The Relationship Between the Frontal QRS-T Angle and High Blood Pressure Response to Exercise

Introduction:In this study, we compared frontal QRS-T angles between normotensive subjects with high blood pressure (BP) respons to exercise test and the control group.Methods:Patients who were scheduled for an exercise test between January 2017 and January 2022 were included in the study. The patient group consisted of people who responded to the exercise test with elevated BP, and the control group included people who responded to the exercise test with normal BP. The data in the electrocardiography device’s report section was used to calculate the QRS and T-axis. The frontal QRS-T angle was identified as the absolute difference between these two axes.Results:Frontal QRS-T angles were found to be significantly higher in the patient group compared with the control group (36.09±14.51 and 20.46±8.12; p<0.001). In multivariate analysis, frontal QRS-T angles were found to be an independent predictor of higher BP response to exercise test [odds ratio: 1,189, 95% confidence interval (CI); 1,083-1,305; p<0.001]. Receiver operating characteristic curve analysis showed that the frontal QRS-T angle value predicting an excessive BP response to exercise test was 27.5º with a sensitivity of 71% and a specificity of 75% (area under the curve: 0.832; 95% CI: 0.75-0.91; p<0.001).Conclusion:The frontal QRS-T angles were found to be significantly higher in the group that gave higher BP response to the exercise test compared to the control group. Patients with a high BP response to exercise test can be detected using the frontal QRS-T angle before the test

Do we damage nucleus pulposus tissue while treating cerebrovascular ischemic neurological deficits with nimodipine?

Aim: Nimodipine is used to prevent cerebrovascular-originated ischemic neurological deficits, yet its effects on nucleus pulposus (NP) cells or annulus fibrosus (AF) cells weren’t studied. This study aimed to examine nimodipine’s effects on vitality and proliferation of chondroadherin (CHAD), type II collagen (COL2A1), and hypoxia-inducible factor 1 alpha (HIF 1?) gene expression in human primary NP/AF cells. Material and Methods: NP/AF cell cultures obtained from 6 patients who underwent microdiscectomy were treated with 100 µMolar nimodipine and analyzed at 0, 24, and 48 h. Data were evaluated using one-way ANOVA and post-hoc Tukey HSD with 95% confidence interval. Results: We observed suppressed cell proliferation and increased necrosis in nimodipine-treated NP/AF cell cultures, especially degenerated tissue. COL2A1 gene expression wasn’t detected in any experimental groups. CHAD and HIF 1? expression had timedependent decreases in control. CHAD and HIF 1? expression were found to decrease at 24h, but increased at 48h in degenerated tissue. In nimodipine-applied intact tissues, CHAD expression was stable at 24h but 1.62 times higher than control at 48h. HIF 1? levels were lower than control. Conclusion: In nimodipine-treated degenerated AF/NP cultures, CHAD and HIF 1? expressions had time-dependent decreases. However, after complete RT-PCR data evaluation, no correlation between nimodipine application and gene expression occurred

Author's Reply [2018]

[No Abstract Available

Miyokard Perfüzyon Sintigrafisinde Kan Basıncı Değerleri Kardiyak İskemiyi Öngördürebilir

Blood Pressures may be Predictor of Cardiac Ischemia in Myocardial Perfusion Scintigraphy Aykut Demirkıran1, Elif İjlal Çekirdekçi2, Birol Topçu3, Hatice Sümeyye Yavuz41Department of Cardiology, Tekirdag State Hospital, Tekirdag2Department of Cardiology, University of Kyrenia, Kyrenia3Department of Medical Biostatistics, Namik Kemal University, Tekirdag4Department of Nuclear Medicine, Tekirdag Corlu State Hospital, TekirdagAbstractDOI: 10.5543/khd.2020.77699 Turk J Cardiovasc Nurs 2020;11(26):105–110Kardiyovasküler Hemşirelik DergisiObjective: Low diastolic blood pressure (DBP) is associated with adverse cardiovascular outcomes in patients with chronic coronary disease (CAD), but its association with ischemia is unknown. Relationship between DBP and the myo-cardial ischemia in myocardial perfusion scintigraphy (MPS) was investigated.Methods: Patients with chronic coronary artery disease who underwent MPS were included. One day stress/rest gated MPI with Tc-99m MIBI protocol was applied to all patients. Blood pressures was measured before MPI. Patients were divided into 2 groups as ?75 mmHg and >75 mmHg according to DBP. The SDS were calculated using the sum of the 17-segment.Results: The patients with DBP ?75 mmHG and with DBP>75 mmHG were compared, there was no significant differ-ence in SDS (4.44±4.67 and 4.65±4.70 respectively; p=0.657). Association of DBP ?75 mmHg with SDS appeared to be primarily among those with SBP >130 mmHg. Patients with DBP ?75mmHg and SBP >130mmHg had different SDS (6.87±6.00 and 4.99±4.77; p=0.015) between patients with DBP >75 mmHg and SBP >130mmHg. Conclusion: Coexistence lower diastolic blood pressures (?75mmHg) with higher systolic blood pressures (>130mmHg) could be a predictor of myocardial ischemia in patients who underwent adenosine stress MPIAmaç:Kronik koroner hastalığı (KAH) olan hastalarda, düşük diyastolik kan basıncının (DKB) mortalite dahil olmak üzere olumsuz kardiyovasküler sonuçlarla ilişkilidir, ancak iskemi ile ilişkisi bilinmemektedir. Bu çalışmamızda düşük diyastolik kan basıncının (DKB) miyokard perfüzyon sintigrafinde (MPS) iskemi ile ilişkisi araştırıldı.Yöntemler:Tüm hastalara tek gün TI-99m MIBI protokolü uygulandı. Kan basınçları işlemden hemen önce ölçüldü. Hastalar DKB değerlerine göre ?75mmHg ve >75mmHg olarak iki gruba ayrıldı. 17 segment kullanılarak SDS (summed difference score) hesapland

