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Türkiye’de Yükseköğretim Kurumları Sınavına (YKS) giren öğrenci sayısı gün geçtikçe artmaktadır. Bu sınav öğrenciler üzerinde stres ve kaygı gibi pek çok psikolojik soruna yol açabilmektedir. Bu araştırmanın amacı, farklı türden ortaöğretim kurumlarının son sınıflarında öğrenim görmekte olan öğrencilerin Yükseköğretim Kurumları Sınavına ilişkin kullandıkları metaforları belirlemek ve analiz etmektir. Araştırmada nitel araştırma yöntemlerinden fenomenolojik araştırma deseni kullanılmıştır. Araştırmanın çalışma grubu, İstanbul İli Silivri ve Büyükçekmece İlçelerinde devlet okullarında öğrenim gören 505 lise son sınıf öğrencisinden oluşmaktadır. Çalışma grubu maksimum çeşitlilik örnekleme yöntemi kullanılarak belirlenmiştir. Araştırmada toplanılan veriler yapılandırılmış görüşme formu kullanılarak elde edilmiştir. Verilerin analizinde tümevarımcı analiz yöntemi kullanılmıştır. Bu kapsamda öğrencilerin oluşturduğu metaforlar, benzerlik ve farklılıklarına göre araştırmacılar tarafından alt tema ve temalar altında toplanmışlardır. Metaforların toplandığı alt temalar “olumsuz çağrışım”, “belirsizlik”, “yarış/mücadele”, “gelecek/umut” alt temaları ve “endişe/kaygı” ile “beklenti” temalarıdır. Çalışmadan elde edilen sonuçlara göre öğrenciler üniversite sınavını en çok “kabusa” ve “ölüme” benzetmişlerdir. Öğrenciler genel olarak üniversite sınavını ölüm kalım meselesi olarak değerlendirmektedir. Çalışmanın son bölümünde ise ortaya çıkan metaforlardan hareketle okul rehberlik servisleri ile ilgili kurumların yapacağı çalışmaların önemine vurgu yapılmıştır

Türkiye’de ortaöğretim kurumlarında sınıf geçme ile ilgili esaslar Millî Eğitim Bakanlığı Ortaöğretim Kurumları Yönetmeliği ile düzenlenmektedir. Anadolu Liselerinde öğrenim gören öğrenciler, Ortaöğretim Kurumları Yönetmeliği gereği 50 not ortalamasına ulaşmaları durumunda zayıf ders sayılarına bakılmaksızın bir üst sınıfa geçebilmektedirler. Araştırmada, örnek durumlar oluşturularak olası notlar belirlenmiş ve öğrencilerin nasıl sınıf geçtikleri tespit edilmiştir. Buna göre öğrenciler, lise öğrenimleri boyunca Matematik, Fizik, Kimya, Tarih, Coğrafya gibi derslerden hiç başarılı olmasalar bile mezun olabilmektedirler. Oysaki ortaöğretim kurumlarının amaçları arasında ortak bir genel kültür kazandırmak, teknolojiden faydalanarak nitelikli eğitim vermek, yabancı dil öğretmek vb. sayılmaktadır. Zayıf ders sayısına bakılmaksızın ortalama ile öğrencilerin sınıf geçmesinin sayılan hedefleri yakalamayı güçleştirdiği düşünülmektedir. Söz konusu durumun lise mezunu sayısını artırdığı, ancak mezunların niteliğini aşağıya çektiği düşünüldüğünden bu makalede Anadolu Liselerinde çalışan öğretmenlerin görüşleri de alınarak Anadolu Liselerinde sınıf geçme sistemi üzerinde önerilerde bulunulmuştur.

Bu çalışmanın amacı, okul müdürlerinin kullandıkları çatışma çözme stratejileri ile öğretmenlerin motivasyonları ve örgütsel bağlılıkları arasında bir ilişki olup olmadığının ortaya çıkarılmasıdır. Araştırma, nicel araştırma yöntemine ve ilişkisel tarama desenine göre gerçekleştirilmiştir. Araştırmanın çalışma grubu 2021-2022 eğitim-öğretim yılında İstanbul ili Silivri ve Çatalca ilçelerinde çalışan 344 öğretmenden oluşmuştur. Araştırma sonucunda elde edilen veriler korelasyon ve regresyon analizleri yapılarak çözümlenmiştir. Bulgular incelendiğinde okul müdürlerinin kullandıkları “hükmetme” çatışma çözme stratejisi ile öğretmenlerin hem “motivasyonları” hem de “örgütsel bağlılıkları” arasında negatif yönlü bir ilişki tespit edilmiştir. Bu sebeple ortaya çıkan çatışmalarda okul müdürlerinin “hükmetme stratejisini” kullanmaktan kaçınmaları tavsiye edilmiştir. Öğretmen motivasyonunun en önemli yordayıcısının “ödün verme” stratejisi; öğretmenlerin örgütsel bağlılığının en önemli yordayıcılarının ise “tümleştirme” ve “ödün verme” stratejileri olduğu tespit edilmiştir. Elde edilen bulgulardan yola çıkılarak araştırmanın son bölümünde eğitim örgütlerinde ortaya çıkan çatışma durumlarında okul müdürlerinin hangi çatışma çözme stratejilerini kullanmalarının öğretmenlerin motivasyonları ve örgütsel bağlılıkları açısından daha uygun olacağı konusunda önerilerde bulunulmuştur., The aim of this study is to find out whether there is a relationship between the "conflict resolution strategies" used by school principals and the "motivation" and "organizational commitment" of teachers. The research was carried out according to the quantitative research method and relational survey design. The study group of the research consisted of 344 teachers working in Silivri and Çatalca districts of Istanbul in the 2021-2022 academic year. The data obtained as a result of the research were analyzed by performing correlation and regression analyzes. When the findings were examined, a negative relationship was found between the "dominating” conflict resolution strategy used by school principals and both the "motivation" and "organizational commitment" of teachers. For this reason, it is recommended that school principals avoid using the “dominating strategy” in the conflicts that arise. It has been determined that the most important predictor of teachers motivation is the strategy of "obliging"; the most important predictors of teachers’ organizational commitment are “integrating” and “obliging” strategies. In the last part of the research, suggestions were made about which conflict resolution strategies would be more appropriate for school principals to use in conflict situations arising in educational organizations in terms of teachers' motivation and organizational commitment.

