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Although there have been few studies concerning BPPV and thyroid autoimmunity and a positive relation was found between them, this study didn't find any relation between BPPV and thyroid autoimmunity. IT is thought that further large-scale studies must be done to clarify the relation.Benign paroxysmal positional vertigo (BPPV) consists of ∼ 20% of vestibular disorders. Self-limited rotatory nystagmus with positional vertigo are the main findings of BPPV. Although canalolithiasis theory was confirmed by demonstrating freely floating debris in the endolymph of the posterior semicircular channel in following studies, currently, the etiology hasn't been explained totally. This study investigated the relation of BPPV and thyroid autoimmunity evaluated via measurement of serum thyroid autoantibodies.Fifty patients (37 female, 13 male) with BPPV (BPPV group), 52 patients (40 female, 12 male) with non-BPPV vertigo (non-BPPV group) and 60 otherwise normal control (38 female, 22 male) samples were enrolled in the study. All samples of BPPV, non-BPPV groups and controls had undergone a cochleovestibular test following thorough ENT examination. After blood samples were drawn from each subject, thyroid-stimulating hormone (TSH), anti-thyroid peroxidase antibody (TPO-Ab) and anti-thyroglobulin antibody (TG-Ab) levels were measured accordingly.In the study, eight patients of the BPPV group (16%) had a high thyroid antibody level. In the non-BPPV group, six patients (11.5%) had elevated thyroid antibodies. In the control group, 15 patients (25%) had elevated thyroid antibodies. TSH values of all subjects were detected to be within normal range. No statistical difference was found between the groups with respect to TG-Ab and TPO-Ab values (p-values = 0.729 and 0.812, respectively).

WOS: 000223692500016, PubMed ID: 15337007, Background. Replacement of the ascending aorta with a prosthetic graft is the preferred surgical procedure for an ascending aortic aneurysm. The choice of external wrapping of the aorta is a simple, fast, and effective method for moderately sized ascending aortic aneurysms with concomitant operations. In this study, we present the midterm results of 62 patients undergoing reduction aortoplasty with external wrapping and different cardiac procedures. Methods. The study group consisted of 48 male and 14 female patients with a mean age of 59.3 +/- 6.0 years. Measurement of the ascending aorta diameters was obtained at three points: before surgery, during the early postoperative period, and during the follow-up. The mean preoperative aortic diameter was 52.7 +/- 0.5 mm. In all patients, the ascending aortic aneurysm was repaired by reduction aortoplasty with external wrapping. Results. Mean follow-up time was 39.6 +/- 18.0 months. There was only one mortality (1.6%) as a result of septic multiple-organ failure and no major surgical complications in the 30-day postoperative period. Reduction aortoplasty of the ascending aorta with external wrapping resulted in a significant reduction of the ascending aorta in all patients (p = 0.000). There was an increase in the mean aortic diameter during the follow-up period (p = 0.000). Although this increase was statistically significant, all measurements of the follow-up period were still within normal range. Conclusions. External wrapping of the aorta offers excellent results with very low mortality and morbidity, and it can be regarded as a safe and effective method for the treatment of ascending aortic aneurysm in selected patients. However, the patients should be carefully monitored for redilatation after the procedure. (C) 2004 by The Society of Thoracic Surgeons.

Anemia is a common problem among older people. Deficiency of essential erythropoiesis elements (iron, vitamin B12, and folic acid) is one of the major causes of anemia in older people. Studies evaluated prevalence of anemia in our country generally consisted of older people admitted to hospital. Studies conducted on community dwelling older people were much more less. The aim of this study is to evaluate prevalence of anemia and nutritional deficiencies in community dwelling elderly in our country. Totally 827 elderly individuals living in community participated in this study.Anemia was defined according to the World Health Organization (Hb13 g/dl for men and Hb12 g/dl for women). Iron, vitamin B12, and folic acid deficiencies were evaluated. Iron deficiency anemia was diagnosed when anemia with iron level60 μg/dl and ferritin level12 ng/ml. Vitamin B12 deficiency anemia was diagnosed when anemia with vitamin B12 level200 pg/ml. Folic acid deficiency anemia was diagnosed when anemia with folic acid level2.6 ng/ml.Prevalence of anemia was found 7.3%. Prevalence of iron deficiency, vitamin B12, and folic acid deficiency were found 7.1%, 64.2% and 10.9%, and 10.9%, respectively. Prevalence of iron deficiency anemia was found 2.8%. Prevalence of vitamin B12 deficiency anemia was found 4.4% and folic acid deficiency anemia was found 1%.Prevalence of anemia was seen 7.3% in our study, but more studies are needed on anemia in community dwelling elderly in our country. Deficiency of iron, vitamin B12, and folic acid is also high in Turkey.

