The diagnostic value of serum copeptin levels in an acute pulmonary embolism

Background: Acute pulmonary embolism (APE) is a common disease which is associated with high mortality and morbidity. Circulating level of copeptin, which was demonstrated to be elevated in heart failure, acute myocardial infarction and pulmonary arterial hypertension, were reported to be independent predictors of poor outcome in recent studies. The aim of the present study was to investigate the clinical utility of copeptin in the diagnosis of APE. Methods: A total of 90 consecutive patients, admitted to emergency service due to acute chest pain and/or dyspnea and who underwent pulmonary computerized tomography angiography (CTA) due to suspicion of APE, were included in this prospective study. The patients diagnosed with APE were defined as APE (+) group and the remaining individuals with normal pulmonary CTA result were defined as APE (–) group. Results: Copeptin levels (7.76 ± 4.4 vs. 3.81 ± 1.34 ng/dL; p < 0.001) were higher in the APE (+) group as compared to the APE (–) group. Copeptin was significantly positively correlated with B-type natriuretic peptide (r = 0.434, p < 0.001), D-dimer (r = 0.315, p = 0.003) and troponin I (r = 0.300, p = 0.004) and inversely correlated with arterial oxygen saturations (r = –0.533, p < 0001). When the correlation of copeptin with right ventricular dysfunction parameters was investigated, it was significantly inversely correlated with the tricuspid annular plane systolic excursion (r = –0.521, p < 0.001) and positively correlated with right to left ventricle ratio (r = 0.329, p = 0.024). Copeptin (OR 1.836, 95% CI 1.171–2.878, p = 0.008) was found as a significant independent predictor of APE in a multivariate analysis, after adjusting for other risk parameters.  Conclusions: Copeptin is a promising new biomarker, which may be used to support the need for further investigations and to improve the diagnosis of patients with APE.

Fragmented QRS complexes are associated with left ventricular systolic and diastolic dysfunctions in patients with metabolic syndrome

Background: Metabolic syndrome (MetS) is found to be associated with deterioration of the left ventricular (LV) systolic and diastolic functions. One of the factors for this impairment is myocardial fibrosis. Fragmented QRS (fQRS) complexes are found to be associated with myocardial fibrosis. The aim of the study was to evaluate if the presence of fQRS on electrocardiogram (ECG) can detect pronounced impairment in the LV systolic and diastolic functions in MetS patients. Methods: The study included 111 (mean age 47 ± 9, 49.5% male) MetS patients and 96 (mean age 45 ± 9, 58.3% male) control subjects without MetS. ECG was evaluated for the presence of fQRS. Each patient underwent conventional echocardiography and tissue Doppler imaging. Results: Fragmented QRS was more common among MetS patients (26.1% vs. 14.6%, p = 0.041). MetS was associated with subclinical LV systolic and LV diastolic dysfunctions. In subgroup analyses of MetS patients, the presence of fQRS on ECG had a higher E/E’ ratio and lower E’ velocity, indicating pronounced diastolic dysfunction, as well as lower isovolumic acceleration (IVA), indicating profound subclinical LV systolic dysfunction. E/E’ ratio and IVA were independent predictors of fQRS presence in patients with MetS. Conclusions: Fragmented QRS is more common among MetS patients compared to non-MetS patients. The presence of fQRS is associated with pronounced subclinical LV systolic and diastolic dysfunctions in MetS patients

Assessment of sustained effects of levosimendan and dobutamine on left ventricular systolic functions by using novel tissue Doppler derived indices in patients with advanced heart failure

Background: Previous studies comparing levosimendan vs. dobutamine have revealed that levosimendan is better in relieving symptoms. Echocardiographic studies have been done using second measurements immediately following a dobutamine infusion or while it was still being administered. The aim of our study was assessment of sustained effects of 24 h levosimendan and dobutamine infusions on left ventricular systolic functions. Methods: A total of 61 patients with acutely decompensated heart failure with New York Heart Association (NYHA) class III or IV symptoms were randomized to receive either levosimendan or dobutamine 2:1 in an open label fashion. Before and 5 days after the initiation of infusions, functional class was assessed, N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels and left ventricular ejection fraction (LVEF), mitral inflow peak E and A wave velocity, and E/A ratios were measured; using tissue Doppler imaging, isovolumic myocardial acceleration (IVA), peak myocardial velocity during isovolumic contraction (IVV), peak systolic velocity during ejection period (Sa), early (E’) and late (A’) diastolic velocities, and E’/A’ and E/E’ ratios were measured. Results: The NYHA class improved in both groups, but improvements were prominent in the levosimendan group. NT-proBNP levels were significantly reduced in the levosimendan group. Improvements in LVEF and diastolic indices were significant in the levosimendan group. Tissue Doppler-derived systolic indices of IVV and IVA increased significantly in the levosimendan group. Conclusions: Improvements in left ventricular systolic and diastolic functions continue after a levosimendan infusion.

