Snapshot evaluation of acute and chronic heart failure in real-life in Turkey: a follow-up data for mortality

Objective: Heart failure (HF) is a progressive clinical syndrome. SELFIE-TR is a registry illustrating the overall HF patient profile of Turkey. Herein, all-cause mortality (ACM) data during follow-up were provided. Methods: This is a prospective outcome analysis of SELFIE-TR. Patients were classified as acute HF (AHF) versus chronic HF (CHF) and HF with reduced ejection fraction (HFrEF), HF with mid-range ejection fraction, and HF with preserved ejection fraction and were followed up for ACM. Results: There were 1054 patients with a mean age of 63.3±13.3 years and with a median follow-up period of 16 (7–17) months. Survival data within 1 year were available in 1022 patients. Crude ACM was 19.9% for 1 year in the whole group. ACM within 1 year was 13.7% versus 32.6% in patients with CHF and AHF, respectively (p<0.001). Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta blocker, and mineralocorticoid receptor antagonist were present in 70.6%, 88.2%, and 50.7%, respectively. In the whole cohort, survival curves were graded according to guideline-directed medical therapy (GDMT) scores ?1 versus 2 versus 3 as 28% versus 20.2% versus 12.2%, respectively (p<0.001). Multivariate analysis of the whole cohort yielded age (p=0.009) and AHF (p=0.028) as independent predictors of mortality in 1 year. Conclusion: One-year mortality is high in Turkish patients with HF compared with contemporary cohorts with AHF and CHF. Of note, GDMT score is influential on 1-year mortality being the most striking one on chronic HFrEF. On the other hand, in the whole cohort, age and AHF were the only independent predictors of death in 1 yea

The basic dynamics of civil wars in Africa: Sudan case

İç savaşlar, Afrika devletlerinin bağımsızlıktan sonra yüzleştiği en önemli problemlerden birisidir. Öyle ki ideoloji, etnisite veya din eksenli iç savaşlar Afrika'nın hemen her bölgesinde karşımıza çıkmaktadır. Sömürgecilik süresince siyasi, ekonomik ve sosyal yapısı sistemli bir şekilde tahrip edilmiş Afrika halklarının, bölge dinamiklerini yansıtmayan, tarihsel süreç içerisinde şekillenmemiş yapay sınırlar üzerinden bağımsızlıklarına kavuşması, kıtada yaşanan iç savaşların en önemli sebebi olmuştur. Kıta devletlerinin, sömürgecilik sisteminin işleyişi için tahrip edilmiş veya dönüştürülmüş istikrarsız yapısı başarısızlığı beraberinde getirmiş ve Afrika kıtası dışa bağımlılıktan kurtulamamıştır. Bu durum küresel politikanın değişen aktörlerinin bu bağımlılıktan istifade ederek Afrika devletlerine müdahale etmesine, çıkarları doğrultusunda muhtelif grupları destekleyerek toplum içerisindeki farklılıkları ayrışmaya sürüklemesine sebep olmuştur. Bu ayrışmalar Afrika devletlerinin bağımsızlıklarından bugüne, sürekli iç savaşlarla yüzleşmesine sebep olmuştur. Sudan devleti, Kızıldeniz'e hâkim pozisyonu, Mısır açısından tarihsel rolü ve başta petrol olmak üzere; birçok değerli kaynağa sahip olması nedeniyle küresel güçlerin ilgi odağı olmuştur. Sömürgecilik haritasındaki sınırlarla bağımsız olan Sudan ülkesinde, birbirlerinden farklı kimliklerin bir arada yaşamak durumunda kalması ayrışmayı beraberinde getirmiştir. Özellikle sömürgecilik döneminde Sudan'ın idaresinde izlenen Arap merkezci idare anlayışı ve Güney Sudan'ın 'Güney Politikası' kapsamında ayrıştırılıp dönüştürülmesi, bağımsızlık sonrası şiddetli iç savaşlara sebep olmuştur. Güney Sudan'da kuzey ve güney arasında yıllarca süren iç savaş Güney Sudan'ın bağımsızlığıyla sonuçlanmıştır. Darfur bölgesindeki iç savaş ise uluslararası kamuoyunun baskısına rağmen devam etmektedir. Sudan'daki bu iki iç savaşın en temel dinamiği, sömürgecilik döneminde kimlikler üzerinde yapılan ayrıştırma ve bağımsızlık sonrası küresel güçlerin çıkar mücadelesi içerisinde Sudan'a müdahalesidir.Civil war is one of the most important problems of African states face so that ideological, ethnic and religional based civil wars emerge in almost every region of Africa. The most significant cause of the civil war is to gain independence of African people, whose political, economic and social structure has been destroyed systematically during colonialism, through artificial borders that do not reflect regional dynamics and have not been shaped in the historical process. The destabilized nature of the continental states, destructed or transformed for the functioning of the colonial system, brought about unsuccess and the African continent did not recover from external dependency. This situation caused intervention of changing actors of global policy to African states benefiting from this dependence and divergence of differences within society by supporting various groups in accordance with their own interests. These distinctions have caused the African states to face civil wars constantly from their independence today. Sudan state has been the center of interest of the global powers of the world because of having valuable resources, especially petroleum reserves, the dominated position around the Red Sea and the historical role for Egypt. Obligation of living together of different identities has brought separation in country of Sudan that is independent by restrictions of colonial map. Especially Arab-centered administrative understanding in Sudan's administration and the convertion and separation of the South Sudan under the "Southern Policy" in colonial period resulted in violent war after the independency.The civil war lasted for years between northern and southern Sudan, resulted in South Sudan's independence. The civil war in the Darfur region continues despite international pressure. The most fundamental dynamics of this two civil war in Sudan are discrimination on the identities during the colonial period and the intervention of Sudan in the struggle for the interests of global powers after independence