Coronary artery bypass grafting operations in patients with an atherosclerotic ascending aorta are still associated with an increased risk of cerebral embolism and mortality despite previously described techniques. Here we present an alternative technique for the construction of a proximal anastomosis avoiding aortic clamping and deep hypothermic circulatory arrest.

Coronary artery disease may coexist with aortoiliac occlusive disease, and concomitant revascularization procedures may be required. The ascending aorta may be used as the source of inflow to both the femoral and coronary arteries in patients who present with coronary artery disease and critical leg ischemia. We present here 2 patients in whom coronary artery bypass grafting and ascending aorta-to-bifemoral bypass operations were performed simultaneously.

The aim of this study is to evaluate our early and mid- term results and the qualities of life of the patients aged eighty years or older who underwent heart surgery.Eighty- eight patients aged 80 years and older who underwent open-heart surgery at Göztepe Şafak Hospital between May 2004 and December 2010 have been included to the study. This study was designed as two-stage: in the first stage, determinants of survival were analyzed retrospectively. In the second stage, the quality of life of survived patients was evaluated by using Short- Form 36 (SF-36), Turkish version in the cross-sectional study. The statistical analysis was performed using Fischer's exact, Pearson Chi-square test, Student t-test, Mann-Whitney U test and logistic regression analysis.In the logistic regression analysis; the left ventricular ejection fraction as50% (OR: 11.02, 95% CI: 2.6-46.6, p0.05), application of redo surgery (OR: 8.3, 95% CI: 1.04-66.6, p0.05), coronary bypass and mitral surgery procedures in the same session (OR: 9.2, 95% CI: 1.6-53.7, p0.05), left main coronary lesion as50% (OR: 4.3, 95% CI: 1.1-17.7, p0.05), preoperative creatinine as1.8 mg/dl (OR: 14.1, 95% CI: 2.6-76.1, p0.01), New York Heart Association class III-IV (OR: 4.9, 95% CI: 1.2-20.1, p0.05), chronic obstructive pulmonary disease (OR: 10.3, 95% CI: 2.5-41.7, p0.01) were found to be risk factors of hospital mortality. Physical functions, social functions and all sub-scales other than the role limitation depending on the emotional situation were evaluated as general population mean or above.We think that with a successful heart surgery in patients aged 80 years and older under appropriate conditions, their life qualities and mean life expectations can return to normal and they can lead a symptomless life.

OBJECTIVE The aim of this study was to compare the requirement for temporary and permanent pacemaker insertion and the incidence of the problems regarding the rhythm following heart transplantation with the bicaval or biatrial technique in the early postoperative period. METHODS Sixty-one patients underwent orthotopic heart transplantation between the dates of September 1989 and December 2008 in our clinics were included to the study. The study was designed as retrospective analysis, and all data were collected from hospital records. The transplantation was performed by using standard biatrial method in 28 of the patients, by using bicaval anastomosis method in 33 of the patients. Statistical analyses were performed using Chi-square, Fischer's exact and Mann-Whitney U tests. Predictors of temporary and permanent pacemaker insertion were analyzed using logistic regression analysis. RESULTS In the biatrial group, the temporary pacemaker requirement (p