Overseas Experience and Requests in Intensive Care Doctors

Objective: To evaluate the overseas experiences of our intensive care unit doctors and to determine out the reasons for our doctors who couldnot go and what support they wanted. Materials and Methods: The created questionnaire was delivered to the doctors via the internet. The survey consisted of three main parts. They were asked in the first part, sociodemographic characteristics; in the second part, how long they went abroad, how they choose the center, from whom they received support; in the third part, the reasons why our physicians who donot have been abroad experienced could not go, on which subject/center they want to gain professional experience, and how to get support in this regard. Results: 31.4% of the 156 participants had professional abroad experience. 55% of those who went stated that they found the center with their own efforts, and very few (13 people, 26%) stated that they received support from the education/administrative unit of the institution they worked during the admission. In academically titled physicians, the level of foreign language and the importance given to education abroad were quite high. It was determined that the frequency of reading articles was correlated only with the duration of the profession. The most common reasons for physicians who couldnot get a chance to go was not being able to find a clinic/scholarship program to go to/not being informed (63.5%) and high accommodation/living fees (48.4%). Conclusion: Professional overseas experience has a high contribution to our physicians and our health system. The biggest obstacle for our physicians who cannot attend is not being able to find a center/clinic to go to. We think that the institutions/associations to which they are affiliated can support this issue

Efficacy and safety of folfiri plus aflibercept in second-line treatment of metastatic colorectal cancer: Real-life data from Turkish oncology group

Aims: The addition of aflibercept to the fluorouracil and irinotecan (FOLFIRI) regimen significantly improved clinical outcomes in patients with metastatic colorectal cancer (CRC) previously treated with oxaliplatin. We aimed to investigate the efficacy and safety of second-line FOLFIRI and aflibercept combination in patients with metastatic CRC in real-life experience. Materials and Methods: Four hundred and thirty-three patients who treated with FOLFIRI and aflibercept in the second-line were included in the study. The clinical and pathological features of the patients were recorded retrospectively. Survival (overall and progression-free survival [PFS]), response rates, and safety data were analyzed. Results: The median age was 61. Majority of patients (87.5%) received first-line bevacizumab and 10.1% of patients received anti-epidermal growth factor receptor agents. About 80% of patients had KRAS, 18.6% of patients had NRAS, and 6.4% of patients had BRAF mutations. The median OS was 11.6 months (95% confidence interval [CI], 10.6-12.6) and the median PFS was 6 months (95% CI, 5.5-6.5). About 4.6% of patients had complete response and 30.6% of patients had partial response as best tumor response. Grade 1-2 toxicities were seen in 33.4% of patients, while grade 3-4 toxicities were recorded in 27% of patients. Eight patients (2%) died due to treatment toxicity. Conclusions: Overall and PFS were similar in routine clinical practice compared to phase III pivotal VELOUR trial. However, response rates were found to be higher. It was observed that there were fewer adverse events compared to the VELOUR trial

The real-life efficacy and safety of osimertinib in pretreated advanced non-small cell lung cancer patients with T790M mutation: A Turkish Oncology Group Study

Introduction Osimertinib, an irreversible third-generation EGFR-TKI, is the standard of care for second-line treatment of T790M-mutant advanced NSCLC patients whose disease progressed after first-line EGFR-TKI therapy. In this multicenter study, we aimed to determine the real-life efficacy and safety of Osimertinib in pretreated advanced NSCLC patients with T790M mutation. Materials and methods This retrospective trial included advanced T790M-mutant pretreated NSCLC patients who received Osimertinib from 24 different centers in Turkey. Primary endpoint was time-to-treatment discontinuation (TTD). Secondary endpoints were objective response rate (ORR), overall survival (OS), and safety. Results Of 163 patients, 68.7% had EGFR exon 19 deletion and 22.7% had exon 21 L858R mutation. Osimertinib was given as second-line treatment in 96 patients (58.9%) and third-line in 48 patients (29.4%). After median of 13-month follow-up, median TTD was 21.6 months with an 82.2% ORR. Estimated median OS was 32.1 months. Grade 3-4 adverse events were seen in 11.7% of the patients. Conclusion Osimertinib is a highly effective option in second- or third-line treatment of NSCLC patients with T790M mutation, with a favorable safety profile