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Objective: Comparison of anterior segment parameters, anterior/posterior keratometry, and corneal astigmatism values ​​in preadolescent children and middle-aged adults. Material and Methods: Right eye measurements from a total of 100 subjects (50 children and 50 adults) were included in the study. Central corneal thickness (CCT), aqueous depth (AD), anterior camera volume (ACV), iridocorneal angle (ICA), anterior/posterior keratometry (ant.K/post.K) values, ​​and corneal astigmatism (Cast.) values ​​were recorded. The groups were compared between themselves, and they were compared in terms of sex within each group. Results: The mean age of the children was 7.82±1.45 and the mean age of the adults was 53.84±6.81. There were significant differences between the groups in terms of age and CCT, AD, ACV, ICA, anterior corneal astigmatism (ant.Cast.), and posterior vertical K (post.K2) values. There were significant differences in AD and ICA between males and females among the children (p=0.036, p=0.005, respectively). There were also significant differences in ACV and ICA between males and females among the adults (p=0.012, p=0.006, respectively). In the correlation analysis, CCT, AD, ACV, ICA, and post.K2 were negatively correlated with age, while ant.Cast. was positively correlated. Conclusion: In our study, CCT and anterior segment parameters were significantly lower in adults. This situation was more evident in women. It is useful to consider these differences in the diagnosis and follow-up of corneal diseases, in deciding on refractive surgery, and in determining the type of surgery, as well as in the diagnosis and follow-up of glaucoma.

In this study, we aimed to evaluate the effect of monocyte/high-density lipoprotein (MHR), which is associated with systemic inflammation: on prolonged hospitalization in patients with mild acute pancreatitis. Patients hospitalized for acute edematous pancreatitis between 01.01.2021 and 31.12.2021 were retrospectively screened. Arrival Ranson scores of the patients were calculated. Those with a Ranson score

Introduction: Endovascular interventions have been increasingly used for the treatment of patients suffering from below-the-knee (BTK) ischemic lesions. Yet, there is a paucity of data regarding long-term adverse events in patients with critical limb ischemia (CLI) undergoing endovascular revascularization for BTK lesions. Recently introduced systemic immune-inflammation index (SII) is a reliable indicator of poor outcomes in various cardiovascular conditions. Herein, we aimed to investigate the prognostic role of the SII on mortality in patients with CLI undergoing endovascular revascularization for BTK lesions. Patients and Methods: The records of 112 patients with symptomatic CLI undergoing endovascular revascularization for BTK lesions between January 2015 and December 2019 were analyzed. Patients were divided into groups with low and high SII values based on an SII cut-off value derived from a ROC analysis. For each group, procedural details and follow-up outcomes were analyzed. Results: The mean follow-up time was 40.3 ± 19.9 months. According to our data, patients with high SII values had higher rates of mortality compared to patients with low SII values (65.2% vs 30.3%, p< 0.001). To determine the SII cut-off value for predicting mortality, the ROC curve was drawn, and the best cut-off value was determined as 966 by using the Youden index, (AUC= 0.658, 95% CI= 0.556-0.760, p= 0.004). Cox multivariate regression analysis also identified the SII score as an independent predictor of mortality. Conclusion: SII is an independent predictor of mortality, especially among patients with CLI who underwent endovascular revascularization for BTK lesions.

Aim: This work was designed to explore the role of the triglyceride-glucose (TyG) index in the prediction of long-term mortality in patients with lower extremity artery disease (LEAD) undergoing endovascular revascularization. Methods: The records of 723 patients with symptomatic LEAD undergoing endovascular revascularization between January 2016 and December 2021, with long-term follow-up until December 2021, were analyzed. Results: The rate of long-term mortality was significantly higher among patients with high TyG index than patients with low TyG index. Conclusion: The TyG index is an independent predictor of long-term mortality in patients with LEAD undergoing endovascular revascularization.

Transcatheter aortic valve implantation (TAVI) is a less invasive and safe therapeutic alternative in patients who are at very high surgical risk or in whom there are contraindications to open surgery. On the other hand, allocating transcatheter therapy to the adequate candidates and identifying a reliable and validated risk stratification tool for mortality prediction is still lacking. The C-reactive (CRP) to albumin ratio (CAR) is a novel inflammation-based prognostic tool and it is strongly associated with inflammation severity and mortality. In this study, we aimed to elucidate the predictive significance of CAR for mortality in patients who underwent TAVI.The records of 321 consecutive patients who underwent TAVI due to symptomatic aortic stenosis between 1 January 2015 and 31 December 2020 were analysed. Patients were divided into two groups based on the CAR values. For each group, all-cause, cardiovascular, and non-cardiovascular mortality occurring72 h after the index procedure and at maximum follow-up was documented.The mean follow-up time was 40 (22-63) months. A total of 180 (56.1%) patients died during long-term follow-up. According to our study, median CAR values were significantly higher among patients who died during follow-ups compared to survivors [1.13 (0.69-2.21) vs 3.56 (1.53-10.00),Our data showed that CAR is an independent predictor of long-term mortality in patients undergoing TAVI due to symptomatic aortic stenosis.

