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Copyright of Gulhane Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gulhane Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gulhane Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In all medical and surgical interventions, the main principle is to inform the patient of possible complications, side and adverse effects of the intervention and patient's acceptance with his/her own will. However, it is impossible to obey this ethical norm in attempting cardiopulmonary resuscitation. May a legal problem arise when the goals of health care providers and the patient and family members could not be overlapped? Have expected survey and quality of life influence on resuscitative efforts? In order to discuss legal and cultural norms in our country, which is still under discussion all over the world, we tried to summarize our own opinions about the patient's autonomy, principle of futility, termination of resuscitation, who should attempt resuscitation and relations with family members during resuscitation under current guidelines and literature. [ABSTRACT FROM AUTHOR]

AIM: The aim of this study was to determine the effect of medicine knowledge on the methods applied for lowering blood pressure among patients with hypertension. METHODS: This cross-sectional study was conducted between February 1 and April 30, 2006. The sample of the study was constituted by 77 patients who had admitted to Gulhane Military Medical Academy Cardiology Outpatient Clinic with the diagnosis of hypertension. The data were collected by using a questionnaire designed by the investigators. Descriptive statistics and chi-square test were used to analyze the data. RESULTS: The mean age of the patients was 54±13 years. Of the patients, 54.5% were female and %90.9 were married. The patients' median duration of disease was 4 years and median duration of using antihypertensive drug was 4 years. Approximately 53% of the study group was educated about the antihypertensive drugs and 70.7% was educated by the physician. The methods applied for lowering blood pressure of patients were: 48.1% use of oral antihypertensive medicine; 40.2% use of traditional methods; %11.7 use of sublingual medicine. In this study, the methods used in case of blood pressure elevation was significantly associated with having been educated about the antihypertensive drugs and knowing the side effects of the drugs (χ²=16.378; p<0.001, χ²=13.467; p<0.01, respectively). CONCLUSION: The results of this study showed that the patients who had been educated about the antihypertensive drugs and their side effects were more frequently preferring to use antihypertensive drug to lower the elevated blood pressure. [ABSTRACT FROM AUTHOR]

Objective: We aimed to compare the postoperative complications in patient with acute lower extremity arterial occlusion who admitted in the late period in whom accompanying embolectomy and fasciotomy in the same session and fasciotomy following embolectomy were applied, because of development of compartment syndrome., Methods: A total of 36 patients (13 female, 23 male) with acute lower extremity arterial occlusion, who admitted to our clinic at least 12 hours after onset of symptoms were enrolled to the study and investigated retrospectively. While embolectomy was performed in all cases, the cases in which mini fasciotomy was performed after development of compartment syndrome constitute the group 1 (n=21) and the ones in whom accompanying embolectomy and closed mini fasciotomy in the same session constitute the group 2 (n=15), groups were formed randomly. Groups were compared in regard of extremity amputation, renal failure, hypoesthesia in lower extremity, paresthesia in fingers in their clinical course. In statistical analysis t test, Chi-square test and Mann Whitney U test were used for comparison of groups, and a p<0.05 was considered as significant., Results: While cardiac originating embolus was the most frequent etiologic factor, femoropopliteal artery was the most frequent involved area in both groups. Morbidity rates were 66.6% in group 1 and 13.3% in group 2 (p<0.002). Amputation below the knee was performed in two patients in group 1., Conclusion: In order to reduce the unfavorable effects of reperfusion injury, accompanying fasciotomy and embolectomy in the same session, may have an important role in decreasing the postoperative mortality rate in patients who admitted in the late stage of lower extremity acute arterial occlusions.

In all medical and surgical interventions, the main principle is to inform the patient of possible complications, side and adverse effects of the intervention and patient's acceptance with his/her own will. However, it is impossible to obey this ethical norm in attempting cardiopulmonary resuscitation. May a legal problem arise when the goals of health care providers and the patient and family members could not be overlapped? Have expected survey and quality of life influence on resuscitative efforts? In order to discuss legal and cultural norms in our country, which is still under discussion all over the world, we tried to summarize our own opinions about the patient's autonomy, principle of futility, termination of resuscitation, who should attempt resuscitation and relations with family members during resuscitation under current guidelines and literature.

Bicuspid aortic valve is the most common congenital cardiac anomaly and it may often coexist with other congenital cardiac anomalies. Its coexistence with discrete subaortic membrane, causing obstruction of the left ventricular outflow tract is very rare. A 21-year-old male patient presented with complaints of exertional dyspnea and dizziness. On transthoracic echocardiography, the parasternal short-axis view showed a bicuspid aortic valve, and parasternal long-axis color Doppler view showed a mosaic pattern in the subaortic region. A more careful examination of the parasternal long-axis views revealed a discrete subaortic membrane. Continuous-wave Doppler flow velocity obtained from the aortic valve was normal; however, a peak gradient of 30 mmHg was observed with the Valsalva maneuver. The fact that there are very few reports on this rare coexistence may be due to failure to recognize discrete subaortic membrane during echocardiographic examination.