BACKGROUND: Microvascular dysfunction is one of the pathophysiological mechanisms in heart failure. Nailfold videocapillaroscopy is a noninvasive technique used to examine the microvasculature. OBJECTIVE: In this study, we aimed to investigate the nailfold capillaroscopic abnormalities in heart failure patients with reduced and preserved ejection fraction and compare those with control group. METHODS: Three groups of patients were recruited for the study: HFrEF group includes the patients with heart failure with reduced ejection fraction (HFrEF), HFpEF group, patients with heart failure with preserved ejection fraction (HFpEF) and control group, healthy asymptomatic individuals. Nailfold videocapillaroscopy was performed with a videodermatoscope and all nailfold images were evaluated for enlargement and hemorrhages. RESULTS: Abnormal videocapillaroscopic findings including enlargement and/or hemorrhages were present in 7 (24%) patients in HFrEF group, 19 (66%) patients in HFpEF group and 11 (37%) in control group. The number of patients with abnormal videocapillaroscopic findings were significantly greater in HFpEF group compared to HFrEF (p

Bu araştırmanın amacı, eğitim bilimleri anabilim dalı, temel eğitim ana bilim dalı ve eğitim yönetimi bilim dallarında “öğretmenlerin mesleki mutlukları, iş mutlulukları, iş yeri mutlulukları, okul mutlulukları ve örgütsel mutlulukları” konulu lisansüstü tezlerin analizini yapmak ve söz konusu tezleri metodolojik açıdan incelemektir. Araştırma, bir sistematik derleme çalışmasıdır. Bu kapsamda, Yükseköğretim Kurumu Ulusal Tez Merkezinde yer alan ve 2000-2021 yılları arasındaki tezler incelenmiştir. Tezler, anahtar kelimelere, yıllara, yapıldıkları üniversitelere, danışman unvanlarına, ana/bilim dallarına, yöntemlerine, örnekleme yöntemlerine, örneklem gruplarına, örneklem büyüklüklerine, veri toplama araçlarına göre analiz edilmiştir. Türkiye’de eğitim alanında son 20 yılda yapılan ve öğretmenlerin mesleki mutluluk, iş mutluluğu, iş yeri mutluluğu, okul mutluluğu, örgütsel mutluluğunu inceleyen 31 lisansüstü tez, araştırmanın kapsamını oluşturmuştur. Söz konusu kavramları konu alan tezlerin 2018 yılından sonra artış gösterdiği, daha çok yüksek lisans seviyesinde tezler yapıldığı, erkek öğretmenler ile kadın öğretmenler arasında genellikle anlamlı bir farklılık olmadığı, tezlerinin çoğunun nicel yöntemlerden yararlanarak oluşturulduğu, ağırlıklı olarak 300-400 örneklem grubu ile yapıldığı ve bu örneklemin daha çok İstanbul’dan seçildiği tespit edilmiştir. Örgütsel mutluluk, mesleki mutluluk, iş mutluluğu, iş yeri mutluluğu, okul mutluluğu kavramlarını ele alan tezler birlikte değerlendirildiğinde, öğretmenlerin söz konusu alanlarda genel olarak “yüksek düzeyde” mutluluğa sahip oldukları görülmüş ve araştırmanın son bölümünde incelenen kavramların çeşitli değişkenlerle ilişkilerine yer verilerek önerilerde bulunulmuştur., The aim of this research is to analyze the postgraduate theses on "teachers' professional happiness, job happiness, workplace happiness, school happiness and organizational happiness" in the departments of educational sciences, basic education and educational administration and to examine these theses from a methodological point of view. The research is a systematic review study. In this context, theses in the National Thesis Center of the Higher Education Institution and between the years 2000-2021 were examined. Theses were analyzed according to keywords, years, universities, advisor titles, departments, methods, sampling methods, sample groups, sample sizes, and data collection tools. The scope of the search consists of 31 postgraduate theses, which have been conducted in the field of education in Turkey in the last 20 years and examine teachers' professional happiness, job happiness, workplace happiness, school happiness, and organizational happiness. The theses on the aforementioned concepts increased after 2018, they were mostly made at the master's level, there was generally no significant difference between male teachers and female teachers, most of the theses were created by using quantitve methods, they were predominantly made with a sample group of 300-400, and this was the case. It was determined that the sample was mostly selected from Istanbul. When the theses that dealing with the concepts of organizational happiness, professional happiness, job happiness, workplace happiness, school happiness are evaluated together, it has been seen that teachers generally have a "high level" of happiness in these areas, and in the last part of the research, suggestions have been made by giving place to the relations of the concepts examined with various variables.

