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Öğe Acute coronary syndrome developed after vincristine administration(2011) Öztürk, Serkan; Baltacı, Davut; Ayhan, Selim; Yazıcı, Mehmet; Sarıtaş, AyhanVincristine and doxorubicin are among the most effective chemotherapeutic agents used in the treatment of malignancies in combination per protocols. However, these chemotherapeutic agents possess great risk for development of cardiotoxicity. The most common manifestations of cardiotoxicity due to use of those chemotherapeutic agents are arrhythmias, systolic dysfunction, cardiomyopathy, pericardial injury and myocardial ischemia. We present a case of acute coronary syndrome with complete atrio-ventricular (AV) block, developed after vincristine and doxorubicin chemotherapy in a patient with multiple myeloma and no cardiac history.Öğe Akut koroner sendrom hastalarında klinik özelliklerin ve transport zamanının akut koroner sendrom sınıflamasına göre karşılaştırılması(2011) Baltacı, Davut; Öztürk, Serkan; Durmuş, İsmet; Kandiş, Hayati; Çelik, ŞükrüAmaç: Akut koroner sendrom hastalarında akut koroner sendrom sınıflarına göre klinik özelliklerin araştırılması amaçlanmıştır. Metot ve Materyal: Çalışma kesitsel tip bir çalışma olup bir universite hastanesi koroner yoğun bakım ünitesinde akut koroner sendrom (AKS) nedeni ile yatırılan hastalarda yapılandırılmış çalışma anketi uygulanarak yapılmıştır. Ankette hastaların klinik ve sosyodemografik özellikleri ile transport zamanaları sorgulanmıştır. Bulgular: 34-88 yaş arası ve yaş ortalaması 60,7412,43 olan 152 olgu alınmıştır. Olguların 39’u kadın geriye kalan 112’si erkek hastalardan oluşmaktadır. Hastaların çoğunluğu (n114,%74,5) STsegment Elevasyonlu miyokart Enfarktüsü (STEMI) olgularından oluşurken, %24,5’i ST-segment Elevasyonsuz Miyokart Enfarktüsü (NSTEMI) hastalarından (n37,%24,5) oluşmuştur. Çalışmadaki olguların çoğunluğunun eğitim düzeyi ilkokul veya altındaydı. Sigara içenlerin sayısı da (n84, %55,6) yüksek oranda saptandı. Olguların %84,8’inde (n128) tipik anginal semptomlar gözlemlenmiştir. Hastaların akut koroner sendrom başlangıcı esnasında %36,4’ünün (n55 ) istirahat halinde olduğu saptanmıştır. Hastalarımızın %60,9 u (n92) pre-enfarkt angina tariflemiştir. Çalışmadaki hastaların şikayetleri genellikle akşam ve sabah saatlerinde (n 46, %30,5; n45, %29,8 sırayla) ortaya çıkmıştır. STEMI olguları NSTEMI olgularına göre yaş ortalaması daha düşük (59,2 12,0; 65,513,3); kadın/erkek oranı ise NSTEMI grubunda daha yüksek bulunmuştur (13/24 vs 88/26). NSTEMI grubunda bulunan hastalar anlamlı olarak daha çok atipik göğüs ağrısı ile başvurdu (p0.03) ve yine NSTEMI grubunda, öncesinde Mİ hikayesi olan hasta sayısının da daha fazla olduğu saptanmıştır (p0.019). Eşlik eden diyabet, hipertansiyon ve koroner arter hastalığı NSTEMI hastalarında STEMI’ e göre sayıca daha fazla bulunmuştur (p0.02). Sonuç: Çalışmamızda STEMI ve NSTEMI vakaları klinik özellikler açısından aralarında bazı farklılıkların olduğu gösterilmiştirÖğe Assessment of the neutrophil to lymphocyte ratio in young patients with acute coronary syndromes(2013) Öztürk, Serkan; Erdem, Alim; Özlü, Mehmet Fatih; Ayhan, Selim; Erdem, Kemalettin; Özyaşar, Mehmet; Yazıcı, MehmetAmaç: Enflamasyonun akut koroner sendrom (AKS) oluşumunda ve ilerlemesinde önemli bir rol oynadığı bilinmektedir. Beyaz kan hücresi ve alt tipleri AKS’li hastalarda enflamasyonun bir göstergesidir. Bu çalışmada, beyaz kan hücresi ve alt tiplerinin 45 yaş genç hastalarda AKS ile ilişkisinin değerlendirilmesi amaçlandı. Çalışma planı: Göğüs ağrısı şikâyetiyle acil servise başvuran ST yükselmesi olmayan AKS’li (STYz-AKS) 84 genç (45 yıl) hastanın (40 ST yükselmesiz miyokart enfarktüslü [STYzME], 44 kararsız anjina pektoris) ve 40 kişilik kontrol grubunun beyaz kan hücresi ve alt tipleri olan nötrofil ve lenfosit oranları geriye dönük olarak incelendi. Bulgular: STYz-AKS’li hastalarda hipertansiyon, diabetes mellitus, sigara kullanımı ve aile öyküsü anlamlı olarak daha yüksekti. Bu grupta ayrıca LDL seviyeleri anlamlı olarak yüksek ve HDL seviyeleri anlamlı olarak düşük bulundu (p0.041 ve p0.009). Gruplar arasında lenfosit oranları anlamlı olarak farklıydı (p0.048). Tüm gruplar arasında ve STYzME’li ile kararsız anjina pektorisli gruplar arasında N/L oranı anlamlı olarak farklı bulundu (p0.001 ve p0.041). Ayrıca, çok değişkenli doğrusal regresyon analizinde hipertansiyonun, nötrofil yüzdesinin ve N/L oranının STYz-AKS için bağımsız öngördürücüler olduğu gösterildi (sırasıyla, beta0.251, %95 GA0.002- 0.523, p0.048; beta0.561, %95 GA0.008-0.137, p0.028 ve beta0.260, %95 GA0.042-0.438, p0.018). Sonuç: N/L oranı, STYz-AKS’li genç hastalarda kontrol grubundan daha yüksek bulunmuştur. Genç STYz-AKS’li hastalarda enflamasyonun beyaz kan hücreleri ve alt tipleri ile değerlendirilmesi daha da önemli rol oynayabilir.