Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Evaluation of Early Cardiac Dysfunction in Patients with Systemic Lupus Erythematosus with or without Anticardiolipin Antibodies(2015) Barutcu, A.; Aksu, F.; Ozcelik, F.; Barutcu, C. A. E.; Umit, G. E.; Pamuk, O. N.; Altun, A.; 0000-0002-3233-8263; 25697770; ABB-5844-2020The aim of this study was to use transthoracic Doppler echocardiographic (TTE) imaging methods to identify cardiac dysfunction, an indicator of subclinical atherosclerosis in asymptomatic systemic lupus erythematosus (SLE) patients in terms of cardiac effects. This study involved 80 patients: a study group (n=50) and control group (n = 30). They were categorized into four subgroups: anticardiolipin antibodies (aCL) (+) (n = 14) and aCL (-) (n = 36); systemic lupus erythematosus disease activity index (SLEDAI) >= 6 (n = 15) and SLEDAI < 6 (n = 35); disease period >= 5 years (n = 21) and disease period < 5 years (n = 29); major organ involvement (+) (n = 19), major organ involvement (-) (n = 31). The ratio of mitral peak velocity of early filling to early diastolic mitral annular velocity (E/E') for the study group was found to be higher than the control (p < 0.01). Systolic septal motion velocity (Ssm) was lower in the study group compared with the control (p < 0.01). Left atrium (LA) dimension was greater in the study group than the control (p < 0.01). Ssm was found to be lower in the aCL (+) patients compared with the control and aCL (-) groups (p < 0.01, p < 0.05, respectively). LA dimension was greater in the aCL (+) and (-) groups compared with the control, (p < 0.01, p < 0.05, respectively) and aCL groups compared with each other (p < 0.05). The E/E' ratio for the aCL (+) and (-) groups was found to be greater than the control (p < 0.05). In the study, both the Ssm and the late diastolic septal velocity (sA') was found to be lower in the SLEDAI >= 6 group compared with SLEDAI < 6 group, (p < 0.001, p < 0.05, respectively). LA dimension was statistically greater in the SLEDAI >= 6 group compared with the SLEDAI < 6 group (p < 0.001). E' and early diastolic septal velocity (sE') were statistically lower in the disease period > 5 years group compared with the disease period < 5 years group (p < 0.01, p < 0.05, respectively). Carrying out regular scans with TTE image of SLE patients is important in order to identify early cardiac involvement during monitoring and treatment. Identifying early cardiac involvement in SLE may lead to a reduction in mortality and morbidity rates.Item Dyslipidemia After Pediatric Renal Transplantation-The Impact of Immunosuppressive Regimens(2017) Habbig, Sandra; Volland, Ruth; Krupka, Kai Kai; Querfeld, Uwe; Dello Strologo, Luca; Yalcinkaya, Fatos; Noyan, Aytul; Topaloglu, Rezan; Webb, Nicholas J. A.; Kemper, Markus J.; Pape, Lars; Bald, Martin; Kranz, Birgitta; Taylan, Christina; Hoecker, Britta; Toenshoff, Burkhard; Weber, Lutz T.; 28370750; AAD-5713-2021Dyslipidemia contributes to cardiovascular morbidity and mortality in pediatric transplant recipients. Data on prevalence and risk factors in pediatric cohorts are, however, scarce. We therefore determined the prevalence of dyslipidemia in 386 pediatric renal transplant recipients enrolled in the CERTAIN registry. Data were obtained before and during the first year after RTx to analyze possible non-modifiable and modifiable risk factors. The prevalence of dyslipidemia was 95% before engraftment and 88% at 1year post-transplant. Low estimated glomerular filtration rate at 1year post-transplant was associated with elevated serum triglyceride levels. The use of TAC and of MPA was associated with significantly lower concentrations of all lipid parameters compared to regimens containing CsA and mTORi. Immunosuppressive regimens consisting of CsA, MPA, and steroids as well as of CsA, mTORi, and steroids were associated with a three- and 25-fold (P<.001) increased risk of having more than one pathologic lipid parameter as compared to the use of TAC, MPA, and steroids. Thus, amelioration of the cardiovascular risk profile after pediatric RTx may be attained by adaption of the immunosuppressive regimen according to the individual risk profile.Item Assessment of Epicardial Fat and Carotid Intima Media Thickness in Gestational Hypertension(2018) Altin, Cihan; Yilmaz, Mustafa; Ozsoy, Hasmet M.; Gezmis, Esin; Balci, Serdar; Tekindal, Mustafa A.; Sade, Leyla E.; Muderrisoglu, Haldun; 0000-0002-3996-5681; 0000-0002-2557-9579; 0000-0002-1001-6028; 0000-0002-1782-7325; 0000-0002-4060-7048; 0000-0003-3737-8595; 0000-0002-9635-6313; 29603491; S-6973-2016; AAE-8301-2021; AAJ-1097-2021; U-9270-2018; AAQ-7583-2021; AAG-8233-2020AimGestational hypertension (GHT) is a common disorder of pregnancy characterized by new onset hypertension without the presence of detectable proteinuria after 20 weeks of gestation. Epicardial fat thickness (EFT) and carotid intima media thickness (CIMT) are suggested as new predictors of subclinical atherosclerosis. Although the relationship between these parameters and essential hypertension has been demonstrated, this association in patients with GHT is still unknown. We aimed to investigate CIMT and