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Adult T-cell acute lymphoblastic leukemia; skin involvement: Case report
(Turkiye Klinikleri, 2015) Şen, Tu?ba; Şen, Bilge Bülbül; Yaldiz, Mehmet; Rifaio?lu, Emine Nur; Ekiz, Özlem; Taş, Zeynel Abidin; Kaya, Hasan
T-cell acute lymphoblastic leukemia (T-ALL), derived from precursor T cell, is a hematologic malignancy which spreads over the extramedullary organs. Skin metastasis of leukemia; leukemia cutis, rarely seen in T-cell leukemia, is infiltration of skin by malign leukemic cells. A thirty-three years old woman who diagnosed as T-ALL one year ago was consulted to our department for skin lesions. In dermatological examination, erythematous brownish nodules and tumors were observed on her face, body and extremities. The lesions were evaluated as T-ALL skin involvement according to histopathological investigation. Chemotherapy was initiated to the patient. After treatment, noduler and tumoral lesions became smaller. However, the patient died because of sepsis. In conclusion, T-ALL which is a malignant hematological disease characterized by bone marrow and internal organ involvement rarely metastases to the skin. Skin involvement of T-ALL indicates poor prognosis. We present this case who has widespread skin lesions because it is rarely seen.
Asemptomatik tip-2 diyabetik hastalarda obezitenin sol ventrikül diyastolik fonksiyonu ve Tei indeksi üzerine etkisi
(2006) Seyfeli, Ergün; Duru, Kemal; Sağlam, Hayrettin; Akgül, Ferit; Seydaliyeva, Tünzale; Yalçın, Fatih; Kaya, Hasan
Amaç: Tip 2 diyabetes mellitus (DM) obezite ile yakın ilişki içindedir. Bu çalışmanın amacı diyabetik hastalarda sol ventrikül (SV) diyastolik fonksiyonu ile Tei indeksi üzerine obezitenin etkisini araştırmaktır. Gereç ve Yöntem: Bu çalışmaya 50 asemptomatik tip-2 DM’li hasta dahil edildi. Hastalar vücut kitle indekslerine göre normal kilolu (10 kadın, 10 erkek) ve obez grup (20 kadın, 10 erkek) olarak ikiye ayrıldı. Vücut kitle indeksinin (VKİ) 18.5-24.9 kg/m2 arasında olması normal kilolu, ?30 kg/m2 olması ise obezite olarak kabul edildi. Hastalara M-mode ve 2 boyutlu Doppler ekokardiyografik ölçümler yapıldı. Tei index-Miyokard performans indeksi (MPİ) daha önce tarif edildiği şekilde ölçüldü. Bulgular: Diyabetik obezlerde diyabetik obez olmayanlara göre sol atrium genişliği, arka duvar kalınlığı, SV kitle, SV kitle indeksi ve rölatif duvar kalınlığı daha yüksek (p=0.001, p=0.004, p<0.001, p=0.048, p=0.038, sırasıyla), buna karşın ejeksiyon fraksiyonu ve fraksiyonel kısalma ise daha düşük bulundu (p=0.044, p=0.011, sırasıyla). Diyabetik obez olmayan hastaların %65’inde mitral E/A oranı <1 iken, diyabetik obez hastalarda ise bu oran %84 idi (p=0.112). Diyabetik obez olmayan hastalara göre diyabetik obezlerde sadece A dalga hızında ise artma anlamlı bulundu. VKİ ile mitral A dalga hızı (r=0.400, p=0.005), arka duvar kalınlığı (r=0.317, p=0.034) ve SV kitle (r=0.451, p=0.002) arasında anlamlı ilişki bulundu. MPİ ise diyabetik obezlerde diyabetik obez olmayanlara göre daha yüksekti. MPİ ile İVGZ (r=0.382, p=0.007), mitral E dalgası (r=-0.544, p<0.001), fraksiyonel kısalma (r=-0.287, p=0.048) ve ejeksiyon fraksiyonu (r=-0.354, p=0.013) arasında anlamlı ilişki bulundu. Sonuç: Obezite diyabetik hastalarda sol venrikülü yapısal ve fonksiyonel olarak olumsuz etkilemektedir.
