Paroxysmal atrial fibrillation and intermittent left bundle branch block: an unusual electrocardiographic presentation of mad honey poisoning

Saritas, Ayhan/0000-0002-4302-1093; Saritas, Ayhan/0000-0002-4302-1093; Kandis, Hayati/0000-0001-9151-6050WOS: 000297498400025PubMed: 22179175

Evaluation of left ventricular systolic asynchrony in patients with subclinical hypothyroidism

Background: The heart was very sensitive to fluctuating thyroid hormone levels. To assess intra-left ventricular (LV) systolic asynchrony in patients with subclinical thyroid dysfunction. Methods: Fifty patients with subclinical hypothyroidism and 40 controls were included. A diagnosis of subclinical hypothyroidism was reached with increased TSH and normal free T4. All subjects were evaluated by echocardiography. Evaluation of intra-LV systolic asynchrony was performed by tissue synchronization imaging (TSI), and four TSI parameters of systolic asynchrony were calculated. LV asynchrony was defined by these parameters. Results: All of the groups were similar in terms of demographic findings and conventional and Doppler echocardiograpic parameters except peak systolic velocity and early diastolic velocity. LV systolic asynchrony parameters of TSI including; standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any 2 of the 12 LV segments (Ts-12), standard deviation of TS of the 6 basal LV segments (Ts-SD-6), maximal difference in Ts between any of the 6 basal LV segments (Ts-6) were significantly lengthened in patients with subclinical hypothyroidism than controls (p < 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). The prevalence of LV asynchrony was significantly higher in patients with subclinical hypothyroidism than control. Conclusions: Patients with subclinical hypothyroidism present evidence of LV asynchrony by TSI. LV systolic asynchrony could be a warning sign of the early stage in cardiac systolic dysfunction in subclinical hypothyroid patients

Evaluation of left atrial mechanical functions and atrial conduction abnormalities in patients with clinical hypothyroid

Background: The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical delay and P wave dispersion in hypothyroid patients. Methods: Thirty-four patients with overt hypothyroid and thirty controls were included. A diagnosis of overt hypothyroid was reached with increased serum TSH and decreased free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay (EMD) were measured by tissue Doppler imaging (TDI). P wave dispersion was calculated by 12 lead electrocardiograms. Results: LA diameter were significantly higher in patients with overt hypothyroid (p = 0.021). LA passive emptying volume and LA passive emptying fraction were significantly decreased with hypothyroid patients (p = 0.002 and p < 0.001). LA active emptying volume and LA active emptying fraction were significantly increased with hypothyroid patients (p < 0.001 and p < 0.001). Intra- and interatrial EMD, were measured significantly higher in hypothyroid patients (30.6 &#177; 6.1 vs 18.0 &#177; 2.7, p < 0.001; and 10.6 &#177; 3.4 vs 6.9 &#177; 1.4, p < 0.001, respectively). P wave dispersion were significantly higher in hypothyroid patients (48.8 &#177; 6.2 vs 44.3 &#177; 7.2, p = 0.022). In stepwise regression analysis demonstrated that, interatrial EMD and LA active emptying fraction related with TSH and fT4. Conclusions: This study showed that impaired LA mechanical and electromechanical function in hypothyroid patients. TSH and T4 were independent determinant of interatrial EMD and LA active emptying fraction

The evaluation of Pat-Pat related injuries in the western black sea region of Turkey

BACKGROUND: Accidents caused by motorized vehicle in the agricultural sector are frequently observed. In Turkey; accidents arising from motorized vehicles, named Pat-Pat, which are used by farmers in the Western Black Sea region is not unusual. METHODS: One hundred five patients who were brought into the Emergency Department of Duzce University, Medical Faculty Hospital between September 2009 and August 2010 due to Pat-Pat related accidents were evaluated. RESULTS: The cases consisted of 73 (69.5%) males and 32 (30.5%) females, ranging from 2 to 73 years of age. In the 10-39 age group, a total of 63 (60.0%) cases were determined. The months when the greatest rate of cases applied to the hospital consisted of July, August, September and the season is summer. The cases were exposed to trauma in roads in 54 (51.4%), and 51 (48.6%) occurred in agricultural area without roads. Eighty seven (82.9%) cases were injured due to the overturning of vehicle. The patients were brought to the hospital using a private vehicle in 54 (51.4%) of the cases and in 51 (48.6%) cases, 112 ambulance system was used. The cases were determined to apply to the hospital most frequently between 6 pm-12 am. The injuries frequently consisted of head-neck and spine traumas, thorax traumas and upper extremity traumas. In 55 (52.4%) cases, open wound-laceration was determined. Seventy five (71.4%) cases were treated in the Emergency Department, and 28 (26.7%) were hospitalized. Three (2.9%) cases were deceased. CONCLUSIONS: Serious injuries can occur in Pat-Pat related accidents, and careful systematic physical examination should be conducted. In order to prevent these accidents, education of farm operators and engineering studies on the mechanics and safety of these vehicles should be taken and legal regulations should be created

A Comparison of Error Correcting Output Coding Methods for Multiclass Classification by Using Support Vector Machine: The Prediction of Self-Monitoring of Blood Sugar