Arslan, Ugur/0000-0001-8572-3571; Yenercag, Mustafa/0000-0002-0933-7852 WOS: 000524288900001 PubMed: 32198929 Background Cardiac resynchronization therapy (CRT) is an important and effective therapy for end-stage heart failure (HF). Nonresponse to CRT is one of the main obstacles to its application in clinical practice. Herein, we investigated the utilization of the optimization technique using noninvasive cardiac output measurement (NICOM) based Mobil-O-Graph device that measures several circulation parameters noninvasively. Methods Seventy-five CRT nonresponder HF patients with an implanted CRT device were included. Patients were randomized equally to 3 groups: NICOM, echocardiographic, and empirical optimization groups. After 3 months of optimization, changes in six minutes walk test (6-MWT), cardiac output (CO), left ventricular ejection fraction (LVEF), and end-systolic volume (LVESV) were measured. New York Heart Association (NYHA) class and hospitalization for HF were also determined. Results There were no statistically significant differences among the three groups in terms of demographics, baseline characteristics. In the NICOM group, the 6-MWT, LVEF, CO, and LVESV measurements showed significant improvements compared to baseline values (P < .05). There was no significant improvement in 6-MWT, LVEF, CO, NYHA class, and LVESV in Echo and Empirical groups after 3 months (P > .05). 6-MWT, CO, LVESV percentages, and hospitalization for HF were significantly different between the groups (P < .05). In post hoc analyzes, the percentages of the change in 6-MWT, CO, LVESV, and hospitalization for HF were significantly higher in the NICOM group (P < .017). Conclusions This study suggests that Mobil-O-Graph device optimization according to CO measures does appear to have potential hemodynamic and clinical benefits in nonresponder CRT patients. Use of Mobil-O-Graph device as an option for optimization of CRT devices can be an attractive method of improving CRT outcomes.

Background and Objectives: An inter-arm systolic blood pressure difference (IASBPD) is defined as a blood pressure (BP) disparity of ≥10 mmHg between arms. IASBPDs are associated with an increased risk of cardiovascular disease (CVD). Similarly, visceral fat accumulation (VFA) is clinically important because it is associated with higher cardiovascular disease risk. Accordingly, this study compared the body composition parameters of IASBPD individuals with individuals who did not express an IASBPD. Materials and Methods: The analysis included 104 patients. The blood pressures of all participants were measured simultaneously in both arms using automated oscillometric devices. Then patients were divided into two groups according to their IASBPD status: Group 1 (IASBPD- (&lt, 10 mmHg)), Group 2 (IASPPD+ (≥10 mmHg)). Body composition parameters were measured using bioelectrical impedance analysis. Results: In 42 (40%) patients, the simultaneously measured IASBPD was equal to or higher than 10 mmHg. The right brachial SBP was higher in 63% of patients. There were no differences between the groups in terms of demographic and clinical characteristics. Regarding the two groups’ body composition parameter differences, VFA was significantly higher in group 2 (p = 0.014). Conclusions: The IASBPD is known to be associated with an increased risk of cardiovascular events. Although the body mass indexes (BMIs) of the two groups were similar, VFA levels in those with a greater than 10 mmHg IASBPD were found to be significantly higher. This finding may explain the increased cardiovascular risk in this group.

Infection is an important factor leading to the exacerbation of heart failure (HF), resulting in hospitalization. Demodex species are obligatory parasites in human skin, and increased density was reported in immunocompromised patients. In this study, we aimed to investigate the Demodex density in hospitalized HF patients compared to that of healthy controls. Methods: This study included 36 HF patients and 36 age and sex-matched healthy controls. Five standardized biopsies were taken from the face of participants and assessed for Demodex by a light microscope. Results: At least one Demodex mite was detected in 20 HF patients and nine of the control group. The number of Demodex mites was significantly higher in the HF group (median 1, min. 0 and max. 10) compared to the control group (median 0, minimum. 0 and maximum. 3). Demodicidosis was positive in 14 of the HF patients. Demodicidosis was not detected in the control group. Conclusions: This study showed that Demodex positivity is more common in HF patients hospitalized for HF exacerbation. Demodicidosis should be considered in hospitalized HF patients.

WOS: 000450917400020 PubMed: 32082811 Total anomalous pulmonary venous return is observed in 1.5 to 3% of congenital heart diseases. Urgent surgical intervention is required following the diagnosis, since severe heart failure is accompanied by cyanosis from the first days of life in most of the patients. This rare congenital heart disease is often managed in adulthood with surgery. Patients who survive until adulthood without a surgical intervention have a large atrial septal defect. A 36-year-old female patient was admitted with complaints of fatigability, shortness of breath, and cyanosis of the lips. Total anomalous pulmonary venous return, secundum-type atrial septal defect, ventricular septal defect, and pulmonary hypertension were diagnosed by transthoracic echocardiography and catheter angiography. After medical treatment, surgery was planned for the patient who responded to the pulmonary vasoreactivity test with iloprost.

