PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item Heart failure with non-reduced ejection fraction: Epidemiology, pathophysiology, phenotypes, diagnosis and treatment approaches(2022) Cavusoglu, Yuksel; Celik, Ahmet; Altay, Hakan; Nalban, Sanem; Ozden, Ozge; Temizhan, Ahmet; Ural, Ditek; Unlu, Serkan; Yilmaz, Mehmet Birhan; Zoghi, Mehdi; 35969235Heart failure (HF) has been classified as reduced ejection fraction (HFrEF), mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF) by the recent HF guidelines. In addition, HF with improved ejection fraction has been defined as a subgroup of HFrEF. In HFrEF, diagnostic workup and evidence-based pharmacological and device-based therapies have been well established. However, HFpEF, which comprises almost half of the HF population, represents significant uncertainties regarding its pathophysiology, clinical phenotypes, diagnosis and treatment. Diagnostic criteria of HFpEF have been changed a few times over the years and still remained a matter of debate. New paradigms including a prominent role of co-morbidities. inflammation, endothelial dysfunction have been proposed in its pathophysiology. As a complex, multifactorial syndrome HFpEF consists of many overlapping clinical and hemodynamic phenotypes. In contrast to HFrEF, clinical outcomes of HFpEF have not improved over the last decades due to lack of proven effective therapies. Although HFrEF and HFpEF have different clinical spectrums and proposed pathophysiological mechanisms, there is no clear defining syndrome postulated for HFmrEF. Clinical characteristics and risk factors of HFmrEF overlap with HFrEF and HFpEF. HFmrEF is also referred as a transitional zone for dynamic temporal changes in EF. So. HFpEF and HFmrEF, both namely HF with non-reduced ejection fraction (HF-NEF), have some challenges in the management of HF. The purpose of this paper is to provide a comprehensive review including epidemiology, pathophysiology, clinical presentation and phenotypes of HF-NEF and to guide clinicians for the diagnosis and therapeutic approaches based on the available data in the literature.Item Comparison of placental alpha microglobulin-1 protein assay (Amnisure) with speculum examination for the diagnosis of premature preterm rupture of membranes (PPROM): a clinical evaluation(2021) Esin, Sertac; Tohma, Yusuf Aytac; Alay, Ismail; Guden, Mahmut; Colak, Eser; Demirel, Nihal; Bas, Ahmet Yagmur; Serdar Yalvac, Ethem; Kandemir, Omer; 0000-0001-9577-4946; 32835549; AAI-8810-2021In this study, we aimed to compare the clinical outcomes of Premature Preterm Rupture of Membranes (PPROM) cases diagnosed by classical speculum examination and by placental alpha microglobulin-1 protein (PAMG-1) assay. The medical records of all patients with singleton pregnancies that were diagnosed with PPROM were retrospectively reviewed. Singleton pregnancies with PPROM diagnosis that was confirmed either by direct visualisation of amniotic fluid leaking through the cervix or by placental alpha microglobulin-1 protein (PAMG-1) assay if no amniotic fluid leakage was documented were included in the study. Demographics, prenatal and postnatal characteristics were reviewed from the medical charts and were recorded. The study included 138 pregnancies with PPROM; 111 patients in clinical speculum examination group and 27 in PAMG-1 assay group. There were no significant differences in maternal and pregnancy characteristics between the clinical speculum examination and PAMG-1 assay groups. Foetal outcomes were comparable between clinical speculum examination and PAMG-1 assay groups. In the clinical speculum examination group, there were nine (8.1%) chorioamnionitis cases, however, there were no chorioamnionitis cases in the PAMG-1 assay group during the latency period (p = .21).Impact statement What is already known on this subject?Placental alpha microglobulin-1 protein assay uses immunochromatography method to detect trace amount of placental alpha microglobulin-1 protein in vaginal fluids and has high sensitivity and specificity for ROM diagnosis. However, to the best of our knowledge, the clinical outcome of ROM cases detected by classical speculum examination and by placental alpha microglobulin-1 protein assay has not been compared in the literature