Öğe Assessment of the neutrophil to lymphocyte ratio in young patients with acute coronary syndromes(Turkish Anaesthesiology and Intensive Care Society, 2013) Öztürk, Serkan; Erdem, Alim; Özlü, Mehmet Fatih; Ayhan, Selim; Erdem, Kemalettin; Özyaşar, Mehmet; Yazıcı, MehmetObjectives: It is well known that inflammation plays a key role in both initiation and propagation of acute coronary syndrome (ACS). White blood cell (WBC) and its subtypes are an indicator of inflammation in patients with ACS. We aimed to evaluate the WBC and its subtypes in patients aged <45 year with acute coronary syndromes. Study design: We retrospectively analyzed WBC and its subtypes (including neutrophil and lymphocyte) in 84 patients (<45 year) who were admitted to the emergency department for chest pain suggestive of ACS (44 unstable angina pectoris, 40 non-ST-segment elevation myocardial infarction [NSTEMI]), and 40 healthy controls. Results: Hypertension, diabetes mellitus, smoking, and family history were significantly higher in NSTE-ACS patients. Also, LDL levels was significantly higher and HDL levels was significantly lower in NSTE-ACS patients (p=0.041 and p=0.009). The difference in percent of lymphocytes between the groups was significant (p=0.048). N/L ratio was significantly different between all groups and between the NSTEMI and USAP (p<0.001 and p=0.041). Our results demonstrated that hypertension, percent of neutrophils, and N/L ratio was a significant independent predictor of NSTE-ACS (Beta=0.251, 95% CI=0.002-0.523, p=0.048; beta=0.561, 95% CI=0.008-0.137, p=0.028 and beta=0.260, 95% CI=0.042-0.438, p=0.018, respectively). Conclusion: N/L was found to be elevated in young patients with NSTE-ACS compared with control group. The inflammation assessed using WBC and its subtypes may be more important in young NSTE-ACS patients. © 2013 Turkish Society of Cardiology.Öğe Assessment of the relationship between aortic pulse wave velocity and aortic arch calcification(2012) Öztürk, Serkan; Baltacı, Davut; Ayhan, Selim Suzi; Durmuş, İsmet; Gedikli, Ömer; Soytürk, Mehmet; Çelik, ŞükrüAmaç: Semptomlu aterosklerotik hastalığı olmayan hastalarda arteryel sertlik parametreleri ile aort kalsifikasyonu arasındaki ilişkiyi incelemeyi amaçladık. Çalışma planı: Çalışma popülasyonu göğüs grafisinde aort yayı kalsifikasyonu olan 41 hasta (grup I, 17 erkek, ortalama yaş 705 yıl) ve kalsifikasyonu olmayan yaş ve cinsiyet eşleştirilmiş 41 kişiden (grup II, 17 erkek, ortalama yaş 686 yıl) oluşturuldu. Semptomlu veya bilinen vasküler hastalığı olanlar çalışmadan dışlandı. Tüm bireylerin arteryel sertlik parametreleri SphygmoCor cihazı ile ölçüldü. Aort nabzı dalga hızı (PWV), augmentasyon basıncı (AP), augmentasyon indeksi (AIx) ve kalp hızına göre düzeltilmiş augmentasyon indeksi (AIx@75) arteryel sertlik parametreleri olarak değerlendirildi. Bulgular: İki grup demografik özellikler, ilaç kullanımı ve serum lipit düzeyleri açısından karşılaştırıldı, gruplar arasında anlamlı fark yoktu. AP grup Ide grup IIye göre anlamlı olarak yüksek bulundu (p0.002). AIx ve AIx@75 gruplar arası benzerdi. Aort PWVsi grup I de grup IIye göre anlamlı olarak yüksek bulundu (p0.0001). Sonuç: Bu çalışmanın bulgularına göre göğüs grafisinde tespit edilen aort yayı kalsifikasyonu artmış aort nabzı dalga hızı ile ilişkilidir.Öğe COMPARISONS OF CLINICAL AND INFLAMMATORY PARAMETERS OF METABOLICALLY HEALTHY AND UNHEALTHY OBESE WITH HEALTHY LEAN BODY INDIVIDUALS IN TURKISH ADULTS(Carbone Editore, 2015) Türker, Yasemin; Baltacı, Davut; Türker, Yasin; Öztürk, Serkan; Iliev, Darko; Sarıgüzel, Yunus Cem; Alaşan,FatihAims: Aimed to determine the frequency, demographic, clinical and inflammatory parameters of metabolically healthy obese (MHO), metabolically unhealthy obese (MuHO) and metabolically healthy lean body individuals (MHLB). Materials and methods: The cross-sectional study was carried out between February 2013 and January 2014. The consecutive patients who admitted to outpatient clinic of obesity and check-up of family medicine, Duzce University, school of medicine, were enrolled. The socio-demographic features and medical history, anthropometric measurements, blood pressure records, blood samples and body fat analysis of total of 1958 patients were obtained. The patients were assigned into three groups as: MHO. MuHO and MHLB. Results: A total of 1958 patients were included. Mean homeostatic model assessment of insulin resistance (HOMAIR) value was significantly higher in