Soylu, Korhan/0000-0001-7908-2763 WOS: 000466057200008 PubMed: 30877018 Cigarette smoking is reportedly associated with coronary, cerebral, and peripheral vascular diseases. Nailfold videocapillaroscopy is a noninvasive imaging technique used to examine the microvasculature. In this study we aim to investigate the capillaroscopic abnormalities of asymptomatic chronic smokers (N = 30), and compare findings to those of healthy nonsmokers (N = 30). Nailfold videocapillaroscopy was performed with a videodermatoscope, with images recorded at 40 x magnification. Capillary morphologies were assessed as normal, enlargement, tortuosity, and microhemorrhages. Capillaroscopic abnormalities were seen in 16 (53.3%) of subjects within the smoker group and seven (23.3%) within the nonsmoker group (p < 0.05). Six smokers had only capillary enlargement; another 10 had both capillary enlargement and microhemorrhages. In comparison, enlarged capillaries and both enlarged capillaries and microhemorrhages were observed in three and four nonsmokers, respectively. In conclusion, nailfold capillaroscopic abnormalities were more common among asymptomatic chronic smokers than healthy nonsmokers, with the enlargement of nailfold capillaries being the most common abnormality. Nailfold videocapillaroscopic examination may serve as an efficient tool in determining micro vascular abnormalities in asymptomatic chronic smokers not only for risk stratification purposes, but also to take the measures needed to preclude future vascular events.

Objectives: Coronary artery fistulas connecting coronary arteries to cardiac cavities are rare but clinically significant anomalies. Clinical Presentation and Intervention: A 47-year-old male patient presented with syncope. Left ventricular dysfunction was detected on echocardiography. Extensive coronary fistulas draining into the left ventricle were found on coronary angiography. Ventricular fibrillation was induced on electrophysiology study. Because of the induction of ventricular fibrillation, extensive fistulas, and presence of other risk factors, an implantable cardioverter defibrillator was implanted. After the detection of ischemia by nuclear scanning, microcoil occlusion of the fistula was performed. Conclusion: The present case describes extensive fistulas complicated with fatal ventricular arrhythmias due to ischemia and left ventricle dysfunction. A cardioverter defibrillator was implanted to prevent sudden cardiac death.

Background and Objectives: The mean platelet volume (MPV) represents a possible marker of platelet activation. There is an association between the platelet count (PC) and inflammation and platelet reactivity. We assessed the association between the MPV/PC ratio and circadian alterations in blood pressure (BP). Material and Methods: One hundred and twenty subjects in total, 80 hypertensive subjects and 40 healthy subjects (controls), were enrolled in the study group. Twenty four hour ambulatory BP monitoring (ABPM) was applied to all subjects. According to ABPM results, the hypertensive subjects were separated into two groups, such as dippers (n = 40) and non-dippers (n = 40). In all subjects, the collection of venous peripheral blood samples was performed on admission for PC and MPV measurements. Results: The two groups exhibited similar clinical baseline characteristics. A significantly higher MPV/PC ratio was determined in non-dippers compared to that in dippers and normotensives. The higher MPV/PC ratio was observed in non-dippers in comparison with that in dippers and normotensives (0.046 &plusmn, 0.007 to 0.032 &plusmn, 0.004 fL/[109/L], 0.046 &plusmn, 0.007 to 0.026 &plusmn, 0.004 fL/[109/L], p &lt, 0.001, respectively). A receiver operating characteristic (ROC) curve analysis showed that the optimum cut-off value of the MPV/PC ratio for predicting non-dipping patterns in hypertensive patients was 0.036 (area under the curve [AUC]: 0.98, p &lt, 0.001). According to the cut-off value, sensitivity and specificity were found to be 95% and 95%, respectively. Conclusions: The higher MPV/PC ratio was determined in non-dipper hypertensive subjects in comparison with that in dipper hypertensive subjects. An elevation of platelet activity and an increase in thrombus burden are reflected by an increase in the MPV/PC ratio. The MPV/PC ratio may underlie the increase in cardiovascular risk in non-dippers compared to that in dippers.

WOS: 000392196600010 PubMed: 27147402 Objective: Although an early repolarization (ER) pattern was considered to be a benign electrocardiographic variant, several studies have shown that it is associated with an increased risk of idiopathic ventricular fibrillation and death. The aim of the present study was to determine whether there is any abnormality in myocardial deformation parameters (strain, strain rate, rotation, and twist) of the left ventricle obtained by speckle-tracking echocardiography (STE) in subjects with ER pattern. Methods: There were two groups in this prospective case-control study. The first group consisted of subjects with ER pattern (n=35). The other group was control without ER pattern (n=25). Subjects with poor echocardiographic image quality and history of cardiovascular, pulmonary, systemic, or metabolic disease were excluded from the study. For STE of the left ventricle, two-dimensional images from apical long-axis, twochamber, and four-chamber views and from parasternal short-axis views were obtained. Results: We did not observe significant differences between the groups for left ventricular (LV) longitudinal deformation parameters, rotation, and twist. When LV circumferential deformation parameters were analyzed, early diastolic strain rate value at the level of apex was higher in subjects with ER pattern (2.3 +/- 0.7 s(-1) vs. 1.9 +/- 0.4 s(-1), p=0.01). Among LV radial deformation parameters, only peak strain (42.5 +/- 16.1% in the ER group vs. 56.9 +/- 21.1% in controls, p=0.004) and early diastolic strain rate (-2.0 +/- 0.7 s(-1) in the ER group vs. -2.3 +/- 0.7 s(-1) in controls, p=0.03) values at the level of papillary muscle were different. Conclusion: In subjects with ER pattern, LV myocardial deformation evaluated by STE is normal with a few regional exceptions. STE does not provide much information about risk stratification of these subjects.

