Koroner arter hastalarında aerobik egzersizin endotel fonksiyonlarına olan etkilerinin değerlendilmesi

TEZ7564Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2009.Kaynakça (s.58-68) var.viii, 69 s. : res. ; 29 cm.Introduction: Endothelial dysfunction is an early manifestation of coronary artery disease. Different methods have been defined for the healing of endothelial functions. The mostly forgotten and important one of these methods is the physical activity which includes aerobic exercise training. The heart, as a specialized form of vessel, has an endothelial system which is forming the composition of endocardium. Therefore, endothelial dysfunction may also leads to impairement of the diastolic functions of the heart. The beneficial effect of aerobic exercise on vascular endothelium may also improve the diastolic functions and exercise capacity. Aim: The aim of this study was to investigate the effect of aerobic exercise training on vascular endothelial functions. Methods: Twenty patients (14 males and 6 females, mean age 56.1±4 years) with stable coronary artery disease were included to the study. Blood and urine samples were taken to calculate plasma homocystein and instant microalbuminuria levels, respectively. Doppler echocardiographic measurements and the amount of brachial flow mediated dilatation were achieved. Patients were trained for four weeks with moderate intensity treadmill exercise, regarding the 60% of peak oxygen uptake. All laboratory and echocardiographic examinations were repeated after the training protocol. Results: Four weeks of regular aerobic exercise training significantly improved flow mediated dilatation of patients with CAD (p=0,001). Transmitral peak velocities evaluated by pulsed wave Doppler, tissue Doppler velocities, flow mediated dilatation and laboratory results are summarized in tableGiri? ve Amaç: Endotel işlev bozukluğu koroner arter hastalığının gelişiminde en erken basamağı oluşturmaktadır. Endotel işlevlerinin iyileştirilmesinde çeşitli yöntemler tanımlanmıştır. Bu yöntemler içerisinde beklide en önemlisi ve en çok unutulanı aerobik egzersizi içeren yeterli fiziksel aktivitedir. Kalp özelleşmiş bir damar olarak kabul edilmekte ve endokardiyumun damar endoteli ile benzer hücrelerden oluştuğu bilinmektedir. Endotel işlevlerinin etkilenmesi ile diyastolik işlevlerin de birlikte etkilenebileceği varsayılmaktadır. Çalışmamızda, aerobik egzersiz antrenmanının endotel işlevlerine olan etkileri incelendi. Gereç ve Yöntem: Çalışmaya 20 kararlı koroner arter hastası (14 erkek ve 6 kadın, yaş ortalaması 56.1 ± 4 yıl) alındı. Kan ve idrar örnekleri alınarak plazma homosistein ve spot idrar mikroalbümin düzeyleri saptandı. Hastaların akıma bağlı vazodilatasyon ölçümleri yanısıra, ekokardiyografi ile nabız dalgalı ve doku Doppler ölçümleri yapıldı. Hastalar daha sonra 4 haftalık, zirve oksijen alımı %60 olacak şekilde orta şiddette aerobik egzersiz antrenmanı programına alındılar. Tüm laboratuvar testleri, akıma bağlı vazodilatasyon ve ekokardiyografi Doppler ölçümleri antrenman sonrası tekrarlanarak, öncesi değerler ile karşılaştırıldılar. Bulgular: Hastalarda 4 haftalık aerobik egzersiz antrenmanı ile akıma bağlı vazodilatasyon ortalama % 15,67,3 düzeyine yükseldi (p=0,001). Antrenman öncesi ve sonrası laboratuvar test sonuçları, akıma bağlı vazodilatasyon, nabız dalgalı Doppler ve doku Doppler bulguları tabloda özetlenmiştir.Bu çalışma Ç.Ü. Bilimsel Araştırma Projeleri Birimi Tarafından Desteklenmiştir. Proje No

Apical hypertrophic cardiomyopathy confused with acute coronary syndrome

Apikal hipertrofik kardiyomiyopati (ApHKMP) nadir görülen bir kardiyomiyopati türüdür. Elektrokardiyografik ve klinik bulguları nedeniyle çok seyrek de olsa koroner arter hastalığı ile karıştırılabilir. Bu yazıda başlangıçta akut koroner sendrom olarak değerlendirilen, ancak daha sonra ApHKMP tanısı konulan bir olgu sunulmaktadır.Apical hypertrophic caridiomyopathy (ApHCMP) is a rare form of cardiomyopathy. It can be misdiagnosed as coronary heart disease because of the similarity of clinical and electrocardiographic findings. We present a case with ApHCMP which confused with acute coronary syndrome

Examination of the Effect of Career Barriers and Presenteeism Behaviors on Teacher Professionalism through Structural Equation Model

The aim of this study is to reveal the effect of career barriers and presenteeism behaviors of physical education and sports teachers on teacher professionalism through a structural equation model. The hypotheses presented because of the literature review were tested with the fictional model. The sample of the study consists of a total of 411 physical education and sports teachers, who work in Ankara. As data collection tools, the Teachers’ Career Barriers Scale, the Stanford Presenteeism Scale and the Teacher Professionalism Scale were used in the research. In the analysis of the data, the theoretically created model was tested through a structural equation model. Considering the findings obtained from the research, it can be stated that the participants are faced with career barriers, that they exhibit their presenteeism behaviors at a reasonable level, and that the professionalism level is above average. On the other hand, it was concluded that male participants encountered more career barriers and displayed more presenteeism behavior, while female participants had a higher professionalism level than that of male participants. In addition, it was determined that administrative barriers affect teacher professionalism, while presenteeism behaviors do not have an impact on professionalism level

Gene-Gene Interaction of ACE I/D, Endothelial Nitric Oxide Synthase 4 a/b and ApoE does not Affect Coronary Artery Disease Severity

Objectives. Previous studies have shown the impact of angiotensin converting enzyme (ACE) insertion/deletion (I/D), endothelial nitric oxide synthase (eNOS) polymorphisms and ApoE genotypes on coronary artery disease (CAD). The aim of this study is to investigate the relationship between the genetic polymorphisms and the severity of CAD and to evaluate their potential interactions. Material and Methods. All patients underwent coronary angiography; coronary score (CS) and severity score (SS) were calculated for them. ACE I/D, eNOS and ApoE polymorphisms were detected by polymerase chain reaction (PCR). Results. Neither CS nor SS showed a direct relationship with eNOS and ApoE genotypes. CS and SS were found to be high in patients carrying the ACE DD allele (p = 0.034 and p = 0.009). In the gene interactions, there was an increase in the SS only in patients with coexisting eNOS b/b genotype and ACE DD allele (p = 0.043). Conclusions. The interactions of the gene polymorphisms investigated don’t play an important role in determining an individual’s risk for the severity of CA