subjects with MuHO than with MHO and MHLB (p<0.001 and p<0.001, respectively). Mean high density lipoprotein cholesterol (HDL-chol) was significantly lower in subjects with MuHO than in both MHO and MHLB (p<0.001). Mean low density lipoprotein cholesterol (LDL-chol) and total cholesterol was significantly higher in MuHO subjects than in MHO and MHLB (p=0.001 and p<0.001; p=0.002 and p<0.001), and lower in MHLB subjects than MHO and MuHO subjects (p<0.001 and p<0.001). Mean high-sensitivity C-reactive protein level was significantly different between groups (p<0.001), and lowest mean level was observed in subjects with MHLB (1.49 +/- 2.27 mg/dL) and highest mean level was observed in subjects with MuHO (5.32 +/- 5.71 mg/dL). Similarly, mean uric acid level was significantly higher in subjects with MuHO than in those with MHO and MHLB (p<0.001 and p<0.001. respectively). Mean uric acid level in MHLB group was lower than MHO and MuHO (p<0.001 and p<0.001, respectively). Conclusion: Obese individuals with metabolically healthy carried high risk for cardiovascular diseases and subclinical inflammation as well as metabolically unhealthy obese individuals, but carried greater risk than individuals with metabolically healthy lean body.Öğe Detection of atrial electromechanical dysfunction in obesity(Taylor & Francis Ltd, 2015) Erdem, Fatma Hızal; Öztürk, Serkan; Baltacı, Davut; Dönmez, İbrahim; Alçelik, Aytekin; Ayhan, Selim; Yazıcı, MehmetIntroduction Obesity is associated with atrial fibrillation and is known as an independent risk factor. The aim of our study was to investigate if there was any association between the body mass index and atrial electromechanical intervals in obese and non-obese patients. Methods Seventy patients were enrolled in the study. Body mass index (BMI), functional capacity, and fasting blood sugar were evaluated; then, these patients were divided into two groups, patients who had a BMI >= 30 were known as obese (35 patients) and those who had a BMI <30 were known as non-obese patients. All patients were evaluated by transthoracic echocardiography. LA volumes were measured by the discs method in the apical four-chamber view. LA active and passive emptying volumes and fraction were calculated. Using TDI, atrial electromechanical coupling (PA) was measured from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum), and right ventricular tricuspid annulus (PA tricuspid). Results LA diameter was significantly higher in obese patients (P=0.021). LA passive emptying volume and fraction were significantly decreased in obese patients (P = 0.038 and P = 0.011). LA active emptying volume and fraction were significantly increased in obese patients (P = 0.001 and P = 0.001). Left intraatrial and interatrial electromechanical delay were significantly higher in obese patients (18.9 +/- 3.8 vs 11.9 +/- 2.0, P < 0.001 and 29.5 +/- 4.1 vs 17.9 +/- 2.5, P < 0.001). Also interatrial electromechanical delay correlated positively with BMI. Conclusion This study revealed that delayed atrial electromechanical interval and impaired LA mechanical functions were related to BMI in obese patients. These findings may be an early sign of subclinical atrial dysfunction and arrhythmias in obese patients.Öğe Detection of left ventricular asynchrony and its relationship with the Tei index in patients with coronary artery ectasia(Pulsus Group Inc, 2013) Öztürk, Serkan; Ayhan, Selim; Aslantaş, Yusuf; Erdem, Alim; Özlü, Mehmet Fatih; Ekinözü, İsmail; Yazıcı, MehmetOBJECTIVE: To evaluate left ventricular (LV) systolic asynchrony and its relationship with the Tei index using tissue Doppler imaging (TDI); and to evaluate the relationship of thrombolysis in myocardial infarction frame count (TFC) and Tei index with LV asynchrony in patients with coronary artery ectasia (CAE). METHODS: A total of 50 CAE patients and 40 control subjects were evaluated. Diagnosis of CAE was made angiographically and TFC was calculated. LV systolic and diastolic function was assessed by conventional echocardiography and TDI. Evaluation of intra-LV systolic asynchrony was performed using tissue synchronization imaging (TSI). RESULTS: In patients with CAE, the Tei index was significantly higher than in controls (0.63 +/- 0.12 versus 0.52 +/- 0.12; P<0.001). LV systolic asynchrony parameters of TSI including SD of the peak tissue velocity (Ts) of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any two of the 12 LV segments (Ts-12), SD of the Ts of the six basal LV segments (Ts-SD-6), maximal difference in Ts between any of the six basal LV segments (Ts-6) were significantly lengthened in patients with subclinical hypothyroidism compared with controls (P<0.001, P<0.001, P<0.001 and P<0.001, respectively). In addition, a positive correlation was found between Ts-SD-12 and the Tei index in patients with CAE (r=0.841; P<0.001) and mean TFC was positively correlated with Ts-SD-12 and the Tei index (r=0.345; P=0.013 and r=0.291; P=0.021, respectively). CONCLUSION: Patients with CAE exhibit evidence of LV systolic asynchrony according to TSI. LV systolic asynchrony is related to the Tei index and mean TFC. Furthermore, the Tei index is an independent risk factor for LV systolic asynchrony.