Isotretinoin is widely used in the treatment of acne vulgaris and other dermatological diseases. Numerous side effects have been reported in the literature. A myocardial bridge occurs when segments of the coronary artery create an intramyocardial tunnel. Atherosclerotic plaque formation frequently occurs in the segment proximal to a myocardial bridge. Coronary thrombus formation, which is often the cause of myocardial infarction in young patients, can be triggered by many factors. Kounis syndrome is described as acute coronary syndromes associated with allergic or hypersensitivity reactions. This article is a description of the case of a patient predisposed to the development of a thrombus by a myocardial bridge who was successfully treated for coronary thrombosis and which may represent a case of Kounis syndrome associated with isotretinoin use presented in the context of the relevant literature.

WOS: 000417874800016 PubMed: 29076819 …

WOS: 000417874800002 PubMed: 29076822 …

WOS: 000343097300008 PubMed: 24721807 The data on the successful use of oral anticoagulation (OAC) in patients with atrial fibrillation are inconclusive. We aimed to describe the indications and the utilization patterns of OAC therapy in patients with atrial fibrillation who have been admitted to a quaternary hospital. Patients who were admitted to a quaternary hospital from January 2011 to January 2012 with atrial fibrillation were included in the study. The data on patient demographics, atrial fibrillation classification, CHA2DS2VASc scores, and the use of OAC were collected. Of the patients admitted, 301 patients met the inclusion criteria. Of these, 277 (92%) had a CHA2DS2VASc score at least 2. Of the patients who met criteria for treatment with OAC, 104 (36.6%) were not on OAC therapy. The reason for this discrepancy was tendency and history of bleeding (29.8%). Of those 180 patients who were on OAC, the time in therapeutic range was higher in those patients less than 50 years as compared with those between ages 65-74 and more than 75 (78.2 versus 42 and 36.1%, P

BACKGROUND Psoriasis is a systemic inflammatory disease associated with increased risk of cardiovascular diseases. The heart rate recovery index (HRRI) is an indicator of autonomic nervous system function and is an independent prognostic risk factor for cardiovascular diseases. The aim of this study was to evaluate the heart rate recovery indices in patients with psoriasis. MATERIAL AND METHODS Thirty-three psoriasis patients (22 male; mean age 41 ± 11 years) and 26 healthy individuals (15 male; mean age 39 ± 11 years) as a control group were included in the study. Baseline electrocardiography, transthoracic echocardiographic examinations, and exercise stress tests were performed in psoriasis and control groups. The heart rate recovery of the psoriasis group at 1, 2, 3, 4, and 5 minutes after maximal exercise were calculated and compared to those of the control group. RESULTS Baseline demographic and clinical characteristics of psoriasis and control groups including age, sex, body mass index, systolic blood pressure, and echocardiographic parameters were similar. Total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels were significantly higher and high-density lipoprotein cholesterol levels were significantly lower in the psoriasis group (p

Background Chemerin is a novel adipokine that plays a role in inflammation and atherosclerosis. Although there are several correlations between hypertension and the inflammatory system, there is still insufficient information about the relationship between blood pressure variability and inflammatory markers. In this study, we aimed to determine whether chemerin levels are elevated in non-dipper patients compared with dippers and healthy controls. Material/Methods This study was composed of a group of 90 patients: 60 hypertensive patients and 30 healthy control subjects (12 males, mean age 53.2±15.4 years). Ambulatory blood pressure monitoring devices (ABPM) were connected to all patients. Using data from the ABPM, hypertensive patients were divided into 2 groups: 30 dipper patients (12 males, mean age 52.5±15.1 years) and 30 non-dipper patients (11 males, mean age 54.6±13.0 years). Complete blood count and biochemistry were measured by standard methods and plasma chemerin concentrations were quantified by ELISA. Results Non-dipper patients demonstrated higher chemerin levels compared to dippers and normotensives (219.7±16.3 vs. 182.4±21.4 ng/ml; 219.7±16.3 vs. 85.4±38.1 ng/ml, respectively, p

Background and Objective: The coronary slow flow phenomenon (CSFP) is a coronary artery disease with a benign course, but its pathological mechanisms are not yet fully understood.The purpose of this controlled study was to investigate the cellular content of blood in patients diagnosed with CSFP and the relationship of this with coronary flow rates. Methods: Selective coronary angiographies of 3368 patients were analyzed to assess Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) values. Seventy eight of them had CSFP, and their demographic and laboratory findings were compared with 61 patients with normal coronary flow . Results: Patients’ demographic characteristics were similar in both groups. Mean corrected TFC (cTFC) values were significantly elevated in CSFP patients (p

