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© 2022, The Author(s), under exclusive licence to Springer Nature Switzerland AG.Background: Transcatheter aortic valve implantation (TAVI) is currently the treatment of choice for the majority of patients at moderate or high surgical risk. However, some complications occur frequently with this procedure. In this study, we aimed to assess whether the cusp-overlap view (COP) technique may be associated with a reduced incidence of some of these complications compared with the classical three-cusp view (TCV) technique. Methods: In this single-center, retrospective study we investigated; technical success, postprocedural permanent pacemaker implantation (PPMI), new-onset stroke, pericardial tamponade, arrhythmia development, acute renal failure, major bleeding, major vascular complications, procedure-related coronary obstruction, new-onset left bundle branch block (LBBB), paravalvular leak, peri-procedural myocardial infarction (MI), day of hospitalization, death, and major adverse cardiac and cerebrovascular events (MACCE) were determined as the clinical endpoints. Results: A total of 281 consecutive patients who met the study criteria and underwent elective or emergency transfemoral TAVI using the self-expandable CoreValve Evolut valve were included. 176 consecutive patients implanted with the classical TCV technique and 105 consecutive patients implanted with the COP technique were compared. Compared with the TCV group, patients in the COP group had lower PPMI (3.8% vs. 10.8%, p = 0.039), in-hospital mortality (1.9% vs. 8.5%, p = 0.018), and 1-year death (4.8% versus 18.8%, p = 0.001), and MACCE rates (12.4% vs 31.3%, p < 0.001). Conclusion: The COP technique may help to reduce the conduction disturbances, PPMI requirement and complication rates that may develop following TAVI. In addition, it is an interesting result that it reduces mortality and MACCE rates in long-term follow-ups.

We aimed to compare the long-term follow-up results of patients with atrial fibrillation (AF) who use vitamin K antagonist (VKA) with effective time in therapeutic range (TTR) and non-vitamin K antagonist oral anticoagulants (NOACs).A total of 1140 patients were followed at 35 different centers for five years. During the follow-up period, the INR values were studied at least 4 times a year and the TTR values were calculated according to the Roosendaal method. The effective TTR level was accepted as60% as recommended by the guidelines. There were 254 patients in the effective TTR group and 886 patients in the NOACs group. Ischemic cerebrovascular disease/ transient ischemic attack (CVD/TIA), hemorrhagic CVD, and mortality were considered primary endpoints based on one-year and five-year follow-ups.Ischemic CVD/TIA (3.9% vs. 6.2%; P = 0.17) and hemorrhagic CVD (0.4% vs. 0.5%, P = 0.69), the one-year mortality rate (7.1% vs. 8.1%; P = 0.59), five-year mortality rates (24% vs. 26.3%; P = 0.46) were not different between the effective TTR and NOACs groups during the follow-up respectively. The CHA2DS2-VASC score was similar between warfarin with the effective TTR group and NOACs group (3 [2-4] vs. 3 [2-4]; P = 0.17, respectively]. Additionally, survival free-time did not differ between the warfarin with effective TTR group and each NOAC in the Kaplan-Meier analysis (dabigatran, P = 0.59; rivaroxaban, P = 0.34; apixaban, P = 0.26; and edoxaban, P = 0.14).There was no significant difference in primary outcomes between the effective TTR and NOAC groups in AF patients.