Öğe Detection of subclinical atrial dysfunction by two-dimensional echocardiography in patients with overt hyperthyroidism(Elsevier Masson, 2012) Ayhan, Selim; Öztürk, Serkan; Dikbaş, Oğuz; Erdem, Alim; Özlü, Mehmet Fatih; Baltacı, Davut; Yazıcı, MehmetBackground. - Hyperthyroidism is an important cardiovascular risk factor in the development of atrial fibrillation and heart failure. Increased atrial electromechanical intervals are used to predict atrial fibrillation, measured by tissue Doppler imaging (TDI). Aims. - To evaluate atrial electromechanical delay (EMD) and left atrial (LA) mechanical function in patients with overt hyperthyroidism. Methods. - Thirty-four patients with overt hyperthyroidism and 34 controls were included. A diagnosis of overt hyperthyroidism was reached with decreased serum thyroid-stimulating hormone (TSH) and increased free T4 (fT4) concentrations. Using TDI, atrial electromechanical coupling (PA) was obtained from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum) and right ventricular tricuspid annulus (PA tricuspid). LA volumes (maximum, minimum and presystolic) were measured by the disks method in apical four-chamber view and indexed to body surface area. LA active and passive emptying volumes and fractions were calculated. Results. - LA diameter was significantly higher in hyperthyroid patients (P = 0.001). LA passive emptying volume and fraction were significantly decreased in hyperthyroid patients (P = 0.038 and P < 0.001). LA active emptying volume and fraction were significantly increased in hyperthyroid patients (P < 0.001 and P < 0.001). Left and right intra-atrial (PA lateral-PA septum and PA septum-PA tricuspid) and interatrial (PA lateral-PA tricuspid) EMDs were significantly higher in hyperthyroid patients (29.2 +/- 4.4 vs 18.1 +/- 2.6, P < 0.001; 18.7 +/- 4.3 vs 10.6 +/- 2.0, P < 0.001; and 10.5 +/- 2.9 vs 7.1 +/- 1.2, P < 0.001, respectively). Stepwise linear regression analysis demonstrated that fT4 and TSH concentrations were independent predictors of interatrial EMD (beta = 0.436, P < 0.001 and beta = -0.310, P = 0.005, respectively). Conclusion. - This study showed prolonged atrial electromechanical intervals and impaired LA mechanical function in patients with overt hyperthyroidism, which may be an early sign of subclinical cardiac involvement and dysrhythmias in overt hyperthyroidism. (c) 2012 Elsevier Masson SAS. All rights reserved.Öğe Effectiveness for self-monitoring of blood sugar on blood glucose control in Turkish patients with type 2 diabetes mellitus(Medical Assoc Zenicadoboj Canton, 2012) Baltacı, Davut; Kutlucan, Ali; Öztürk, Serkan; Sarıtaş, Ayhan; Çeler, Ahmet; Celbek, Gökhan; Ankaralı, HandanAim Diabetes mellitus (DM) is a chronic disease requiring continuous monitoring and treatment. Self-monitoring of blood glucose (SMBG) is frequently recommended. The purpose of the study was to evaluate effectiveness of SMBG on metabolic control in Turkish patients with type 2 DM. Methods The cross-sectional study enrolled type 2 diabetic patients without insulin regimen. The participants were assigned to three groups according to status of SMBG: group 1- regular, group 2 - irregular and group 3 - never SMBG implementation. Results A total of 349 patients were enrolled. There was no significant difference in mean fasting and post-prandial blood glucose, lipid profile values between the groups. The number of patients with high education level in group 1 was higher than groups 2 and 3 (p = 0.001). HbA1c level was higher in groups 2 and 3 than group I, but not significantly (p = 0.285). Mean spot urinary albumin-creatinine ratio (ACR) in group I is significantly lower than in groups 2 and 3 (p = 0.008 and p = 0.044, respectively), but no significant difference was observed between group 2 and 3 (p = 0.473). Conclusion The study indicated that regular use of SMBG was not superior to irregular/never use of SMBG on glycemic control, but it seemed to be good intervention for prevention of diabetic nephropathy. We suggestively offered that SMBG should be recommended for patients with a high education level to meet the goal of its use, and it should be incorporated into self-management with effective educational intervention.