Association between aortic stiffness and left ventricular function in inflammatory bowel disease

Background: Recent studies have reported an increased incidence of both aortic stiffness and left ventricular (LV) systolic and diastolic dysfunction in patients with inflammatory bowel disease (IBD). However, the association between aortic stiffness and the LV function has not been fully defined. We aimed to investigate the relationship between aortic stiffness and the LV function in IBD patients. Methods and Results: Seventy-two patients with IBD (56 cases of ulcerative colitis and 16 cases of Crohn’s disease) and 50 healthy controls were consecutively enrolled in this study. The LV systolic and diastolic functions were assessed using conventional echocardiographic techniques, including tissue Doppler echocardiography. The degree of aortic strain and distensibility were calculated based on the aortic diameters measured on M-mode echocardiography at the level of 3 cm above the aortic valve and the blood pressure values obtained on sphygmomanometry. There were significant differences between the IBD and control group in the degree of aortic strain and distensibility. Significant differences were also observed between the patient and control groups in the parameters of the LV systolic and diastolic functions. Moreover, aortic stiffness was found to be associated with the LV function in the patient group. Conclusions: There is a significant relationship between aortic stiffness and LV systolic and diastolic dysfunction in patients with IBD, based on the findings of this study. The parameters of aortic elasticity measured according to 2-dimensional echocardiographic methods can be beneficial for predicting early cardiovascular risk in cases of IBD. (

Impact of transcatheter aortic valve implantation on the left ventricular mass

Background: Aortic stenosis (AS) induces pressure overload of the left ventricle (LV) and results in left ventricular hypertrophy. The remodeling of the LV in patients with AS is a com­plex process including structural and functional disturbances. After aortic valve replacement, reverse remodeling of LV begins. The aim of this study was to evaluate the impact of transcatheter aortic valve ımplantation (TAVI) on LV mass (LVM) in early and mid-term follow-ups after the procedure. Methods and Results: We enrolled consecutive 75 patients who underwent successful TAVI. Transthoracic echocardiography was performed prior to TAVI and at hospital discharge, in the 1st month and 6th month of the follow-ups. The mean LV ejection fraction improved significantly after TAVI (54.2 ± 15.0% to 57.3 ± 11.7%, p < 0.001). There were no significant changes between the baseline and discharge mean LVM and LVM index values (LVMI; p = 0.1). However, LVMI decreased significantly in the 1st month of follow-up compared to baseline (123.3 ± 20.3 to 127.9 ± 21.3 g/m2, respectively, p < 0.001). Also, significant regression of LVM was observed at the 1st month of follow-up compared to baseline (228.3 ± 33.5 g vs. 236.5 ± 34.2 g, respectively, p < 0.001). Furthermore, the significant regression in both of LVM and LVMI continued at 1st and 6th months of the follow-ups (p < 0.001). Conclusions: A significant regression of LVM was observed after TAVI. These changes may have prognostic value in patients with severe AS

Immediate recovery of the left atrial and left ventricular diastolic function after transcatheter aortic valve implantation: A transesophageal echocardiography study

Background: Chronic increased afterload due to severe aortic stenosis (AS) results in com­pensatory concentric left ventricular (LV) hypertrophy and LV dysfunction. These in turn cause remodeling of the left heart. The aim of this study was to investigate the acute effect of transcatheter aortic valve implantation (TAVI) on left atrial (LA) mechanics and LV diastolic function. Methods: The study consisted of a total of 35 consecutive patients (mean age was 77.7 ± 5.0 years, 25 female) undergoing TAVI. All TAVI procedures have been performed under the transesophageal echocardiography (TEE) guidance. Before and 24 h after TAVI, all patients underwent transthoracic echocardiography (TTE) and mitral inflow velocities with pulsed-wave (PW) Doppler including early filling wave (E), late diastolic filling wave (A), and E/A ratio were obtained. LV diastolic function was also explored by pulsed tissue Doppler imaging (TDI). Early (E’) and late (A’) diastolic annular velocities, E’/A’ ratio and E/E’ ratio were obtained. In addition, during the procedure before and minutes after the valve implantation, the left atrial appendage-peak antegrade flow velocity (LAA-PAFV) was measured and recorded with TEE. Results: Compared with baseline, the mean mitral E, septal E’ and E’/A’ ratio increased significantly after TAVI. In addition, the LAA-PAFV increased significantly within minutes of TAVI (32.45 ± 10.7 cm/s vs. 47.6 ± 12.6 cm/s, p < 0.001). Conclusions: TAVI improves LV diastolic function and LA performance immediately

Impact of transcatheter aortic valve implantation in patients with reduced ejection fraction

