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58. Coronary artery dimensions, anatomic findings, and distributions of Southern Turkey

Author

KURT, İbrahim, DÖNMEZ, Yurdaer, YILDIRIM, Abdullah, GENÇ, Ömer, ACELE, Armağan, DEMİRTAŞ, Abdullah, BULUT, Atilla, KOCA, Hasan, and ARSLAN, Ahmet

Subjects
coronary artery,diameter,distribution,quantitative coronary analysis, Medicine, Koroner arter,çap,dağılım,kantitatif koroner analiz, Tıp
Abstract

Amaç: Sol ana koroner arter (SAKA) başta olmak üzere majör koroner arterlerin çapları, yapılacak revaskülarizasyon tedavilerinin başarısı için önemli bir öngördürücüdür. Uluslararası literatüre bakıldığında çeşitli popülasyonlarda koroner arterlerin anjiyografik bulgularına dair yayınlar görülmektedir. Amacımız Türkiye’nin Doğu Akdeniz bölgesindeki bir toplulukta SAKA ve majör epikardiyal arterlerin çaplarını “Quantitative Coronary Analysis” (QCA) yazılımı ile incelemek, koroner anjiyografik bulguları ve dağılımlarını ortaya koymaktı.Gereç ve Yöntem: 2016 yılında koroner arterleri normal saptanan 1139 hasta retrospektif olarak çalışmaya alındı. Hastaların anjiyografi görüntüleri incelendi ve QCA yazılımı aracılığıyla koroner arter çapları değerlendirildi. Bulgular: Çalışma grubumuzda 528 kadın (%46,4), 611 erkek (%53,6) yer alıyordu. Ortalama yaş 57,3±11,4 yıl idi. Hipertansiyon sıklığı %46,3 (527 hasta) ve diyabetes mellitus sıklığı %12,2 idi (139 hasta). Sigara içen hasta sayısı 497 idi (%43,6). İntermedier arter 183 hastada görüldü (%16,1). Az gelişmiş sağ koroner arter 106 (%9,3), az gelişmiş sirkumfleks arter 56 (%4,9) ve az gelişmiş sol ön inen arter 1 (%0,1) hastada saptandı. Proksimal ve distal SAKA çapı ve alanı erkeklerde anlamlı olarak daha fazlaydı. Vücut yüzey alanına göre endekslendiğinde bu farkın ortadan kalktığı saptandı.Sonuç: Çalışmamız Türkiye’nin Doğu Akdeniz bölgesinde koroner arter çaplarının incelenmesine yönelik en geniş kapsamlı çalışmadır. Bulgularımız genel olarak beyaz ırk verilerine benzerdir. Çeşitli popülasyonlara ait SAKA proksimal, distal çapları, uzunluğu ve alanına ilişkin verileri içeren yayınlar ile uluslararası literatürün daha da zenginleşeceğine inanmaktayız., Objective: Major coronary artery (CA) diameters, including those of the left main coronary artery (LMCA) are important predictors of the success of revascularization therapies. In the international literature, there are some studies regarding angiographic CA findings in various populations. Our aim was to assess the LMCA and major CA diameters with Quantitative Coronary Analysis (QCA) software, and to report their distributions of East Mediterranean Turkish population. Materials and Methods: In 2016, 1139 patients who had normal CA were retrospectively included. Angiographic views were evaluated and CA diameters were measured using QCA.Results: There were 528 women (46.4%), and 611 men (53.6%) in our study group. The mean age was 57.3±11.4 years. Hypertension frequency was 46.3% (527 patients), and the frequency of diabetes mellitus was 12.2% (139 patients). There were 497 smoking patients (43.6%). The intermediate artery was seen in 183 (16.1%) patients. There were 106 (9.3%) rudimentary right CAs, 56 (4.9%) rudimentary circumflex arteries, and 1 (0.1%) rudimentary left anterior descending artery. Proximal and distal LMCA diameters and their circular areas were significantly greater in men. When coronary artery diameters were indexed to body surface area, there was no difference between genders.Conclusion: Our work is the largest scale study regarding quantification of coronary artery diameters of East Mediterranean Turkish population. Our findings are similar to those of Caucasians in general. We believe that the international literature will become richer with studies containing information regarding proximal and distal diameters, lengths, and areas of LMCA in various populations