Öğe The Effects of Ivabradine on Left Ventricular Synchronization and Tei Index in Patients with Systolic Heart Failure(Taiwan Soc Cardiology, 2017) Erdem, Fatma Hizal; Öztürk, Serkan; Öztürk, Selçuk; Erdem, Alim; Ayhan, Selim; Öztürk, Mustafa; Yazıcı, MehmetBackground: The aim of our study was to evaluate in stable outpatients with systolic heart failure (HF) the 3 months effect of ivabradine on LV synchronization and Tei index in stable outpatients with systolic HF. Methods: We evaluated prospectively 40 (30 males, 10 females) patients with HF. All patients were evaluated before and after treatment by transthoracic M mode, two dimensional (2D), pulsed-wave (PW), continuous wave (CW), color flow and tissue Doppler imaging (TDI) and tissue synchronization imaging (TSI). Standard deviation of Ts of the 12 LV segments (Ts-SD-12) is the most widely used parameter of intra-LV asynchrony. Results: Thirty men and 10 women with mean +/- SD age of 64.7 +/- 9.9 years were included in this study. Most of the patients benefitted from some degree of clinical improvement, 12/16 (75.0%) from NYHA III to II and 18/24 (75.0%) from II to I, respectively. Resting heart rate was significantly reduced after ivabradine treatment (84.3 +/- 11.4 vs. 66.5 +/- 11.5 bpm, p <0.001). E/E' and Tei index were significantly changed after ivabradine treatment (17.3 +/- 9.0 vs. 14.8 +/- 7.1, p = 0.02 and 0.86 +/- 0.74 vs. 0.81 +/- 0.69, p = 0.02). Intra-LV synchrony parameters Ts-SD-12 and Ts-12 were significantly reduced after ivabradine (46.8 +/- 13.6 vs. 42.7 +/- 13.1, p = 0.01 and 142.5 +/- 44.0 vs. 128.5 +/- 45.2, p = 0.009). Conclusions: The present study demonstrated that adding ivabradine to the standard therapy reduced HR and significantly improved LV ventricular asynchrony and Tei index in systolic HF patients.Öğe Effects of the Degree of Obesity on Achieving Target Blood Pressure and Metabolic Deterioration in Obese Individuals: A Population-Based Study(Karger, 2013) Öztürk, Serkan; Baltacı, Davut; Türker, Yasemin; Kutlucan, Ali; Yengil, Erhan; Deler, Mehmet Harun; Ankaralı, HandanBackground/Aims: This study aimed to evaluate the severity of obesity and its impact on achieving target blood pressure and metabolic derangement in obese individuals. Methods: This cross-sectional and population-based study was conducted between January and December 2012. A total of 1837 consecutive obese patients admitted to our outpatient clinic were enrolled. The anthropometric and blood pressure measurements, bioelectrical impedance fat analysis, blood sample analysis, impaired glucose status, metabolic syndrome, and insulin resistance of 1265 obese patients were compared between groups of patients separated by severity of obesity. Results: Only approximately one-third of patients with previous hypertension achieved normal blood pressure. In addition, the majority of patients without previous hypertension had higher blood pressure at the end of the study compared with baseline. The percent of patients with an impaired fasting blood glucose >= 100 mg/dL was 38.5%. The frequency of impaired glucose tolerance was 39.1% in the patients who underwent OGTT. Body mass index (BMI) was associated with impaired blood glucose, hypertension, insulin resistance, and the development of metabolic syndrome. The incidences of metabolic syndrome, insulin resistance, impaired glucose tolerance, and uncontrolled blood pressure were significantly different between groups of differing obesity severity (p<0.001, p<0.001, p=0.041, and p<0.001, respectively). Conclusion: The severity of obesity was associated with the failure to achieve target blood pressure and metabolic syndrome. Based on our data, blood pressure and metabolic parameters in obese patients should be monitored frequently and treated with caution. Copyright (C) 2013 S. Karger AG, BaselÖğe Evaluation of left atrial mechanical functions and atrial conduction abnormalities in patients with clinical hypothyroid(Via Medica, 2012) Öztürk, Serkan; Dikbaş, Oğuz; Özyaşar, Mehmet; Ayhan, Selim; Özlü, Fatih; Baltacı, Davut; Yazıcı, MehmetBackground: The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical delay and P wave dispersion in hypothyroid patients. Methods: Thirty-four patients with overt hypothyroid and thirty controls were included. A diagnosis of overt hypothyroid was reached with increased serum TSH and decreased free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay (EMD) were measured by tissue Doppler imaging (TDI). P wave dispersion was calculated by 12 lead