Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item The Effect of Coronary Angiography and Femoral Access on Femoral Artery Distensibility and Elasticity(2021) Gunesli, Aylin; Acibuca, Aynur; 33791115Aim of the study: The aim of this study was to evaluate the long-term effects of access to the femoral artery for the purposes of coronary angiography through the measurement of femoral artery distensibility and elasticity on the accessed and non-accessed sides. Material and methods: This cross- sectional study included patients who underwent femoral angiography at least 1 year previously. Those whose femoral artery was accessed once formed Group 1 (n = 59), those who were accessed twice formed Group 2 (n = 57), those accessed 3 times formed Group 3 (n = 55), and those with more than 3 accesses, Group 4 (n = 60). The groups were compared in respect of femoral artery elasticity and distensibility in the accessed and non-accessed sides. Results: No statistically significant difference was determined in respect of femoral distensibility and elasticity in Group 1 (9.40 +/- 0.84 vs 9.48 +/- 0.75, p = 0.107 and 0.23 +/- 0.03 vs 0.23 +/- 0.03, p = 0.433, respectively). However, a significant difference was observed between the two sides in terms of distensibility and elasticity in Group 2 (9.02 +/- 0.81 vs 9.23 +/- 0.75, and 0.21 +/- 0.02 vs 0.22 +/- 0.02), in Group 3 (8.49 +/- 0.77 vs 9.18 +/- 0.9 and 0.19 +/- 0.02 vs 0.21 +/- 0.02), and in Group 4 (8.14 +/- 0.74 vs 9.03 +/- 0.81 and 0.16 +/- 0.01 vs 0.2 +/- 0.02, p <0.001, for all comparisons). Conclusion: While a single access in the femoral artery for coronary angiography does not affect femoral artery elasticity and distensibility, multiple accesses may have adverse effects.Item An epidemiological study to define the recent clinical characteristics and outcomes of infective endocarditis in southern Turkey(2021) Acibuca, Aynur; Yilmaz, Mustafa; Okar, Sefa; Kursun, Ebru; Acilar, Onur; Tekin, Abdullah; Demiroglu, Yusuf Ziya; Muderrisoglu, Ibrahim Haldun; 0000-0002-9866-2197; 0000-0002-5658-870X; 33830167; AAZ-9711-2021; ABD-7304-2021Introduction: The aim of this study was to characterise the recent features of patients with infective endocarditis (IE) at one referral centre in southern Turkey, in order to be able to identify the high-risk subgroup and revise preventative measures and management strategies. Methods: Medical records of patients 18 years and older, who had been diagnosed with IE according to the Duke criteria between January 2009 and October 2019, were retrospectively evaluated in a referral general hospital. Results: The total of 139 IE cases comprised 59.7% males and 40.3% females, with a mean age of 55 +/- 16 years. The most encountered symptom was fever (55.4%) and the mitral valve (54%) was the most frequently involved. The most common causative micro-organisms were coagulase-negative staphylococci (30.2%). The in-hospital mortality rate was 30.2%, with congestive heart failure, chronic renal disease and chronic dialysis found to be significantly associated with in-hospital mortality. Conclusion: The study results demonstrate the recent epidemiological features of IE in southern Turkey that are important for clinicians to manage diagnostic and therapeutic processes successfully. Older age, the predominance of staphylococci and higher surgery rates are consistent with the changing trends of IE in some parts the world.Item Cardiotoxicity of Trastuzumab Emtansine (T-DM1): A Single-center Experience(2021) Acibuca, Aynur; Sezer, Ahmet; Yilmaz, Mustafa; Sumbul, Ahmet Taner; Demircan, Senol; Muderrisoglu, Ibrahim Haldun; Ozyilkan, Ozgur; 0000-0002-3444-8845; 34898302; ABG-4047-2020Objective New anti-cancer drugs promise to increased survival benefits and reduce adverse events. Trastuzumab emtansine (T-DM1) is a novel anti-human epidermal growth factor receptor 2 agent that has shown minimal cardiotoxicity in clinical trials. However, data on real-life outcomes are required. Methods A retrospective review of our center's medical records was performed, including female patients aged >= 18 years with a diagnosis of metastatic breast cancer who were treated with T-DM1. Descriptive statistics were used to investigate clinical features that could increase the risk of cardiotoxicity. Cardiotoxicity was determined by comparing pre and post-T-DM1 echocardiogram results and was defined as a decrease in the left ventricular ejection fraction (LVEF) >10% to below 55%. Results Data from 41 female patients with a mean age of 52 +/- 11.5 years were evaluated. A significant LVEF decrease (from 59% to 33%) was observed in one patient during T-DM1 treatment. Further investigation showed that this decrease was due to underlying coronary artery disease, and LVEF recovered to the baseline value after coronary revascularization. Conclusion T-DM1 seems to be safe in terms of cardiotoxicity. Real-life data with a larger sample size are still needed to confirm the cardiac safety of T-DM1.Item A Case of Mediastinal Mesenchymal Tumor Resembling Hemopericardium(2021) Acibuca, Aynur; Yilmaz, Mustafa; Karadeli, Elif; Canpolat, Emine Tuba; Erol, Tansel; 34404995Mediastinal neoplasms are rare in the elderly, and clinical suspicion is the first and most important step of differential diagnosis. Mediastinal tumors can be misdiagnosed because their symptoms or signs can overlap with cardiovascular