Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Short-Term Outcomes of Patent Ductus Arteriosus Closure With New Occlutech (R) Duct Occluder: A Multicenter Study(2016) Dedeoglu, Reyhan; Bilici, Meki; Demir, Fikri; Demir, Fadli; Acar, Onur Caglar; Hallioglu, Olgu; Pac, Aysenur; Kiziltas, Alev; Karabel, Duran; Kula, Serdar; Cimen, Derya; Baspinar, Osman; Atik, Sezen Ugan; Saltik, Irfan Levent; https://orcid.org/0000-0003-4444-0027; 27090770; V-1112-2019Aim: Over the past 2 decades, transcatheter occlusion of patent ductus arteriosus (PDA) with coils and the duct occluders evolved to be the procedure of choice. A new device, the Occlutech PDA1 occluder (ODO) device has been designed. Herein, we aimed to evaluate the characteristics and short-term results of patients who underwent transcatheter closure of PDA using the ODO. Methods: We reviewed the clinical records of 60 patients from different centers in Turkey between December 2013 and January 2016. The medical records were reviewed for demographic characteristics and echocardiographic findings. Device size was selected on the narrowest diameter of PDA. Results: The median patient age was 2.5 years (6 months-35 years), and median PDA diameter was 2.5mm (1.2-11 mm). Fifty-eight of 60 patients (96.6%) had successful ODO implantation. The occlusion rates were 37/58 (63.7%) at the end of the procedure, 51/58 (87.9%) at 24-48 hours post-procedure, and 57/58 (98.2%) on echocardiography at a median follow-up of 7.6 months. Conclusion: Our results indicate that transcatheter closure of PDA using the ODO is effective. Larger studies and longer follow-up are required to assess whether its shape and longer length make it superior to other duct occluders in large, tubular, or window-type ducts.Item Early Effects of Renal Replacement Therapy on Cardiovascular Comorbidity in Children With End-Stage Kidney Disease: Findings From the 4C-T Study(2018) Schmidt, Bernhard M. W.; Sugianto, Rizky Indrameikha; Thurn, Daniela; Azukaitis, Karolis; Bayazit, Aysun K.; Canpolat, Nur; Eroglu, Ayse Guler; Caliskan, Salim; Doyon, Anke; Duzova, Ali; Karagoz, Tevfik; Anarat, Ali; Deveci, Murat; Mir, Sevgi; Ranchin, Bruno; Shroff, Rukshana; Baskin, Esra; Litwin, Mieczyslaw; Ozcakar, Z. Birsin; Buscher, Rainer; Soylemezoglu, Oguz; Dusek, Jiri; Kemper, Markus J.; Matteucci, Maria C.; Habbig, Sandra; Laube, Guido; Wuehl, Elke; Querfeld, Uwe; Sander, Anja; Schaefer, Franz; Melk, Anette; https://orcid.org/0000-0002-3316-8032; 28926375; B-5785-2018Background The early impact of renal transplantation on subclinical cardiovascular measures in pediatric patients has not been widely investigated. This analysis is performed for pediatric patients participating in the prospective cardiovascular comorbidity in children with chronic kidney disease study and focuses on the early effects of renal replacement therapy (RRT) modality on cardiovascular comorbidity in patients receiving a preemptive transplant or started on dialysis. Methods We compared measures indicating subclinical cardiovascular organ damage (aortal pulse wave velocity, carotid intima media thickness, left ventricular mass index) and evaluated cardiovascular risk factors in 166 pediatric patients before and 6 to 18 months after start of RRT (n = 76 transplantation, n = 90 dialysis). Results RRT modality had a significant impact on the change in arterial structure and function: compared to dialysis treatment, transplantation was independently associated with decreases in pulse wave velocity (ss = -0.67; P < 0.001) and intima media thickness (ss = -0.40; P = 0.008). Independent of RRT modality, an increase in pulse wave velocity was associated with an increase in diastolic blood pressure (ss = 0.31; P < 0.001). Increasing intima media thickness was associated with a larger increase in body mass index (ss = 0.26; P = 0.003) and the use of antihypertensive agents after RRT (ss = 0.41; P = 0.007). Changes in left ventricular mass index were associated with changes in systolic blood pressure (ss = 1.47; P = 0.01). Conclusions In comparison with initiating dialysis, preemptive transplantation prevented further deterioration of the subclinical vascular organ damage early after transplantation. Classic cardiovascular risk factors, such as hypertension and obesity are of major importance for the development of cardiovascular organ damage after renal transplantation.Item The effect of helicobacter pylori eradication on atrophic gastritis and intestinal metaplasia : a retrospective single center research(2020) Suna, N.; Etik, D.; Ocal, S.; Gunduz, C.; Acikgoz, A.; Bildik, I; Gursoy, A.; Kasgoz, I; Tuleylioglu, H.; Boyacioglu, A.; 0000-0003-3719-9482; 0000-0002-4724-0728; 0000-0001-6234-7788; 33094583; ABH-4817-2020; AAJ-4707-2021; AAI-8822-2021Background and study aims : Gastric cancer (GC) is one of the major causes of cancer-related deaths worldwide. Helicobacter pylori (Hp) plays an important role in gastric carcinogenesis by inducing precancerous changes such as atrophic gastritis (AG) and intestinal