electrocardiograms. Results: LA diameter were significantly higher in patients with overt hypothyroid (p = 0.021). LA passive emptying volume and LA passive emptying fraction were significantly decreased with hypothyroid patients (p = 0.002 and p < 0.001). LA active emptying volume and LA active emptying fraction were significantly increased with hypothyroid patients (p < 0.001 and p < 0.001). Infra- and interatrial EMD, were measured significantly higher in hypothyroid patients (30.6 +/- 6.1 vs 18.0 +/- 2.7, p < 0.001; and 10.6 +/- 3.4 vs 6.9 +/- 1.4, p < 0.001, respectively). P wave dispersion were significantly higher in hypothyroid patients (48.8 +/- 6.2 vs 44.3 +/- 7.2, p = 0.022). In stepwise regression analysis demonstrated that, interatrial EMD and LA active emptying fraction related with TSH and fT4. Conclusions: This study showed that impaired LA mechanical and electromechanical function in hypothyroid patients. TSH and T4 were independent determinant of interatrial EMD and LA active emptying fraction. (Cardiol J 2012; 19, 3: 287-294)Öğe Evaluation of left ventricular systolic asynchrony in patients with subclinical hypothyroidism(Via Medica, 2012) Öztürk, Serkan; Alçelik, Aytekin; Özyaşar, Mehmet; Dikbaş, Oğuz; Ayhan, Selim; Özlü, Fatih; Yazıcı, MehmetBackground: The heart was very sensitive to fluctuating thyroid hormone levels. To assess intra-left ventricular (LV) systolic asynchrony in patients with subclinical thyroid dysfunction. Methods: Fifty patients with subclinical hypothyroidism and 40 controls were included. A diagnosis of subclinical hypothyroidism was reached with increased TSH and normal free T4. All subjects were evaluated by echocardiography. Evaluation of intra-LV systolic asynchrony was performed by tissue synchronization imaging (TSI), and four TSI parameters of systolic asynchrony were calculated. LV asynchrony was defined by these parameters. Results: All of the groups were similar in terms of demographic findings and conventional and Doppler echocardiograpic parameters except peak systolic velocity and early diastolic velocity. LV systolic asynchrony parameters of TSI including; standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any 2 of the 12 LV segments (Ts-12), standard deviation of TS of the 6 basal LV segments (Ts-SD-6), maximal difference in Ts between any of the 6 basal LV segments (Ts-6) were significantly lengthened in patients with subclinical hypothyroidism than controls (p < 0.001, p < 0.001, p < 0.001 and p < 0.001, respectively). The prevalence of LV asynchrony was significantly higher in patients with subclinical hypothyroidism than control. Conclusions: Patients with subclinical hypothyroidism present evidence of LV asynchrony by TSI. LV systolic asynchrony could be a warning sign of the early stage in cardiac systolic dysfunction in subclinical hypothyroid patients. (Cardiol J 2012; 19, 4: 374-380)Öğe Evaluation of smoking habits among Turkish family physicians(Sage Publications Inc, 2014) Baltacı, Davut; Bahçebaşı, Talat; Aydın, Leyla Yılmaz; Öztürk, Serkan; Set, Turan; Eröz, Recep; Kara, İsmail HamdiSmoking is still a major public health problem in Turkey. It was aimed to investigate smoking prevalence and habits among Turkish family physicians. Cross-sectional study among physicians working in primary care settings was established. A self-administered study survey was applied. The surveys of 1233 family physicians were analyzed. The study included 704 (57.1%) male and 529 (42.9%) female physicians. Mean age (SD) was 38.94 (7.01) years. The proportions of the current, the former and never smokers among family physicians were 34.1%, 14.7% and 51.3%, respectively. Mean age (SD) of smoking initiation was 21.73 (5.04) years. Mean duration (SD) of smoking use was 14.61 (7.29) years. Proportion of current smoker in male physicians was quite higher than in female counterparts (36.9% vs. 30.4%; p < 0.001). Mean age (SD) of smoking initiation in female was 21.42 (4.59) years, but in male was 22.33 (4.98) years (p = 0.36). In female physicians, mean age (SD) for quitting cigarette smoking was found higher than in male (35.85 (6.35) years vs. 33.09 (6.45) years; p = 0.004). No significant difference between nicotine dependence (mean score (SD) of 3.76 (2.48) vs. 3.65 (2.82); p > 0.05) and mean (SD) unit of cigarette a day (18.34(6.03) vs. 17.17 +/- 6.79; p > 0.05) between genders was observed. The number of male physicians who started smoking before faculty was higher than female counterparts (15.5% vs. 8.6%; p = 0.023). In conclusion, the smoking prevalence among Turkish family physicians is considerably high.