In this study, we aimed to investigate the prognostic value of C-reactive protein (CRP) to albumin ratio (CAR) for predicting restenosis in superficial femoral artery (SFA) lesions and its association with subsequent clinical outcomes in patients undergoing endovascular intervention.The records of 685 consecutive patients who underwent endovascular intervention due to symptomatic peripheral artery disease were analyzed. Patients were divided into 2 groups, based on the CAR values. For each group, technical aspects of procedures and subsequent clinical outcomes were analyzed.According to our study, patients with high CAR values had higher rates of restenosis (30.2% vs. 10.3%, P 0.05) and mortality (31.3% vs. 12.9%, P 0.05). The rate of lower extremity amputations was also significantly higher in patients with high CAR values compared to those with low CAR values (9.1% vs. 3%, P 0.05). With respect to Receiver operating characteristic ROC curves of inflammatory markers, the area under the curve (AUC) value of CAR was statistically significant (AUC: 0.659; 95% confidence interval CI: 0.611-0.706; P 0.01).Our data showed that CAR is an independent predictor of restenosis and poor clinical outcomes in patients undergoing endovascular intervention.

IntroductionSodium-glucose co-transporter 2 (SGLT-2) inhibitors have been shown to reduce the risk of atrial fibrillation (AF) occurrence in patients with diabetes mellitus (DM). In this prospective study, we aimed to analyze the effect of SGLT-2 inhibitors as an add-on therapy to metformin on P wave indices and atrial electromechanics in patients with type 2 DM. MethodsA total of 144 patients enrolled. Electrocardiographic indices were recorded on admission and at 3rd and 6th month of the combination therapy. P wave indices and atrial electromechanical coupling intervals were measured and compared. ResultsAlthough decrease in P wave dispersion (62.78 +/- 9.59 vs. 53.62 +/- 10.65; p = .002) became significant at 6th month of combination therapy, significant decreases in P wave terminal force in V-1 (37.79 +/- 3.45 vs. 32.01 +/- 5.74; p = .035), left atrial volume index (35.87 +/- 6.57 vs. 31.33 +/- 7.31; p = .042), left sided intra-atrial electromechanical delay (32.09 +/- 9.17 vs. 27.61 +/- 8.50; p = .016), right sided intra-atrial electromechanical delay (31.82 +/- 4.92 vs. 27.65 +/- 8.05; p = .042), and interatrial electromechanical delay (29.65 +/- 7.52 vs. 25.96 +/- 4.30; p = .044) were seen as early as 3rd month of treatment. Besides, there was no statistically significant difference between Empagliflozin and Dapagliflozin subgroups in terms of mentioned parameters. ConclusionSGLT-2 inhibitors as an add-on therapy to metformin were shown to significantly improve P wave indices and atrial electromechanics in type 2 DM patients as early as the 3rd month of treatment. It was thought that this may be one of the underlying mechanisms of the decrease in the frequency of AF with the use of SGLT2 inhibitors.

Cardiovascular complications, including ventricular arrhythmias associated with abnormalities of ventricular repolarization, are the leading cause of morbidity and mortality in patients with acromegaly. Herein, we aimed to investigate ventricular repolarization using Tp-e interval, Tp-e interval/QT, and Tp-e interval/QTc ratios in acromegalic patients compared to healthy subjects.A total of 29 patients (aged 51.9 ± 11.2, 65.5% women) with acromegaly and 30 control subjects (aged 47.3 ± 14.4, 63.3% women) were enrolled in the study. Tp-e and QT interval, corrected QT (QTc), Tp-e/QT, and Tp-e/QTc ratios were calculated from the 12-lead electrocardiogram.Tp-e interval (89.28 ± 12.16 vs. 75.97 ± 9.92 ms; p0.001), Tp-e/QT ratio (0.237 ± 0.045 vs. 0.212 ± 0.029; p = 0.019), and Tp-e/ QTc ratio (0.218 ± 0.031 vs. 0.195 ± 0.026; p = 0.003) were significantly higher in patients with acromegaly compared to control group. A positive correlation was determined between left atrial volume index (LAVI) and Tp-e interval (r = 0.272, p = 0.039).The current study is the first to have shown significantly increased Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were increased in acromegalic patients. These results may be important for screening malignant arrhythmic events in acromegaly.

Purpose: Atrial fibrillation (AF) is commonly seen in patients with hypertrophic cardiomyopathy (HCM) and is associated with left atrial enlargement, fibrosis and diastolic dysfunction. Cardiac magnetic resonance (CMR) imaging provides important information about the geometric pattern of hypertrophy that may related to worse clinical outcomes such as arrhythmic events. The purpose of this study was to determine whether helical pattern is associated with increased risk for AF and diastolic dysfunction in patients with HCM. Methods: A total of 50 consecutive patients with HCM referred for CMR imaging were enrolled into the study. The helical pattern was evaluated by measurement of the maximal left ventricle wall thickness (LVWT) for each of the 17 classical LV segments. Results: A spiral pattern was observed in 20 patients (40%). We found significantly higher incidence of AF in patients who detected helical distribution than in those who did not (40% vs. 10%, p = 0.012). Left atrial volume index (LAVI) was also higher in patients with helical pattern compared to non-helical pattern (32.5 mL/m2 ± 16.9 vs. 23.7 mL/m2 ± 5.8; p < 0.001). Conclusion: Our study suggests that presence of helical pattern is associated with significantly increased risk of development AF and LAVI in HCM patients.

