Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4809
Browse
9 results
Search Results
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 Acute Coronary Syndrome In Geriatric Patients In An Intensive Care Unit(2021) Keskin, Suzan; Akgun, Arzu Neslihan; Ciftci, Orcun; Muderrisoglu, Ibrahim HaldunObjective: The advancing age of acute coronary syndrome and the ageing population are leading to an increase in the number of elderly patients with acute coronary syndrome in our clinical practice. In our study, we aimed to investigate the effect of acute coronary syndrome in the geriatric patient group. Materials and Method: We retrospectively included geriatric patients who were in intensive care units because of different diagnoses, who also showed an acute coronary syndrome, and who had been diagnosed using the sequential organ failure assessment score. This score is used to describe the condition of a patient with sepsis and the extent of organ damage during treatment in an intensive care unit. We reviewed patients who were at Baskent University Faculty of Medicine between 25 March 2015 and 12 March 2020. Results: We included 63 patients aged 77.27 +/- 7.65 years. There were 40 (63.5%) males and 23 (36.5%) females. A total of 42 (89.4%) patients died in the first 5 months, one (2.1%) died between the 6th and 10th months, two (4.3%) between the 11th and 20th months, and two (4.3%) between the 21st and 30th months. We found a significant relationship between the sequential organ failure assessment score and mortality rate (p<0.05). The sequential organ failure assessment score was reliable in predicting mortality in geriatric patients with acute coronary syndrome, with 57% sensitivity and 75% specificity. Conclusion: Mortality of geriatric patients with acute coronary syndrome can be significantly determined using the sequential organ failure assessment scores.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 Markers of coagulation and fibrinolysis do not detect or predict the presence of left atrial appendage thrombus in patients with atrial fibrillation(2020) Doganozu, Ersin; Ciftci, Orcun; Hasirci, Senem; Yilmaz, Kerem Can; Karacaglar, Emir; Sade, Leyla Elif; Muderrisoglu, Ibrahim Haldun; Ozin, Mehmet Bulent; 0000-0002-2538-1642; 0000-0001-8926-9142; 0000-0002-8342-679X; 0000-0003-3737-8595; 32147650; ABI-6723-2020; W-5233-2018; AAK-7805-2021; AAJ-1331-2021; AAQ-7583-2021Objective: This study was designed to evaluate the role of hemostatic variables in arterial blood serum in left atrial thrombosis and to define any hemostatic variables, such as serum biomarkers, that could potentially reduce the need for transesophageal echocardiography. Method: This study included patients with non-valvular asymptomatic atrial fibrillation (AF), either paroxysmal, persistent, or chronic. The presence of an left atrial appendix (LAA) thrombus was used to form 2 groups: thrombus (+) and thrombus (-). The serum levels of the thrombotic/fibrinolytic markers including beta-thromboglobulin, prothrombin fragment 1+2, thrombin/antithrombin complex, human plasminogen activator inhibitor-1/tissue plasminogen activator complex, and D-dimer were compared between 2 groups. Results: The mean age of the study population was 65.6 +/- 12.2 years (range: 30-96 years), and 33 (61.1%) patients were male. Fourteen (25.9%) patients had an LAA thrombus and 40 patients did not. Two groups did not differ significantly with regard to any of the coagulation/fibrinolysis markers. The LAA thrombus (+) group had significantly higher rates of heart failure, peripheral artery disease, coronary artery disease, and chronic obstructive pulmonary disease (p<0.05). Neither the serum levels of the study markers nor demographic and clinical parameters were predictive of an LAA thrombus in binary logistic regression analysis. Conclusion: The arterial blood serum markers did not differ significantly between groups with and without an LAA thrombus and did not predict an LAA thrombus in patients presenting with AF.