Published
2019

68. Effect of cryoballoon ablation parameters on recurrence in patients with paroxysmal atrial fibrillation

Author

Demirtaş, Abdullah Orhan, İçen, Yahya Kemal, Dönmez, Yurdaer, Koca, Hasan, Kaypaklı, Onur, Şahin, Durmuş Yıldıray, Koç, Mevlüt, and Tayfur Ata Sökmen Tıp Fakültesi

Subjects
Cryoballoon ablation, Recurrence, Nüks, Atriyal fibrilasyon, Atrial fibrillation, Kriyobalon ablasyon
Abstract

Objective: The aim of this research was to investigate the relationship between atrial fibrillation (AF) recurrence and second generation cryoballoon ablation (CBA) procedural parameters in patients with non-valvular paroxysmal AF (PAF). Methods: A total of 131 patients with a PAF diagnosis who underwent second-generation CBA (59 male; mean age: 55.2±10.6 years) were enrolled. Recurrence was defined as the detection of AF on a 12-lead electrocardiography (ECG) recording, or an attack lasting at least 30 seconds observed on Holter ECG records. CBA procedural data and echocardiographic findings were recorded and compared. Results: After 1 year of follow-up, AF recurrence was detected in 27 patients. Patients with recurrence were older and had higher rates of hypertension and diabetes (p, Amaç: Bu çalışmada, valvüler olmayan paroksismal atriyal fibrilasyonu (PAF) olan hastalarda AF nüksü ile ikinci jenerasyon kriyobalon ablasyon (KBA) prosedürü parametreleri arasındaki ilişkiyi araştırmayı planladık. Yöntemler: İkinci jenerasyon KBA (59 erkek; ort. yaş 55.2±10.6 yıl) yapılan PAF tanısı alan 131 hasta dahil edildi. Nüks, 12 derivasyonlu elektrokardiyografide (EKG) AF görülmesiyle ya da ritim Holter kayıtlarında en az 30 saniye süren AF ataklarının saptanması olarak tanımlandı. Bazı KBA prosedür verileri ve ekokardiyografik bulgular kaydedildi ve karşılaştırıldı. Bulgular: Bir yıl sonra izlemde 27 hastada AF nüks tespit edildi. Nüksü olan hastalar daha yaşlıydı ve daha yüksek hipertansiyon ve diyabet oranları vardı (hepsi için, p

Published
2019

69. Biomechanical properties of osteoporotic rat femurs after different hormonal treatments: genistein, estradiol, and estradiol/progesterone

Author

Özkaya, Mustafa, Azboy, İbrahim, Demirtaş, Abdullah, Arslan, Arslan Kağan, Özkul, Emin, Akcan, Adnan, Tolunay, Tolga, Demir, Teyfik, Özkaya, Mustafa, Azboy, İbrahim, Demirtaş, Abdullah, Arslan, Arslan Kağan, Özkul, Emin, Akcan, Adnan, Tolunay, Tolga, and Demir, Teyfik

Abstract

Introduction: The purpose of the study is to compare the effects of genistein, estradiol, estradiol/progesterone combination on the bone mineral density and biomechanical properties of ovariectomized rats' bone. Methods: 50 female adult Sprague-Dawley rats were divided into five groups. Bilateral ovaeriectomy were performed in all groups except the sham-operated group. Groups were a sham-operated group and a control group (water was given), estradiol treated group (17-b estradiol 0.015 mg/kg per day), genistein treated group (genistein 10 mg/kg per day), and an estradiol/progesterone combination group (17-b estradiol 0.015 mg/kg plus drosperinone 0.028 mg/kg per day). The water or hormones were implemented in relevant groups for eight weeks by orogasthric catheter. The bone mineral density and biomechanical properties of the femur were analyzed. Results: Genistein, estradiol, and estradiol/progesterone groups increased bone mineral density significantly compared to the control group. In diaphysis and metaphysis bending test, all groups had higher peak load values than the control group. There were statistically significant differences between the estrogen/progesterone group and control group in diaphysis bending with regard to peak load. There were statistically significant differences between the estradiol and control groups in metaphysis bending with regard to peak load. In axial rotation test, all groups had higher peak torque values than the control groups. Conclusions: Genistein, estradiol and estrogen/progesterone combination improved the biomechanical properties of the ovariectomized rat bone. Genistein which has less side effects may be considered as an alternative in the treatment of postmenopausal osteoporosis.

