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Öğe ASSOCIATION OF INCREASED TRIGLYCERIDE LEVELS IN METABOLIC SYNDROME WITH CORONARY ARTERY DISEASE(Professional Medical Publications, 2010) Helvaci, Mehmet Rami; Kaya, Hasan; Gundogdu, MehmetObjective: We tried to understand significance of increased triglyceride (TG) values in metabolic syndrome and coronary artery disease (CAD). Methodology: Check up cases with a TG value lower than 60 mg/dL were collected into the first, between 60 and 99 mg/dL into the second, between 100 and 149 mg/dL into the third, between 150 and 199 into the fourth, and 200 mg/dL and greater into the fifth groups. Results: Study included 478 cases. Values of the mean age, weight, body mass index, TG, and low density lipoprotein cholesterol (LDL-C) and prevalences of smoking, white coat hypertension (WCH), hypertension (HT), type 2 diabetes mellitus (DM), and CAD increased gradually and significantly nearly in all steps from the first towards the fifth groups. Conclusion: Metabolic syndrome may be a progression step between complete physical health and irreversible end points, such as obesity, type 2 DM, HT, CAD, and stroke. Hypertriglyceridemia and White Coat Hypertension (WCH) may be the most significant reversible parameters of the syndrome, and it is better to have the lowest TG value as much as possible. The most significant increase was seen after the value of 100 mg/dL. The overweight, smoking, hypertriglyceridemia, hyperbetalipoproteinemia, and WCH may only be one of hundreds of parameters of the syndrome. Therefore, it is advisable that underlying etiologies rather than revesible parameters of the syndrome should be targeted for treatment. For example, increased TG and LDL-C values, and prevalence of WCH by aging may be secondary to decreased physical and mental stresses in elderly.Öğe Association of increased triglyceride levels in metabolic syndrome with coronary artery disease(2010) Helvaci, Mehmet Rami; Kaya, Hasan; Gundogdu, MehmetObjective: We tried to understand significance of increased triglyceride (TG) values in metabolic syndrome and coronary artery disease (CAD). Methodology: Check up cases with a TG value lower than 60 mg/dL were collected into the first, between 60 and 99 mg/dL into the second, between 100 and 149 mg/dL into the third, between 150 and 199 into the fourth, and 200 mg/dL and greater into the fifth groups. Results: Study included 478 cases. Values of the mean age, weight, body mass index, TG, and low density lipoprotein cholesterol (LDL-C) and prevalences of smoking, white coat hypertension (WCH), hypertension (HT), type 2 diabetes mellitus (DM), and CAD increased gradually and significantly nearly in all steps from the first towards the fifth groups. Conclusion: Metabolic syndrome may be a progression step between complete physical health and irreversible end points, such as obesity, type 2 DM, HT, CAD, and stroke. Hypertriglyceridemia and White Coat Hypertension (WCH) may be the most significant reversible parameters of the syndrome, and it is better to have the lowest TG value as much as possible. The most significant increase was seen after the value of 100 mg/dL. The overweight, smoking, hypertriglyceridemia, hyperbetalipoproteinemia, and WCH may only be one of hundreds of parameters of the syndrome. Therefore, it is advisable that underlying etiologies rather than revesible parameters of the syndrome should be targeted for treatment. For example, increased TG and LDL-C values, and prevalence of WCH by aging may be secondary to decreased physical and mental stresses in elderly.Öğe Body mass index or body weight alone(Medi+World Int, 2013) Helvaci, Mehmet Rami; Aydin, Yusuf; Gundogdu, MehmetBackground: Excess weight and smoking may be the major underlying causes of metabolic syndrome. Methods: Consecutive patients with coronary heart disease (CHD) were studied. Results: Study included 1,620 females and 1,240 males. Prevalences of CHD were similar in both sexes (3.8% versus 4.4%, respectively, p>0.05). Smoking and chronic obstructive pulmonary disease (COPD) were higher in males with CHD (p<0.001 and p<0.05, respectively). Low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) were higher in females (p= 0.008 and p= 0.002, respectively). Hypertension (HT) and diabetes mellitus (DM) were higher in females, too (p<0.001 and p<0.05, respectively). WCH was also higher in females, but the difference