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 Evaluation of Ventricular Repolarization Parameters in Patients Admitted to Emergency Department with Electrical Injury(2020) Celik, Casit Olgun; Ciftci, Orcun; Muratoglu, Murat; Muderrisoglu, Ibrahim HaldunObjective: Prolonged T-peak to T-end (Tp-e), a ventricular repolarization parameter, has been related with ventricular arrhythmias (VAs). Novel electrocardiogram (ECG) parameters of ventricular repolarization have received considerable attention recently. In this study, we sought to investigate ventricular repolarization indexes such as the Tp-e and corrected Tp-e (Tp-ec) intervals, Tp-e/QT, Tp-e/QTc, and Tp-ec/QT ratios in patients with electrical injuries (EIs). Methods: Thirty-six patients diagnosed with EIs and 35 age- and sex-matched healthy control patients were included. Admission ECGs of the EI patients were compared with those of the healthy controls. QT and QTc intervals were measured, and the Tp-e and Tp-ec intervals, Tp-e/QT, Tp-ec/QT, and Tp-e/QTc ratios were then calculated from a 12-lead surface ECG. Results: The QT, Tp-e, Tp-e/QT, Tpe/QTc, Tp-ec/QT were not significantly different between the control group and the EI group (p > 0.05). However, the mean QTc interval was significantly higher in the EI group compared to the control group (412.81 +/- 25.46 vs 396.31 +/- 26.47 ms; p:0.009). Furthermore, the Tp-ec and Tp-ec/QT of the EI subgroup with elevated troponin levels significantly differed from those of the EI patients with normal troponin levels (p:0.033 and p:0.016, respectively). Conclusions: This retrospective study indicated that patients with EIs tend to have a prolonged QTc interval. Additionally, Tp-ec and Tp-ec/QT, which reportedly designate the tendency for VAs, were significantly higher in the EI patients with elevated troponin I levels than the EI patients with normal troponin levels, suggesting that patients with myocardial injury may be prone to VAs.Item MELD-XI score predicts in-hospital mortality independent of simplified pulmonary embolism severity index among patients with intermediate-to-high risk acute pulmonary thromboembolism(2019) Ciftci, Orcun; Celik, Casit Olgun; Uzar, Guldeniz; Kupeli, Elif; Muderrisoglu, Ibrahim Haldun; 31709948Introduction: Acute pulmonary thromboembolism (PTE) is a highly morbid and fatal condition. Although several risk stratification models exist for prediction of mortality risk in PTE, no study has yet focused on the effect of impaired vital organ function, such as renal or hepatic impairment, on mortality in PTE. MELD-XI (Model for end-stage liver disease excluding INR) score predicts mortality among patients with end-stage hepatic and cardiovascular disorders. Herein, we aimed to test MELD-XI score for predicting in-hospital prognosis of patients with intermediate-to-high risk acute PTE. Materials and Methods: We reviewed the medical records patients older than 18 years hospitalized with intermediate-to-high risk PTE between 01.06.2011 and 01.01.2019. Simplified pulmonary embolism severity index (sPESI) score and MELD-XI score were calculated, and in-hospital mortality determined. MELD-XI score was compared between patients with and without in-hospital mortality and was correlated to sPESI score. The predictive power of MELD-XI score for in-hospital mortality was sought and an in-hospital survival analysis with Kaplan Meier curve and log-rank test was done for MELD-XI score. Results: A total of 104 patients [mean age of 70.8 +/- 15.9 years; 68 (65.4%) females]. Fourteen (13.5%) patients died at hospital. MELD-XI and sPESI scores were significantly correlated to each other and were higher in deceased patients than the survivors [17.3 (IQR 14.3) vs. 10.12 (IQR 2.99); p < 0.05 and 2 (IQR 1) vs. 1 (IQR 1); p < 0.05, respectively]. MELD-XI score and sPESI score were significant predictor of in-hospital mortality in multivariate analysis. A MELD-XI score >= 10.25 had a sensitivity of 78.6% and a specificity of 70.0% for in-hospital mortality. A survival analysis revealed that a high MELD-XI category (MELD-XI score >= 10.2) significantly worsened in-hospital survival (p < 0.01; log rank test). Conclusion: MELD-XI score performs well for mortality prediction among patients with intermediate-to-high risk PTE. This subject needs to be further studied by large, randomized controlled studies.Item Cardiac autonomic nervous dysfunction detected by both heart rate variability and heart rate turbulence in prediabetic patients with isolated impaired fasting glucose(2016) Balcioglu, Akif Serhat; Akinci, Sinan; Cicek, Davran; Coner, Ali; Bal, Ugur Abbas; Muderrisoglu, Ibrahim Haldun; 0000-0002-9446-2518; 0000-0002-5711-8873; 0000-0001-5250-5404; 