Objectives: Metabolic syndrome (MetS) is associated with increased risk for cardiovascular events. We evaluated heart dimensions in hypertensive patients with MetS., Study Design: The study included 75 hypertensive patients (34 males, 41 females; mean age 51+/-9 years) without coronary artery disease. Patients were evaluated in two groups depending on the presence or absence of MetS. Age- and gender-matched 20 healthy subjects (9 males, 11 females; mean age 50+/-5 years) comprised the control group. The diagnosis of MetS was based on the presence of at least three of five MetS criteria. Hypertension was defined as arterial blood pressure exceeding 140/85 mmHg on three consecutive measurements or the use of antihypertensive drugs. Echocardiographic measurements included interventricular septal thickness, left ventricular internal diameter, posterior wall thickness, aortic diameter, left atrial diameter, relative wall thickness, and left ventricular mass., Results: Metabolic syndrome was present in 32 hypertensive patients (42.7%; 18 males, 14 females). The mean number of MetS criteria was 2.6+/-1.0 in the hypertensive group. Compared to the control group, patients with or without MetS exhibited significantly increased interventricular septum and posterior wall thickness, left atrial diameter, relative wall thickness, and left ventricular mass (p<0.05). The only significant difference between the two patient groups was that MetS was associated with a greater left atrial diameter (p=0.019). Left atrial diameter was correlated with the number of MetS criteria (r=0.51; p<0.001)., Conclusion: Left ventricular dimensions are not influenced by MetS. Rather than MetS, hypertension is primarily responsible for changes in left ventricular dimensions. However, left atrial enlargement is more prominent in patients with MetS, suggesting that each MetS criterion contributes to left ventricular diastolic dysfunction.

Objectives: Early diagnosis and treatment of coronary artery disease is gaining more importance because of its increasing incidence. The calculation of coronary risk score is one of the most important approaches. The aim of the study is to find out the relation between coronary risk score and vessel distribution of the coronary heart disease., Methods: The study included 49 patients (mean age = 63+/-8 years; 36 males) whose coronary disease was proven by coronary angiography. The severity of the disease is established according to the number of the vessels with >50% stenosis., Results: According to the results; age (p=0.548), gender (p=0.116), uric acid (p=0.091), and smoking (p=0.718) are not effective on diseased vessel distribution. Similarly, total coronary risk score and vessel involvement was not correlated (p=0.115). The ten year coronary risk and vessel involvement was not in good correlation, too (p=0.523). Low-density lipoprotein (LDL)-cholesterol levels were lower in patients with multiple vessel disease but the statistical significance was borderline (p=0.051). High-density lipoprotein (HDL)-cholesterol levels were lower in multiple vessel disease (p=0.004). Both LDL-cholesterol and HDL-cholesterol scores were decreasing with increased number of involved vessels (p=0.035, p=0.001). Multivariate analysis revealed that blood pressure score, and HDL cholesterol score were directly related and LDL-score were inversely related to the number of the involved vessels. The height and vessel involvement was also in good correlation (p=0.024)., Conclusion: The LDL-cholesterol, HDL-cholesterol, diastolic blood pressure and height are affective on the number of the involved vessels. The total coronary risk scores are not correlated with the severity and distribution of the disease.

Objective: The aim of the study was to determine the relation between some parameters, which can be obtained from cardiac catheterization pressure records, and coronary artery disease., Methods: The study included 65 patients, in whom coronary angiography was performed by the cardiologists of the study. The parameters could be obtained in 40 patients (59+/-6 years; 28 male), and statistical analysis included the data of these patients. From the pressure recordings, myocardial performance index (MPI), isovolumetric relaxation time (IVRT), isovolumetric contraction time (IVCT), ejection time (ET), augmentation wave amplitude (AW), augmentation wave time (AWT) and augmentation index (AI) were measured manually. Coronary artery disease was defined as the presence of any lesion, without regarding the degree of narrowing. The parameters were evaluated with respect to relation with presence of coronary artery disease (Mann-Whitney U test), relation with risk factors for atherosclerosis (Mann-Whitney U test and Chi square test) and capability of predicting coronary artery disease (area under ROC curve, AUC). Statistical significance was set at 0.05., Results: The presence of coronary artery was significantly related to AI, AWT, AW, IVCT and MPI (p<0.001 for all). The most sensitive parameters for coronary artery disease were AI (sensitivity 94%, AUC -0.846, p<0.001) and AW (sensitivity 94%, AUC -0.848, p<0.001), while the most specific one was AWT (specificity 82%, AUC -0.833, p<0.001). The MPI and IVCT were weakly related with risk factors, while IVRT had stronger relation. The parameters of augmentation wave were significantly related with high density lipoprotein cholesterol, whereas the relation with low density lipoprotein cholesterol was weak., Conclusion: The parameters, which are obtained from cardiac catheterization pressure recordings, are related with coronary artery disease. They may be useful for predicting future coronary artery disease especially in patients with normal coronary angiogram. It is useful to add these parameters into the reports of coronary angiograms.