The Role of HATCH Score in the Prediction of Ischemic Cerebrovascular Events in Patients with Heart Failure and Atrial Fibrillation

The presence of both atrial fibrillation (AF) and heart failure (HF) increases the risk of an ischemic cerebrovascular event (CVE) by roughly fivefold. The HATCH score is a score used to predict new-onset AF. Although there are some differences, it contains risk factors similar to the CHA2DS2-VASc score. Our study aimed to investigate the relationship between the HATCH score and ischemic CVE. This retrospective study obtained data from 1719 HF patients between 2015 and 2022. About 673 patients with AF were included in the study. In the univariate and multivariate Cox regressions, we found that CHA2DS2-VASc and HATCH scores were independent predictors of ischemic CVE ( p = 0.001 and  < p = 0.001 , respectively). The ROC analysis, AUC for the CHA2DS2-VASc score was 0.884 (95% CI 0.828-0.940, <p = 0.001 ). For the HATCH score, the AUC was 0.978 (95% CI 0.966-0.991, <p = 0.001 ). The HATCH score can be an independent predictor of the development of ischemic CVE in HF patients with AF

Influence of pesticides on the pH regulatory enzyme, carbonic anhydrase, from European Seabass liver and bovine erythrocytes

The objective of this study was to assess the inhibitory effects of six commonly used pesticides, cyhalothrin, cypermethrin, dichlorvos, methamidophos, chlorpyrifos and methylparathion, on the pH regulatory enzyme carbonic anhydrase (CA) of Dicentrarchus labrax (European Seabass) liver (dCA) and bovine erythrocytes (bCA). Results of the study showed that the pesticides displayed quite variable inhibition profiles with KI values ranging from 0.376 to 26.164 M against dCA, and from 1.174 to 53.281 M against bCA. Methyl- parathion was the most effective inhibitor for both enzymes. Overall data show that all of the tested pesticides inhibit both dCA and bCA at low concentrations indicating that indiscriminate use of these pesticides might cause disruption of acid base regulation resulting in animal deaths. Our results also point out that susceptibility to these pesticides varies among CAs from different organisms

Snapshot evaluation of acute and chronic heart failure in real-life in Turkey: A follow-up data for mortality

YILMAZ, MEHMET BIRHAN/0000-0002-8169-8628WOS: 000522763500008PubMed: 32120368Objective: Heart failure (HF) is a progressive clinical syndrome. SELFIE-TR is a registry illustrating the overall HF patient profile of Turkey. Herein, all-cause mortality (ACM) data during follow-up were provided. Methods: This is a prospective outcome analysis of SELFIE-TR. Patients were classified as acute HF (AHF) versus chronic HF (CHF) and HF with reduced ejection fraction (HFrEF), HF with mid-range ejection fraction, and HF with preserved ejection fraction and were followed up for ACM. Results: There were 1054 patients with a mean age of 63.3 +/- 13.3 years and with a median follow-up period of 16 (7-17) months. Survival data within 1 year were available in 1022 patients. Crude ACM was 19.9% for 1 year in the whole group. ACM within 1 year was 13.7% versus 32.6% in patients with CHF and AHF, respectively (p<0.001). Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta blocker, and mineralocorticoid receptor antagonist were present in 70.6%, 88.2%, and 50.7%, respectively. In the whole cohort, survival curves were graded according to guideline-directed medical therapy (GDMT) scores <= 1 versus 2 versus 3 as 28% versus 20.2% versus 12.2%, respectively (p<0.001). Multivariate analysis of the whole cohort yielded age (p=0.009) and AHF (p=0.028) as independent predictors of mortality in 1 year. Conclusion: One-year mortality is high in Turkish patients with HF compared with contemporary cohorts with AHF and CHF. Of note, GDMT score is influential on 1-year mortality being the most striking one on chronic HFrEF. On the other hand, in the whole cohort, age and AHF were the only independent predictors of death in 1 year