Evaluation of the effect of mitral stenosis severity on the left ventricular systolic function using isovolumic myocardial acceleration

Background: Isovolumic acceleration (IVA) is a new tissue Doppler parameter in the as­sessment of systolic function of both left and right ventricles. It remains unaffected with the changes in pre- and after-load within the physiological range. The aim of our study was to assess the effect of mitral stenosis degree, which is determined by echocardiography, on the left ventricular (LV) function using IVA. Methods: A total number of 62 patients with mitral stenosis (MS) and 32 healthy controls were examined. The severity of MS (mild, moderate, and severe) was determined on the basis of mitral valve area (MVA) and the mean diastolic mitral gradient findings. The peak myocardial velocities during isovolumic contraction, systole, early diastole and late diastole were measured by using tissue Doppler imaging (TDI). Results: All TDI-derived global LV basal wall systolic (peak myocardial isovolumic contra­ction velocity, peak myocardial systolic velocity and IVA), and diastolic velocities (peak early and late diastolic velocities) were significantly decreased in the patients with MS, compared to the healthy patients (p < 0.001, for all). However, IVA was not different when the degree of MS was evaluated (p = 0.114). In addition, IVA was not correlated with the MVA (r = 0.185, p = 0.150). Conclusions: Left ventricular function is impaired in patients with MS regardless of the severity of the disease.

A simplified acute kidney injury predictor following transcatheter aortic valve implantation: ACEF score

Background: Transcatheter aortic valve implantation (TAVI) is an effective, less invasive treatment alternative for symptomatic severe aortic stenosis (AS). Acute kidney injury (AKI) following TAVI is a common complication and is associated with worse outcomes. The age, creatinine, ejection fraction (ACEF) score is a simple scoring method, including only three parameters: age, creatinine, and ejection fraction (EF). The score was well established in predicting AKI after coronary interventions.Aims: We aimed to evaluate whether this simple scoring method, ACEF, may predict a development of AKI in patients who underwent TAVI.Methods: A total of 173 consecutive patients with symptomatic severe AS who underwent TAVI were included retrospectively. The primary endpoint of the study was the development of AKI. Study population was divided into two groups according to the presence of AKI. The ACEF score was calculated with the formula: age/EF + 1 (if baseline creatinine >2 mg/dl).Results: Twenty-nine patients developed AKI. The median (interquartile range) ACEF score was 1.36 (1.20–1.58). The ACEF score was found to be an independent predictor of AKI (P <0.001). The ACEF score ≥1.36 predicted AKI development with a sensitivity of 96.6% and specificity of 58.8%. Moreover, hypertension, hemoglobin levels, contrast volume, and aortic valve area (AVA) were found to be independent predictors of AKI.Conclusions: Our study revealed that the ACEF score was an independent predictor of AKI. A simple and objective score might be very useful in predicting AKI development in patients undergoing TAVI

Live Cell Imaging of Bone Marrow Stromal Cells on Nano-pitted and Polished Titanium Surfaces: A Micro-Incubator in vitro Approach

Current orthopedic implants are not conducive for optimal integration of the biomaterial with newly-formed tissue (osseointegration) inside a patient’s body. In this study, medical-rade Ti-6Al-4V was used as a substrate due to its biocompatibility and ability to facilitate cellular adhesion and proliferation. Live cell imaging was conducted on bone marrow stromal cells, genetically modified to express the green fluorescent protein (GFP), from the 24-96 hours growth period, with the first 24 hours of growth being held inside a lab-scale incubator. Periodic images were recorded on nanopitted anodized and polished Ti-6Al-4V substrates to study how substratestiffness influences adhesion and proliferation. Collected images were analyzed for mitosis, adhesion, and filopodia-stretchability using ImageJ, an image processing program. Images were enhanced in order to perform cell counts at 24, 48, 72, and 96 hours of growth. Continuous recordings were produced to account for the number of mitosis occurrences and cellular migration on each of the substrates. Based on the conducted experiments, it appears that polished Ti-6Al-4V has a higher cell adherence than “nanopitted” anodized surface and an improved rate of proliferation which may be because the cells once adhered on the nano-pitted surface have less ability to detach in-order to undergo mitosis.https://engagedscholarship.csuohio.edu/u_poster_2014/1004/thumbnail.jp