© 2022 by Türkiye Klinikleri.Objective: In this study, the relationship between the MDR1 gene and ankylosing spondylitis (AS) was investigated. Genetic and environmental factors are known to play an important role in the pathogenesis of AS. It is obvious that different patients have different reactions to prescribed drugs and drug dosages during standard treatment. One of these factors is the P-glycoprotein encoded by the MDR1 gene. The most widely studied alleles of this gene are rs1045642-NM_000927.4:c.3435T>C, p. Ile1145Ile (C3435T), rs2032582-NM_000927.4:c.2677T>G/A, p. Ser893Ala/Thr (G2677T/A) and silent rs1128503-NM_000927.4:c.1236T>C, p. Gly412Gly (C1236T). Material and Methods: The study group was formed from 34 patients with biological therapy, 32 patients with other treatments (66 AS patients in total) and 32 healthy individuals. DNA isolation was performed using a High Pure PCR Template Preparation Kit. RNA isolation was performed with TRIzol manual isolation. For quantitative real-time polymerase chain reaction, a Roche LightCycler FastStart DNA Master device HybProbe was used. Results: There was no statistically significant difference between groups regarding the investigated polymorphisms. In the biological therapy [tumor necrosis factor alpha (TNF-α) inhibitor] group, a significant decrease was found in MDR1 gene expression (p

Objectives: Collateral circulation is assumed to prevent myocardial ischemia in healthy subjects and in patients with coronary artery disease. Visceral adipose tissue is an active component of total body fat, which holds some biochemical characteristics that have impact on several normal and pathological processes in the human body. In this study, we investigated the relationship between visceral fat ratio and coronary collateral circulation (CCC).Materials and Methods: Totally 148 patients with stable angina pectoris were recruited to the study and all patients’ heights and weights were recorded after the coronary angiography. The study subjects were divided into two groups as those between 1 and 9, and those >10 by classifying their visceral fat ratio with bioelectrical impedance analysis method. Patients were classified as poor CCC group (grade 0 and 1) and good CCC group (grade 2 and 3) based on the Rentrop’s classification of CCC.Results: In the analysis in accordance with collateral classification, visceral fat percentage (13.7±4.7 versus 10.1±4.0, p=0.01) and body mass index (28.2±2.4 versus 27.3±2.3, p=0.040) were found significantly higher in the poor collateral group. Diabetes mellitus was significantly higher in patient with high visceral fat ratio. In multivariate logistic regression analysis for collateral growth, visceral fat percentage [odds ratio (OR): 0.740, %95 confidence interval (CI): 0.602 0.909, p=0.040] and coronary stenosis percentage (OR: 1.220, %95 CI: 1.070-1.390, p=0.003) were found meaningful, independent from the other factors. In ROC analysis, increase in visceral fat level decreased collateral growth with 72.7% sensitivity and 58.5% specificity.Conclusion: The increase in visceral fat seems an independent factor for poor collateral development.

Monocyte to HDL cholesterol ratio (MHR), lymphocyte to monocyte ratio (LMR), and neutrophil to lymphocyte ratio (NLR) have been proposed as novel systemic inflammatory markers. The aim of this study was to explore the association between MHR, LMR and NLR with pulmonary arterial hypertension (PAH). The study is a single-center, retrospective Cross-sectional study. The study group consisted of 73 patients with PAH and the control group 77 participants without cardiac pathology as determined by echocardiography. On admission, blood sampling to calculate MHR, LMR, NLR, and detailed clinical data were obtained. According to the Pearson test, systolic pulmonary artery pressure (PAP) value Higher MHR, NLR and lower LMR that indicates an enhanced inflammation were significantly increased in patients with PAH when compared with controls. Compared to many other inflammatory markers, these markers are widely available. positively correlated with the MHR and NLR (r:.35, P.001 and r:.33, P.001, respectively), but negatively correlated with LMR (r: -.26, P = .001). After multivariate logistic regression analysis, MHR, LMR, and NLR remained as significant predictors of PAH (OR: 2.651, 95% CI: 1.227-5.755, P = .007; OR: 0.647, 95% CI:0.450-0.931, P = .005; OR: 1.350, 95% CI: 1.054-1.650 P = .030, respectively).