Ercan Kurtipek,1 Mehmet Mermer,1 Bilgenur Y&inodot;ld&inodot;r&inodot;m,1 Mehmet Akif Yazar,2 Mustafa Duran,3 Faysal Duksal4 1Department of Chest Diseases, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey; 2Department of Anesthesiology and Reanimation, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey; 3Department of Cardiology, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey; 4Department of Chest Diseases, University of Health Sciences, Konya Beyhekim Training and Research Hospital, Selcuklu, Konya, TurkeyCorrespondence: Ercan Kurtipek, Department of Chest Diseases, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey, Email kurtipek14@hotmail.comObjective: Extensive research has been conducted to identify the predictive criteria for COVID-19 disease. White blood cell, C-reactive protein, CRP/albumin ratio, neutrophil-to-lymphocyte ratio and ferritin are among the indicators of increased inflammatory response; hence, they could be used to determine the prognosis of COVID-19 cases. Within the scope of this study, we aimed to elucidate the predictivity of NLR, CAR and other laboratory parameters on the duration of hospital stay and mortality in patients with COVID-19.Materials and Method: The data of 1516 COVID-19 patients who were hospitalized in our institution have been analyzed retrospectively. Patients were divided into two groups those who deceased within the first 10 days of hospitalization (Group I, ≤ 10 days) and those who deceased in the later period (Group II, > 10 days). Age, gender, time to mortality after hospitalization, neutrophil count, CRP, neutrophil-to-lymphocyte ratio (NLR), CRP/albumin ratio (CAR), and d-dimer values were obtained from blood samples taken during hospitalization.Results: NLR and CAR values were significantly higher in those who died in the first 10 days compared to the other group (p< 0.02 and p< 0.001, respectively). In addition, WBC, neutrophil, CRP and d-dimer levels were statistically significantly higher than the other group (p< 0.05). Logistic regression analysis results for NLR and CAR were significant. The cut-off values were calculated (5.74 and 4.27, respectively) for both parameters. Among the most common comorbid diseases were hypertension (HT) in 41%, coronary artery disease (CAD) in 41.7%, asthma-chronic obstructive pulmonary disease (COPD) in 36.7%, diabetes mellitus (DM) in 36.1%.Conclusion: NLR and CAR may have a decisive influence in determining the length of stay in hospital for patients who die in hospital due to COVID-19. In addition, it is recommended that COVID-19 cases with diabetes be followed closely.Keywords: COVID-19, neutrophil-to-lymphocyte ratio, CRP/albumin ratio, hospital mortality, predictive value

Objective: One of the well-known prolonged effects of coronavirus disease 2019 (COVID-19) is the gradual loss of pulmonary functions, known as ‘long COVID’. Due to the importance of this deleterious condition, several studies have been conducted to investigate predictors of long COVID throughout hospital admission and after hospital discharge. Recently introduced, the atherogenic index of plasma (AIP) has a better predictive value for the prediction of adverse events in COVID-19 patients compared to other biomarkers. This study aimed to explore the role of AIP in the prediction of long COVID among COVID-19 survivors. Material and Methods: We evaluated 52 eligible patients with a diagnosis of long COVID and 80 healthy control subjects with a prior history of COVID-19. To confirm long COVID diagnosis, all subjects underwent a standardized questionnaire which recount the presence or absence of COVID-19-related complaints. All participants’ past medical records and clinical, and demographic characteristics were scanned and underwent comprehensive physical examination and echocardiographic assessment Results: According to our study, body surface area, Troponin T, NT-pro-BNP, and AIP were the independent predictors of long COVID. AIP was the best predictor of long COVID among the aforementioned parameters (p=0.005). To determine the AIP cut-off value for predicting long COVID, the receiver operating characteristic (ROC) curve was drawn and the best cut-off value was determined as 0.113 by using the Youden index, (AUC:0.658, 95% CI:0.556-0.760, P=0.002). Conclusion: Our data indicate that AIP is an independent predictor of long COVID.

Amaç: Sol ventrikül apikal trombüsü (LVAT), akut miyokard enfarktüsü sonrası hastalarda artmış morbidite ve mortalite ile ilişkilidir. Bu çalışmada sol ventrikül apikal trombozu ile CHA2DS2-VASc skorlama sistemi arasındaki ilişkiyi değerlendirmek amaçlandı.Materyal ve Metot: Bu çalışmaya Ocak 2010 ile Ocak 2020 arasında kliniğimizde takip edilen 456 (LVAT'li 146, kontrol grubu ile benzer demografik özelliklere sahip ventriküler trombozu olmayan 300) hasta dahil edildi.Bulgular: Tüm çalışma popülasyonunda tanı sırasında ortalama CHA2DS2-VASc skoru 3,05±1,34 olarak hesaplandı ve CHA2DS2-VASc skoru LVAT'de istatistiksel olarak daha yüksekti (p= 0,029). LVAT grubunda CHA2DS2-VASc skoru 2'nin üzerinde olan hasta sayısı %79 iken kontrol grubunda %55 idi (p, Objective: Left ventricular apical thrombus (LVAT) is associated with increased morbidity and mortality in patients after acute myocardial infarction. In this study, it was aimed to evaluate the relationship between the left ventricle apical thrombosis and the CHA2DS2-VASc scoring system.Materials and Methods: A total of 456 patients (146 with LVAT, 300 without ventricular thrombosis with demographic characteristics similar to the control group) followed in our clinic between January 2010 and January 2020 were included in this study.Results: The mean CHA2DS2-VASc score was calculated as 3.05±1.34 in the whole study population during diagnosis and CHA2DS2-VASc score was higher statistical significance in the LVAT (p= 0.029). While the number of patients with CHA2DS2-VASc score above 2 in the LVAT group was 79%, it was 55% in the control group (p

PurposeThis study aimed to identify the main and emerging structural patterns in the growth of the literature on probiotic research in food science, analyze current trends and determine gaps and present future projections.Design/methodology/approachA total of 1,301 scientific documents retrieved from Scopus database dated from 1993 to 2021 were analyzed by using bibliometric and scientometric tools.FindingsThe most influencer journals, leading countries and hotspots were identified by scientometric mapping. “Lactic acid bacteria”, “lactobacillus”, “lactobacillus plantarum”, “viability”, “functional foods” and “microencapsulation” were the top keywords that indicate main emerging areas. After a clear understanding of the current situation, future directions can be better projected. Therefore, investigating new probiotic microorganisms with advanced health promoting properties, adapting the new organisms to various food formulations, identifying the probiotic potential of unexplored traditional fermented foods and developing of nondairy probiotic foods can be the studies of the future.Research limitations/implicationsProbiotic concept has been revised during years and valuable knowledge has been accumulated over past decades. The findings demonstrate the development and trends of probiotic related food science researches. This is the first study to address the limitations of prior systematic literature reviews by applying network analysis and guide future works to fill the identified gaps.Originality/valueThe probiotic concept has been revised for years and valuable knowledge has been accumulated. Within the expanding literature, scientometric and bibliometric analysis will provide valuable contribution for identifying the main patterns, analyzing current trends, determining gaps and presenting future projection. This work presents detailed analysis to determine tendencies in probiotic research in food science.