Öğe Evaluation of the corrosion inhibiting efficacy of a newly synthesized nitrone against St37 steel corrosion in acidic medium: Experimental and theoretical approaches(Elsevier Science Bv, 2018) Gerengi, Hüsnü; Solomon, Moses M.; Öztürk, Serkan; Yıldırım, Ayhan; Gece, Gökhan; Kaya, ErtuğrulA novel amphiphilic nitrone, N-phenyl-1-(4-((11-(pyridin-1-ium-1yl) undecanoyl) oxy)phenyl)methanimine oxide bromide (NP-1-4-11-PUOPMOB) has been synthesized from a fatty acid derivative as a starting material. Structural characterization of the new compound has been realized by spectroscopic techniques (FTIR, H-1 NMR, and C-13 NMR). The corrosion inhibition effect of the compound for St37 steel corrosion in 1 M HCl medium has been investigated using experimental (weight loss, electrochemical impedance spectroscopy, potentiodynamic polarization, dynamic electrochemical impedance spectroscopy) and theoretical approaches complemented by surface morphological examination using energy dispersive X-ray spectroscopy, scanning electron microscope, and atomic force spectroscopy. Results from both chemical and electrochemical techniques reveal that the presence of the nitrone in the acid solution impedes St37 steel corrosion. The inhibition efficiency obtained at 125 ppm and 150 ppm concentrations for all methods is found to be over 90%. NP-1-4-11-PUOPMOB behaves as a mixed type corrosion inhibitor according to the potentiodynamic polarization studies. The adsorption of NP-1-4-11-PUOPMOB molecules onto the metal surface follows Langmuir adsorption isotherm and the calculated K-ads (equilibrium constant of the adsorption process) value reflects strong interaction. There is evidence of NP-1-4-11-PUOPMOB adsorption on the metal surface from SEM, EDAX, and AFM studies. Experimental and theoretical results are in good agreement.Öğe Evaluation of vitamin B12 level in middle-aged obese women with metabolic and nonmetabolic syndrome: case-control study(Tubitak Scientific & Technical Research Council Turkey, 2012) Baltacı, Davut; Kutlucan, Ali; Öztürk, Serkan; Karabulut, İsmail; Yıldırım, Hayriye Ak; Çeler, Ahmet; Kara, İsmail HamdiAim: To investigate the correlation between vitamin B12 and body mass index (BMI) along with insulin resistance (IR) in middle-aged obese women. Materials and methods: The study was designed as a case-control study. The study group included middle-aged obese women and the control group included aged-matched lean women. Weight, height, and hip and waist circumferences were measured. Biochemical parameters such as fasting and postprandial glucose, vitamin B12 and folic acid levels, and lipid profiles were assayed. Results: Enrolled in the study were 116 middle-aged obese and 103 aged-matched healthy lean women. The vitamin B12 level of the obese women was significantly lower than that of the lean women (244.1 +/- 131.5 pg/mL vs. 336.2 +/- 163.1 pg/mL, P = 0.002). However, there was no significant difference in folic acid levels between the groups (P > 0.05). The vitamin B12 level was similar in the obese women with metabolic syndrome and those without (245.1 +/- 145.3 pg/mL vs. 241.2 +/- 96.5 pg/mL, P > 0.05), but the level in the control group was significantly higher than that of patients with obesity and metabolic syndrome (P = 0.010 and P = 0.020, respectively). Vitamin B12 levels correlated with BMI (r = -0.259, P = 0.003) but not with IR (r = -0.053, P > 0.05). Conclusion: The vitamin B12 concentration was low in obese patients and this level negatively correlated with BMI, but not with homeostasis model assessment-estimated IR (HOMA-IR).Öğe Evaulation of atrial conduction abnormalities and left atrial mechanical functions in patients with subclinical thyroid disorders(Via Medica, 2012) Öztürk, Serkan; Dikbaş, Oğuz; Baltacı, Davut; Özyaşar, Mehmet; Erdem, Alim; Ayhan, Selim Suzi; Yazıcı, MehmetIntroduction: Changes of thyroid hormones levels may lead to effects, not only in ventricular function, but also atrial function. The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical coupling and P wave dispersion in patients with subclinical thyroid disorders. Material and methods: Eighty patients with subclinical thyroid disorders and forty controls were included. A diagnosis of subclinical thyroid disorders were reached with increased or decreased serum TSH and normal free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay were measured by tissue Doppler imaging (TDI). Results: All groups had similar demographic findings. LA mechanical functions significantly impaired in subclinical thyroid disorders than control group. Intra- and Interatrial delay, were measured significantly higher in patients with subclinical thyroid disorders