Coronary endarterectomy is a controversial procedure that plays a particular role in the treatment of coronary artery disease. We retrospectively investigated the results for 548 patients who underwent coronary endarterectomy as an adjunctive therapy for coronary artery bypass graft surgery during the period between 1996 and 2004. We assessed short-term outcomes and identified risk factors for adverse outcomes. Mean patient age was 67.9 + 9.3 years and mean angina class was 2.7 + 0.3. The mean number of distal anastomoses was 3.8 + 1.1 patients (73.4%) had single and 151 (27.6%) multiple coronary artery endarterectomies. Of the 151 patients who underwent multiple endarterectomies, 97 (17.7%) had endarterectomies in 2 coronary arteries, 40 (7.2%) in 3 coronary arteries, 11 (2%) in 4 coronary arteries, 2 (0.36%) in 5 coronary arteries, and 1 (0.18%) in 6 coronary arteries. Postoperative mortality was 6.2% (34 patients). The predictors for early mortality were recent myocardial infarction and left ventricular dysfunction. Our results suggest that adjunctive coronary endarterectomy can be accomplished with acceptable results but with higher mortality rates than ordinary coronary artery bypass grafting. Adjunctive coronary endarterectomy should be considered as a last option for the surgical treatment of diffuse coronary disease.

Background Recent refinements in percutaneous techniques have resulted in an increase in the numbers of patients with diffuse coronary artery disease who are referred to cardiac surgeons. Long-segmental reconstruction of the diffusely diseased left anterior descending (LAD) coronary artery with the left internal thoracic artery (LITA) has been shown to be beneficial for patients with diffuse coronary artery disease. In this retrospective study, we analyzed the long-term outcomes obtained with this technique. Methods Between April 1997 and February 2006, 3736 coronary artery bypass grafting (CABG) operations were performed by our team. Of these cases, 524 patients (14%) with the diffusely diseased LAD underwent a long-segmental reconstruction procedure with a LITA graft. Results The cohort consisted of 372 men (71%) and 152 women (29%), and the mean age was 56.5 ± 8.2 years. The mean length of the arteriotomy incision was 4.5 ± 1.2 cm (range, 2 to 10 cm). Postoperative mortality was 1.9%, and the myocardial infarction rate was 6.9%. At 3, 5, and 7 years, overall survival was 93.8% ± 0.5%, 89.6% ± 1.5%, and 85.5% ± 2.6%, and actuarial freedom from angina recurrence was 94.5% ± 1%, 88.5% ± 2%, and 82.9% ± 3%, respectively. Among survivors, interim angiographic evaluation was performed in 128 patients at a mean follow-up of 52.4 ± 13.5 months, and the patency rate of the LITA–LAD anastomosis was 91.4%. Conclusions Patients with diffuse LAD disease present a major challenge for cardiovascular surgeons. The long-term results of long-segmental LAD reconstruction are very encouraging, and this approach may be used safely in this subgroup of patients.

In Ebstein's anomaly, the aim of surgical intervention is the restoration of tricuspid valve competence. In some circumstances, however, paucity of the leaflet tissue precludes successful repair and negatively influences the long-term durability of the valvuloplasty procedure. We report a modified technique that provides satisfactory results for right atrioventricular valve function.

Acute rheumatic fever can follow throat infections with group A streptococci. Certain serotypes of group A streptococci such as M1, M3, M5, M6, M14, M18, M19, M24 are associated with this disorder. Immunity to streptococci and to rheumatic fever depends on antibodies to the M proteins. Due to current scarcity of M-typing sera, many laboratories use T typing and opacity factor production for serotype identification of group A streptococci. In order to, investigate the most common serotypes of group A streptococci in our country in recent years we studied T-agglutination typing and opacity factor of 120 group A streptococci strains isolated from throat cultures of 930 children.Diffuse, stable suspensions of group A streptococci were tested with polyvalent antisera (T,U,W,X,Y) by slide agglutination. Microplate method was used for opacity factor detection.T-protein -agglutination patterns U (2,4,6,28) were the most common among typeable strains. The rate of T-protein -agglutination patterns T (1,3,13, B3264) and X (8,14,25,Imp.19) were 20 % and 18 % respectively. Opacity factor production rate of isolated group A streptococci strains was 65%.To profit global assessment of rheumatic fever and rheumatic heart disease, more epidemiological and serotyping research is required in our country.