Aerobic exercise training after stroke has positive effects on quality of life, motor recovery, and aerobic endurance. The aim of this study was to investigate the effectiveness of anti-gravity treadmill gait training and underwater walking therapy on cardiorespiratory fitness, gait and balance in stroke survivors.The study included 39 patients with a history of stroke who were admitted to our center between July 2017 and January 2018. The patients were randomly assigned to anti-gravity treadmill training, underwater walking therapy, or a control group. The aerobic capacity of the participants was evaluated with the 6-min walk test and cycle ergometer testing before and after the treatment. Balance was examined using the Berg Balance Scale (BBS).There was a statistically significant increase from pre- to post-treatment with regard to maximum heart rate and length of walking distance during 6-min walk test parameters in patients who underwent anti-gravity treadmill training (p 0.05). The cycle ergometer training results showed significant improvements compared to baseline after treatment in patients who underwent anti-gravity training in terms of maximum heart rate attained during exercise stress testing, time to complete the test, rates of metabolic equivalents of task scores and peak oxygen consumption (p 0.05). Improvements were also observed in ventricular repolarization indices including corrected QT intervals (QTc), Tp-e interval and Tp-e/QT, Tp-e/QTc ratio in the anti-gravity group (p 0.05). BBS results showed no statistically significant difference in all groups (p 0.05).The data of this study showed that anti-gravity treadmill training has favorable effects on cardiorespiratory fitness in stroke survivors.

Background: Percutaneous mitral balloon valvuloplasty (PMBV) has been established as an effective and safe treatment modality for symptomatic patients with severe rheumatic mitral stenosis. While Wilkin Score (WS) ≤ 8 are associated with higher rates of procedural success and lower rates of restenosis, higher WS are associated with lower rates of procedural success and higher rates of restenosis. It is well known that platelets have substantial role in thromboembolic complications of rheumatic mitral stenosis and various studies showed that increased platelet (PLT) activity in rheumatic mitral stenosis. The aim of this study was to assess the usefulness of PLT indices as a predictor of restenosis in patients who underwent PMBV. Methods: We retrospectively enrolled 178 consecutive patients who underwent PMBV. Patients were classified into the two groups. Study group (n=21) included patients whom we performed redo PMBV during their follow-up as a result of mitral restenosis following previous PMBV (index procedure) and control group (n=157) included patients whom did not undergo a redo PMBV. PLT indices including PLT count, Platelecrit and mean platelet volume values were evaluated in these groups. Results: In study group, PLT count (210 ± 49 vs. 241 ± 62, p=0.010), PCT [0.203 (0.173-0.230) vs. 0.260 (0.243-0.290), p

Objectives Although percutaneous coronary interventions become a common treatment modality for coronary artery diseases, lesion localization make these procedures more complex. As the lesion localizes near to the bifurcation site, more complex PCI procedures, overqualified equipments are needed and complication risk increases. Previous studies have demonstrated the strong correlation between wide angulation and significant coronary stenosis. However, a paucity of data exists about the association between bifurcation angle and lesion localization distance. In this study we analysed the effect of coronary bifurcation angle and left main coronary artery length on the atherosclerotic lesion localization. Methods Patients, who underwent coronary angiography between 01.01.2017- 31.12.2019 were scanned. Patients having atherosclerotic lesions causing more than 50% luminal narrowing and Medina classification score (0,0,0) were evaluated. After exclusion, 467 patients were included. 5 bifurcation subgroups (LAD-CX, LAD-Dx, CX-OM, RCA-RV, RPD-RPL) were formed. Distance of lesion to the bifurcation site, bifurcation angle and left main coronary artery length were analysed by 2 experienced cardiologists with invasive quantitaive coronary angiography (QCA) by using "extreme angio and cardiac pacs" software system. Results There was a strong inverse correlation between bifurcation angle and lesion localization distance to the bifurcation site (r = -0.706; p < 0.0001). There was a nonsignificant negative correlation between Left-main coronary artery length and lesion localization. Regression analysis revealed that bifurcation angle is an independent risk factor for predicting the localization of an atheroslerotic lesion in 5 mm length from the point of bifurcation site (β = -0.074, p < 0.0001). A cut-off value of 80.5° coronary bifurcation angle was found to have 84.1% sensitivity and 81.3% specificity in prediction of atherosclerotic lesion localization in 5 mm length from the point of bifurcation site. Conclusion In this study we showed that as the bifurcation angle increases, atherosclerotic lesions tend to approach to the bifurcation site. Since invertentions encompassing bifurcation sites are more complex, lesions with increased angulation may need extra care as they are more likely to present with further complications. Furthermore, bifurcation angle is an independent risk factor for lesion localization.

