The relationship between oxidative stress and coronary artery ectasia

Background: Whereas coronary artery ectasia (CAE) is a rare abnormality of the coronary arteries, co-existent coronary artery disease (CAD) is commonly seen in CAE patients. Since a causative relationship has been shown to exist between oxidative stress and CAD, we sought to determine whether any relationship exists between oxidative stress and CAE. Methods: Fourty four patients with CAE (without CAD) and 86 controls (without any coronary disease) were recruited from among 1,520 patients undergoing coronary angiography. CAE subgroups were determined in accordance with the Markis classification system. Mean values for serum total oxidant status (TOS), total antioxidant status (TAS) and the oxidative stress index (OSI) were statistically compared between these two study groups and among CAE subgroups, with p = 0.05 set as the threshold for statistical significance. Results: TOS and OSI were significantly increased (p = 0.018 and 0.0002) and TAS decreased (p = 0.031) in the CAE versus control group. TOS and TAS were independently related to CAE (p = 0.037 and 0.039), with an r2 of 0.127. Interestingly, however, among CAE subgroups, no differences were observed. Conclusions: Oxidative stress might be implicated in the pathogenesis of CAE. Clinically-defined CAE subgroups did not differ in terms of oxidative stress status. However, the clinical implications of these findings are unclear and warrant further investigation. (Cardiol J 2010; 17, 5: 488-494

Paris'ten Türkiye

Taha Toros Arşivi, Dosya No: 142-Zekeriya-Yıldız-Sabiha Sertel. Not: Gazetenin "Düşünenlerin Forumu" köşesinde yayımlanmıştır

International Congress of Emerging Trends in Tourism (ICETT 2021)

Kitap (Açık Erişim)Son dönemde dünyanın birçok bölgesinde meydana gelen değişimler, olumlu ve olumsuz yönleri ile turizm hareketlerini kolaylıkla yönlendirmektedir. Covid-19 Salgını bu durumun son örneklerinin başında gelmekte ve halen sonuçları tam olarak bilinememektedir. Yeni normal olarak ifade edilen dünya düzeninde turizm işletmeleri yönetimi, turizm pazarlaması, turizm yatırımları, turizm faaliyetine yönelik işbirliği olanakları, turistik tüketici eğilimleri, turizm eğitimi, turizm planlaması ve politikaları alanlarında gelişmeler ve değişimlerin ortaya çıkması kaçınılmaz hale gelmiştir. Bu muhtemel değişimler ve gelişmeler, mevcut alan araştırmalarına ek olarak yeni yaklaşımların, teorilerin ve incelemelerin geliştirilmesini gerekli kılmaktadır. Giderek artan rekabet ortamında, turizm sektöründeki uygulamaların da yapılan araştırma çalışmaları ile uyumlaştırılması ve geliştirilmesi önemli bir süreçtir. Bu bağlamda, 30 Eylül - 02 Ekim 2021 tarihleri arasında, Necmettin Erbakan Üniversitesi Turizm Fakültesi ev sahipliğinde, Konya Büyükşehir Belediyesi işbirliğiyle, tarihi ve kültürel değerleri ve gelişmiş alt ve üst yapı donanımlarıyla öne çıkan, kadim şehrimiz Konya’da “Uluslararası Turizmde Yükselen Eğilimler Kongresi ” isimli Uluslararası bir kongre gerçekleşmiştir. Bu kongrenin, turizm endüstrisine yönelik yeni pazarlama, organizasyon, işbirlikleri, gelişen ve dönüşen teknolojik yaklaşımlar, farklılaşan tüketici eğilimleri ve yeni oluşumların tartışılacağı bir bilimsel platform olmuştur. Bu kongreye ait özet bildirilerin yer aldığı kitab açık erişim olarak sunulmuştur

Comparison of estimated continuous cardiac output with echocardiography in patients with systolic heart failure