Published
2019

70. Biomechanical properties of osteoporotic rat femurs after different hormonal treatments: genistein, estradiol, and estradiol/progesterone

Author

Tolunay, Tolga, Özkaya, Mustafa, Azboy, İbrahim, Demirtaş, Abdullah, Arslan, Arslan Kağan, Özkul, Emin, Demir, Teyfik, Akcan, Adnan, Tolunay, Tolga, Özkaya, Mustafa, Azboy, İbrahim, Demirtaş, Abdullah, Arslan, Arslan Kağan, Özkul, Emin, Demir, Teyfik, and Akcan, Adnan

Abstract

Introduction: The purpose of the study is to compare the effects of genistein, estradiol, estradiol/progesterone combination on the bone mineral density and biomechanical properties of ovariectomized rats' bone. Methods: 50 female adult Sprague-Dawley rats were divided into five groups. Bilateral ovaeriectomy were performed in all groups except the sham-operated group. Groups were a sham-operated group and a control group (water was given), estradiol treated group (17-b estradiol 0.015 mg/kg per day), genistein treated group (genistein 10 mg/kg per day), and an estradiol/progesterone combination group (17-b estradiol 0.015 mg/kg plus drosperinone 0.028 mg/kg per day). The water or hormones were implemented in relevant groups for eight weeks by orogasthric catheter. The bone mineral density and biomechanical properties of the femur were analyzed. Results: Genistein, estradiol, and estradiol/progesterone groups increased bone mineral density significantly compared to the control group. In diaphysis and metaphysis bending test, all groups had higher peak load values than the control group. There were statistically significant differences between the estrogen/progesterone group and control group in diaphysis bending with regard to peak load. There were statistically significant differences between the estradiol and control groups in metaphysis bending with regard to peak load. In axial rotation test, all groups had higher peak torque values than the control groups. Conclusions: Genistein, estradiol and estrogen/progesterone combination improved the biomechanical properties of the ovariectomized rat bone. Genistein which has less side effects may be considered as an alternative in the treatment of postmenopausal osteoporosis.

Published
2019

72. Yabancı cisim batmalarına ortopedik yaklaşım

Author

Alemdar, Celil, Demirtaş, Abdullah, Gem, Mehmet, Özkul, Emin, Azboy, İbrahim, Bulut, Mehmet, Ancar, Cahit, Dicle Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Ortopedi ve Travmatoloji Ana Bilim Dalı, Alemdar, Celil, Demirtaş, Abdullah, Gem, Mehmet, Özkul, Emin, Azboy, İbrahim, Bulut, Mehmet, and Ancar, Cahit

Subjects
Yaralanma, Foreign body, extremity, Localization, Ekstremite, Medicine, Injury, Yabancı cisim, Lokalizasyon, Extremity, localization
Abstract