Background: Aortic stenosis increases with age. According to guidelines, left ventricular systolic dysfunction is an indication for aortic valve replacement, even in asymptomatic patients. There is no clear data on the application of transcatheter aortic valve implantation (TAVI), which is a method showing continuous improvement in recent years, in patients with reduced ejection fraction (REF) having a poor prognosis for surgical aortic valve replacement. We therefore aimed to investigate the effect of TAVI on left ventricular ejection fraction (LVEF) and also its efficacy and safety in patients with REF. Methods and results: The study included 104 patients who underwent transfemoral TAVI in our clinic. The patients were divided into two groups: LVEF ≤ 45% (REF group, n = 28) and LVEF > 45% (preserved ejection fraction [PEF] group, n = 76). Follow-up measure­ments were performed at baseline, discharge, 1st, 6th and 12th months. No statistical difference was found between the groups with respect to complications and mortality rates. A statistically significant difference was detected in LVEF after TAVI, either in all patients (53.9 ± 14.6, 57.0 ± 11.4, 59.4 ± 8.4, 60.4 ± 6.8, 63.2 ± 3.9, respectively, at baseline, discharge, 1st, 6th and 12th months, p < 0.001) or in the groups separately. A statistically significant increase in LVEF (p < 0.001) was determined at discharge, 1st, 6th and 12th months, whereas LVEF increased in all follow-ups of the PEF group, however this elevation reached a statistical significance only at the 1st month (p = 0.04). Conclusions: Our study has shown the positive effect of TAVI on LVEF and its effective and safe applicability in patients with REF.

Ergenlerde anne baba tutumları, cinsiyet ve akademik başarının iyimserlik ile ilişkisi .

The present study aimed to investigate optimism level of adolescents’ aged between 14-18 and its relation with parenting style, gender, and academic achievement. The sample consisted of 1366 students (708 male, 645 female, and 13 missing value) who volunteered to participate in the study from Ümitköy Anatolian High School, Türk Telekom Anatolian Technical High School and 75. Yıl High School in Ankara. Life Orientation Test (Scheier & Carver, 1985) and Parental Attitude Scale (PAS; Lamborn, Mounts, Steinberg, Dornbusch, 1991) were used as the data collection instruments. The results of one way and two way ANOVA indicated that the main effect of parenting style and academic achievement on optimism level of adolescents was found significant. The results yielded that the main effect for gender, the gender and parenting style interaction effect and the academic achievement and parenting style interaction effect was not significant. Optimism levels of high achiever adolescents were found higher than low achiever adolescents’. The results revealed significant differences in optimism scores of the adolescents as a function of four parenting styles. In other words, the results of this study showed that the adolescents who perceived their parents as authoritative had a relatively higher level of optimism than those who perceived their parents as authoritarian and neglectful. Results also indicated that the adolescents who characterize their parents as permissive had a relatively higher level of optimism than those who characterize their parents as neglectful and authoritarian.M.S. - Master of Scienc

COVID-19 Pandemisinin Eğitim Düzeyine Göre Gebelik Oranlarına Etkisi

Amaç:COVİD-19pandemisinin eğitim düzeyine göre, gebe kalma oranları ve doğum şekli üzerineetkisinin değerlendirilmesi amaçlanmıştır. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Gereçler: Bu çalışma, KütahyaSağlık Bilimleri Üniversitesi Kadın Hastalıkları ve Doğum polikliniğine gebeliktanısıyla başvuran hastaların verilerinin retrospektif olarak incelenmesiyleoluşturulmuştur. Pandemi öncesindeki 6 aylık dönem ile pandemi sırasındaki 6aylık dönem; eğitim düzeyleri, gebelik oranları ve doğum şekli açısındankarşılaştırılmıştır.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Bulgular: Pandemi öncesi 6aylık periyotta 960 yeni gebelik başvurusu olmasına karşın pandemi döneminde 6aylık periyotta 541 yeni gebelik başvurusu olmuştur. Tüm eğitim düzeylerinde,pandemi öncesi döneme göre pandemi döneminde değişim olmuştur (p&lt;0.001). &nbsp;Pandemi öncesi dönemde ilkokul mezunu yenigebelik başvurusu %26.1’den pandemi döneminde bu oran artarak %40.1’eyükselmiştir. Üniversite ve üstü eğitim düzeyinde yeni gebelik oranı %16’dan%5.9’a düşmüştür. Sezaryen oranları pandemi öncesi döneme göre anlamlı olarakartmıştır (p=0.002). &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Sonuç: COVID-19pandemisinin kadınlar ve çiftler üzerinde olumsuz etkileri olmaktadır. Dahaönceki pandemilerde olduğu gibi COVID-19 pandemisinde de gebe kalma oranlarıolumsuz yönde etkilenmektedir. &nbsp;Kadınlardaeğitim düzeyi arttıkça, pandemi öncesine göre gebe kalma oranları azalmıştır. Doğum şekli açısından sezaryenile doğum pandemi öncesi %54.1 iken pandemi döneminde ise %62.3 olarak belirginşekilde artmıştır. Bu sonuçların genellenebilmesi için ülke bazında çokmerkezli araştırmalara ihtiyaç vardır.&nbsp;</p