was nonsignificant probably due to the small sample sizes (p>0.05). Although body weight of males with CHD was significantly higher (79.1 versus 74.4 kg, p= 0.027), females had a higher BMI value (29.7 versus 28.3kg/m2, p>0.05), but the difference was nonsignificant probably due to the above reason again. Conclusion: Metabolic syndrome is a systemic atherosclerotic process mainly caused by aging, excess weight, and smoking. Smoking and excess weight come with a similar degree of clinical severity. CHD, as a major consequence of the syndrome, is seen with similar prevalences in both sexes with the higher prevalence of smoking in males against the higher prevalences of BMI and its consequences including LDL-C, TG, WCH, HT, and DM in females. Although body weight is higher in males, BMI and its consequences are higher in females, thus BMI should be preferred to determine excess weight rather than weight alone.Öğe Gender differences in coronary heart disease in Turkey(Professional Medical Publications, 2012) Helvaci, Mehmet Rami; Kaya, Hasan; Gundogdu, MehmetObjectives: To find out whether or not there are some gender differences according to prevalence and underlying risk factors of coronary heart disease (CHD). Methodology: The study was performed in the Internal Medicine Polyclinic on consecutive patients coming with any complaint at and above the age of 15 years between August 2005 and March 2007. Patients under 15 years of age are examined in Paediatrics Department. Results: The study included 2860 cases. Prevalence of CHD was similar both in males and females (4.4% vs 3.8%, p > 0.05, respectively). Mean age of CHD was 63.5 years in males and 61.5 years in females (p > 0.05). Prevalence of smoking was higher in males with CHD (54.5% vs 9.6%, p < 0.001). Females had a nonsignificantly higher mean body mass index (BMI) (28.3 vs 29.7 kg/m2, p > 0.05). Mean values of low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) were higher in females (115.6 vs 132.6 mg/dL, p = 0.008 and 150.1 vs 250.3 mg/dL, p = 0.002, respectively). White coat hypertension (WCH) was nonsignificant (23.6% vs 30.6%, p > 0.05), but hypertension (HT) and diabetes mellitus (DM) were significantly higher in females (p<0.001 and p < 0.05, respectively). On the other hand, coronary artery stenting (CAS) and/or coronary artery bypass graft (CABG) surgery was greater among males (21.8% vs 1.6%, p < 0.001). Conclusion: CHD is probably seen with similar prevalences in both sexes in Turkey with some prominent differences in the underlying risk factors. Prevalence of smoking was higher in males, whereas mean values of the BM!, LDL-C, TG and prevalences of the WCH, HT, DM were higher in females. On the other hand, prevalence of CAS and/or CABG surgery was significantly higher in males.Öğe Gender differences in patients with metabolic syndrome in coronary artery interventions(Medical Association of Zenica-Doboj Canton, 2013) Helvaci, Mehmet Rami; Kaya, Hasan; Gundogdu, MehmetAim We tried to understand whether or not there was a gender difference in coronary artery interventions in coronary heart disease (CHD) cases in the present study. Methods The study was performed in two phases. The irst phase was performed at the Internal Medicine Polyclinic of the Dumlupinar University between August 2005 and March 2007. CHD was diagnosed either angiographically or with history of coronary artery stenting (CAS) and/or coronary artery bypass graft (CABG) surgery. The second phase was performed at the Internal Medicine Polyclinic of the Mustafa Kemal University between March 2007 and April 2012. During the second phase, the CHD patients with CAS and/or CABG surgery were detected and divided into two groups according to the gender. Results Mean age and prevalence of CHD were similar in both genders (p>0.05 for both) in the irst phase. Smoking was higher in males with CHD, in 30 cases (54.5%) of males versus six (9.6%) cases of females (p<0.001), as well as chronic obstructive pulmonary disease (COPD), in ten (18.1%) cases of males versus four (6.4%) cases of females (p<0.05). Although the body mass index (BMI) and white coat hypertension (WCH) were insigniicantly higher (p>0.05 for both), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) were signiicantly higher in females with CHD (p= 0.008 and p= 0.002, respectively). Hypertension (HT) and diabetes mellitus (DM) were higher in females with CHD, too (p<0.001 and p<0.05, respectively). On the other hand, CAS and/or CABG surgery were signiicantly higher in male CHD cases (21.8% versus 1.6%, p<0.001). Parallel to the irst phase cases, majority of CAS and/or CABG surgery cases were males in the second phase cases too (90.2% versus 9.7%, p<0.001). Conclusion As some components of the metabolic syndrome, smoking and COPD were higher in males whereas BMI, WCH, LDL-C, TG, HT and DM were higher in females. Despite similar prevalences of CHD in both sexes, CAS and/or CABG surgery were signiicantly higher in males probably due to fear of loss of power required for their dominant roles in life and sexuality.