WOS: 000234085000002, PubMed ID: 16385917, Objective - The optimal treatment of patients with co-existing occlusive coronary and carotid arterial disease is controversial. This study reports our experience with simultaneous carotid endarterectomy and coronary bypass in conjunction with cardiopulmonary bypass with mild hypothermia. Methods and results - From March 2001 to June 2004, 72 patients underwent simultaneous coronary bypass and carotid endarterectomy. Their mean age was 68.9 years and there were 56 men and 16 women. The indication for carotid endarterectomy was a lumen diameter reduction of more than 75% and/or the presence of ulcerated/unstable plaque. Carotid endarterectomy was done during cardiopulmonary bypass under mild hypothermia, haemodilution, systemic heparinization and controlled haemodynamics under pulsatile perfusion for additional cerebral protection. The mean cardiopulmonary bypass time was 64.7 minutes and aortic cross-clamp time 32.4 minutes, and the mean number of grafts per patient was 2.7. Four patients had perioperative neurological complications (5.5%) and two had permanent deficits (2.7%). The procedure-related mortality was 3 (4.1%). Conclusions - We suggest that combining coronary revascularization and carotid endarterectomy and performing both under cardiopulmonary bypass is safe, offering acceptable morbidity and mortality rates.

12th World Congress of the International-Society-of-Cardiothoracic-Surgery -- MAR 03-06, 2002 -- LUZERN, SWITZERLAND, WOS: 000185423300026, PubMed ID: 12957767, Objective: The role of coronary artery bypass grafting (CABG) in patients with severe left ventricular dysfunction was evaluated. Methods: Two hundred and twelve patients (152 men, 60 women; age 35 to 82, mean 55) with ejection fraction (EF) of less than 30% underwent CABG between January 1996 and February 2001 by a single surgeon (SA). They compromised of 12% of 1759 patients operated on in this period. EF ranged from 17% to 30% (mean 25%). Preoperatively 68% had congestive heart failure and 72% had severe angina (CCS 3 or 4). A left main lesion was found in 26% of the cases. The mean number of grafts was 3.18 per patient. The left internal mammary artery (LIMA) was used on 107 patients (50.4%). Preoperative intraaortic balloon pump (IABP) was used on 32 patients (15%). Endarterectomy was performed on 53 patients (25%). The patients were followed for up to 58 months (mean 28.7). Results: Twelve patients died in hospital (5.6%). Survival was 94%, 87%, 80% and 73% at 1, 2, 3 and 4 years respectively. Among the preoperative variables survival was negatively affected by chronic renal failure, older age, congestive heart failure, elevated pulmonary artery pressure and recent myocardial infarction, by means of multivariate analysis. Preoperative IABP support improved the operative mortality significantly (P=0.002). Use of LIMA did not have any influence on survival. Conclusion: CABG on patients with poor left ventricular function: (1) Can be performed with an acceptable mortality. (2) Mid term results are encouraging. (3) Preoperative IABP support improves the chance of survival. (C) 2003 Elsevier Ireland Ltd. All rights reserved., Internat Soc Cardiothoracic Surg

WOS: 000181673700011, PubMed ID: 12848702, We report a case of a huge left ventricular pseudoaneurysm following myocardial infarction. Early after myocardial infarction, the pseudoaneurysm was missed during the cardiac examination. The patient underwent coronary bypass surgery with endoaneurysmorraphy of the pseudoaneurysm, and made a satisfactory recovery.

Background/aim: The possibility of adverse effects of the oral glucose tolerance test (OGTT) carried out for the screening of gestational diabetes among pregnant women and fetuses is a frequently discussed topic. The purpose of this study was to investigate the effects of the hyperglycemia peak during OGTT on the levels of oxidants and antioxidants in the body.Materials and methods: Eighty individuals who applied to the Outpatient Clinic with suspected diabetes and OGTT indication were included in the study. Glucose, total oxidant capacity status (TOS), total antioxidant capacity (TAS), superoxide dismutase (SOD), and lipid hydroperoxide (LOOH) levels were tested on blood samples collected from these individuals at 0, 60, and 120 min during the OGTT carried out with 75 g of glucose. Oxidative stress index (OSI) was calculated as the ratio of TOS to TAS.Results: While the oxidative parameters TOS and LOOH were significantly increased at 60. min of OGTT, only LOOH was significantly increased at 120. min of OGTT. Significant decreases in antioxidative parameters (TAS, SOD) were observed at 60. and 120. min of the OGTT and OSI was significantly increased at 60. and 120. min of the OGTT.Conclusion: Oxidative stress parameters were increased and antioxidative parameters were decreased during the OGTT. However, more extended studies are required to determine the effects of the increased oxidative stress on pregnant women and fetuses.