ACUTE MITRAL INSUFFIENCY DUE TO BLUNT CHEST TRAUMA

Künt toraks travmasına bağlı olarak gelişen kardiak yaralanmalar sonucu nadir olarak valvüler lezyonlar ortaya çıkabilmektedir. Acil serviste araç içi trafik kazası nedeniyle değerlendirilen 20 yaşındaki erkek olgunun fizik muayenesinde mitral odakta üfürüm, akciğer kontüzyonu ve şüpheli kot fraktürü saptandı. Daha önceden kardiyak rahatsızlığı ve efor kapasitesinde kısıtlılığı olmadığını ifade eden olguya elektif şartlarda ekokardiyografi (EKO) yapıldı ve posterior leaflet flail görünümde, posterior leafleti tutan kordal yapılarda rüptür ve mitral yetmezlik jetinin tüm sol atriumu doldurmakta olduğu tesbit edilerek ağır mitral yetmezliği (MY) tanısı kondu. Genel durumu iyi olan ve kardiyak yetmezlik bulguları olmayan olgunun medikal tedavisi düzenlenerek servis izlemine alındı. Elektif şartlarda operasyon önerildi. Künt toraks travması ile acil serviste değerlendirilen hastaların kardiyak travmaya açık hastalar olduğu unutulmamalı, dikkatli ve tam fizik muayene yapılmalıdır. Valvuler lesions may be observed due to cardiac injuries after blunt thoracic traumas. A 20 year -old male patient admitted to the emergency department after a car accident. His physical examination reveled a pansystolic murmur at mitral area by auscultation. On his chest X-ray examination, it was found out that pulmonary contusion and a suspected rib fracture were present. This patient didn't declare any prior cardiac illness and exertional dsypnea. Echocardiographic examination was carried out under elective circumstances. This examination defined a flail-like appearance at the posterior leaflet of the mitral valve, rupture of the chordae holding mitral posterior leaflet and severe mitral regurgitation. His general condition was fine and he is given medical treatment at our clinic, and elective mitral valvuler surgery has been proposed. The patients admitted to the emergency department because of blunt chest trauma should be carefully examined

The Cardiopulmonary Effects of the Gene-related Peptide Family.

Cardiopulmonary diseases are very common among the population. They are high-cost diseases and there are still no definitive treatments. The roles of members of the calcitonin-gene related-peptide (CGRP) family in treating cardiopulmonary diseases have been studied for many years and promising results obtained. Especially in recent years, two important members of the family, adrenomedullin and adrenomedullin2/intermedin, have been considered new treatment targets in cardiopulmonary diseases. In this review, the roles of CGRP family members in cardiopulmonary diseases are investigated based on the studies performed to date

The Cardiopulmonary Effects of the Gene-related Peptide Family.

Cardiopulmonary diseases are very common among the population. They are high-cost diseases and there are still no definitive treatments. The roles of members of the calcitonin-gene related-peptide (CGRP) family in treating cardiopulmonary diseases have been studied for many years and promising results obtained. Especially in recent years, two important members of the family, adrenomedullin and adrenomedullin2/intermedin, have been considered new treatment targets in cardiopulmonary diseases. In this review, the roles of CGRP family members in cardiopulmonary diseases are investigated based on the studies performed to date

Pregnancy and hydatid cyst Gebelik ve kist hidatik

Cyst hydatid disease (CHD) can be localized in every organ and frequently seen in Turkey. Twenty weeks pregnant woman was admitted with hemoptysis and dyspnea. Chest X-ray revealed bilateral homogeneous dansities. We planned to end pregnancy or follow untill term, as diagnosis of CHD. The patient refused delivery. Eleven months later she was admitted with haemoptysis and syncope. Chest X-ray showed cavitary lesion, pleural effusion, pneumothorax in right lung and another cavitary lesion in left. Tube thoracostomy performed with the diagnosis of perforated cyst hydatid (CH) and the patient operated. CH may enlarge in pregnancy. Cyst rupture can cause anaphylactic shock and hemoptysis. Pregnancy and CHD occur occasionally together and there is no consensus about treatment

Prevalance of adolescent pregnancies and educational status of pregnant adolescents admitted to the Kırıkkale University Faculty of Medicine, Department of Gynecology and Obstetrics