Objective: To analyze the coronary angiograms of patients with symptomatic heart disease in order to determine the frequency and characteristics of coronary-cameral communications (CCCs) in a single center. Subjects and Methods: The coronary angiograms of 16,573 patients with symptomatic heart disease performed from November 2001 to January 2011 were analyzed. The diagnosis of coronary fistula and coronary-cameral microcommunications (CCMCs) was made according to previously defined criteria. Results: Of the 16,573 patients, 15 (0.09%; 8 males and 7 females, mean age 63 ± 12 years) had CCCs, while coronary fistulas were identified in 2 (0.01%). In the first patient, the coronary fistula arose from the branches of the left anterior descending (LAD) artery and the right coronary artery (RCA) and drained into the right ventricle. In the second patient, the fistula originated from branches of the LAD artery, the circumflex (Cx) artery and the RCA and drained into the left ventricle. In 7 patients, the CCMCs originated from the LAD artery. In 3 patients, the Cx artery was the origin. The CCMCs originated from the RCA in 2 patients. In 1 patient the CCMC took its origin from the RCA and the Cx artery, while in 2 patients the CCMCs were associated with intracardiac masses in the left atrium and the right atrium, respectively. Conclusion: The prevalence of CCCs in adult patients was low and that of large coronary fistulas was even lower; coronary fistulas are probably very rare in adult patients because the majority of them are detected and treated during childhood.

Akut koroner sendrom, koroner arter hastaliginda kritik bir donemin klinik olarak yansimasidir. Elektrokardiyografi (EKG) ve biyokimyasal belirteclere dayanarak ST yukselmeli miyokard infarktusu, non-ST yukselmeli miyokard infarktusu ve kararsiz angina olarak 2 ana gruba ayrilir. Bu klinik gruplarin ortak patofizyolojisi plak rupturu veya erozyonu sonrasi trombus olusumudur. Akut koroner sendrom ile basvuran hastalarin tedavisinde amac iskeminin duzeltilmesi ve olum, miyokard reinfarktusu ve hayati tehdit eden aritmileri iceren komplikasyonlarin onlenmesidir. Tedavi agirlikli olarak EKG ve biyobelirtecler tarafindan yonlendirilir. Genel olarak, tedavi secenekleri, antiplatelet tedavi, antitrombinler, fibrinolitik, perkutan koroner girisim ve kalp cerrahisidir. Primer perkutan koroner girisim veya fibrinoliz ile saglanan hizli ve kalici reperfuzyon hastalarda erken ve uzun vadeli sonuclari iyilestirir. The treatment of ST elevation myocardial infarction Acute coronary syndrome is the clinical manifestation of the critical phase of coronary artery disease. Based on electrocardiogram (ECG) and biochemical markers it is distinguished from ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and unstable angina. The common underlying pathophysiology is related to plaque rupture or erosion with subsequent thrombus formation. Treatment of patients presenting with an acute coronary syndrome aims at immediate relief of ischaemia and the prevention of serious adverse events, including death, myocardial reinfarction, and life-threatening arrhythmias. The general management is predominately guided by the ECG and biomarkers. In general, treatment options include antiplatelet therapy, antithrombins, fibrinolytics, percutaneous coronary interventions, and cardiac surgery. In patients with ST-segment elevation rapid and sustained reperfusion of the infarct related artery by primary percutaneous coronary intervention or fibrinolysis improves early and long-term outcome. J. Exp. Clin. Med., 2012; 29: S127-S131

Pacemaker and implantable cardioverter defibrillators (ICD) systems are useful in detection and differentiation of many symptomatic and asymptomatic arrhythmias. In this report, we described a rare condition that caused by failure in detection of a clinical tachyarrhythmia by a dual chamber pacemaker that implanted because of intermittent atrioventricular (AV) block and sinus node disease in a 46-year-old patient. In our case, bidirectional interatrial block was demonstrated; and the symptoms associated with high ventricular rate caused by left atrial tachyarrhythmias relieved after AV node ablation.

WOS: 000386539200007 PubMed ID: 27904512 Introduction: The arrhythmia potential has not been investigated adequately in psoriatic patients. In this study, we assessed the ventricular repolarization dispersion, using the Tp-e interval and the Tp-e/QT ratio, and investigated the association with inflammation. Material and methods: Seventy-one psoriasis vulgaris patients and 70 age and gender-matched healthy individuals were enrolled in the study. The severity of the disease was calculated using Psoriasis Area and Severity Index scoring. The QTd was defined as the difference between the maximum and minimum QT intervals. The Tp-e interval was defined as the interval from the peak of the T wave to the end of the T wave. The Tp-e interval was corrected for heart rate. The Tp-e/QT ratio was calculated using these measurements. Results: There were no significant differences between the groups with respect to basal clinical and laboratory characteristics (p > 0.05). The Tp-e interval, the corrected Tp-e interval (cTp-e) and the Tp-e/QT ratio were also significantly higher in psoriasis patients compared to the control group (78.5 +/-8.0 ms vs. 71.4 +/-7.6 ms, p < 0.001, 86.3 +/-13.2 ms vs. 77.6 +/-9.0 ms, p < 0.001 and 0.21 +/-0.02 vs. 0.19 +/-0.02, p < 0.001 respectively). A significant correlation was detected between the cTp-e time and the Tp-e/QT ratio and the PASI score in the group of psoriatic patients (r = 0.51, p < 0.001; r = 0.59, p < 0.001, respectively). Conclusions: In our study, we detected a significant increase in the Tp-e interval and the Tp-e/QT ratio in patients with psoriasis vulgaris. The Tp-e interval and the Tp-e/QT ratio may be predictors for ventricular arrhythmias in patients with psoriasis vulgaris.