Snapshot evaluation of acute and chronic heart failure in real-life in Turkey: A follow-up data for mortality

Objective: Heart failure (HF) is a progressive clinical syndrome. SELFIE-TR is a registry illustrating the overall HF patient profile of Turkey. Herein, all-cause mortality (ACM) data during follow-up were provided. Methods: This is a prospective outcome analysis of SELFIE-TR. Patients were classified as acute HF (AHF) versus chronic HF (CHF) and HF with reduced ejection fraction (HFrEF), HF with mid-range ejection fraction, and HF with preserved ejection fraction and were followed up for ACM. Results: There were 1054 patients with a mean age of 63.3±13.3 years and with a median follow-up period of 16 (7–17) months. Survival data within 1 year were available in 1022 patients. Crude ACM was 19.9% for 1 year in the whole group. ACM within 1 year was 13.7% versus 32.6% in patients with CHF and AHF, respectively (p<0.001). Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta blocker, and mineralocorticoid receptor antagonist were present in 70.6%, 88.2%, and 50.7%, respectively. In the whole cohort, survival curves were graded according to guideline-directed medical therapy (GDMT) scores ?1 versus 2 versus 3 as 28% versus 20.2% versus 12.2%, respectively (p<0.001). Multivariate analysis of the whole cohort yielded age (p=0.009) and AHF (p=0.028) as independent predictors of mortality in 1 year. Conclusion: One-year mortality is high in Turkish patients with HF compared with contemporary cohorts with AHF and CHF. Of note, GDMT score is influential on 1-year mortality being the most striking one on chronic HFrEF. On the other hand, in the whole cohort, age and AHF were the only independent predictors of death in 1 yea

Evaluation of the relationship between coronary slow flow phenomenon and serum magnesium levels

Aim: Coronary slow flow phenomenon (CSFP) is a microvascular circulation disorder. It is known that serum magnesium has positive effects on anti-inflammation, vasodilatation and endothelial functions. This observational study investigated the association of serum magnesium levels with CSFP.Materials and Methods: Patients who had undergone coronary angiography (CAG) after noninvasive testing were included in the study. CAG records were reassessed for CSFP and 100 patients were diagnosed as having CSFP. Control subjects (n = 80) had normal coronary flow. Serum Mg levels and other biochemical parameters such as glucose, creatinine, cholesterol levels and hemoglobin samples were collected before CAG. Serum Mg values were categorized into two groups: Mg levels equal/under and above 1.9 mg/dL.Results: The mean patient age was 56.1±9.7 years; 68.9% of patients were men. Patient’s hypertension, diabetes mellitus history and smoking habits rate were similar between groups. Biochemical tests revealed lower serum magnesium levels (1.87 vs 1.95mg/dL, p=0.02) for CSFP patients and controls, respectively. In multivariate regression analysis, a serum magnesium level under 1.9 mg/dL (OR:3.33, 95% CI:1.75-6.37, p<0.001) and male gender (OR:2.08, 95% CI: 1.016-4.34, p=0.04) were found to be independent predictors of CSFP.Conclusion: Low serum magnesium levels were associated with CSFP. However, these results are not sufficient to fully determine the role of Mg levels in the mechanism of CSFP-related chest pain

An Analysis on Coronary Artery Disease Severity with Serum Adropin Level in Patients with Acute ST-Segment Elevation Myocardial Infarction

Objective Adropin is associated with energy balance in tissues and organs. The SYNTAX score (SS) is used to determine the severity of ST-segment elevation myocardial infarction(STEMI). The aim of this study was to determine the relationship between serum adropin levels and disease severity in STEMI patients.Materialsand MethodsEighty-nine patients who underwent coronary angiography (CAG) for STEMI were included in the study. The STEMI patients were divided into two subgroups: Group 1(SS< 22) and Group 2 (SS ≥ 23). 43 patients who underwent CAG and had normal coronary arteries were included in the study as a control group.Results Groups 1 and 2 included more male participants than the control group (89.7% and 74.2% vs. 34.9%, respectively, p < 0.001). The smoking rate was higher in Groups 1 and2 than in the control group (55.1% and 34.4% vs. 11.6%, respectively, p≤0.001). Serum adropin levels were lower in Group 1 than in the control group (147.3 ± 149.2 mg/Land 228.1 ± 253.3 ng/L, p = 0.03). Serum adropin levels were the lowest in Group 2 (87.8 ± 23.2 ng/L, 147.3 ± 149.2 ng/L, and 228.1 ± 253.3 ng/L, p = 0.004). Serum adropinlevels were also negatively correlated with SS (r = -0.33, p = 0.002).Conclusion Serum adropin levels decreased more in STEMI patients than in those without coronary artery disease (CAD). In addition, serum adropin levels decreased with increasingSS;this indicates the severity of CAD