The aim of this study was to investigate the frequency of oral anticoagulant drugs and time in therapeutic range in patients receiving warfarin in addition to the epi-demiological trial of non-valvular atrial fibrillation previously conducted in Turkey (The Atrial Fibrillation: Epidemiological Registry trial). Furthermore, the prevalence of major adverse events and mortality rates of the patients were evaluated during the long-term follow-up period.We created a national data registry for non-valvular atrial fibrillation patients, reflecting all geographic regions by population density. In that context, the study included all consecutive atrial fibrillation patients older than 18 years of age who were admitted to the cardiology outpatient clinic except for patients those with prosthetic heart valvesand rheumatic mitral valve stenosis.This study included 2592 patients from 35 different centers. The mean age was 68.7 ± 11.1 years, and 55.5% of the patients were female. The most common comorbid diseases were chronic kidney disease (69%) and hypertension (65.5%). The time in ther- apeutic range rate in the general population was 40%, and the mortality rate at 5-year follow-up was 29.4%.The Atrial Fibrillation: Epidemiological Registry 2 study showed higher use of anticoagulant in non-valvular atrial fibrillation patients than in previous national stud-ies. Furthermore, this study demonstrated that most of the non-valvular atrial fibrilla- tion patients are in the high-risk group and the time in therapeutic range rates are still low in Turkey. As a result, this is a significant reason for switching from warfarin to non-K vitamin-dependent new oral anticoagulant treatments.

In patients with unstable angina pectoris (UAP) or non-ST elevation myocardial infarction (NSTEMI), long-term mortality remains high despite improvements in the diagnosis and treatment. In this study, we investigated whether serum albumin level is a useful predictor of long-term mortality in patients with UAP/NSTEMI. Consecutive patients (n = 403) who were hospitalized with a diagnosis of UAP/NSTEMI were included in the study. Patients were divided into 2 groups based on the presence of hypoalbuminemia and the relationship between hypoalbuminemia and mortality was analyzed. Hypoalbuminemia was detected in 34% of the patients. The median follow-up period was 35 months (up to 45 months). Long-term mortality rate was 32% in the hypoalbuminemia group and 8.6% in the group with normal serum albumin levels ( P < .001). On multivariate analysis, hypoalbuminemia, decreased left ventricular ejection fraction, and increased age were found to be independent predictors of mortality ( P < .05). The cutoff value of 3.10 g/dL for serum albumin predicted mortality with a sensitivity of 74% and specificity of 67% (receiver-operating characteristic area under curve: 0.753, 95% CI: 0.685-0.822). All-cause long-term mortality rates were significantly increased in patients with hypoalbuminemia. On-admission albumin level was an independent predictor of mortality in patients with UAP/NSTEMI.

The aim of this study is to analyze the studies on TAVI with the bibliometric method and to perform a scientiometric analysis of the top 100 most cited articles for researchers.The Thomson Reuters Web of Science database was searched for all relevant articles using the terms "TAVR" and "TAVI". The results were ordered according to the number of citations. We also analyzed the 100 most cited articles (T100) by annual average citation count (ACpY), years, research methods, author, institution, journal, funding agencies, and keywords. Analyses were also performed between the total number of citations, ACpY, impact factors, and publication time.The article titled "Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery" was the most cited article (n = 4616). The article titled "Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients" had the highest ACpY count (n = 497). The United States was the country that contributed the most to the T100 list. While the journal that contributed the most with 32 articles was "Journal of the American College Of Cardiology", the journal in which the top 10 most cited articles were published most frequently was the "New England Journal of Medicine". In addition, the most publications were made in 2012.Although this bibliometric analysis study has some limitations, it allows the most cited publications on TAVI to be analyzed systematically and provides scientific contributions.

© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disorder with recurrent fever, abdominal pain, serositis, articular manifestations, erysipelas-like erythema, and renal complications as its main features. Caused by the mutations in the MEditerranean FeVer (MEFV) gene, it mainly affects people of Mediterranean descent with a higher incidence in the Turkish, Jewish, Arabic, and Armenian populations. As our understanding of FMF improves, it becomes clearer that we are facing with a more complex picture of FMF with respect to its pathogenesis, penetrance, variant type (gain-of-function vs. loss-of-function), and inheritance. In this study, MEFV gene analysis results and clinical findings of 27,504 patients from 35 universities and institutions in Turkey and Northern Cyprus are combined in an effort to provide a better insight into the genotype-phenotype correlation and how a specific variant contributes to certain clinical findings in FMF patients. Our results may help better understand this complex disease and how the genotype may sometimes contribute to phenotype. Unlike many studies in the literature, our study investigated a broader symptomatic spectrum and the relationship between the genotype and phenotype data. In this sense, we aimed to guide all clinicians and academicians who work in this field to better establish a comprehensive data set for the patients. One of the biggest messages of our study is that lack of uniformity in some clinical and demographic data of participants may become an obstacle in approaching FMF patients and understanding this complex disease.

The purpose of this research was to determine administrators' views on their awareness of educational planning, purpose, benefits and problems they encounter with it. It was also aimed to find out if the administrators received education and training in educational planning. The research employed a qualitative phenomenological research design. The participants were 15 administrators who were determined with a maximum diversity method. The data were gathered with semi-structured interview technique and analyzed with descriptive analysis approach. Results revealed that most administrators received in-service training or education in educational planning, underlined numerous benefits, and they are aware of the importance of it. It was also discovered that although some administrators encounter problems, they consider educational planning as an important tool to achieve organizational goals.

OBJECTIVE We aimed to determine the relationship between LMR and MHR and in-hospital and long-term mortality in patients with ACS. METHODS We retrospectively collected patients with ACS undergoing coronary angiography between January 2012 and December 2013. RESULTS In total, 825 patients with a mean age of 62.4 ± 12.9 years (71.3% male) were enrolled in the study. Patients were divided into three tertiles based on MHR levels and LMR levels. In-hospital mortality of the patients was significantly higher amongst patients in the upper MHR tertile when compared with the lower and middle MHR tertile groups [30 (10.9%) vs 8 (2.9%) and 14 (5.1%); P

WOS:000595335800014 PMID: 33030023 2 They suggested providing more detailed information on the enrolled patients regarding history of coronary artery disease (CAD). However, we consider that doing that is not needed. In studies evaluating the treatment of cardiovascular diseases (interventional treatment, drug treatment, or markers with a possible prognostic value), it is typically needed to group the patients based on the presence of hypertension, presence of diabetes with regard to HbA1c levels, treatment compliance, and duration of the disease

Introduction: Atherosclerosis is a chronic inflammatory process and inflammation is an important component of acute coronary syndrome (ACS). Platelet-to-lymphocyte ratio (PLR) is a useful parameter showing the degree of the inflammatory response. Aim: To explore the association between PLR and long-term mortality in patients with ACS. Material and methods: A total of 538 patients who had a diagnosis of ACS between January 2012 and August 2013 were followed up to 60 months. On admission, blood sampling to calculate PLR and detailed clinical data were obtained. Results: In total, 538 patients with a mean age of 61.5 ±13.1 years (69% male) were enrolled in the study. Median follow-up was 79 months (IQR: 74–83 months). Patients were divided into 3 tertiles based on PLR levels. Five-year mortality of the patients was significantly higher among patients in the upper PLR tertile when compared with the lower and middle PLR tertile groups (55 (30.7%) vs. 27 (15.0%) and 34 (19.0%); p < 0.001, p = 0.010 respectively). In the Cox regression analysis, a high level of PLR was an independent predictor of 5-year mortality (OR = 1.005, 95% CI: 1.001–1.008, p = 0.004). Kaplan-Meier analysis according to the long-term mortality-free survival revealed the higher occurrence of mortality in the third PLR tertile group compared to the first (p < 0.001) and second tertiles (p = 0.009). Conclusions: PLR, which is an easily calculated and universally available marker, may be useful in long-term risk classification of patients presenting with ACS.