Objective: Although foreign body injuries are quite common, there are an insufficient number of publications on this matter. The aim of this study was to evaluate patients with foreign body injuries, and to determine the treatment algorithm. Methods: A total of 97 patients were evaluated, including 53 men and 44 women. Ninety-one patients underwent surgery, and six patients were treated conservatively. Surgery was performed in the operating room in all cases. To ensure that the foreign body was removed, fluoroscopic control was completed during and after the procedure. Antibiotics were administered routinely to all patients, and the need for tetanus prophylaxis was evaluated in each patient. Results: The mean age of the patients was 16.5 (range: 2-58) years. Regarding the type of foreign body, there was injury due to: a needle in 65 patients, glass in 14, wood in 7, iron spit in 1, iron bar in 1, pieces of metal in 3, and other foreign bodies were found in 6 patients. There were 25 injuries of the upper extremity, and 72 of the lower extremity. The time of admission to the hospital after the injury ranged from 1 day to 3 years. Obvious signs of infection were detected in 10 patients. There were no complications after the follow-up of patients who were treated conservatively. Conclusion: Foreign body penetration is a severe injury that may cause significant problems when ignored. Treatment algorithms prepared according to the type of injury would guide the most appropriate approach to these injuries. J Clin Exp Invest 2013; 4 (4): 443-448. Amaç: Toplumda çok sık görülmesine rağmen, ortopedik sahayı ilgilendiren yabancı cisim batmaları literatürde yeteri kadar yer bulmamıştır. Çalışmamızın amacı yabancı cisim batması nedeni ile takip ettiğimiz hastaları değerlendirmek ve tedavi yaklaşımı ortaya koymaktır. Yöntemler: 53 erkek, 44 kadın olmak üzere toplam 97 hasta değerlendirildi. Hastaların 91’ine cerrahi, 6’sına konservatif tedavi uygulandı. Cerrahi girişimlerin tamamı ameliyathane şartlarında gerçekleştirildi. Operasyon sırasında ve sonrasında skopi kontrolü yapılarak yabancı cisim ya da cisimlerin çıkarıldığından emin olundu. Rutin olarak antibiyotik uygulanan hastalar tetanoz profilaksisi açısından da değerlendirildi. Bulgular: Hastaların ortalama yaşı 16,5 (dağılım; 2-58) YIL idi. Hastaların 65’inde iğne, 14’ünde cam, 7’sinde tahta, 1’inde şiş, 1’inde demir çubuk, 3’ünde metal parçası ve 6’sında diğer yabancı cisimler tespit edildi. Yaralanmaların 25’i üst ekstremitede, 72’si ise alt ekstremitede idi. Yaralanma sonrası hastaneye başvuru süresi 1 gün-3 yıl arasında değişmekteydi. Toplam 10 hastada belirgin enfeksiyon bulguları tespit edildi. Konservatif kalınan hastaların sonraki takiplerinde komplikasyon görülmedi. Sonuç: Yabancı cisim batmaları, dikkatli değerlendirilmediğinde önemli sorunlara yol açabilen ciddi yaralanmalardır. Yaralanmanın tipine göre hazırlanan tedavi şemaları en uygun yaklaşımı belirlemede yol gösterici olacaktır.

Published
2013

93. Appropriate Use of Aspirin in Real-Life Cardiology Practice: Results from the The Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study (ASSOS) Study.

Author

Çelik, Oğuzhan, Çil, Cem, Başaran, Özcan, Demirci, Erkan, Ozan Tanık, Veysel, Altuntaş, Emine, Memiç Sancar, Kadriye, Örsçelik, Özcan, Yetim, Mücahit, Bekar, Lütfü, Karaarslan, Osman, Özlek, Bülent, Özlek, Eda, Gökçek, Aysel, Doğan, Tolga, Murat Resulzade, Mubariz, Kaya, Çağlar, Küçük, Emrah, Kırış, Tuncay, and Orhan Demirtaş, Abdullah

Subjects
OUTPATIENTS, CARDIOLOGY, RESEARCH, HYPERTENSION, CONFIDENCE intervals, CROSS-sectional method, MULTIVARIATE analysis, AGE distribution, MEDICAL cooperation, DIABETES, ANTICOAGULANTS, INAPPROPRIATE prescribing (Medicine), ASPIRIN, DRUG prescribing, DRUG utilization, PHYSICIAN practice patterns, MEDICAL practice, ODDS ratio, LOGISTIC regression analysis, SMOKING, HEART failure
Abstract