than control group. PA lateral and interatrial delay were positively correlated with TSH (r = 0.507, p = 0.006 and r = 0.455, p = 0.015, respectively) in subclinical hypothyroid patients. There was negative correlation between TSH and interatrial delay (r = -0.492,p = 0.006) in subclinical hyperthyroid patients. Linear multivariate regression analysis demonstrated that, TSH was the only an independent factor of interatrial delay in patients with subclinical thyroid disorders. Conclusions: This study showed that impaired LA mechanical and electromechanical function in subclinical thyroid disorders. TSH was an independent determinant of interatrial delay. Prolonged atrial electromechanical coupling time and impaired mechanical atrial functions may be related to the increased incidence of arrhythmias. (Endokrynol Pol 2012; 63 (4): 286-293)Öğe Investigation of relationship of visceral body fat and inflammatory markers with metabolic syndrome and its components among apparently healthy individuals(E-Century Publishing Corp, 2015) Türker, Yasemin; Baltacı, Davut; Türker, Yasin; Öztürk, Serkan; Sönmez, Cemil Işık; Deler, Mehmet Harun; Ankaralı, HandanMetabolic syndrome is a cluster of disorders and great risk for cardiovascular diseases. We aimed to investigate association between severity of metabolic syndrome (MetS) and anthropometric measurements, and to evaluate correlation of MetS and its components with metabolic deterioration and inflammatory indexes. The cross-sectional study enrolled 1474 patients with obesity and overweight. The patients were grouped as MetS and Non-MetS, and were sub-grouped as group 1 (three criteria), 2 (four criteria) and 3 (>= five criteria) according to NCEP ATP III. Mean age was 38.7 +/- 11.9 years and BMI was 35.1 +/- 6.3 kg/m(2). Lipid profile, anthropometric and blood pressure measurements, liver function tests, bioelectric impedance body fat compositions, insulin resistance and HbA1c, and spot urinary albumin-creatinine ratio were significantly different between groups of MetS and Non-MetS. Age, lipid profile, bioelectric impedance fat analyses, BMI, blood pressure values, glucose, insulin resistance, uric acid and hs-CRP levels were significantly different between groups of MetS component groups. ROC analysis revealed that hs-CRP was found to be more predictive for severity of metabolic syndrome components 3 and 4 (P=0.030); uric acid and visceral fat were more actual to predict severity of metabolic syndrome between 3 and 5 MetS components, (P=0.006) and uric acid was detected as more actual to predict severity of MetS between 4 and 5 components (P=0.023). In conclusion, uric acid, hs-CRP and visceral body fat composition were useful to predict to severity of MetS in primary care.Öğe Is the neutrophil-to-lymphocyte ratio indicative of inflammatory state in patients with obesity and metabolic syndrome?(Turkish Soc Cardiology, 2015) Bahadır, Anzel; Baltacı, Davut; Türker, Yasemin; Türker, Yasin; Iliev, Darkov; Öztürk, Serkan; Sarıgüzel, Yunus CemObjective: Obesity causes subclinical inflammation. Leukocyte count and high-sensitivity C-reactive protein (hs-CRP) are used to indicate inflammation in clinical practice. Also, inflammatory markers are evaluated as important indicators of cardiovascular risk in patients with obesity and metabolic syndrome (MetS). We aimed to investigate the usage of the neutrophil-lymphocyte ratio (NLR) as an inflammatory marker in obese patients with and without MetS. Methods: The study included a total of 1267 patients. The patients were assigned groups according to degree of obesity and status of MetS. Metabolic and inflammatory markers were compared between groups, and correlation analysis was performed. Results: Leukocyte count and hs-CRP were significantly different (p<0.001), but NLR was not different between body mass index (BMI) groups (p=0.168). Both lymphocyte and neutrophil counts were significantly increased with increased degree of obesity (p<0.001, p=0.028, respectively). Leukocyte, neutrophil, and lymphocyte counts and hs-CRP level showed a significant correlation with BMI (r=0.198, p<0.001; r=0.163, p<0.001; r=0.167, p<0.001; r=0.445, p<0.001, respectively), whereas NLR was not correlated with BMI (r=0.017, p=0.737). Only a significant association between a MetS severity of 5 and 4 with hs-CRP level was observed (p=0.028), whereas there was no statistically significant association for leukocyte count and NLR (p=0.246; p=0.643, respectively). Conclusion: NLR was not a good indicator of inflammation, while leukocyte and hs-CRP were more useful biomarkers to indicate inflammation in non-diabetic patients with obesity and MetS.