Amaç: Bu retrospektif çalışmada, Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Polikliniği'ne başvuran adölesan gebelerin eğitim durumlarını ve adölesan gebeliğin prevalansını inceledik. Materyal ve Metot: Şubat 2001 ile Eylül 2003 tarihleri arasında antenatal takibi yapılan 954 gebe kadına ait kayıtlar incelendi. Sonuçlar: Takip edilen 954 gebe kadının %7.9'unun adofesan yaş grubunda olduğu bulundu. Adölesanların eğitim durumuna geldiğimizde %69.3'ünün ilköğretim mezunu, %26.6'sının lise mezunu olduğu ve %1.3'ünün halen bir yükseköğretim kurumunda eğitim görmekte olduğu tespit edildi. Tartışma: Kırıkkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Polikliniği'ne başvuran gebelerde, adölesan gebelik oranı (%7.9) Türkiye genelinden düşük bulunurken, eğitim düzeyi daha yüksek olarak tespit edilmiştir.Objective: In this retrospective study, we wanted to determine the prevalence of adolescent pregnancies and educational status of the adolescent pregnant women admitted to the outpatient clinic of Kırıkkale University, Faculty of Medicine, Department of Obstetrics and Gynecology. Materials and Methods: Records of antenatal follow up of 954 pregnant women between February 2001 and September 2003 were analyzed. Results: Out of 954 pregnant women who were followed up antenatally, 7.9% were in adolescent age group. As for the educational status of these adolescents, 69.3% were primary school graduate, 26.6% were high school graduate and 1.3% were attendant to a university programe. Conclusion: Although the rate of adolescent pregnancies admitted to the outpatient clinic of Kırıkkale University, Faculty of Medicine, Department of Obstetrics and Gynecology (7.9%) was not as high as in the general population of Turkey, their educational status were higher

Peripartum Management of a Pregnant with Glanzmann’s Thrombasthenia: A Case Report

In this study, we aimed to present the case of a patient with Glanzmann’s thrombasthenia (GT) which is a hereditary disorder characterized by defective platelet function. A twenty-six-year old woman with GT who underwent cesarean section due to labor arrest and persisting vaginal bleeding despite receiving 18 unit of random platelet concentrates, 6 units of apheresis platelet concentrates, and 2 units of erythrocyte suspension. Since patients with GT are at high risk for massive bleeding during and after delivery, they should give birth under close monitoring in advanced healthcare centers where experienced hematologists are available.(The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 208-11

Ayak bileği-brakiyal indeksi diyabetik hastalarda mevcut glisemik kontrolle doğrudan ilişkili midir?

Objectives: In this study, we aimed to investigate the association between the ankle-brachial index (ABI) and glycemic control in type 2 diabetic patients. Patients and methods: This cross-sectional study included a total of 136 (41 males, 95 females; mean age 54.4±8.4 years; range, 33 to 76 years) type 2 diabetic patients. Demographic, metabolic characteristics, laboratory data and vascular complication status of the patients were recorded. For the ABI measurement, blood pressure on ankle posterior tibialis artery was measured using hand Doppler. Results: The mean duration of diabetes was 118.6±89.2 months and the mean HbA1c value was 8.03±1.7%. According to the ABI values, only one patient was in the ABI 0.9 group. Of our patients, 65.6% were within ABI values of 0.9-1.4 (normal) and 33.5% were within ABI values of >1.4 (high) group. According to the HbA1c values (7%, 7-9% and >9%), the ABI value was not statistically significantly different (p=0.472). The ABI value was only correlated with triglyceride (r= -0.173 p=0.049), total cholesterol (r= -0.214 p=0.014), and glomerular filtration rate (r=0.248 p=0.006). The mean HbA1c value was 8.3% in the group whose ABI value was between 0.9-1.4, while the mean HbA1c level value was 7.5% in the group whose ABI value was ABI >1.4 (p=0.01). Conclusion: In our study, the ABI value was not found to be correlated with the HbA1c value. The HbA1c value was lower in the group whose ABI values were higher.ÖZ Amaç: Bu çalışmada tip 2 diyabetik hastalarda Ayak bileği-brakiyal indeksinin (ABİ) glisemik kontrolle ilişkisi değerlendirildi. Hastalar ve Yöntemler: Bu kesitsel çalışmaya tip 2 diyabeti olan toplam 136 (41 erkek, 95 kadın; ort. yaş 54.4±8.4 yıl; dağılım, 33-76 yıl) hasta alındı. Hastaların demografik, metabolik özellikleri ve laboratuvar verileri ve komplikasyon durumları kaydedildi. Ayak bileğibrakiyal indeks ölçümü için ayak bileği posterior tibial arterden kan basıncı el Doppleri kullanılarak ölçüldü. Bulgular: Ortalama diyabet süresi 118.6±89.2 ay ve ortalama HbA1c değeri %8.03±1.7 idi. Ayak bileği-brakiyal indeks değerlerine göre, yalnızca bir hasta ABİ 0.9 grubunda idi. Hastalarımızın %65.6’sı ABİ 0.9-1.4 (normal) grubunda, %33.5’i ABİ >1.4 (yüksek) grubundaydı. HbA1c değerlerine göre (HbA1c; %7, %7-9 ve >%9) ABİ değerleri istatistiksel olarak anlamlı düzeyde farklı değildi (p=0.472). ABİ değeri yalnızca trigliserid (r= -0.173 p=0.049), total kolesterol (r= -0.214 p=0.014) ve glomerüler filtrasyon hızı (r= 0.248 p=0.006) ile ilişkili bulundu. ABİ değeri 0.9-1.4 olan grupta ortalama HbA1c değeri %8.3 iken, ABİ değeri >1.4 olan grupta ortalama HbA1c değeri %7.5 idi (p=0.01). Sonuç: Çalışmamızda ABİ değeri HbA1c değeri ile ilişkili bulunmadı. Yüksek ABİ değeri olan grupta HbA1c değeri daha düşük bulundu