Akut perikardit ile komplike olan özafagus yırtığı

Özofagus perforasyonu yüksek mortalite hızı olan ciddi bir durumdur. Özofagus perforasyonunun gecikmiş tanısı mediastinit ve perikardit gibi yıkıcı komplikasyonlarla sonuçlanabilmektedir. Özofagus perforasyonları nadiren yabancı cisim aspirasyonuna bağlı olmaktadır. Bu yazıda tavuk kemiği yutulmasına bağlı ve ilk bulguları akut nonspesifik perikarditi düşündüren komplike olmuş özofagus perforasyonlu 59 yaşında bir erkek olgu sunuldu.Esophageal perforation is a serious condition with a high mortality rate. Delayed detection of esophageal perforation may result in devastating complications such as mediastinitis and pericarditis. Esophageal perforation is rare- ly due to aspiration of foreign bodies. Here we report the case of a 59-year-old male patient with complicated esophageal perforation due to ingestion of a chicken bone, whose first signs are considered to be acute non-specific pericarditis

Relationship between serum endocan levels and other predictors of endothelial dysfunction in obese women

Endocan, or endothelial cell-specific molecule-1 (ESM-1), is a potential inflammatory marker implicated in endothelial dysfunction. The purpose of this study was to determine the correlation between serum endocan levels and the presence and severity of endothelial dysfunction, and the relationships with serum intracellular adhesion molecule-1 (ICAM-1), adiponectin (a marker of inflammation), high sensitivity C-reactive protein (hsCRP) levels, and carotid intima-media thickness (cIMT) in obese subjects. Serum endocan, ICAM-1, adiponectin, hsCRP levels, and cIMT were evaluated in 76 obese women (BMI > 30 kg/m(2)) and 53 controls (BMI < 25 kg/m(2)). ICAM-1 (P = .01), hs-CRP (p < 0.001), and cIMT (p < .001) were significantly higher, while adiponectin (P = .006) was significantly lower, in obese women compared with the controls. Serum endocan levels were similar between the obese (470.5 +/- 171.3 pg/mL) and controls (471.9 +/- 146.3 pg/mL) (P = .732). There was no correlation between serum endocan values and the endothelial dysfunction markers, hsCRP (r = -.021), ICAM-1 (r = -.054), adiponectin (r = .113), or cIMT (r = -.060) in obesity. Endocan is not a suitable marker of endothelial dysfunction in the context of obesity. More research is required to evaluate the role of endocan in the regulation of inflammatory processes in obesity.Recep Tayyip Erdogan University 2015.53002.106.03.0

Koroner arter hastalığı risk faktörlerinin dağılımı: bölgesel bir analiz

Amaç: Bu çalışmadaki amacımız, Rize ili ve civarında koroner arter risk faktörlerinin sıklık ve dağılımını incelemektir. Yöntem ve gereç: Bu gözlemsel çalışmaya, 452 hasta (333 erkek, 119 kadın) alındı. Hastaların demografi k özelliklerinin yanı sıra, geleneksel risk faktörleri kaydedildi. Hastalar yaşa, cinsiyete ve elektrokardiyografi k özelliklerine göre gruplara ayrıldı. Bulgular: Çalışmaya katılan hastaların yaş ortalaması 63 ± 13 iken, % 74’ü erkekti. Sigara kullanımı ve HT genç yaşta ve erkeklerde daha fazla görüldü (% 71). Diyabetes mellitusta yaş grupları arasında fark tespit edilmedi. Kadınlarda HDL-C (P < 0,001) ve Total-C/HDL-C oranı (P < 0,05) erkeklere göre daha yüksek bulundu. Sigara kullanımı ve aile hikayesi yaşla birlikte azalma gösterdi. Sonuç: Hastaların % 97’sinde en az bir risk faktörü mevcuttu. Dolayısıyla çalışmamız, en önemli morbidite ve mortalite nedeni olan koroner arter hastalığında, hastalardaki risk faktör değişikliğinin ne kadar önemli olduğunu bizlere tekrar vurgulamaktadır.Aim: To analyze the frequency and distribution of coronary artery risk factors in the city of Rize and its surrounding areas. Materials and methods: Th is observational study included 452 patients (333 men, 119 women). In addition to demographic characteristics of the patients, conventional risk factors were also recorded. Th e patients were grouped according to their ages, gender, and electrocardiographic characteristics. Results: Th e mean age of participants was 63 ± 13 years and 74% were male. Smoking and hypertension (HT) were seen more oft en (71%) in younger male patients. No diff erence among age groups was detected with regard to the occurrence of diabetes mellitus. Th e levels of HDL-cholesterol (P < 0.001) and the ratio of total cholesterol to HDL-cholesterol (P < 0.05) were found to be relatively higher in female patients. Th e prevalence of smoking and familial risk factors both decreased with age. Conclusion: At least one of these risk factors was detected in 97% of patients. Th erefore, our study continues to emphasize the crucial role of modifi cation of risk factors in patients with coronary artery disease, the most important etiologic factor for morbidity and mortality

