Muderrisoglu, Haldun; https://orcid.org/0000-0002-2557-9579; https://orcid.org/0000-0002-4171-7484; https://orcid.org/0000-0002-5658-870X; https://orcid.org/0000-0002-9635-6313; 28453377; S-6973-2016; AAI-8947-2021; ABD-7304-2021; AAG-8233-2020Objective: Since asthma and atherosclerosis may share similar pathophysiological mechanism, this study is planned to investigate whether epicardial fat thickness (EFT), carotid and femoral intima media thicknesses, which are markers of subclinical atherosclerosis, are increased in patients with asthma. Methods: The study was designed as a cross-sectional study. A total of 154 participants (83 patients with asthma and 71 healthy volunteers) were enrolled into the study. Epicardial fat, carotid, and femoral intima media thicknesses were measured and recorded in both groups. The statistical difference between the two groups was examined. Results: Both carotid and femoral intima media thicknesses were significantly higher in patients with asthma compared to control group (5.52 +/- 0.4 mm vs. 5.36 +/- 0.4 mm; p = 0.038 and 5.64 +/- 0.4 mm vs. 5.46 +/- 0.5 mm; p = 0.036, respectively). However, there was not a significant difference in EFT between the groups [5.9 mm (5.3-6.6; IQR = 1.3) vs. 5.6 mm (4.7-6.5; IQR = 1.8); p = 0.1]. On comparison of control group and asthma subgroups (mild, moderate, and severe), there was a statistically significant difference among these four groups in terms of carotid and femoral intima media thicknesses (p = 0.002 and p < 0.001, respectively). Subgroup analyses showed that this difference was mainly due to patients with severe asthma. Conclusions: Carotid and femoral intima media thicknesses in asthmatic patients were found to be increased compared to the normal population. As a result, the risk of subclinical atherosclerosis in asthmatic patients may be high.Item Assessment of Atrial Fibrillation and Ventricular Arrhythmia Risk after Transplantation in Patients with End Stage Renal Disease by P Wave/QT Interval Dispersion, Tp-e Interval, Tp-e/QT Interval Ratio(2018) Yilmaz, Mustafa; Altin, Cihan; Tekin, Abdullah; Arer, Ilker; Yabanoglu, Hakan; Caliskan, Kenan; Moray, Gokhan; Ozin, Bulent; Muderrisoglu, Haldun; Haberal, Mehmet; https://orcid.org/0000-0002-2557-9579; https://orcid.org/0000-0002-5658-870X; https://orcid.org/0000-0002-1161-3369; https://orcid.org/0000-0002-8767-5021; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0003-3821-412X; https://orcid.org/0000-0002-9635-6313; https://orcid.org/0000-0002-3462-7632; S-6973-2016; ABD-7304-2021; AAJ-7865-2021; AAJ-7201-2021; AAE-1041-2021; AAD-9938-2021; AAG-8233-2020; AAJ-8097-2021Item Assessment of Atrial Fibrillation and Ventricular Arrhythmia Risk after Bariatric Surgery by P Wave/QT Interval Dispersion(2018) Yilmaz, Mustafa; Altin, Cihan; Tekin, Abdullah; Erol, Tansel; Arer, Ilker; Nursal, Tarik Zafer; Torer, Nurkan; Erol, Varlik; Muderrisoglu, Haldun; 0000-0002-3628-4661; 0000-0002-5658-870X; 0000-0002-2557-9579; 0000-0002-9635-6313; 28900850; AAN-5153-2021; ABD-7304-2021; IQV-1169-2023; S-6973-2016; AAG-8233-2020The association of obesity with atrial fibrillation (AF) and with ventricular arrhythmias is well documented. The aim of this study was to investigate whether weight reduction by a laparoscopic sleeve gastrectomy has any effect on P wave dispersion (PWD), a predictor of AF, and corrected QT interval dispersion (CQTD), a marker of ventricular arrhythmias, in obese individuals. In a prospective study, a total of 114 patients (79 females, 35 males) who underwent laparoscopic sleeve gastrectomy were examined. The patients were followed 1 year. PWD and CQTD values before and 3rd, 6th, and 12th months after the surgery were calculated and compared. There was a statistically significant decline in body mass index (BMI), PWD, and CQTD values among baseline, 3rd, 6th, and 12th months (p < 0.001 for all comparisons). Correlation analysis showed a statistically significant correlation between Delta PWD and Delta BMI (r = 0.719, p < 0.001), Delta PWD and Delta left ventricular end-diastolic diameter (LVEDD) (r = 0.291, p = 0.002), Delta PWD and Delta left atrial diameter (LAD) (r = 0.65, p < 0.001), Delta CQTD and Delta BMI (r = 0.266, p = 0.004), Delta CQTD and Delta LVEDD (r = 0.35, p < 0.001), Delta CQTD and Delta LAD (r = 0.289, p = 0.002). In multiple linear regression analysis, there was a statistically significant relationship between Delta PWD and Delta BMI (beta = 0.713, p < 0.001), Delta PWD and Delta LVEDD (beta = 0.174, p = 0.016), Delta PWD and Delta LAD (beta = 0.619, p < 0.001), Delta CQTD and Delta BMI (beta = 0.247, p = 