diseases, which have a higher prevalence among the older population. The diagnostic process should be managed with multimodality imaging and clinical judgement. Here, the case of a 74-year-old male patient, who presented with shortness of breath, is examined. A chest X-ray revealed an increased cardiothoracic ratio, and he was diagnosed with hemopericardium following an emergent chest computed tomography. In the echocardiography, it was suspected that a hyperechogenic area adjacent to the heart might be due to a mass, and further examinations confirmed a mediastinal neoplasm. A surgical biopsy was performed, and it was determined to be a mesenchymal tumor. To conclude, clinicians should keep in mind the possibility of paracardiac neoplasm in the elderly, as well as in other age groups, when encountering mediastinal widening so that the patient can be protected from unnecessary interventions such as pericardiocentesis.Item THE OUTCOMES OF USING FIXED-DOSE NOMOGRAM-GUIDED UNFRACTIONATED HEPARIN THERAPY IN ELDERLY PATIENTS IN COMPARISON WITH YOUNGER PATIENTS(2020) Acibuca, Aynur; Muderrisoglu, Ibrahim Haldun; 0000-0002-3444-8845; ABG-4047-2020Introduction: In elderly patients, the dosing of unfractionated heparin is difficult because of changing metabolism, which affects the determination of a therapeutic level. The aim of this study was to evaluate the effects of unfractionated heparin therapy in an older population and to determine whether there was any difference from a younger population in terms of the activated partial thromboplastin time results and complication rates when using a standard nomogram. Materials and Methods: A total of 120 patients aged <80 years (Group 1) and 120 patients aged >= 80 years (Group 2), all of whom had been given unfractionated heparin therapy for selected indications in the coronary care unit, were randomly selected and retrospectively enrolled in the study. Infusion time up to a maximum of 48 hours was included, and activated partial thromboplastin time results in that period were categorised as subtherapeutic, therapeutic, or supratherapeutic. The rates of the patients' subtherapeutic, therapeutic, and supratherapeutic results were compared between groups. Results: The peak activated partial thromboplastin time level was higher in patients aged >= 80 years (58.85 [51.28] vs 76.50 [57.45], p<0.001). The supratherapeutic activated partial thromboplastin time percentage (0 [0.25] vs 0.20 [0.43], p<0.001) and numbers of first activated partial thromboplastin time in the supratherapeutic range (10% vs 24.2%, p=0.004) were significantly higher in the older group. Conclusion: Over-anticoagulation may be a problem in the elderly population when using standard nomograms. It was concluded that improvements should be made for a nomogram specific to an older population.Item Blood pressure limits affecting carotid artery injury: a cross sectional study(2020) Guenesli, Aylin; Acibuca, Aynur; Altin, Cihan; Gezmis, Esin; Tekindal, Mustafa Agah; Yalcin, Cigdem; Alkan, Ozlem; 0000-0002-3444-8845; 0000-0001-7526-3460; 0000-0002-1001-6028; 0000-0001-5483-8253; AAE-8301-2021; ABG-4047-2020; AAM-4169-2021; AAM-4284-2021Purpose: Although it is well known that high blood pressure causes undesirable effects on carotid arteries, it is not clear as to which threshold value this effect starts. The aim of this study is to evaluate and determine this threshold. Materials and Methods: This cross-sectional study included a total of 308 individuals in the following groups; group 1: individuals with systolic blood pressure (SBP) <120 mmHg and diastolic blood pressure (DBP) <80 mmHg (optimal), group 2: SBP 120-129 mmHg and/or DBP 80-84 mmHg (normal), group 3: SBP 130-139 mmHg and/or DBP 85-89 mmHg (high-normal), group 4: SBP 140-159 mmHg and/or DBP 90-99 mmHg, group 5: SBP 160-179 mmHg and/or DBP 100-109 mmHg, and group 6: SBP >= 180 mmHg and/or DBP >= 110 mmHg. Carotid distensibility and elasticity were measured in all groups. Results: A statistically significant difference was determined between the groups in carotid distensibility and elasticity. SBP>135.5 mmHg started to affect carotid distensibility with 78.2% sensitivity and 74.6% specificity, and DBP>86.5 mmHg with 79.3% sensitivity and 71.6% specificity. Carotid elasticity was seen to be affected by SBP>137.5 mmHg with 80.4% sensitivity and 73.1% specificity, and DBP>88.5 mmHg with 79.1% sensitivity and 73.8% specificity. Conclusion: Carotid distensibility and elasticity decreases with increasing blood pressure. Individuals in high-normal group should be evaluated in terms of carotid disease, and it may be necessary to start treatment early in these patients.Item THE CHANGE OF FRONTAL QRS-T ANGLE AFTER RENAL TRANSPLANTATION IN DIALYSIS PATIENTS(2020) Acibuca, Aynur; Yilmaz, Mustafa; Okar, Sefa; Kus, Murat; Caliskan, Kenan; Torer, Nihan; Torun, Dilek; Moray, Gokhan; Muderrisoglu, Haldun; Haberal, Mehmet A.Item Relapsed acute myeloid leukemia presenting with myocardial hypertrophy and constrictive pericardial physiology(2019) Acibuca, Aynur; Yeral, Mahmut; Kocer, Nazim Emrah; Koc, Zafer; Gullu, Hakan; 0000-0002-3444-8845; 31062759; ABG-4047-2020; ABC-4148-2020Item First case of cardiac amyloidosis presenting as right atrial mass(2019) Acibuca, Aynur; Okar, Sefa; Canpolat, Tuba; Koc, Zafer; Gullu, Hakan; 0000-0003-1413-7393; 0000-0002-3444-8845; 31475954; AAF-2872-2020; ABG-4047-2020