Background: Cardiac output (CO) is an important hemodynamic parameter in the management of heart failure. The aim of this study was to compare CO measurements obtained from the bedside monitor specialized for CO measurement, which is known as estimated continuous CO (esCCO), and  transthorasic echocardiography (echoCO) in patients with ejection fraction (EF) <40%.Methods: A total of 49 patients (36 male) with EF <40% were studied in this study. CO was measured using esCCO and transthorasic echocardiography (TTE). Measurements of CO were compared using Bland-Altman statistical method.Results: Mean ejection fraction was 27.11 ± 7.31%. Measurements of CO using esCCO and echoCO were found to be different (5.44±1.10 L/min vs. 5.08±1.08 L/min, respectively, p=0.004). CO was higher in esCCO compared to TTE. Bland-Altman analysis showed that the bias between esCCO and echoCO was -0.36 L/min [95% CI: -0.60 – (-0.13)], 95% limits of agreement were ranged from -1.77 to 1.05 L/min, and percentage errors of measurements of CO was 13%. A significant positive correlation was found between esCCO and echoCO (r = 0.785, p< 0.001).Conclusions: esCCO was well correlated with echoCO in patients with low EF. The esCCO may be useful for non-cardiologist such as specialist for anaesthesiology and thorasic disease. Also, it may be used in the patients with HF having poor echocardiographic image quality due to co-morbidities including chronic obstructive pulmonary disease

Impaired global and segmental myocardial deformation assessed by two-dimensional speckle tracking echocardiography in patients with vitamin B12 deficiency

Background: Contrary effects of vitamin B12 deficiency have been shown on the cardiovascular system. Aim of our study was to analyze left ventricular (LV) myocardial deformation, by using the two dimensional (2D) speckle tracking echocardiography (STE) in patients with vitamin B12 deficiency and normal LV ejection fraction.Methods: Twenty-five patients with vitamin B12 deficiency (B12 levels &lt; 200 pg/mL; meanage: 29.6 ± 8.2 years, 15 female), and 27 healthy controls (B12 levels &gt; 200 pg/mL; meanage: 30.1 ± 6.9 years, 13 female) were included in the study. 2D echocardiography images were transferred to a workstation for further offline analysis. Longitudinal peak systolic (LPSS) and global strain (LGS) was obtained from 4 chamber and apical long axis (APLAX) views.Results: Standard echocardiographic parameters and tissue Doppler imaging (TDI) velocities were compared between the groups. All LPSS values in the patient group except for apical 4C septal wall longitudinal strain were significantly decreased than those in the control group. There was a positive correlation between B12 levels and strain values except apical 4C septal wall strain values.Conclusions: We found that in patients with vitamin B12 deficiency, global and segmental myocardial deformation was impaired and this impairment was correlated with the levels of vitamin B12

Remifentanil-based total intravenous anesthesia for pediatric rigid bronchoscopy: comparison of adjuvant propofol and ketamine

OBJECTIVE: Laryngoscopy and stimuli inside the trachea cause an intense sympatho-adrenal response. Remifentanil seems to be the optimal opioid for rigid bronchoscopy due to its potent and short-acting properties. The purpose of this study was to compare bolus propofol and ketamine as an adjuvant to remifentanil-based total intravenous anesthesia for pediatric rigid bronchoscopy. MATERIALS AND METHODS: Forty children under 12 years of age who had been scheduled for a rigid bronchoscopy were included in this study. After midazolam premedication, a 1 µg/kg/min remifentanil infusion was started, and patients were randomly allocated to receive either propofol (Group P) or ketamine (Group K) as well as mivacurium for muscle relaxation. Anesthesia was maintained with a 1 µg/kg/min remifentanil infusion and bolus doses of propofol or ketamine. After the rigid bronchoscopy, 0.05 µg/kg/min of remifentanil was maintained until extubation. Hemodynamic parameters, emergence characteristics, and adverse events were evaluated. RESULTS: The demographic variables were comparable between the two groups. The decrease in mean arterial pressure from baseline values to the lowest values during rigid bronchoscopy was greater in Group P (p = 0.049), while the reduction in the other parameters and the incidence of adverse events were comparable between the two groups. The need for assisted or controlled mask ventilation after extubation was higher in Group K. CONCLUSION: Remifentanil-based total intravenous anesthesia with propofol or ketamine as an adjuvant drug along with controlled ventilation is a viable technique for pediatric rigid bronchoscopy. Ketamine does not provide a definite advantage over propofol with respect to hemodynamic stability during rigid bronchoscopy, while propofol seems more suitable during the recovery period

Epidemiology, anticoagulant treatment and risk of thromboembolism in patients with valvular atrial fibrillation: Results from Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER)