27025199; AAK-4322-2021; ABD-7321-2021; AAD-5564-2021; AAC-8036-2020Objective: Cardiac autonomic nervous dysfunction (CAND), a severe complication of diabetes, has also been shown to affect prediabetic patients. The role of isolated impaired fasting plasma glucose (IFG), a subtype of prediabetes, is not clear in the pathogenesis of CAND. The aim of this study was to examine the relationship between isolated IFG and cardiac autonomic function using heart rate variability (HRV) and heart rate turbulence (HRT) indices derived from 24-h Holter-electrocardiogram recordings. Methods: This observational, prospective, cross-sectional study examined 400 consecutive subjects divided into three groups according to oral glucose tolerance test results: the control group [Group I, fasting plasma glucose (FPG) <100 mg/dL and normal glucose tolerance, n=193], the isolated IFG group (Group II, FPG >= 100 and <126 mg/dL, n=134), and the isolated impaired glucose tolerance (IGT), both IFG and IGT, or newly diagnosed diabetes' group (Group III, n=73). Patients with non-sinus rhythm, known diabetes mellitus, coronary artery disease, heart failure, severe valvular disease, or receiving medical therapy that may affect HRV and HRT indices were excluded. Time domain HRV parameters, turbulence onset (TO), turbulence slope (TS), and HRT category were examined. Chi-square, one-way analysis of variance, Kruskal-Wallis H, and Mann-Whitney U tests were used to compare variables where appropriate. The correlation between Holter data and FPG levels was analyzed using the Spearman's test. Multiple linear regression analysis was performed to identify independent predictors of the HRV and HRT parameters. Results: Median (interquartile range 25-75) FPG levels in Groups I, II, and III were 89 (83/93) mg/dL, 109 (104/116) mg/dL, and 174 (150.5/197) mg/dL, respectively. There were significant differences in HRV and HRT parameters between and among all groups. While HRV parameters and TS decreased from Group I to Group III, TO and HRT category gradually increased. Additionally, FPG level was significantly correlated with SDNN, r=-0.220; SDNN index, r=-0.192; SDANN, r=-0.207; RMSSD, r=-0.228; pNN50, r=-0.226; TO, r=0.354; and TS, r=-0.331 (all p<0.001). Conclusion: CAND, as detected by both HRV and HRT, appear to be present in the isolated IFG subtype of prediabetes.Item The effect of high-dose steroid treatment used for the treatment of acute demyelinating diseases on endothelial and cardiac functions(2017) Caldir, Mehmet Vedat; Celik, Guner Koyuncu; Ciftci, Ozgur; Muderrisoglu, Ibrahim Haldun; 27965510Objective: The cardiovascular effects of short-term high-dose steroid treatment (pulse steroid treatment) have not yet been clarified. We examined the short-and long-term effects of pulse steroid treatment in demyelinating diseases on endothelial and cardiac functions. Methods: In this prospective study, we included 35 patients (20 females and 15 males; mean age, 32.8 +/- 9.3 years) who were not treated with steroids and who were previously diagnosed with multiple sclerosis or neuromyelitis optica. Patients were evaluated before, 1 week after, and 3 months after the steroid treatment. Brachial artery flow-mediated relaxation and cardiac systolic/diastolic function were evaluated using echocardiography to assess physical examination results, carotid intima-media thickness, and endothelial function. Results: There was no difference between biochemical values, systolic function, left ventricular dimensions, and carotid intima-media thicknesses in the three evaluation periods. There were significant increases in the body mass index, body weight, and systolic/diastolic blood pressure measurements at 1 week and 3 months after treatment (p<0.001). There was a significant decrease in brachial artery flow-mediated relaxation at 1 week and 3 months (1 versus 2, p=0.042; 1 versus 3, p=0.003). In Doppler measurements at 1 week and 3 months, there was an increase in mitral A velocity, IVRT, and EDT values and a decrease in the E/A ratio in line with diastolic dysfunction. Conclusion: Pulse steroid therapy used for demyelinating diseases deteriorated endothelial and left ventricular diastolic functions in the early and late periods. Future studies are needed to evaluate the development of cardiovascular mortality and morbidity in patients receiving this type of treatment.