EFT in patients with GHT. MethodsA total of 90 patients (44 GHT and 46 controls) were enrolled. Patients with diabetes mellitus, chronic hypertension and cardiovascular disease (CVD) were excluded. In the third trimester, the mean CIMT at the far wall of both left and right common carotid arteries was measured on B-mode duplex ultrasound. EFT was measured on the free wall of the right ventricle at the end systole in the parasternal long-axis view by standard transthorasic 2D echocardiography. ResultsUnlike the mean CIMT (0.52 0.13 mm vs 0.47 +/- 0.11 mm; P = 0.078), the mean EFT was significantly higher in the GHT group compared to the controls (5.31 +/- 1.68 mm vs 4.17 +/- 1.16 mm; P = 0.002). In multivariate logistic regression analysis, among the most pertinent clinical variables, only EFT is an independent determinant of GHT (OR: 2.903; 95% confidence interval [CI]: 1.454-5.796; P = 0.003). In receiver operating characteristic (ROC) analysis, EFT >5.5 mm had 82.6% specificity and 52.3% sensitivity in predicting a diagnosis of GHT (ROC area under curve: 0.689, 95% CI: 0.577-0.802, P = 0.002). ConclusionMaternal EFT may be higher in pregnant women with GHT in comparison with those of controls.Item Peri-Implant Crevicular Fluid And Serum Levels Of Soluble ST2 In Peri-Implant Diseases: A Pilot Study(2023) Ozgur, Engin; Topcu, Deniz Ilhan; Bayraktar, Nilufer; Alptekin, Nilgun Ozlem; https://orcid.org/0000-0002-7911-198X; https://orcid.org/0000-0002-1219-6368; https://orcid.org/0000-0002-7886-3688; https://orcid.org/0000-0003-4104-6462; 36504319; E-3717-2019; Y-8758-2018; G-1816-2014Background and ObjectiveSoluble ST2 (sST2) is a current biomarker of cardiovascular disease. It is used to predict susceptibility to cardiovascular diseases and to analyze their prognosis. Serum sST2 level increases in inflammatory diseases such as periodontitis. However, the level of sST2 in peri-implant diseases and crevicular fluid has not been investigated yet. Thus, the aim of this cross-sectional study is to analyze the level of sST2 in peri-implant health and diseases. MethodsSixty-nine participants were divided into 3 groups as peri-implant health (PH), peri-implant mucositis (PM), and peri-implantitis (P-I). Peri-implant crevicular fluid (PICF) and serum samples were collected from each participant. The levels of sST2 and IL-6 in PICF and sST2, IL-6, and CRP in serum were compared between the groups. Pocket depth (PD), modified bleeding index (mBI), modified plaque index (mPI), keratinized mucosa index (KTW), and gingival/mucosal recession (REC) were recorded as clinical parameters. Biomarkers in the serum and PICF were analyzed by ELISA kit. ResultsSixty-nine patients were included in the study. The differences in the following parameters were statistically significant between groups: age (p = .009), implant function time (p = .027), PD (p < .001), mBI (p < .001), mPI (p < .001), and KTW (p = .043). The PICF volume of P-I and PM groups were statistically higher than PH (p < .001). The amount of sST2 in P-I and PM groups were higher than PH (p = .043). Serum CRP was higher in the P-I group than in other groups (p = .034). There were no significant differences in serum sST2 (p = .247) and IL-6 (p = .110) levels between groups. ConclusionThe PICF levels of sST2 were significantly higher in PM and P-I groups compared to the healthy group. However, no significant difference was observed between the groups in terms of serum sST2 level.Item Consensus Statement of Endocrinology, Cardiology, and Nephrology(ENCARNE) Experts on Prevention, Diagnosis, and Management of Cardiovascular and Renal Complications of Diabetes(2021) Altay, HakanAn array of medical practitioners, including endocrinologists, family physicians, internal medicine specialists in nephrology and cardiology, unceasingly investigate, diagnose and treat over 8 million diabetic patients in Turkey. Apart from routine glycemic regulation, several frequent coexisting comorbidities such as obesity, hypertension, dyslipidemia, and their associated complications should also be promptly managed. Due to the concomitant occurrence of complications, the involvement of additional specialties in the precise management of such conditions becomes indispensable. Owing to the ever-expanding knowledge about the prevalence and clinical manifestations of diabetes, various international medical societies publish annual diabetes guidelines, which makes it too cumbersome as well as challenging for the practicing physicians to follow these comprehensive guidelines in clinical practice. There is an unmet need for an easyto-read and concise document for all physicians working for diabetes management for a standardized approach for better management of diabetes and improved patient care. This consensus report was prepared collectively by the Society of Endocrinology and Metabolism Turkey, Turkish Society of Cardiology, Turkish Society of Nephrology, Turkish Society of Hypertension and Renal Diseases to prevent cardiac and renal complications of diabetes, to timely detect these complications by using pertinent measures and to develop, implement and monitor strategies for managing them effectively.