Association between tumor markers (CA125, CA15-3) and homozygous sickle cell anemia
(Bayrakol Medical Publisher, 2022) Kavvasoglu, Gamze Hande; Kavvasoglu, Baris; Kaya, Hasan
Aim: Sickle Cell Anemia (SCA) is a systemic and chronic inflammatory disease and is one of the most common hemoglobinopathies in the world and in our country. Cancer antigen 15-3 (CA15-3) and cancer antigen (CA125) have an important place in cancer screening, treatment follow-up and disease follow-up today. However, it has been shown that it may be high in some diseases other than these purposes. In this study, we also planned to determine the relationship between tumor markers and patients with SCA, which is a chronic inflammatory and ischemic disease. Material and Methods: Patients over the age of 18 who were diagnosed with homozygous SCA and followed up in the Department of Internal Diseases of Hatay Mustafa Kemal University Health Practice and Research Hospital and applied to the outpatient clinic were included in the study. Height, weight, body mass index (BMI) and waist circumference of all patients were measured. Echocardiographic examination was performed. Blood samples were collected from the patients to study CA125 and CA15-3 on appropriate days and conditions. Results: A total of 34 patients, 19 female and 15 male, and 35 healthy volunteers, 16 female and 19 male, were included in the study. In the echocardiographic examinations, the ejection fraction was normal in the control and SCA groups, and no signs of pericardial effusion were found. The mean CA15-3 of the patients with SCA was 56.42 +/- 23.73 U/ml, the mean of CA15-3 of the control group was 9.99 +/- 4.62 U/ml, and there was a statistically significant difference (p=0,001). The median CA125 value of patients with SCA was calculated as 5.95 U/ml, while the highest was 99 U/ml and the lowest was 1.8 U/ml. While the median CA125 value of the control group was calculated as 6 U/ml, the highest measurement was 17.8 U/ml and the lowest measurement was 0.7 U/ml. There was no any statistically significant difference between the groups. Discussion: Although the CA15-3 level was high in patients with SCA, the CA125 level was normal. We think that CA15-3 level is important in understanding the pathophysiology and mechanism of SCA and in terms of follow-up. Our study should be supported by studies with large patient participation.
ASSOCIATION OF FETUIN-A WITH GLUCOSE-6-PHOSPHATE DEHYDROGENASE AND OXIDATIVE STRESS IN SICKLE CELL ANEMIA
(Carbone Editore, 2016) Ulutas, Kemal Turker; Buyukbas, Sadik; Yilmaz, Nigar; Arpaci, Abdullah; Kaya, Hasan
Aim: Oxidative stress has crucial effects over vascular pathophysiology of Sickle Cell Anemia (SCA), and contributes atherosclerosis at advanced stages of the disease. In contrast to be acknowledged the possible role of Fetuin-A in the development of atherosclerosis, its association with vascular changes in SCA appears to warrant further investigation. In the study, we aimed to illuminate vascular pathophysiology of SCA via investigating Fetuin-A levels and its relationship with oxidative stress parameters. Material and methods: Fourty SCA patients and and 35 healthy individuals (n: 35) were included in the study all. After analyzing hematological data, Malondialdehyde (MDA), Glutathione Peroxidase (GSH-Px), Superoxide Dismutase (SOD) and Catalase (CAT) were measured throughout preparing hemolysate from samples with EDTA. Fetuin-A was analyzed from serum samples. Results: Fetuin-A (p<0.001) and MDA levels (p<0.001) were measured significantly higher in SCA group. Similarly, G6PD (p<0.001) and SOD (p<0.01) enzyme activities were determined higher in SCA when compared to the control group. A novel positive correlation was found among Fetuin-A, G6PD (r=0.435, p<0.0001) and MDA (r=0.547, p<0.0001). However, there was no statistical significance between the groups for CAT and GSH-Px. ROC analyze suggested 0,97 ng/mL as the cutoff value for Fetuin-A (Area Under the Curve: 0.713, sensitivity: 62%, specificity: 80%, p:0,002) and 0,06 mu mol/gr Hb as the cutoff value for MDA (Area Under the Curve: 0.898, sensitivity: 87 %, specificity: 80%, p:<0,001). Conclusion: Elevated Fetuin-A in patients with SCA and its positive correlations with both MDA and G6PD suggested that Fetuin-A might have an important role for pathophysiology of SCA. Additionally, Fetuin-A may be useful for evaluating severity of disease with high specificity cutoff value as MDA.