Serum monocyte chemoattractant protein 1 levels in patients with stable coronary artery disease

Amaç: Monosit kemoatraktan protein 1 (MCP-1) aterosklerozun enflamasyonunda artan ve plazmadaki düzeyinin artışı ile kardiyovasküler hastalıkların morbidite ve mortalite artışını göstermede öngördürücüdür. Bu araştırmada, koroner arter hastalığının (KAH) yaygınlığı ile MCP-1 düzeyi arasındaki ilişki araştırıldı. Gereç ve Yöntem: Çalışmaya, KAH şüphesiyle elektif koroner anjiyografi (KAG) yapılan, yaş ortalamaları 60±11 yıl olan, 52 erkek, toplam 80 hasta alındı. KAG öncesi, MCP-1 seviyeleri ölçümü için venöz kan örnekleri alındı. Hastaların yaş, cinsiyet ve ateroskleroz risk faktörleri sorgulandı. KAG’de %50’den fazla darlık ciddi KAH olarak kabul edildi. KAH yaygınlığı, ciddi derecede daralmış damar sayısı ile belirlendi. Serum MCP-1 düzeyleri, KAH yaygınlığı ile karşılaştırıldı. Bulgular: Ortalama MCP-1 seviyeleri, koroner lezyonları olan hastalarda, normal koroner arter hastalarına (NKA) göre daha yüksekti (194±40 pg/ml ; 164±35 pg/ml, p=0.003). MCP-1 seviyeleri, tutulan koroner arter sayısı ile artış görüldü (NKA: 164±35 pg/ml, kritik olmayan plaklar; 184±33 pg/ml, 1-damar: 198±39 pg/ml, 2- damar: 183±43 pg/ml ve 3- damar: 219±47 pg/ml, p=0,004). Bununla birlikte, çok değişkenli regresyon analizinde, MCP-1 seviyesi, KAH mevcudiyetiyle bağımsız bir ilişki bulunmadı. Sonuç: MCP-1 düzeyleri, tutulan koroner damar sayısı ile ilişkilidir. Bununla birlikte, bu ilişki geleneksel KAH risk faktörlerinden bağımsızdır. Bu bulgu, MCP-1’in geleneksel KAH risk faktörlerinden bağımsız bir belirteç olarak aterosklerotik süreci yansıttığını göstermektedir.Aim: Monocyte chemoattractant protein 1 (MCP-1) is known to increase during atherosclerotic inflammation and is a predictor of increased mortality and morbidity of cardiovascular diseases. The aim of the present study was to determine the relationship of MCP- 1 levels with the extent of coronary artery diseases (CAD). Material and Method: Eighty patients (52 males) with a mean age of 60±11 years who underwent elective coronary angiography with suspicion of CAD were consecutively included in the study. Venous blood samples were collected before angiography to measure MCP-1 levels. Age, gender, and atherosclerosis risk factors of patients were evaluated. On coronary angiography, a stenosis of over 50% was considered as severe CAD. The extent of CAD was determined by number of severely stenosed vessels. The serum MCP-1 levels were compared with the extent of CAD. Results: The mean serum MCP-1 level was higher in patients with coronary lesions compared to patients with NCA (Normal coronary arteries) (194±40 pg/ml vs. 164±35 pg/ml, p=0.003). The level of MCP-1 was shown to increase with the number of coronary arteries (NCA: 164±35 pg/ml, Non-critical plagues; 184±33 pg/ml, 1-vessel: 198±39 pg/ml, 2-vessel: 183±43 pg/ml and 3-vessel: 219±47 pg/ml, p=0.004). However, in multivariate regression analysis, MCP-1 level was not independently associated with presence of CAD. Conclusion: The levels of MCP-1 were related to number of involved coronary arteries. However, this relationship was not independ- ent of conventional coronary risk factors. This finding suggests that MCP-1 in atherosclerotic process may be the reflection of response of the body to the traditional coronary risk factors rather than to be an independent causative risk factor