Background: The aim of this study was to perform a multicenter, prospective investigation regarding the epidemiology, the current effectiveness of therapeutic anticoagulation, and the risk of thromboembolism in patients with valvular atrial fibrillation (AF) based on the records of the Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study. Methods: Patients were selected from a total of 2,242 consecutive admissions that presented with AF diagnosed via electrocardiogram. Those diagnosed with non-valvular AF were excluded from the AFTER study population, which left 497 patients with valvular AF for analysis. Results: The etiology of valvular AF in patients was either attributed to rheumatic mitral valve stenosis (n = 217) or possessing a prosthetic heart valve (n = 280). Out of all the patients with valvular AF, 83.1% were taking warfarin for anticoagulation. Only 36.1% demonstrated a therapeutic international normalized ratio (INR), and among those patients it was found that 19.1% exhibited a labile INR. Multivariate analysis revealed that age was the only independent predictor of thromboembolic events in patients with valvular AF. Conclusions: Many valvular AF patients are not maintained at therapeutic INR levels, which poses a threat to patient health as they age and are at greater risk for thromboembolism

Uric acid and high sensitive C-reactive protein are associated with subclinical thoracic aortic atherosclerosis

AbstractBackground and purposeThe detection of atherosclerotic lesions in the aorta by transesophageal echocardiography (TEE) is a marker of diffuse atherosclerotic disease. Hyperuricemia is a well-recognized risk factor for cardiovascular diseases. However, no data are available concerning the relationship between serum uric acid (UA) and subclinical thoracic aortic atherosclerosis. We aimed to investigate the association between thoracic aortic atherosclerosis and serum UA level.MethodsWe studied 181 patients (mean age 46.3±8 years) who underwent TEE for various indications. Four different grades were determined according to intima–media thickness (IMT) of thoracic aorta. UA and other biochemical markers were measured with an automated chemistry analyzer.ResultsTEE evaluation characterized thoracic aortic intimal morphology as Grade 1 in 69 patients, Grade 2 in 52 patients, Grade 3 in 31 patients, and Grade 4 in 29 patients. The highest UA level was observed in patients with Grade 4 IMT when compared with Grade 1 and 2 IMT groups (p<0.001 and p=0.014, respectively). UA levels in patients with Grade 3 and Grade 2 IMT were also higher than patients with Grade 1 IMT group (p<0.001, for all). In multiple linear regression analysis, IMT was independently associated with UA level (β=0.350, p<0.001), age (β=0.219, p=0.001), total cholesterol (β=−0.212, p=0.031), low-density lipoprotein cholesterol (β=0.350, p=0.001), and high sensitivity C-reactive protein (hsCRP) levels (β=0.148, p=0.014).ConclusionUric acid and hsCRP levels are independently and positively associated with subclinical thoracic atherosclerosis

TEKHARF Taramasinda ölüm yaşi: 56700 Kişi-yillik izlemede dönemsel e?ilim ve bölgesel da?ilim

PubMed ID: 19553737Objectives: We analyzed the temporal trend and regional distribution of age at all-cause death and the sex-specific and age-bracket defined coronary mortality in the 18-year follow-up of the Turkish Adult Risk Factor Study. Study design: The participants of the Turkish Adult Risk Factor Study who have been examined in even years were last surveyed in August 2008. A total of 1,582 individuals were surveyed, which constituted half of the alive participants of the overall cohort. Information on death was obtained from first-degree relatives and/or health personnel of local heath offices. Survivors were evaluated by history, physical examination, and 12-lead electrocardiography. The cumulative follow-up was 56,700 person-years. Results: Of 1582 participants, 868 (431 men, 437 women) were examined, in 604 subjects information was gathered, and 47 participants (26 men, 21 women) were ascertained to have died. Twenty-two deaths were classified as of coronary origin. Cumulative assessment of the entire cohort in the age bracket of 45-74 years disclosed coronary mortality to be 7.64 per 1000 person-years in men and 3.84 in women and persisted to be the highest among 30 European countries, whereas overall mortality declined at a greater proportion. Overall mean ages at death were deferred within a 12-year period by 7.4 years in men and 6 years in women, to 71.9 and 74.8 years, respectively. The extension of this mean survival was similar among urban-rural areas and geographic regions. Conclusion: Coronary mortality declined modestly, but life expectancy of Turkish adults rose by a mean of nearly seven years in the 12 years to 2003-08, without showing major differences in sex, urban-rural dwelling, or geographic regions