ASSOCIATION OF INCREASED TRIGLYCERIDE LEVELS IN METABOLIC SYNDROME WITH CORONARY ARTERY DISEASE
(Professional Medical Publications, 2010) Helvaci, Mehmet Rami; Kaya, Hasan; Gundogdu, Mehmet
Objective: 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.
Association of increased triglyceride levels in metabolic syndrome with coronary artery disease
(2010) Helvaci, Mehmet Rami; Kaya, Hasan; Gundogdu, Mehmet
Objective: 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.
Bilateral primary breast lymphoma: A rare case
(2011) Yetim, İbrahim; Durgun Yetim, Tülin; Özkan, Orhan Veli; Diner, Güvenç; Savaş, Nazan; Davran, Ramazan; Helvacı, Rahmi; Kaya, Hasan
Primary non Hodgkin’s lymphoma of the breast is rare. Bilateral involvement of the breasts is even morerare. Lymphomas are divided into two groups: Hodgkin’s Lymphoma and non Hodgkin’s lymphoma. Diffuse large cell non Hodgkin’s lymphoma is the most common type. A 56 year old female presented with masses in both breasts. An excisional biopsy was obtained from both tumoral masses. Histopathological assessment revealed diffuse large cell non Hodgkin’s lymphoma and chemotherapy was started. Here we present the case of bilateral primary breast lymphoma while discussing clinical characteristics, treatment modalities and the outcomes.
Body weight and white coat hypertension
(2009) Helvaci, Mehmet Rami; Kaya, Hasan; Sevinc, Alper; Camci, Celaletdin
Objective: To understand prognostic significance of white coat hypertension (WCH), and any its association with excess weight. Methodology: We studied consecutive check up patients between the ages of 35 and 70 years to be able to see possible consequences of excess weight on health and to avoid debility induced weight loss in elderly people. Results: The study included 721 cases (426 females). Prevalences of normal weight, overweight, and obesity were detected as 19.0%, 43.3%, and 37.5%, respectively. There were gradual and significant increases in the prevalences of WCH and hypertension (HT) towards the overweight and obesity groups (p<0.001 for all). So 73.7% of the obesity cases had either WCH or HT, and overall prevalence of WCH was 37.9%, which was nearly equal to the prevalence of obesity. When we compared the groups according to the prevalences of hyperbetalipoproteinemia, dyslipidemia, diabetes mellitus (DM), and coronary heart disease (CHD), gradual and significant increases towards the overweight and obesity groups were seen nearly in all steps. Conclusion: There is gradual increased prevalence of WCH in the overweight and obesity groups, parallel to gradually increased prevalences of hyperbetalipoproteinemia, dyslipidemia, HT, DM, and CHD. In addition nearly equal prevalence of WCH with obesity, and additional very low prevalence of sustained normotension in obesity group, WCH should be accepted as an alarming sign of excess weight and many associated disorders in future rather than just being a predisposing factor of HT and atherosclerosis alone. Its management should be focused on prevention of excess weight.