Successful thrombolysis using recombinant tissue plasminogen activator in cases of severe pulmonary embolism with mobile thrombi in the right atrium

Hereby, we report two cases of acute pulmonary embolism with concomitant right-sided thrombus, which were successfully treated using recombinant tissue plasminogen activator (rtPA). These patients had life-threatening acute right ventricular failure, which dramatically improved within hours following thrombolysis. These cases emphasize the clinical utility of rtPA for the treatment of life-threatening pulmonary embolism. © 2014 Akadémiai Kiadó, Budapest

Relation of Angiographic Thrombus Burden with Severity of Coronary Artery Disease in Patients with ST Segment Elevation Myocardial Infarction

Durakoglugil, Emre/0000-0001-5268-4262; Cetin, Mustafa/0000-0001-6342-436X; duman, hakan/0000-0002-1441-7320WOS: 000365240100001PubMed: 26573108Background: We planned to investigate the relationship of thrombus burden with SYNTAX score in patients with ST elevation myocardial infarction (STEMI). Material/Methods: We retrospectively enrolled 780 patients who underwent PPCI in our clinic due to STEMI. Clinical, laboratory, and demographic properties of the patients were recorded. Angiographic coronary thrombus burden was classified using thrombolysis in myocardial infarction (TIMI) thrombus grades. Results: Patients with high thrombus burden were older, with higher diabetes prevalence longer pain to balloon time, higher leukocyte count, higher admission troponin, and admission CK-MB concentrations. SYNTAX score was higher and myocardial perfusion grades were lower in patients with high thrombus burden. Multivariate logistic regression analysis revealed SYNTAX score as the strongest predictor of thrombus burden. ROC analysis demonstrated a sensitivity of 75.5%, specificity of 61.2%, and cut-off value of >14 (area under the curve (AUC): 0.702; 95% confidence interval [CI]: 0.773-0.874; P<0.001) for high thrombus burden. Conclusions: SYNTAX score may have additional value in predicting higher thrombus burden besides being a marker of coronary artery disease severity and complexity

Pleiotropic Effects of HDL Subfraction and Associated Enzymes on Protection Against Coronary Artery Disease

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEYyilmaz, adnan/0000-0001-9769-9791WOS: 000329858400087[No abstract available]Turkish Soc Cardio