Öğe Gender differences in severity of sickle cell diseases in non-smokers(Professional Medical Publications, 2013) Helvaci, Mehmet Rami; Ayyildiz, Orhan; Gundogdu, MehmetObjective: To find out gender differences in severity of sickle cell diseases (SCDs) in non-smokers. Methods: Three groups of SCDs patients on the basis of red blood cell (RBC) transfusions were included. Less than 10 units in their lives were kept in Group-1, Ten units of higher in Group-2 and 50 units or higher as the Third Group. Patients with a history of using one pack of cigarettes -year or above were excluded. Results: The study included 269 patients. Mean ages of the groups were similar (28.4, 28.5, and 28.9 years, respectively). Prevalences of cases without any RBC transfusion in their lives were 7.2% and 3.7% in females and males, respectively (p < 0.05). Prevalences of cases without any painful crisis were 13.8% and 6.0% in females and males, respectively (p < 0.001). There was progressive increase according to mean painful crises, clubbing, chronic obstructive pulmonary disease (COPD), leg ulcers, stroke, chronic renal disease (CRD), pulmonary hypertension, and male ratio from the first towards the third groups (p < 0.05, nearly for all). Mean ages of mortal cases were 29.1 and 26.2 years in females and males, respectively (p > 0.05). Conclusion: The higher painful crises per year, digital clubbing, COPD, leg ulcers, stroke, CRD, pulmonary hypertension, and male ratio of the third group, lower male ratio of patients without any RBC transfusion, lower male ratio of patients without any painful crisis, lower mean ages of male SCDs patients with mortality, and longer overall survival of females in the world could not be explained by well known strong atherosclerotic effects of smoking alone, instead it may be explained by the dominant role of male sex in life.Öğe RELATIONSHIP BETWEEN VON WILLEBRAND FACTOR ACTIVITY AND THERAPEUTIC SUCCESS OF THROMBOLYTIC THERAPY IN PATIENTS WITH MYOCARDIAL INFARCTION(Modestum Ltd, 2007) Kiki, Ilhami; Kose, Nuri; Gundogdu, Mehmet; Kaya, Hasan; Cetinkaya, RamazanAim: Von Willebrand Factor is a glycoprotein, which plays role in primary hemostasis, mainly acts getting platelets to adhere onto the subendothelial tissue and carrying Factor VIII. Although vWF deficient animals had been shown to be resistant to atherosclerosis and thrombotic events, it had not been proven in humans. In this study, we aimed to investigate whether a relationship exists between VWF activity and therapeutic success of thrombolysis. Methods: The study was carried out on 40 patients who were administered thrombolytic therapy due to myocardial infarction and 30 healthy controls. Von Willebrand Factor activity was measured in plasma samples which were taken before the procedure. The results were compared between therapy effective and ineffective patients and controls. Results: Average vWF activity was 131.0 +/- 64.0% in patients whereas 113.9 +/- 47.7% in controls (p> 0.05). On the other hand, mean VWF activities of 24 patients who achieved therapeutic success and 16 therapy failed patients were 103.9 +/- 58.9% and 171.7 +/- 49.0% respectively (p< 0.01). Conclusion: In this study; we found that plasma vWF activity is among the factors affecting the outcome of thrombolytic therapy in patients with myocardial infarction so, it may be used to predict the therapeutic success of thrombolysis.