Abstract: SVMs were initially developed to perform binary classification. However, in many real-world problems, particularly pattern recocnation studies, aimed to determine the distinctive features of large number of class or group. For this reason, a number of methods to generate multiclass SVMs from binary SVMs have been proposed by researchers and this is still a continuing research topic. In this study we aimed to compare classification accuracy and computational cost of four multiclass approaches using a original and simulated data sets. Error Corrected Output Coding (ECOC) based multiclass approaches that is used in this study creates many binary classifiers and combines their results to determine the class label of a test pixel. As a result of the comparisons for all conditions examined in this study, it's found that the classification accuracy and computational cost of One vs. One multiclass approach is better than the other multiclass approaches. In classification or pattern recognization problems, some of supervised machine learning methods or algorithms can be easily extended to multiclass problems. However, some other powerful and popular classifiers, such as AdaBoost and Support Vector Machines, do not extend to multiclass easily. In those situations, the usual way to proceed is to reduce the complexity of the multiclass problem into multiple simpler binary classification problems.    

Association Between Patients Sociodemographic Characteristics and Their Satisfaction with Primary Health Care Services in Turkey

Ankarali, Handan Camdeviren/0000-0002-3613-0523WOS: 000327752700003Objective: To investigate the influence of patient's socio-demographic features on patient's satisfaction with primary health care (PHC) services in the Turkish population Design: Cross-sectional and population-based study Settings: Forty-five family health centers from 15 cities throughout Turkey Subjects: One thousand two hundred and ten patients were randomly selected. The self-administered study survey was applied. Main Outcome Measures: Association between patients' sociodemographic features and patient satisfaction with primary care settings Results: The mean age of subjects was 37.4 +/- 14.7 years. When mean total score for incisions of sociodemographic features was evaluated, it was observed that the patient satisfaction level was high in female than male patients, married than unmarried patients, patients with high income than low income, in employed and unemployed than officers (p = 0.028, p = 0.043, p = 0.001, and p = 0.006, respectively). The patients with high income level had significantly higher level of satisfaction than those with low income in all domains of patient satisfaction. Female patients were more satisfied with communication, medical care, and support and information domains. Married patients were more satisfied with communication and medical care. The officers were less satisfied than other status of occupation. The patients with university level of education were more satisfied than those with middle and high school level of education. Conclusion: Income level, marital and occupational status of patient's sociodemographic features had significant influence on satisfaction levels in the Turkish populatio

Effects of the Degree of Obesity on Achieving Target Blood Pressure and Metabolic Deterioration in Obese Individuals: A Population-Based Study

Background/Aims: This study aimed to evaluate the severity of obesity and its impact on achieving target blood pressure and metabolic derangement in obese individuals. Methods: This cross-sectional and population-based study was conducted between January and December 2012. A total of 1837 consecutive obese patients admitted to our outpatient clinic were enrolled. The anthropometric and blood pressure measurements, bioelectrical impedance fat analysis, blood sample analysis, impaired glucose status, metabolic syndrome, and insulin resistance of 1265 obese patients were compared between groups of patients separated by severity of obesity. Results: Only approximately one-third of patients with previous hypertension achieved normal blood pressure. In addition, the majority of patients without previous hypertension had higher blood pressure at the end of the study compared with baseline. The percent of patients with an impaired fasting blood glucose ≥100 mg/dL was 38.5%. The frequency of impaired glucose tolerance was 39.1% in the patients who underwent OGTT Body mass index (BMI) was associated with impaired blood glucose, hypertension, insulin resistance, and the development of metabolic syndrome. The incidences of metabolic syndrome, insulin resistance, impaired glucose tolerance, and uncontrolled blood pressure were significantly different between groups of differing obesity severity (ppp=0.041, and pConclusion: The severity of obesity was associated with the failure to achieve target blood pressure and metabolic syndrome. Based on our data, blood pressure and metabolic parameters in obese patients should be monitored frequently and treated with caution

Association Between Survivin Gene Polymorphisms and the Susceptibility to Colon Cancer Development in the Turkish Population

Ankarali, Handan Camdeviren/0000-0002-3613-0523; Yaykasli, Kursat/0000-0001-7550-6370WOS: 000351055100074PubMed: 25374237Background: Colon cancer is one of the most common cancers worldwide. Apoptosis is a necessary physiological process for cell elimination which is very important both cellular homeostasis and cell proliferation and differantiation. Dysregulation can lead to uncontrolled cell growth and tumor development. Survivin, a member of the IAP family, plays a key role in promotion of cell proliferation as well as inhibition of apoptosis in cancer cells. The aim of this study was to investigate whether specific genetic polymorphisms of survivin could be associated with colon cancer development and progression in a Turkish population. Our study is the first to our knowledge to investigate the relationship between colon cancer risk and survivin gene polymorphisms. Materials and Methods: The relation between colon cancer and survivin -31 G/C (rs9904341), -241 C/T (rs17878467) and -625 C/G (rs8073069) polymorphism in promotor site of survivin gene associated with apoptosis was investigated using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: Individuals with -31C allele and CC genotype were found to have a higher risk of developing colon cancer (OR=13.4, p=0.01). The -241 CT genotype considerably increased the risk of colon cancer (OR=12.0, p=0.0001). However, there was no significant varaition of the survivin -625 C/G polymorphism among colon cancer patients and controls in our study. Conclusions: This study provides the first evidence that survivin -31 G/C and -241 C/T SNP significantly contribute to the risk of colon cancer in the Turkish population