Role of the systemic immune-inflammation index in threatened abortion patients and predicting of abortion

Purpose: Our study aimed to compare the systemic immune inflammation index (SII), one of the hematological inflammation parameters, between pregnant women diagnosed with threatened abortion (TA) and healthy pregnant women, and to evaluate the prediction of abortion in pregnant women with TA. Methods: This retrospective study compared 150 patients with TA group and 150 age- and gestational week-matched healthy pregnant women (control group). Complete blood count parameters were assessed. SII, white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), plateletcrit (PCT), platelet distribution width and monocyte to lymphocyte ratio (MLR) values were calculated. The SII value was calculated as follows: platelet count × (neutrophil/lymphocyte). Results: SII, NLR, MLR, WBC, RDW, and PCT values were significantly higher in the TA group compared to the control group (923 ± 683 vs. 579 ± 364 [p < 0.001], 3.3 ± 2.0 vs. 2.1 ± 1.1 [p < 0.001], 0.3 ± 0.1 vs. 0.2 ± 0.2 [p < 0.001], 9.84 ± 2.87 vs. 8.6 ± 1.6 [p < 0.001], 13.9 ± 1.9 vs. 14.4 ± 2.3 [p = 0.032] and 0.3 ± 0.1 vs. 0.2 ± 0.0 [p < 0.001], respectively). Using receiver operating characteristics curve analysis to predict abortion in AI patients, the highest area under the curve was found for SII (0.727 for SII and 0.666 for NLR). Conclusion: SII, NLR, MLR, RDW, and platelet to lymphocyte ratio (PLR) levels were significantly increased in patients with TA. This study supports the idea that several inflammatory pathways may play an important role in the pathogenesis of this disorder. SII may be a much better marker than NLR and PLR for predicting the inflammatory status of the disease and abortion in an ongoing pregnancy

ÇOCUKLUK ÇAĞINDA UZAMIŞ ATEŞİN PARAZİTER BİR NEDENİ: KALA-AZAR

GİRİŞ: Leishmaniazis, Phlebotominae (tatarcık sineği) cinsinin vektörlüğü ile insana bulaşan intraselüler bir protozoan olan Leishmania spp. ile meydana gelir. Burada; bu hastalık için endemik bölgeden uzamış ateş, kilo kaybı ve splenomegali ile başvuran bir olgu sunulmaktadır.OLGU: Öncesinde sağlıklı iki yaş on aylık erkek hasta, 1 aydır aralıklı olarak devam eden ateş ve tartı kaybı ile dış merkeze başvurmuş. Pansitopeni saptanması sonucunda yapılan serolojik testleri negatif ve kemik iliği örneklemesi normal raporlanan hasta şikayetinin devam etmesi nedeniyle tarafımıza yönlendirilmiş. Geliş muayenesinde 40 ℃ ateş ile yaklaşık 4 cm kadar palpabl yumuşak kıvamlı, düzgün kontürlü splenomegalisi ve 1 cm de hepatomegalisi olan hastanın; hemogramında pansitopeni ve akut faz reaktanlarında yükseklik mevcuttu. Hastadan kültür örnekleri ile birlikte viral serolojiler ve Brusella açısından tetkikler gönderildi. Ateşi devam eden hastada makrofaj aktivasyon sendromu ön tanısıyla bakılan; ferritin ve trigliserid düzeyinin yüksek, fibrinojen düzeyinin ise alt sınırda saptanması üzerinde hastanın kemik iliği aspirasyonu tekrarlandı. Kemik iliği yaymasında amastigotları görülen hastaya viseral leishmaniazis tanısı konarak 3mg/kg/gün dozunda liposomal amfoterisin B tedavisi başlandı. Tedavinin ikinci dozundan itibaren ateşi ile splenomegalisi gerileyen ve laboratuvar parametreleri tamamen normale dönen hasta şifa ile taburcu edildi.SONUÇ: Tanıda gecikme olması halinde; makrofaj aktivasyon sendromuna komplike olabilen ve mortalite riski artan bu hastalık; ülkemizin endemik bir bölge olması nedeniyle, uzamış ve odağı bulunamayan ateş, organomegali ve pansitopeni tablosunda mutlaka akla gelmelidir