BODY WEIGHT AND WHITE COAT HYPERTENSION
(Professional Medical Publications, 2009) Helvaci, Mehmet Rami; Kaya, Hasan; Sevinc, Alper; Camci, Celaletdin
Objective: To understand prognostic significance of white coat hypertension (WCH), and any its association with excess weight. Methodology: We studied consecutive check up patients between the ages of 35 and 70 years to be able to see possible consequences of excess weight on health and to avoid debility induced weight loss in elderly people. Results: The study included 721 cases ( 426 females). Prevalences of normal weight, overweight, and obesity were detected as 19.0%, 43.3%, and 37.5%, respectively. There were gradual and significant increases in the prevalences of WCH and hypertension ( HT) towards the overweight and obesity groups (p<0.001 for all). So 73.7% of the obesity cases had either WCH or HT, and overall prevalence of WCH was 37.9%, which was nearly equal to the prevalence of obesity. When we compared the groups according to the prevalences of hyperbetalipoproteinemia, dyslipidemia, diabetes mellitus (DM), and coronary heart disease (CHD), gradual and significant increases towards the overweight and obesity groups were seen nearly in all steps. Conclusion: There is gradual increased prevalence of WCH in the overweight and obesity groups, parallel to gradually increased prevalences of hyperbetalipoproteinemia, dyslipidemia, HT, DM, and CHD. In addition nearly equal prevalence of WCH with obesity, and additional very low prevalence of sustained normotension in obesity group, WCH should be accepted as an alarming sign of excess weight and many associated disorders in future rather than just being a predisposing factor of HT and atherosclerosis alone. Its management should be focused on prevention of excess weight.
Descriptive epidemiology of non-hodgkin's lymphomas in Hatay
(2013) Özgür, Tümay; Yaldiz, Mehmet; Kaya, Hasan; Yengil, Erhan; Toprak, Serhat
The incidence of Non-Hodgkin's Lymphomas (NHL) varies among different parts of the world. NHL are the 12th most common cancer in Europe and increasing dramatically during the last years. In this study, it was aimed to analyse the descriptive epidemiology of NHL in Hatay region with retrospective archieve datas. One hundred and thirty-three NHL cases between 2005 and 2013 have been reviewed retrospectively in the Pathology Department of the Mustafa Kemal University. All of the cases were classified according to World Health Organization modified in 2008. Eighty-two (61.7%) cases were male and 51 (38.3%) cases were female. Ninety-two of the cases (69.2%) were nodal lymphoma, and the remaining 41 (30.8%) were extranodal lymphoma. The most common extranodal involvement regions were tonsils and nasopharynx with frequencies of 21.9% (9) and 19.5% (8), respectively. The age distribution pattern revealed that NHL were mostly diagnosed in the ages of 41-65 years in nodal (41.3%) and extranodal sited NHL groups (53.6%). The most frequent NHL was diffuse large cell B cell lymphoma (50.4%) and chronic lymphocytic leukemia/small lymphocytic lymphoma (17.3%). Our results were similar with the literature. Further epidemiologic studies with larger series defining the profile of NHL subtypes may be more worthy.
Dyslipidemia May Be An Indicator for Trend of Body Weight
(Medi+World Int, 2008) Helvaci, Mehmet Rami; Akdemir, Cihangir; Kaya, Hasan; Ozer, Cahit
Background: Prevalence of excess weight is increasing with a high cost on health worldwide. Methods: The study was performed in the Internal Medicine Polyclinic on routine check up patients, and consecutive patients at and above the age of 20 years were studied to permit growth of height in youngers. Results: The study included 1068 cases (628 females) totally. There were only 19 (1.7%) cases with underweight and 307 (28.7%) with normal weight, so 69.4% (742) of cases at and above the age of 20 years had excess weight. The prevalence of excess weight increased from 28.7% (52) in the third to 63.6% (100) in the fourth decades (p<0.001), and decreased from 87.0% (94) in the seventh to 78.5% (84) in the eighth decades (p<0.05). Similarly, prevalences of hyperbetalipoproteinemia, hypertriglyceridemia, and dyslipidemia showed similar patterns of tendency with the excess weight, by increasing in the fourth and decreasing in the eighth decades of life (p<0.05 in all). Conclusion: Prevalence of excess weight and dyslipidemia are increasing by decades, particularly in the fourth decade, and this increase turns to a decrease in the eighth decade of life. So 30th and 70th years of age may be the breaking points of life, both for dyslipidemia and body weight, and dyslipidemia may be a pioneer sign for tendency of body weight. Probably decreased physical and mental stresses after the age of 30th years and debility and comorbid disorders induced restrictions after the age of 70th years may be the major causes for the changes.