Müellifi Bilinmeyen Manzum Bir İlmihâl: Şerâʼit-i İslâm

Bu çalışmada Eski Türkiye Türkçesi dönemine ait Şerâʼit-i İslâm adlı müellifi bilinmeyen manzum bir ilmihâl değerlendirilecektir. Eski Türkiye Türkçesi döneminde telif-tercüme faaliyetlerinin başlamasıyla beraber dinî eserler Arapça ve Farsçadan tercüme yoluyla Türkçeye kazandırılmış veya dinî konuları halka öğretmek amacıyla doğrudan Türkçe eserler kaleme alınmıştır. Türkçe kaleme alınan eserler arasında temel dinî bilgileri öğretmek ve halka anlatmak için yazılan manzum ilmihâller önemli bir yer tutmaktadır. Şerâʼit-i İslâm isimli manzum ilmihâl de bu dönemde kaleme alınan eserlerden biridir. Mesnevi nazım şekliyle didaktik tarzda telif edilen bu ilmihâl, sade ve anlaşılır bir dille kaleme alınmıştır. İslam’ın şartlarının anlatıldığı Şerâʼit-i İslâm, kelime-i şehâdet, namaz, oruç, zekât ve hac fasıllarından oluşmaktadır. Eserde genel olarak kelime-i şehadet getirerek Allah’ın birliğini tasdik etmenin gerekliliği, namazın ehemmiyeti, orucun fazileti, zekâtın miktarı, haccın kimlere farz olduğu, hacda yapılması gerekenler ve benzeri konular nasihat üslubuyla ve şiirsel bir dille anlatılmıştır. Eserin toplam beyit sayısı 260’tır. İstanbul Süleymaniye Kütüphanesi, İstanbul Büyükşehir Belediyesi Atatürk Kitaplığı ve Ankara Milli Kütüphane Adnan Ötüken İl Halk Kütüphanesi’nde olmak üzere üç nüshasına ulaşılabilen eserin müellifi ve telif tarihi bilinmemektedir. Eser, dil ve imlâ bakımından Eski Türkiye Türkçesi özellikleri göstermesinin yanı sıra eserde bu dönemin söz varlığına ait birçok kelime de bulunmaktadır. Halka yönelik yazıldığı anlaşılan eserde; halk dilinde kullanılan ibâre, deyim ve kelimelerin yanı sıra Arapça ve Farsça kelime ve tamlamaların kullanıldığı görülür. Türkçeye hâkim bir şairin eliyle kaleme alındığı görülen eser, Eski Türkiye Türkçesi döneminde dinî nitelikli eserlerin Türkçe kaleme alındığını göstermesi açısından önemlidir. Makalede, Şerâʼit-i İslâm adlı manzum ilmihâlin yapısı ve muhtevası hakkında bilgi verilerek, nüshaları tanıtılmaktadır. Ayrıca eserin tenkitli metnine yer verilerek, dil ve imlâ özellikleri ile söz varlığı hakkında bilgi verilmiştir

The examination of the Kamil al-Tabir a work of Murat II period in terms of language and literature education by preparing language features, critical edition and index

Çalışmaya konu olan eser; Hubeyş et-Tiflisî’nin Farsça telif edip Anadolu Selçuklu sultanı II. Kılıcarslan’a sunduğu Kâmilü’t-Tâbir adlı tâbirnâmenin II. Murat döneminde Beylerbeyi Karaca Bey’in emriyle adı bilinmeyen bir mütercim tarafından yapılan Türkçe tercümesidir. Eski Türkiye Türkçesi özellikleri gösteren eser, bir ansiklopedik rüya tâbirleri sözlüğüdür ve tespit edilen altı nüshası mevcuttur.Çalışma beş bölümden oluşmaktadır. Birinci bölüm; problem, araştırmanın amacı ve araştırmanın önemini içeren “Giriş” bölümü, ikinci bölüm; çalışmayla ilgili “Alanyazını”, üçüncü bölüm; çalışmada izlenen usulü anlatan “Yöntem” bölümü, dördüncü bölüm; çalışmaya konu olan eserin; nüshalarının, dil incelemesinin, tenkitli metninin ve eserin açıklamalı dizininin yer aldığı “Bulgular” bölümü ve son olarak da beşinci bölüm; “Sonuç” bölümüdür.Çalışmada eserin dil incelemesi yapılmış, tenkitli metni ortaya konmuş ve eserin açıklamalı dizini hazırlanmıştır. Kâmilü’t-Tâbir Tercümesi üzerinden tâbirnâme metinlerinin dil özellikleri, söz varlığı ve Türk dili ve edebiyatı eğitimindeki yeri ve önemi belirlenmeye çalışılmıştır. Çalışmamızda kaynak metin olarak kullanılan tâbirnâmenin söz varlığı Türkiye Türkçesinin kelime hazinesine mutlaka büyük katkılar sağlayacaktır.This study covers the Turkish translation of Kamil al-Tabir, originally written in Persian by Hubeyş al-Tiflisî and presented to the Anatolian Seljuk Sultan Kılıcarslan II. The work was translated by an unknown translator commissioned by Beylerbeyi Karaca Bey during the reign of Murat II. The work, demonstrating characteristics of the Old Türkiye Turkish Language, is an encyclopedic dictionary of dream interpretations and exists in six manuscripts.The study comprises five sections. Whereas, the first section is the \"Introduction\", which presents the problem, the purpose of the research, and the importance of the research; the following sections cover the related \"Literature Review\", the \"Method\" describing the procedure followed, the \"Findings\" including the manuscripts of the work, language analysis, critical edition, and index of the work with a dictionary and \"Conclusions\", consecutively.In the study, the linguistic analysis and the critical edition of the work were conducted, and a glossary index of the work was composed. An effort was made to bring out the linguistic and stylistic features, lexicon, and significance of tabirnâme texts through the Translation of Kamil al-Tabir within the context of Turkish language and literature education. The uncovered lexicon of the tabirnâme, the source text of our study, will surely make great contributions to the vocabulary of the Modern Türkiye Turkish Language