Background: Proper clinical use of blood and blood products requires competent theoretical and practical knowledge of transfusion medicine. The Curriculum Development and Standard Determination System Medical Specialization Board is prepared Hematology Specialist Education Core Curriculum in Turkey. In this study, we aimed to determine the access of hematologists to the learning objectives defined by curriculum for the transfusion medicine and the factors affecting it.Methods: Hematologists who have been members of Turkish Hematology Society since 2013 have been included in the study, The survey questions were prepared based on the curriculum for transfusion medicine. The study was applied to hematologists with "survey monkey" application. The questionnaire consisted of a competence self-assessment with Likert scale and theoretical multiple-choice knowledge questions. Results: Of the 213 hematologists, 54 (25%) were included in the study. Hematologists rated their competences in the clinical competence areas as 3,65 ± 0,73 (median 3,60) as "I know but not t a sufficient level". The participants 'perception of competence was "I know, but not at a sufficient level'" with an average of 3.31 ± 0.84 (median3.5) in the blood banking field, while the average in hemapheresis and transfusion medicine was 4.04 ± 0.63 (median 4) as "enough". In interventional procedures, hematologists stated that their vocational competences were 2,79± 0,92 (median 2,93) on average as "I have an idea- I know, but not enough". The correct answer to 13 theoretical questions was an average of 6,96 ± 1,89 (median 7). Hematologists performing blood rotation felt significantly more competent than the physicians who could not do the rotation in the blood bank, blood banking t(52) = -3.9, p < .001 , transfusion medicine and interventional competence t(52) = -2.2, p = .04 . Physicians who believed that they are sufficient in the blood banking area, were more confident in transfusion medicine r(54) = .67, p

Background: Insulin-like growth factor(IGF) is the primary mediator of growth hormone. IGF-1 may have an importantrole in protecting the myocardial functions following an acute myocardialinfarction (AMI). Literature reveals only a limited number of studiesinvestigating the relationship between the serum IGF-1/IGF binding protein-3 (IGFBP-3)levels and the left ventricular functions post AMI. We aimed to determineIGF-1 and IGFBP-3 levels and evaluate their effect on cardiac functions postAMI.Material and Method: Sixty five patients who were includedin the study and the control group had 26 patients. Blood samples of thepatients were obtained on the second day of their admission. The patientsunderwent echocardiographic examination on the 7th day of theirhospitalization.Results: The serum IGF-1 and IGFBP-3 levels of the patient group werehigher than those of the control group; however only IGF-1 levels werestatistically significant (243,2±87,9 ng/mL versus 177,2±81,8 ng/mL p=0,001).The increase in the wall thickness and LV chamber size did not correlate withthe decrease in LVEF and IGF-1/IGFBP-3 levels. The patients who had minorcardiac events had lower IGF-1 levels but this was not statisticallysignificant (210.5±88.5 versus 253.1±86.1 p>0.05). Conclusion: IGF-1 and IGFBP-3 levels elevatedfollowing an the early AMI, but these markers were not correlated with theechocardiographical measurements in early post MI period., Giriş; İnsülin benzeri büyüme faktörü (İGF), büyüme hormonunun primer mediatördür. İGF-1 akut miyokard infarktüsü (AMİ) sonrası miyokard fonksiyonlarının korunmasında önemli olabilir. Literatürde AMI sonrası İGF-1/İGF binding protein-3 (IGFBP-3) ​​düzeyleri ile sol ventrikül fonksiyonları arasındaki ilişkiyi araştıran sınırlı sayıda çalışma vardır. Bizim amacımız, AMİ sonrası serum İGF-1 ve İGFBP-3 düzeylerini belirlemek ve kardiyak fonksiyonlar üzerindeki etkisini değerlendirmektir.Çalışma planı; Çalışamaya koroner yoğun bakım ünitesine yatırılan ve kabul edilme kriterlerine sahip olan 65 hasta alındı. Kontrol grubu daha önce koroner arter hastalığı olmayan ve dışlanma kriterlerine sahip olmayan 26 kişiden oluşturuldu. Hastaların kan örnekleri aç olarak yatışının ikinci gününde alındı. Serum İGF-1 ve İGFBP-3 düzeyleri ölçüldü. Hastaların ekokardiyografik değerlendirmesi ortalama yatışının 7. gününde yapıldı.Bulgular; Hasta grubunun serum İGF-1 ve İGFBP-3 düzeyleri kontrol grubuna göre daha yüksek tespit edildi. Ancak sadece IGF-1 düzeyleri (243,2 ± 87,9 ng / ml ve 177,2 ± 81,8 ng / ml p = 0.001) istatistiksel olarak anlamlı idi. Sol ventrikül (SV) duvar kalınlığı ve boşluk boyutlarındaki artış veya SV ejeksiyon fraksiyonlarındaki azalma ile İGF-1/İGFBP-3 düzeyleri arasında ilişki saptanmadı. Hasta grubunda minör kardiyak olaylar ile düşük İGF-1 düzeyleri arasında istatiksel olarak anlamlı olmayan bir ilişki tespit edildi. (253,1 ± 86,1 ve 210,5 ± 88,5 p> 0.05).Sonuç; Daha önceki benzer çalışma sonuçlarından farklı olarak AMİ sonrası serum İGF-1 düzeylerinde yükselme tespit ettik. Ancak İGF-1 düzeyleri ile hastane içi kardiyak olaylar ve ekokardiyografik parametreler arasında ilişki bulamadık. AMİ ile İGF / İGFBP düzeyleri arasındaki bağlantılar karmaşık gibi görünmektedir ve bu ilişkiyi açıklamak için daha ileri çalışmalar gereklidir.