Purpose: Neutrophil gelatinase-associated lipocalin (NGAL) is a protein belonging to the lipocalin superfamily and plays a role in atherosclerosis, renal injury and inflammation. The present study aimed to investigate serum NGAL concentrations in groups of patients with dipper and non-dipper hypertension (HT) and to characterize the relationship between NGAL concentration and circadian blood pressure in hypertensive patients. Methods: A total of 41 (22 male, 19 female, mean age: 56.1 ±8.9 years) non-dipper HT patients, 40 (19 male, 21 female, mean age: 54.0 ±10.0 years) dipper HT patients and 42 age- and gender-matched healthy individuals were enrolled in the study. Dipper and non-dipper HT were diagnosed via ambulatory blood pressure monitoring. Serum NGAL concentrations were measured by enzyme-linked immunosorbent assay from blood samples obtained from patients. Results: Serum NGAL concentrations were found to be significantly higher in the non-dipper and dipper HT patient groups in comparison with the control group (84.9 ±23.0 ng/ml and 62.1 ±17.8 vs. 46.6 ± 13.7 ng/ml, p

PubMed ID: 25706659, Aim: The aim of this study was to evaluate the effect of ivabradine treatment on aortic stiffness by measuring aortic elastic parameters in patients with heart failure (HF) receiving ivabradine treatment. Materials and Methods: The study included clinical patients who were diagnosed with HF (ejection fraction

WOS: 000357329700007 PubMed: 25430414 Objective: The underlying mechanism of coronary slow flow (CSF) has not yet been clarified, although many studies have been conducted to understand its pathophysiology. In this study, we investigated the role of a very potent vasoconstrictor, urotensin-II (UII), in the pathophysiology of CSF. This prospective and controlled investigation aimed to evaluate the association between CSF and serum levels of UII. Methods: Our study included 32 patients with slow flow in any coronary artery and 32 patients with normal coronary arteries. Coronary flow was calculated using the Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) method, and CSF was defined as TFC >= 39 for the left anterior descending artery, TFC >= 27 for the circumflex coronary artery, and TFC >= 24 for the right coronary artery. UII levels in blood samples obtained from both groups were measured by enzyme-linked immunosorbent assay ( ELISA) method. Results: UII levels were significantly higher in the CSF group than in the control group [122 pg/mL (71-831), 95 pg/mL (21-635), respectively; p

Yuksel, Serkan/0000-0001-9501-4568 WOS: 000322319500004 PubMed: 23602280 …

WOS: 000369881500011 PubMed: 26925123 Introduction: Neutrophil-to-lymphocyte ratio (NLR), which is an essential marker of inflammation, has been shown to be associated with adverse outcomes in various cardiovascular diseases in the literature. In this study we sought to evaluate the association between NLR and prognosis of acute pulmonary embolism (APE). Material and methods: We retrospectively evaluated blood counts and clinical data of 142 patients with the diagnosis of pulmonary embolism (PE) from Ondokuz Mayis University Hospital between January 2006 and December 2012. The patients were divided into two groups according to NLR: NLR < 4.4 (low NLR group, n = 71) and NLR >= 4.4 (high NLR group, n = 71). Results: Massive embolism (66.2% vs. 36.6%, p < 0.001) and in-hospital mortality (21.1%, 1.4%, p < 0.001) were higher in the high NLR group. In multivariate regression analysis NLR >= 5.7, systolic blood pressure (BP) < 90 mm Hg, serum glucose > 126 mg/dl, heart rate > 110 beats/min, and PCO2 < 35 or > 50 mm Hg were predictors of in-hospital mortality. The optimal NLR cutoff value was 5.7 for mortality in receiver operating characteristic (ROC) analysis. Having an NLR value above 5.7 was found to be associated with a 10.8 times higher mortality rate than an NLR value below 5.7. Conclusions: In patients presenting with APE, NLR value is an independent predictor of in-hospital mortality and may be used for clinical risk classification.

WOS: 000340560300009 PubMed: 24801557 Objectives There is accumulating evidence that inflammation plays a major role in the development of the slow coronary flow (SCF) phenomenon. In this study, we aimed to study the biomarker neutrophil gelatinase-associated lipocalin (NGAL) as it relates to SCF. Materials and methods Patients who underwent coronary angiography before and had no significant epicardial coronary disease were included in the study. Patients who had Thrombolysis in Myocardial Infarction frame counts (TFCs) above the normal cutoffs were considered to have SCF and those within normal limits were considered to have normal coronary flow (NCF). The NGAL levels and biochemical profiles of all patients were studied and analyzed with coronary flow parameters. Results There were 50 patients in the SCF group and 50 patients in the NCF group. The serum NGAL level was higher in those patients in the SCF group versus the NCF group (75.2 +/- 39.7 vs. 50.6 +/- 24.2, P < 0.001). There was a significant correlation between the NGAL levels and TFC (r=0.684, P < 0.001). Multivariable regression analysis showed that the NGAL levels were an independent predictor of the SCF phenomenon (odds ratio = 1.060, 95% confidence interval: 1.008-1.115, P = 0.023). Conclusion In this study, we show that patients with SCF have elevated levels of NGAL. We further show a strong correlation between the NGAL levels and coronary blood flow. We conclude that elevated NGAL levels might be a useful tool in predicting SCF in patients who undergo coronary angiography. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