0.011), Delta CQTD and Delta LVEDD (beta = 0.304, p < 0.001), Delta CQTD and Delta LAD (beta = 0.235, p = 0.009). PWD and CQTD values of patients were shown to be attenuated after bariatric surgery. These results indirectly offer that there may be a reduction in risk of AF, ventricular arrhythmia, and sudden cardiac death after obesity surgery.Item Impact of Sleeve Gastrectomy on Epicardial Fat Tissue and Carotid Intima Media Thickness(2017) Altin, Cihan; Erol, Varlik; Aydin, Elcin; Yilmaz, Mustafa; Sade, Leyla Elif; Gulay, Huseyin; Muderrisoglu, Haldun; 0000-0002-2557-9579; 0000-0003-0907-3647; 0000-0003-3737-8595; 0000-0002-0442-6178; 0000-0002-9635-6313; S-6973-2016; AAI-8276-2021; AAQ-7583-2021; AAJ-6407-2021; AAG-8233-2020Item Investigation of the Relationship Between Asthma and Subclinical Atherosclerosis by Carotid/Femoral Intima Media and Epicardial Fat Thickness Measurement(2017) Yilmaz, Mustafa; Yilmaz, Eylul Bozkurt; Sen, Nazan; Altin, Cihan; Muderrisoglu, Haldun; 0000-0002-2557-9579; 0000-0002-9635-6313; S-6973-2016; AAG-8233-2020Item Epicardial Adipose Tissue Thickness and Carotid Intima-Media Thickness in Hemodialysis Patients(2017) Aydin, Elcin; Altin, Cihan; Sakalhoglu, Onur; Yilmaz, Mustafa; Gezmis, Esin; Sade, Leyla Elif; Muderrisoglu, Haldun; 0000-0002-9635-6313; 0000-0003-0907-3647; 0000-0002-1001-6028; 0000-0003-3737-8595; 28559657; AAG-8233-2020; AAI-8276-2021; AAE-8301-2021; AAQ-7583-2021; HGC-1839-2022Background: It is well-known that cardiovascular risk and all-cause mortality is increased in hemodialysis patients. Epicardial fat thickness (EFT), which reflects visceral adiposity, has been suggested as a new cardiometabolic risk factor. The purpose of this study was to investigate EFT in hemodialysis patients. Methods: A total of 144 consecutive patients (60 hemodialysis patients and 84 controls) were enrolled into the study, and patients with diabetes mellitus and cardiovascular diseases (CVD) were excluded. EFT was measured on the free wall of the right ventricle at end-diastole from the parasternal long-axis view by standard transthorasic 2D echocardiography. Results: The groups were similar in terms of sex distribution, age, blood pressure, heart rate and frequencies of CAD risk factors including smoking status, family history of CAD and hypertension. There were no significant differences between the hemodialysis patients and controls in 2D echocardiographic parameters, including ejection fraction and biochemical parameters except low-density lipoprotein, high-density lipoprotein and c-reactive protein. Despite having lower body mass index, EFT levels were significantly higher in hemodialysis patients compared to the controls (8.0 +/- 2.2 mm vs. 5.8 +/- 1.9 mm; p < 0.01). In multivariate linear regression analysis we determined that hemodialysis patient status was found to be an independent predictor for both EFT ((3 = 0. 700, p = 0.014) and carotid intima-media thickness (CIMT, beta = 0. 614, p = 0.047). Conclusions: Hemodialysis patients are independently associated with high EFT and CIMT.Item Prophylactic Ozone Administration Reduces Renal Ischemia-Reperfusion Injury in The Rat(2016) Kal, Oznur; Akillioglu, Ishak; Kal, Ali; Celik, Esin; Yilmaz, Mustafa; Onal, Merih; Onal, Ozkan; https://orcid.org/0000-0002-7751-4961; https://orcid.org/0000-0001-7544-5790; AAJ-7586-2021; AAJ-4936-2021Background: The objective of this study was to examine the role of ozone oxidative preconditioning after renal IR (ischemia reperfusion) injury. Methods: Twenty-eight Wistar rats were randomized into four groups: sham operated (S), IR, ozone (O), and O+IR. The S group was administered physiological saline (PS) intraperitoneally (i.p.) for seven days. The IR group was subjected to renal ischemia for 1 h by occlusion of the left renal artery and vein, followed by reperfusion for 2 h. The O group was administered ozone i.p. for seven days. In the O+IR group, ozone was administered i.p. for seven days before the IR procedure. IR injury (as in the IR group) was induced on the eight day. Laboratory analyses of renal tissue samples for superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) were performed. Results: The total oxidant score (TOS) and total antioxidant capacity (TAC) of the blood samples were also analyzed. The degree of renal injury was highest in the IR group. In the O+IR group, renal injury was decreased. The antioxidant parameters were increased in the O group. The oxidant parameters were highest in the IR group. Conclusion: Ozone preconditioning ameliorated renal IR injury, with a significant decrease observed in the renal IR injury score.