Purpose: Studies report deleterious impacts of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on multiple organs in the human body, not only in the acute infection period but also in the long-term sequelae. Recently defined pulmonary pulse transit time” (pPTT) was found to be a useful parameter regarding the evaluation of pulmonary hemodynamics. The purpose of this study was to determine whether pPTT might be a favorable tool for detecting the long-term sequelae of pulmonary dysfunction associated with coronavirus disease 2019 (COVID 19).Methods: We evaluated 102 eligible patients with a prior history of laboratory-confirmed COVID 19 hospitalization at least 1 year ago and 100 age and sex-matched healthy controls. All participants’ medical records, clinical, and demographic features were analyzed and underwent detailed 12- lead electrocardiography, echocardiographic assessment, and pulmonary function tests.Results: According to our study, pPTT was positively correlated with forced expiratory volume in the 1st second, peak expiratory flow, and tricuspid annular plane systolic excursion, (r= 0.478; pr= 0.294; p= 0.047, r= 0.314; p= 0.032) as well as negatively correlated with systolic pulmonary artery pressure, (r= -0.328; p= 0.021).Conclusion: Our data indicate pPTT might be a convenient method for early prediction of pulmonary dysfunction among COVID 19 survivors.

Amaç: Enfektif endokardit (EE), kalbin iç yüzeyinden kaynaklanan sistemik bir enfeksiyondur. Hastalığın nadir olması ve büyük randomize klinik çalışmalardan veri bulunmaması nedeniyle, EE'nin önlenmesi, teşhisi ve tedavisi için öneriler hala uzman görüşlerinden ve gözlemsel kohort çalışmalarından elde edilmektedir. Bu çalışmada Türkiye'deki tek bir üçüncü basamak hastanesinde EE'nin epidemiyolojik ve klinik özelliklerini tanımlamayı amaçladık.Materyal ve Metot: Kardiyoloji kliniğimize EE nedeniyle başvuran 61 (≥18 yaş) hastanın kayıtları geriye dönük olarak incelendi. Hastaların klinik ve demografik özellikleri, laboratuvar değerleri, mikrobiyolojik bulgular, tedavi yöntemleri, transtorasik ekokardiyografi (TTE) kayıtları ve transözofageal ekokardiyografi (TÖE) tetkikleri ve hastanede yatış sonuçları değerlendirildi.Bulgular: Verilerimize göre EE'den ölen hastalarda, hayatta kalanlara göre serum beyaz kan hücresi (WBC), sedimantasyon (ESR), C reaktif protein (CRP) ve prokalsitonin düzeyleri anlamlı olarak yüksekti (p, Objective: Infective endocarditis (IE) is a systemic infection which results from the inner surface of the heart. Due to rarity of disease and absence of data from large randomized clinical trials, recommendations for prevention, diagnosis and treatment of IE are still derived from expert opinion and observational cohort studies. In this study to we aimed to describe the epidemiological and clinical features of IE in a single tertiary-care hospital in Turkey.Materials and Methods: The records of 61 patients aged ≥18 who were admitted to our cardiology clinic due to IE were investigated retrospectively. Clinical and demographic characteristics of patients, labratory values, microbiological findings, treatment modalities, records of transthoracic echocardiography (TTE), and transesophageal echocardiography (TEE) examinations and hospitalization outcomes were evaluated.Results: According to our data, serum white blood cell (WBC), sedimantation (ESR), C reactive protein (CRP) and procalcitonin levels were significantly higher in patients who died from IE compared to those who survived (p

The authors emphasize the application scope of the deep learning (DL) technologies in the instructional analysis, design, development, implementation, and evaluation of the educational tools that can enhance the 21st-century modes and models of learning and instruction. The latest trend in the remote learning systems opens a wonderful opportunity for the DL technologies to be integrated with these systems that can impact the way of learning, teaching, design, and development of such systems. The DL technologies provide the data driven decisions and analytical outcomes that can be integrated with the educational technologies. The existing educational technologies and remote learning systems lack in such integrated DL services that can impact the overall education learning systems of the 21st century. The learners and instructors can also benefit from such DL-integrated educational tools. The authors expand further details on the application and implication of the DL services mentioned above in the chapter.

SUMMARY INTRODUCTION: According to recent studies, the rate of atrioventricular block requiring permanent pacing in patients following transcatheter aortic valve implantation varied between 5.7% and 42.5%. Fragmented QRS is a useful marker of myocardial scar and can predict adverse cardiac events. In this study, we examined association between f ragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation. OBJECTIVE: In this study, we examined association between fragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation’ sentence is enough for it. METHODS: We retrospectively analyzed standard 12-lead electrocardiographic recordings of 124 consecutive patients in whom a CoreValve prosthesis was implanted. We examined 12-lead electrocardiogram before and after procedure along with one- and six-month follow-up. We documented QRS fragmentation and postprocedural rhythm disturbances. RESULTS: There was a significant increase in the frequency of left bundle branch block, (21.1 versus 0%, p