Epikardiyal adipoz dokunun P dalga ve QT dispersiyonu ile ilişkisi

Amaç: Epikardiyal adipoz doku (EAD) kalpte pek çok endok- rin ve parakrin etkiye sahip olan çeşitli enflamatuvar ve atero- jenik ajanları salgılar. Bu çalışmada, EAD’nin elektrokardiyo- gafinin (EKG) basit, non-invaziv aritmi belirteçleri olan QT ve P dalga dispersiyonu (QTd, PDd) üzerine etkisini araştırmayı planladık. Yöntemler: Kesitsel yapıda çalışmamıza koroner arterle- ri normal 70 hasta alındı. Bu hastalara 12 derivasyon EKG, ekokardiyografi, biyokimyasal çalışmalar yapılarak, QTd, PDd ve EAD kalınlığı hesaplandı. Bulgular: Ortanca EAD 4.1 mm olarak bulundu. EAD yaş (r=0.412, p<0.001), vücut ağırlığı (r=0.262, p=0.028), beden kitle indeksi (r=0.396, p<0.001), sol atriyum boyutu (r=0.518, p<0.001), açlık plazma glukozu (r=0.245, p=0.041), maksi- mum P dalga süresi (r=0.343, p=0.004), minimum P dalga süresi (r=0.275, p=0.021) ve PDd (r=0.265, p=0.026) ile ko- releydi. QTd ile çalışılan parametreler arasında ilişki saptan- madı. Ancak PDd; EAD kalınlığı (r=0.265, p=0.026), sol atri- yum boyutu (r=0.483, p<0.001) ve trigliserit düzeyi (r=0.267, p=0.028) ile ilişkiliydi. Çok değişkenli analiz sol atriyum bo- yutunun PDd’nin tek bağımsız belirleyicisi olduğunu ortaya koydu. Sonuç: Çalışmamızda EAD ile PDd arasında anlamlı bir ilişki saptadık. Her ne kadar EAD hem PDd ve hem de sol atriyum boyutu ile ilişkili ise de, sol atriyum boyutu, koroner arterle- ri normal hastalarda atriyum fibrilasyonu riski için EAD’den daha önemli gibi görülmektedir.Objective: Epicardial adipose tissue (EAT) secretes various pro- inflammatory and atherogenic mediators that have several en- docrine and paracrine effects on heart. This study investigated the influence of EAT on QT and P wave dispersions (QTd, PWd), as simple, non-invasive tools of proarrhythmia on surface ECG. Methods: This was a cross-sectional study and included 70 patients with normal coronary arteries who underwent 12-derivation electrocardiography, echocardiography and bio- chemical examinations in order for QTd, PWd, and EAT thick- ness to be measured. Results: Median EAT thickness was 4.1 mm. Correlation analyses revealed that EAT was significantly associated with age (r=0.412, p<0.001), weight (r=0.262, p=0.028), body mass index (r=0.396, p<0.001), left atrium diameter (r=0.518, p<0.001), fasting plasma glucose (r=0.245, p=0.041), maxi- mum P wave duration (r=0.343, p=0.004), minimum P wave du- ration (r=0.275, p=0.021) and PWd (r=0.265, p=0.026). No rela- tion was found between study parameters and QTd. However, P wave dispersion was significantly related to EAT thickness (r=0.265, p=0.026), left atrium diameter (r=0.483, p<0.001), and the triglyceride levels (r=0.267, p=0.028). Multiple linear regression analyses revealed left atrial diameter as the only in- dependent predictor of PWd. Conclusion: A significant association between EAT and PWd was demonstrated in the study. While EAT is related to both increased PWd and left atrial size, left atrial diameter seems to be more important than EAT for prediction of atrial fibrilla- tion (AF) in patients with normal coronary arteries

Cholesterol forms and traditional lipid profile for projection of atherogenic dyslipidemia: lipoprotein subfractions and erythrocyte membrane cholesterol

yilmaz, adnan/0000-0003-4842-1173WOS: 000330341200002PubMed: 24240543Atherogenic dyslipidemia characterized by abnormal changes in plasma lipid profile such as low high-density lipoprotein (HDL) and increased triglyceride (TG) levels is strongly associated with atherosclerotic diseases. We aimed to evaluate the levels of pro- and antiatherogenic lipids and erythrocyte membrane cholesterol (EMC) content in normo- and dyslipidemic subjects to investigate whether EMC content could be a useful marker for clinical presentation of atherogenic dyslipidemia. Low-density lipoprotein (LDL), HDL and their subfraction levels and erythrocyte lipid content were determined in 64 normolipidemic (NLs), 42 hypercholesterolemic (HCs) and 42 mixed-type dyslipidemic subjects (MTDs). Plasma atherogenic lipid indices [small-dense LDL (sdLDL)/less-dense HDL (LHDL), TC/HDL-C, TG/HDL-C and Apo B/AI] were higher in MTDs compared to NLs (p < 0.001). the highest sdLDL level was observed in HCs (p < 0.01). Despite a slight increase in EMC level in dyslipidemic subgroups, the difference was not statistically significant. A significant negative correlation, however, was observed between EMC and sdLDL/LHDL in HCs (p < 0.035, r = -0.386). Receiver operating characteristic curves to predict sdLDL level showed that TG and EMC levels had higher area under curve values compared to other parameters in HCs. We showed that diameters of larger LDL and HDL particles tend to shift toward smaller values in MTDs. Our results suggest that EMC content and TG levels may be a useful predictor for sdLDL level in hypercholesterolemic patients.TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [2008.102.02.2]Supported in part by TUBITAK (Grant No. 2008.102.02.2)