Aim: The aim of this study was to establish the degree of aortic stiffness and levels of neutrophil gelatinase-associated lipocalin (NGAL) in patients with stable ischemic heart disease. Materials and Methods: Patients who were found to have stable, noncritical lesions on coronary angiography were included in the study [noncritical coronary artery disease (CAD)]. The control group consisted of those patients who had similar risk profiles and metabolic parameters without atherosclerosis on angiography. Results: A total of 101 patients were included in the study of which 56 had noncritical CAD. Whereas the aortic strain (9.11 ± 3.4 vs. 14.01 ± 4.1%, p < 0.001) and aortic distensibility (3.98 ± 1.9 10-6 cm2/dyn vs. 6.33 ± 2.3 10-6 cm2/dyn, p < 0.001) were lower in the noncritical CAD group, the aortic stiffness index was higher (6.34 ± 3.9 vs. 3.37 ± 2.4, p < 0.001) as compared to controls. Serum NGAL levels were higher in the noncritical CAD group (79.29 ± 38.8 vs. 48.05 ± 21.4 ng/ml, p < 0.001). NGAL levels were negatively correlated with aortic strain (p < 0.01, r = 0.57) and distensibility (p < 0.001, r = 0.62), but positively correlated with the aortic stiffness index (p < 0.001, r = 0.72). Conclusion: We show that in patients with noncritical CAD, the degree of aortic stiffness and NGAL levels are higher. These markers can be used as tools for further risk stratification of patients with noncritical CAD.

Yuksel, Serkan/0000-0001-9501-4568 WOS: 000325413800004 PubMed: 23301552 Hypertension terms "dipper" and "non-dipper" are propounded by the change that occurs during ambulatory blood pressure (BP) monitoring. The purpose of this study is to present whether the serum urotensin II levels are different in patients with dipper and non-dipper hypertension and to put forward the effects causing this difference, if there are any. Patients recently diagnosed with hypertension were included in the study. With ambulatory BP monitoring, 81 patients with high BP were divided into two groups, dipper (n = 40) and non-dipper (n = 41). Serum urotensin II levels were analyzed by ELISA method. Serum urotensin II levels were higher in patients with non-dipper hypertension than in patients with dipper hypertension (204 [106-533] vs. 140 [96-309], P = .004). There was a positive correlation between total systolic BP and serum urotensin II levels (r = 0.408 and P = .009), but the relation in the non-dipper hypertension group was not significant (r = 0.194 and P = .2). In conclusion, serum urotensin II levels were higher in non-dipper HT patients than dipper HT patients. This higher urotensin II level might be responsible for poor prognoses.

A woman aged 70 years was transferred from another medical centre to our hospital because of shortness of breath, hemoptysis, and ischemic changes in the right foot (Fig. 1A). She had chronic renal failure and had been enrolled in a hemodialysis treatment program for 6 years. Transesophageal echocardiography showed a guidewire in the right atrium and right ventricle, with multiple mobile thrombi attached to it. The guidewire entered the right atrium through the superior vena cava, passed into the right ventricle through the lateral tricuspid valve annulus, and then looped in the right ventricle. One of the thrombi was entrapped within a patent foramen ovale and oscillated between right and left atria (Fig. 1B; Video 1 ; view video online). Pulmonary computed tomography angiography showed emboli in the segmental artery of the right lower lobe and a subsegmental artery of the left lower lobe. Because of the precarious state of the patient and the risk of further emboli, it was decided to take the patient for emergency cardiac surgery. The intracardiac guidewire and multiple thrombi were removed successfully (Fig. 1C). Unfortunately, because of multiple comorbidities, hemodynamic instability, and profound acidosis, she died on the second postoperative day. Vascular interventional procedures are widely used, resulting in increased complication rates. Guidewire loss may lead to thrombosis, embolism, sepsis, arrhythmia, or perforation. Loss of a complete guidewire is a rarely reported complication. Percutaneous retrieval is the preferred treatment, with low complication and high success rates. Various devices and techniques, such as loop snares, 2-wire or triplewire technique, basket retrievers, special catheters, grasping

Congenital anomalies of the coronary arteries affect about 1.3% of individuals. One of the most commonly encountered anomalies involves the anomalous origination of a coronary artery from the opposite sinus of Valsalva. The incidence of ectopic left coronary artery arising from the right sinus of Valsalva was found between 0.017-0.15% in coronary angiography and autopsy series. Catheter-based revascularization of anomalous artery is a therapeutic challenge and needs experience. In this case report, we demonstrated successful percutaneous coronary interventions to anomalous left main coronary artery osteal lesion and proximal lesion in anomalous left anterior descending artery in two patients with anomalous left coronary artery origin from right sinus of Valsalva. J. Exp. Clin. Med., 2013; 30:93-95