Giriş ve Amaç: Miyokart enfarktüsüne yanıt olarak ortaya çıkan patofizyolojik değişiklikler, kardiyak yeniden şekillenme ile sonuçlanır. Tedavi edilmediği takdirde bu patolojik süreç, ventriküler fonksiyonun bozulmasına ve malign ventriküler aritmilerin gelişmesine neden olur. Son zamanlarda kullanılmaya başlanan EKG tabanlı kardiyo-elektrofizyolojik denge indeksinin çeşitli kardiyak durumlarla ilişkili olduğu gösterilmiştir. Bu çalışmada, miyokart enfarktüsü sonrası gelişen kardiyak yeniden şekillenme ile kardiyo-elektrofizyolojik denge indeksi arasındaki ilişkiyi araştırmayı amaçladık.Gereç ve Yöntemler: Çalışmaya, Ocak 2020 ile Ocak 2021 arasında hastanemize akut miyokart enfarktüsü ile başvuran ve başarılı perkütan koroner girişim uygulanan 18 yaş ve üzeri hastalar dahil edildi. Kardiyak yeniden şekillenmenin değerlendirilmesi amacıyla; sol ventrikül (SV) kütlesi, sol ventrikül kütle indeksi (SVKİ) ve rölatif duvar kalınlığı (RDK), tedavi başlamadan önce ve işlemden altı ay sonra kardiyo-elektrofizyolojik denge indeksi parametreleri (QT/QRS, QTc/QRS) ile birlikte değerlendirildi.Bulgular: Çalışmamıza göre, altı aylık takip sonunda QT/QRS ve QTc/QRS değerleri başlangıç değerlerine göre anlamlı derecede düşük bulundu (4.73∓0.60 vs 4.62∓0.55 & 4.93∓0.59 vs 4.78∓0.55, sırasıyla p, Objective: Pathophysiological changes in response to myocardial infarction (MI) result in cardiac remodeling. Left untreated this pathologic process contributes to impairment of ventricular function and development of malignant ventricular arrhythmias. Recently introduced ECG‐based marker index of cardio‐electrophysiological balance (iCEB) has been shown to be associated with various cardiac conditions. Herein, we aimed to investigate the association between the iCEB and cardiac remodeling in post-MI patients.Materials and Methods: Patients aged ≥18 years presenting with acute MI who underwent successful percutaneous coronary intervention between January 2020 and January 2021 were recruited. Regarding the assessment of cardiac remodeling, left ventricular (LV) mass, LV mass index (LVMI), and relative wall thickness (RWT) were measured before the start of treatment and six months after the procedure along with the QT/QRS ratio (iCEB), and QTC/QRS ratio (iCEBc).Results: According to our study, estimated QT/QRS (iECB) and QTc/QRS (iECBc) ratios were found to be significantly lower at six-month follow-up compared to baseline values (4.73∓0.60 vs 4.62∓0.55 & 4.93∓0.59 vs 4.78∓0.55, p

SUMMARY OBJECTIVE: Coronary artery bypass graft (CABG) surgery is a well-established treatment modality for patients with multivessel coronary artery disease (CAD). Syntax II Score has been established as novel scoring system with better prediction of postprocedural outcomes. This study aimed to investigate the prognostic value of SYNTAX II Score for predicting late saphenous vein graft (SVG) failure in patients undergoing isolated CABG. METHODS: The records of 1,875 consecutive patients who underwent isolated CABG with at least one SVG were investigated. Those who underwent coronary angiography and SVGs angiography at least 1 year after the CABG were included. Patients were divided into two groups based on the presence or absence of SVG failure. For each group, predictors of late SVG failure and subsequent clinical outcomes were analyzed. RESULTS: According to this study, the presence of hypertension, higher rates of repeat revascularization, and higher SYNTAX II Scores were found to be independent predictors of late SVG failure. In addition, the prognostic value of SYNTAX II Score was found to be significantly higher than anatomical SYNTAX Score in terms of predicting late SVG failure and major adverse cardiovascular and cerebrovascular event. CONCLUSIONS: There was a strong association between SYNTAX II Score and late SVG failure in patients undergoing isolated CABG.

Background It is well known that approximately 20% of patients who undergo cardiac surgery experience weight loss in postoperative period. However, there is a lack of data on postoperative consequences of malnutrition. This study aimed to investigate the relationship between nutritional status and long-term outcomes in patients undergoing isolated coronary artery bypass grafting (CABG). Material and methods A total of 586 patients who underwent isolated CABG in our center between January 2015 and March 2016 were included in this study. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of all-cause death, non-fatal myocardial infarction (MI), and stroke. Patients were divided into two groups based on their MACCE outcomes. Prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and controlling nutritional status (CONUT) scores were used to show the nutritional status. Results The mean follow-up time of the whole study group was 38.08 ± 13.4 months. The follow-up time was 39 ± 13 months in patients with mortality, while it was 20 ± 15 months in those without mortality. The PNI and GNRI values were lower in patients with major adverse cardiac and cerebrovascular events (MACCE) compared to patients without MACCE. The median CONUT score was higher in patients with MACCE. Conclusion Our study showed that nutritional indices including PNI, CONUT, and GNRI were associated with long-term MACCE and mortality in patients who underwent isolated CABG. The use of these scores in order to predict prognosis in patients treated with CABG seems to be an applicable method in clinical practice.

Pacemakers are foreign bodies which often used in the treatment of arrhythmias. Infection of pacemaker and the parts associated with pacemaker is extremely rare. The most important risk factors for development of infection; duration of the procedure, complications during operation and immunodeficiency of the patient. These infections are often seen when the pacemaker was inserted or removed as a result of the contamination. Although pacemaker infections are rare, the mortality rate is high. The most common causative agent is staphylococcus, gram negative bacteria and fungi may also be rarely causative agents. Ochrobactrum anthropi is a gram-negative, aerobic, oxidase positive, urease positive, motile and non-lactose-fermenting bacillus previously known as “ Achromobacter group”. It is an opportunistic pathogen that can cause infection in especially immunosupressive patients with permanent central venous catheter. The main infections reported due to this agent; bacteremia, central venous catheter-related sepsis, endocarditis, endophthalmitis, pancreatic abscess, urinary tract infections, meningitis, pelvic abscess and osteomyelitis. In the literature, just one case has been reported which developed pacemaker infection due to this agent. In this manuscript, fifty-four-year-old Afghan nationality patient was presented with the diagnosis of pacemaker and pacemaker lead infections.

Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide and a large proportion of patients with AF are older than 75 years of age. Mitral annular calcification (MAC), which is usually observed in advanced age, is associated with increased risk of AF and cardio-embolic stroke in the general population. Objectives: This study was performed to assess whether presence of MAC and its severity predict cardio-embolic stroke in elderly patients with first diagnosed AF. Methods: In this cross-sectional study, 72 elderly patients suffering from acute cardio-embolic stroke with first diagnosed AF and 79 elderly control group patients with first diagnosed AF and without stroke were investigated. A parasternal short-axis view at the level of the mitral annulus was used for MAC measurements. The severity of MAC was measured from the anterior to posterior edge at its greatest width. Results: MAC thicknesses were significantly higher in the stroke group. ROC curve analysis showed that a cut point of 2.5 mm for the value of MAC thickness exhibited 68.1% sensitivity and 77.2% specificity for detecting cardio-embolic stroke in elderly patients with AF. In multivariate logistic regression analysis, MAC thickness (OR = 1.173, 95% CI 1.083-1.270; p < 0.001) was found to be independent predictor of cardio-embolic stroke in elderly patients with AF. Conclusion: MAC thickness may provide useful information for the relevant risk evaluation of elderly patients with AF. Pre-stroke MAC presence and its severity appear to have better clinical value for predicting cardio-embolic stroke in elderly patients with AF, independent from traditional risk factors for stroke.

Background/aim: We aimed to investigate the relationship between risk factors and the presence of coronary artery disease (CAD) in a young population with stable angina pectoris (SAP).Materials and methods: A total of571 individuals younger than 60 years old, admitted to the outpatient clinic with chest pain and referred for coronary angiography between January 2015 and December 2017, were included in the study. All clinical and biochemical parameters were documented in the hospital records. Coronary angiography of patients was monitored from records. The individuals were divided into two groups. The patient group consisted of 363 individuals with at least one-vessel stenosis of ≥70%, and the control group consisted of 208 individuals with normal coronary angiography. We compared the traditional and nontraditional risk factors of these two groups in terms of the presence of CAD.Results: Prevalence of male sex and smoking were higher in the patient group, and the prevalence of hypertension and diabetes were similar in the two groups. In the patient group, mean age, blood cholesterols, serum gamma-glutamyltransferase, hemoglobin, and white blood cell and lymphocyte levels were higher, while estimated glomerular filtration rate (eGFR), high-density lipoprotein cholesterol (HDL-C), platelets, and neutrophil/lymphocyte and platelet/lymphocyte ratios were lower. Low eGFR and HDL-C levels, older age, male sex, smoking, and high levels of low-density lipoprotein cholesterol and lymphocytes were independent risk factors for the presence of CAD in young patients.Conclusion: Contrary to studies performed in the elderly, traditional and nontraditional risk factors could not exactly predict the presence of CAD in a young population with SAP.

Because of cardiac hypertrophy and electrophysiological alterations associated with preeclampsia, worsening of preexisting arrhythmias or occurrence of de novo arrhythmias are common in patients with preeclampsia. Tp-e/QT and Tpe/QTc ratios are accepted as reliable indexes for predicting ventricular arrhythmias. In this study, we examined the impact of preeclampsia on ventricular repolarization indices in patients with preeclampsia by using the QT, QTc and Tp-e interval, Tp-e/QTratio, and Tp-e/QTc ratio.We analyzed electrocardiographic recordings of sixty pregnant women with preeclampsia and thirty age-matched healthy pregnant women. Women presenting with preeclampsia were divided into 2 groups and classified as early (gestational age 34 weeks at clinical onset) or late (≥34 weeks) onset preeclampsia. Ventricular repolarization indices were evaluated.The QT and Tp-e intervals were found to be longer in patients with earlyonset preeclampsia compared to patients with late-onset preeclampsia and helthy pregnants (377.6 ± 23 ms vs 374.3 ± 15 ms, 362 ± 15 ms82.6 ± 9.4 ms vs 74.0 ± 10.6 ms, 68.6 ± 10 ms). In adition, Tp-e/QT and Tp-e/QTc ratio were significantly higher in this patient population compared to others (0.21 ± 0.02 vs 0.19 ± 0.02, 0.18 ± 0.020.19 ± 0.02 vs 0.16 ± 0.02, 0.15 ± 0,02, p 0.05 respectively).Our data showed that preeclampsia has unfavorable effects on electrocardiographic indices of ventricular repolarization compared to healthy pregnant women. This effect is more prominent in patients with early-onset preeclampsia.

Objectives Vascular calcification is a well-known phenomenon and affects coronary and carotid arteries as well as other arterial beds. Presence of arterial calcification is associated with major adverse events in patients undergoing percutaneous coronary artery or carotid artery intervention. Even though there is a clear association between worse outcome and coronary-carotid calcification, there is no research that interrogated the relationship between iliac arterial calcification and clinical outcomes because of lack of data. Therefore, in this study, we aimed to investigate the impact of iliac arterial calcification on procedure success rates and long-term outcomes among patients undergoing endovascular intervention. Methods The records of 453 consecutive patients who underwent endovascular intervention due to symptomatic peripheral artery disease were analyzed. Patients were divided into two groups based on the presence or absence of heavy calcification of iliac arteries. For each group, technical aspects of procedures and subsequent clinical outcomes were analyzed. Results According to our study, the rate of restenosis following endovascular intervention at 6 and 12 months were similar between two groups. On the other hand, long-term restenosis was significantly higher in patients with heavy calcification of iliac arteries as compared to patients with low calcification on iliac arteries (32.2% vs. 12.8%, p < 0.05). Conclusions Our data showed that there was a strong association between heavy calcification of iliac arteries and long-term restenosis in patients undergoing endovascular intervention.