metaplasia (IM). In our study, we aim to compare the grade of AG and IM before and after Hp eradication in patients who underwent esophagogastroduodenoscopy (EGD) in our center. Patients and methods : The data of 40.060 patients who underwent EGD for various reasons in our Endoscopy Unit between June 2011 and November 2017 were retrospectively evaluated. The grade of AG and IM before and after Hp eradication of patients meeting the study criteria were compared with each other. In addition, these findings were compared using OLGA and OLGIM staging systems. Results : A total of 175 patients, 89 (50.9%) women and 86 (49.1%) men, were included in the study. The mean age was 55 +/- 12 years. The mean time between two EGD examinations was 38 +/- 14 months. Significant improvement was observed in the grade of AG on corpus and antrum after Hp eradication (P=0.000, P=0.008). In the corpus and antrum, the grade of IM was regressed but this was not significant (P=0.80 and P=0.370 respectively). There was a decrease in OLGA stages after Hp eradication (P=0.000). There was also a reduction in the OLGIM stages, but this was not significant(P=0.341). Conclusion: Our study demonstrates that Hp eradication may reduce the risk of developing GC by providing an improvement in AG and IM which are precancerous changes in GC.Item Longitudinal Strain and Strain Rate for Estimating Left Ventricular Filling Pressure in Heart Transplant Recipients(2020) Colak, Ayse; Muderrisoglu, Haldun; Pirat, Bahar; Eroglu, Serpil; Aydinalp, Alp; Sezgin, Atilla; Sade, Leyla Elif; 0000-0002-3761-8782; 0000-0003-4576-8630; 32998008; AAD-5841-2021; AAI-8897-2021Traditional parameters have limited value to estimate left ventricular filling pressure (LVFP) in orthotropic heart transplant (OHT) recipients. We hypothesized that global longitudinal strain (GLS), diastolic, and systolic strain rate (SR) would be depressed in OHT recipients with elevated LVFP and could overcome the limitations of traditional parameters. We studied consecutively OHT patients at the time of endomyocardial biopsies and retrospectively pretransplantation studies conforming to the same protocol. Comprehensive echocardiography with strain measurements was performed. Results were compared with pulmonary capillary wedge pressure (PCWP) obtained from right heart catheterization that was performed just after the echocardiography study. In all, 74 studies were performed in 50 OHT recipients. Mean PWCP was 11.8 +/- 4.3 mm Hg (range: 4 to 25 mm Hg). Several parameters, but not left atrial volume index, mitral inflow velocities, annular velocities, and their ratio (E/e'), were different between studies with normal (n = 47) and elevated PCWP (n = 27). Area Under Curve for GLS (0.932*), E/e'SR (0.849*), and systolic SR (0.848*) (*p 0.0001) were more accurate than traditional parameters for predicting PCWP 12 mm Hg. GLS, systolic SR and E/e'SR remained accurate regardless of LV ejection fraction and allograft vasculopathy. Meanwhile, E/e' was accurate to predict PWCP in native failing hearts before transplantation. Changes in GLS and E/e'SR tracked accurately changes in PCWP. In conclusion, traditional indices of diastolic function perform poorly in OHT recipients, whereas GLS and E/e'SR provide reliable means of LVFP, irrespective of ejection fraction and allograft vasculopathy. These parameters also track reasonably well the changes in LVFP. (c) 2020 Elsevier Inc. All rights reserved.Item Serum Adiponectin Level as a Predictor of Subclinical Cushing's Syndrome in Patients with Adrenal Incidentaloma(2016) Unal, Asli Dogruk; Ayturk, Semra; Aldemir, Derya; Tutuncu, Neslihan Bascil; 27656211Subclinical Cushing's syndrome (SCS) is a condition of slight but chronic cortisol excess in patients with adrenal incidentaloma (AI) without typical signs and symptoms of Cushing's syndrome. Adiponectin has potent roles in modulating energy balance and metabolic homeostasis and acts in opposition to glucocorticoids. This study aimed to evaluate adiponectin level in SCS and nonfunctional AI (NAI) patients and its relation with metabolic parameters. Patients with AI (n = 40) and metabolically healthy controls (n = 30) were included. In AI patients and controls, detailed medical history assessment, physical examinations, anthropometric measurements, and laboratory measurements were performed. Age, body mass index, waist circumference, and lipid profiles were significantly higher and waist-to-hip ratio and adiponectin level were significantly lower in the AI patients than in the controls. The midnight cortisol and urinary free cortisol levels were significantly higher in the SCS patients (n = 8) than in the NAI patients (n = 32). Adiponectin level of the SCS group was significantly lower than those of the NAI and control groups. The sensitivity and specificity for an adiponectin level of <= 13.00 ng/mL in predicting the presence of SCS were 87.5% and 77.4%, respectively. In conclusion, adiponectin is valuable in predicting the presence of SCS in AI patients.