In this study,which is aimed at analyzing the opinions of teachers about the selection ofelective courses in high schools, the case study design of qualitative researchmethods is used. The data obtained from the interviews with the teachers willbe evaluated using descriptive data analysis, which is one of the gualitativedata analysis technigues.It is seen thatthe Ministry of National Education, school administrations and students areeffective in determining the elective courses. It is seen that the schooladministrations have chosen the elective courses of the teachers. The majorityof teachers state that elective courses are compulsory elective courses. Thereasons for not opening different elective courses are the lack of space.Although the majority of teachers do not find elective courses useful, thereare also teachers who find it useful or think it is useful for the universityexam. It has been concluded that the elective courses do not contribute to theacademic development of the student and that the student selects the electivecourses as a compulsory one.

PMID:30930444 A 19-year-old man was admitted due to sudden onset and progressively increasing shortness of breath, cough, nausea, and vomiting. The patient had undergone aortic and mitral valve replacement with mechanical prosthesis for the treatment of infective endocarditis 4 years ago.

Araştırmada farklı düzeyde eğitim verilen (lisans, yüksek lisans ve doktora) eğitim fakültelerinde çalışan öğretim elemanlarının sınıf içi iletişim becerilerinin incelenmesi amaçlanmıştır. Bu doğrultuda nicel araştırma yöntemlerinden ilişkisel tarama modeli uygulanmıştır. Araştırmanın çalışma grubu, seçkisiz olmayan örnekleme yöntemlerinden amaçlı örnekleme yöntemiyle belirlenmiş ve üç üniversitede öğrenim gören öğrencilerden veri toplanmıştır. Veri toplama aracı olarak iletişim becerileri ölçeği (Karagöz ve Kösterelioğlu, 2008) kullanılmıştır. Analiz sonuçlarında farklı düzeyde eğitim veren eğitim fakültelerinde iletişim becerileri açısından “saygı”, “ifade becerisi” ve “demokratik tutum” alt boyutlarında anlamlı bir fark gözlenemezken, “değer”, “engeller” ve “motivasyon” alt boyutlarında, öğretim düzeyi farklılaşan üniversitelere göre anlamlı farklar gözlenmiştir. Özellikle öğretmenin öğretim ortamında iyi bir model oluşturmasını, sıcak ve coşkulu olmasını, mesajın kaynağa etkili şekilde ulaşmasını belirlemeye çalışan “motivasyon” boyutu lisans düzeyinde eğitim veren üniversitede daha yüksek, doktora düzeyinde ise daha düşük bulunmuştur. “Değer” ve “engeller” alt boyutlarında ise, verilen eğitimin derecesi yükseldikçe öğretim elemanlarının iletişiminin arttığı görülmektedir. Öğretim elemanlarının iletişim becerileri konusundaki farkındalıklarını artırması için gerekli önlemler alınarak iletişim becerisi eğitimi verilmesi önerilmektedir This research study aims to examine the communication skills of the instructors of the educational faculties providing undergraduate, graduate and doctorate levels of education. In this study, a relational screening model as part of quantitative research methods was applied. The study group of the study was determined by purposeful sampling method. Communication skills scale (Karagöz and Köstereklioğlu, 2008) was used as the data collection tool. According to the results gained in this study, there is no significant difference regarding communication skills and sub-dimensions of respect, expression skills and democratic attitudes at higher education institutions providing different levels of education. However, there was a significant difference in sub-dimensions of value, obstacles and motivation at the universities where teaching levels differed. In particular, the motivational dimension that helps the teacher create a good model in the teaching environment makes him or her warm and enthusiastic, and that determines the effective communication of the message was found to be lower in B.A. level. Results also reveal that the higher the level of education increases, the better the instructor communication skills considering the dimension of value and obstacles Results also provide teacher trainers with important implications in terms of developing communications skills