Öğe Smoking induced atherosclerosis in cancers(Drunpp-Sarajevo, 2012) Helvaci, Mehmet Rami; Aydin, Yusuf; Gundogdu, MehmetBackground: Strong associations between smoking and systemic atherosclerosis and cancers are well documented. Methods: Consecutive female and males with coronary heart disease (CHD) were studied. Results: Study included 1,620 females and 1,240 males. Prevalences of CHD were similar in both sexes (3.8% versus 4.4%, respectively, p>0.05). Mean ages of CHD cases were 61.5 versus 63.5 years in both sexes, respectively (p>0.05). Smoking and chronic obstructive pulmonary disease were significantly higher in males with CHD (54.5% versus 9.6%, p<0.001 and 18.1% versus 6.4%, p<0.05, respectively). On the other hand, body mass index and white coat hypertension were higher in female patients (29.7 versus 28.3 kg/m(2) and 30.6% versus 23.6%) but differences were nonsignificant (p>0.05 for both) probably due to small sample sizes. Whereas low density lipoprotein cholesterol and triglyceride were higher in females with CHD, significantly (132.6 versus 115.6 mg/dL, p=0.008 and 250.3 versus 150.1 mg/dL, p=0.002, respectively). Similarly, hypertension and diabetes mellitus were also higher in females, significantly (58.0% versus 30.9%, p<0.001 and 51.6% versus 38.1%, p<0.05, respectively). Conclusion: Aging alone may be the most significant disease of human being, and probably systemic atherosclerosis is the major cause of it. Smoking and excess weight may be the major causes of the systemic atherosclerotic process, and they come with similar degree of clinical severity. Although the well known mutagenic effects of smoking, its role in cancers may also be related with the systemic atherosclerotic process that immune cells can not eradicate cancer cells due to insufficient blood supply, effectively.Öğe Spuriously high phosphate level which is promptly resolved after plasmapheresis in a patient with multiple myeloma(Pergamon-Elsevier Science Ltd, 2007) Kiki, Ilhami; Gundogdu, Mehmet; Kaya, HasanWe present a 57 year old female patient with IgG multiple myeloma and marked hyperphosphatemia. The patient had no clinical symptoms related to hyperphosphatemia. Serum inorganic phosphate measurements were repeated on sulfosalicylic acid deproteinized serum samples, yielding normal phosphate levels. We realized that this hyperphosphatemia was spurious because of high paraprotein levels. Afterwards, therapeutic plasma exchange (TPE) was administered due to hyperviscosity and bleeding tendency. After the administration of TPE, serum phosphate was reduced to normal level. Therapeutic plasma exchange resulted in steady-state serum phosphate levels during the three months follow up period. We concluded that high phosphate levels must be confirmed by measuring in deproteinized serum samples in multiple myeloma patients in order to distinguish pseudohyperphosphatemia from the true ones. In addition, TPE effectively reduces the spuriously elevated phosphate levels possibly by removing paraproteins. (C) 2007 Elsevier Ltd. All rights reserved.Öğe White coat hypertension may be an initial sign of the metabolic syndrome.(2012) Helvaci, Mehmet R; Kaya, Hasan; Gundogdu, Mehmetto understand the role and significance of WCH in definition of the metabolic syndrome. the study was performed in the Internal Medicine Polyclinic of the Dumlupinar University between August 2005 and March 2007. We took consecutive patients at and above the age of 20 years. Their medical histories including smoking habit, DM, dyslipidemia, and already used medications were learnt, and a routine check up procedure including fasting plasma glucose (FPG), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and an electrocardiography was performed. Comparison of proportions was used as the method of statistical analysis. the study included 1,068 cases. Prevalences of excess weight increased from the third (28.7%) up to the seventh decades (87.0%), gradually (p<0.05 nearly in all steps), and then decreased in the eighth (78.5%, p<0.05) decade of life. The most significant increase was seen during the passage from the third to the fourth decades (28.7% versus 63.6%, p<0.001) with a similar fashion to smoking. Hyperbetalipoproteinemia, hypertriglyceridemia, dyslipidemia, impaired glucose tolerance (IGT), and WCH had a similar fashion with excess weight by increasing until the seventh decade and decreasing afterwards (p<0.05 nearly in all steps). Whereas hypertension (HT), type 2 diabetes mellitus (DM), and coronary heart disease (CHD) always increased without any decrease by decades (p<0.05 nearly in all steps), indicating their irreversible natures. WCH may be an initial sign of the systemic atherosclerotic process that can be detected easily and prevented by a trend towards weight loss.