Background: Indications and appropriateness of aspirin use have not been well investigated in Turkey. Aims: To investigate the prescription patterns and appropriateness of aspirin in a real-world clinical setting. Study Design: Cross-sectional study. Methods: The Appropriateness of Aspirin Use in Medical Outpatients: A Multicenter, Observational Study (ASSOS) is a cross-sectional and multicenter study that included 5007 consecutive patients aged 18 or over who presented to 30 different cardiology outpatient clinics from 14 cities throughout Turkey. Only patients using aspirin (80-325 mg) were included. The study population was divided into 2 groups regarding the use of aspirin: primary prevention (PP) group and secondary prevention (SP) group. The indication of aspirin use was evaluated following the 2016 European Society of Cardiology (ESC) and the 2016 United States Preventative Services Task Force (USPTF) guidelines in the PP group. Results: A total of 5007 patients (mean age 62.15 ± 11.05, 39% female) were enrolled. The PP group included 1132 (22.6%) patients, and the SP group included 3875 (77.4%) patients. Of the 1132 patients, inappropriate use of aspirin was determined in 100% of the patients according to the ESC guidelines, and 71% of the patients according to the USPTF guidelines. Multivariate logistic regression analysis showed age OR: 0.98 CI (0.97-0.99) P = .037, smoking OR: 0.60 CI (0.44-0.82) P = .001, heart failure OR: 2.11 CI (1.14-3.92) P = .017, hypertension OR: 0.51 CI (0.36-0.74) P < .001, diabetes mellitus OR: 0.34 CI (0.25-0.47) P < .001, oral anticoagulant use OR: 3.01 CI (1.10-8.25) P = .032, and female sex OR: 2.73 CI (1.96-3.80) P < .001 were independent predictors of inappropriate aspirin use in PP patients. Conclusion: Although there are considerable differences between the USPTF and the ESC guidelines with respect to recommendations for aspirin use in PP, inappropriate use of aspirin in Turkey is frequent in real-world practice for both guidelines. Besides, heart failure, oral anticoagulant use, and the female sex of the patients were independent predictors of inappropriate use of aspirin. INSET: 183. [ABSTRACT FROM AUTHOR]

Published
2021
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94. Intravesical Mitomycin-C with Bladder Wall Hyperthermia in Intermediate and High-risk Non-muscle Invasive Bladder Cancers: Prospective Clinical Trial with a Single-treatment Arm.

Author

Demirtaş, Abdullah, Tombul, Şevket Tolga, Sönmez, Gökhan, Demirleğen, Akın, Demirtaş, Türev, and Tatlışen, Atila

Subjects
*BLADDER, *CANCER chemotherapy, *CANCER relapse, *CLINICAL trials, *LONGITUDINAL method, *SURVIVAL, *THERMOTHERAPY, *INTRAVESICAL administration, *ADVERSE health care events, *DESCRIPTIVE statistics, *MITOMYCINS, BLADDER tumors
Abstract

Objective: Bacillus Calmette-Guérin (BCG) limited availability, cost, and allergic response in some patients limit its use, leading to the search for alternative agents. We aimed to present the outcomes of intermediate- and high-risk non-muscle invasive bladder cancers treated with bladder wall thermochemotherapy (BWT) system via a single-arm prospective study. Materials and Methods: Overall, 44 patients were enrolled and subjected to a treatment with mitomycin-C and BWT for 6 weeks, followed by a monthly maintenance for up to 1 year. The recurrence rate, progression rate, recurrence-free survival, progression-free survival, and side effects were evaluated. Results: In the intermediate- and high-risk groups, the median follow-up duration was 14 and 17 months; recurrence rates were 28.6% and 23.3%; progression rates were 7.1% and 23.3%; the recurrence free survival at the 24th month were 78.6% and 80.0% and the progression free survival at the 24th month were 92.6% and 76.7%, respectively. All the patients suffered from dysuria lasting for 2-3 days; five of the 442 BWT application developed allergic reactions requiring treatments with oral agents. Conclusion: BWT showed comparable recurrence and progression rates, but seemed safer than BCG when our findings were compared to those of published studies. It could be an alternative for individuals who are not suitable for BCG or in a case of BCG unavailability. [ABSTRACT FROM AUTHOR]

Published
2020
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100. ICD İmplantasyonu Sonrası Görülen Nadir Komplikasyon: Cilt Nekrozu

Author

DEMİRTAŞ, Abdullah Orhan, Avcı, Eyup, and AKGÜN, Didar Elif

Subjects
ICD,komplikasyon, Medicine, ICD,complication, Tıp
Abstract

The beneficial effects of the implantable cardioverter defibrillator (ICD) on the primary and secondary prevention and on the long term mortality are well documented. Skin necrosis is a very rare complication of ICD implantation, which is a very frequent procedure in our routine practice., Primer ve sekonder profilaksi açısından implante edilebilir kardiyoverter defibrilatör (ICD)’ ün birçok çalışmada uzun dönemde mortalite açısından faydalı olduğu gösterilmiştir. Rutin pratiğimizde sıkça uygulanan ICD implantasyonu sonrası görülen cilt nekrozu nadir bir komplikasyondur.

Published
2017

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