previously. What do the results of this study add?Although statistically insignificant, cases diagnosed by PAMG-1 assay had lower risk of chorioamnionitis during latency period. What are the implications of these findings for clinical practice and/or further research?Whether cases diagnosed by PAMG-1 assay represent a milder form of rupture of membranes than cases diagnosed by classical speculum examination group warrants further research.Item Reliability of Real-Time Sonoelastography in the Diagnosis of Supraspinatus Tendinopathy(2021) Aydin, Elcin; Soylev, Gozde Ozcan; Muratli, Sedit Kivanc; Limnili, Bora Bora; Boya, Hakan; Tekindal, Mustafa Agah; Agildere, Muhtesem; 0000-0001-8742-5543; 0000-0001-8742-5543; 31107427; AAI-8276-2021; AAJ-4917-2021The practicality of real-time sonoelastography in the diagnosis of tendinopathy is being discussed since the beginning of its use in musculoskeletal system. The aims of this study were to compare the elasticity of pathologic supraspinatus tendon with the uninvolved side by sonoelastography and to determine the relationship between the sonoelastographic findings and magnetic resonance imaging (MRI) grade of the tendinosis. Eighty-2 patients (50 males, 32 females, mean +/- SD age = 53.61 +/- 16.15 years, range = 20-84 years) with unilateral supraspinatus tendinosis were included in this study. Three grades of tendinosis were identified in MRI (grade 1: mild, grade 2: moderate, and grade 3: severe). The strain ratio (SR) of the tendinosis area to the healthy normal area of the same tendon tissue and SR of the tendinosis area to ipsilateral subcutaneous fat tissue were evaluated with sonoelastography. The SRs of the tendinosis areas were also compared with the control (contralateral) side tendon tissue and subcutaneous fat tissue of the same patients. Between-groups comparisons were also done according to the MRI grading. Statistical analysis was done using paired t test (P < 0.005 was considered statistically significant). There was a statistically significant difference in the comparison of the SRs of the tendinosis areas to subcutaneous fat tissues on ipsilateral shoulders (TA/SFT) and the healthy supraspinatus tendon area (TA/ST) of the same shoulder. There was also statistically significant difference when compared with the control side measurements (P < 0.01). In patients who have grade 1 and grade 3 tendinosis on MRI, there was statistically significant difference between elastrographic evaluation of affected and unaffected sides. Real-time sonoelastography is a reliable diagnostic method in patients with rotator cuff tendinosis and shall be kept in mind as a noninvasive, inexpensive, and practical diagnostic test in suitable cases.Item A New Imaging Technique for the Diagnosis of Thyroid Cancer: Thyroidography(2019) Aysan, Erhan; Aydin, Ozan; Ercivan, Merve; Aksoy, Direnc; Yavuz, Alp Erdem; 31387418Background: Microcalcifications are the most important diagnostic parameter for thyroid cancer. We developed a new imaging technique based on low dose X-rays that specifically reveal microcalcifications via a new software algorithm. Method: A prospective clinical trial was planned and 45 cases (37 women, 8 men, women/men: 4.6, age range: 17-68, mean age: 43) were included in the study. After total thyroidectomy with standard technique, the fresh thyroid tissues were integrated into the human neck simulator. Raw (DICOM) images were obtained for each tissue sample with a standard mammography device and transformed into new images (thyroidograms) by a new software algorithm. Preoperative ultrasonography (USG) images, DICOM images, and thyroidograms were evaluated in order to observe micro and macrocalcifications by the same experienced radiologist. Results: Twenty-four cases were malignant and 21 cases were benign after histopathologic evaluation. Microcalcification detection with the thyroidography was statistically significant for sensitivity, positive predictive value, negative predictive value, and accuracy (p < 0.05) but not for specificity (p > 0.05) compared to the USG and DICOM images for the malignant and also benign cases. Conclusion: This new imaging technique is hopeful for diagnosis of thyroid cancer according to microcalcification detection and may complement thyroid USG.