Effect of sickle cell diseases on height and weight
(Professional Medical Publications, 2011) Helvaci, Mehmet Rami; Kaya, Hasan
Objectives: We tried to understand what are the effects of the sickle cell diseases (SCD) on metabolic parameters, especially the body weight and height in the study. Methodology: The study was performed in the Hematology and Internal Medicine Polyclinics on SCDs and routine check up patients. Results: The study included 122 patients with SCDs (58 females) and 176 control cases. Mean age of the SCDs cases was 28.6 years. When we compared the patients and control groups, mean body weight and body mass index (BMI) were significantly reduced in the SCDs cases (71.6 vs. 57.8 kg and 24.9 vs. 20.7 kg/m2, p= 0.000 for both), whereas the mean heights were similar in both groups (166.1 vs. 168.5 cm, respectively, p>0.05). Similar to the decresed mean body weight and BMI, mean values of the low density lipoprotein cholesterol and high density lipoprotein cholesterol were significantly lower in the patients group (p= 0.000 for both), whereas the fasting plasma glucose and triglyceride values were unchanged between the groups (p>0.05). Additionally, probably parallel to the reduced mean body weight and BMI, mean values of the alanine aminotransferase (34.9 vs. 56.7 U/L, p= 0.000) and systolic and diastolic blood pressures were also significanly lower in the patients group (113.3 vs. 118.8 and 72.3 vs. 83.6 mmHg, respectively, p<0.01 for both), all of which can be explained by definition of the metabolic syndrome. Conclusion: Although the body weight can significantly be reduced by SCDs, the body height may strongly be determined by heredity.
Effect of weight loss on P wave dispersion in obese subjects
(Wiley, 2006) Duru, Mehmet; Seyfeli, Ergun; Kuvandik, Guven; Kaya, Hasan; Yalcin, Fatih
Objective: The aim of this study was to investigate effect of loss weight on P wave dispersion in obese subjects. Research Methods and Procedures: After a 12-week weight loss program (diet and medical therapy), a total of 30 (24 women and six men) obese subjects who had lost at least 10% of their original weight were included in the present study. All subjects underwent a routine standard 12-lead surface electrocardiogram. Electrocardiograms were transferred to a personal computer by a scanner and then magnified 400 times by Adobe PhotoShop software (Adobe Systems, Mountain View, CA). P wave dispersion, which is also defined as the difference between the maximum P wave duration and the minimum P wave duration, was also calculated. Results: After a 12-week weight loss program, BMI (p < 0.001), maximum P wave duration (p < 0.001), and P wave dispersion (p < 0.001) significantly decreased. The mean percentage of weight loss was 13% (10% to 20.3%). The decrease in the level of P wave dispersion (21 +/- 10 and 7 +/- 12 ins, p < 0.002) was more prominent in Group II (>= 12% loss of their original weight) than Group I (<12% loss of their original weight) after the weight loss program. A statistically significant correlation between decrease in the level of P wave dispersion and percentage of weight loss was found (r = 0.624, p < 0.001). Discussion: Substantial weight loss in obese subjects is associated with a decrease of P wave duration and dispersion. Therefore, these observations suggest that substantial weight loss is associated with improvement in atrial repolarization abnormalities in obese subjects.
Effect of weight loss on QTc dispersion in obese subjects
(2006) Seyfeli, Ergün; Duru, Mehmet; Kuvandik, Güven; Kaya, Hasan; Yalçın, Fatih
Amaç: Artmış QTc dispersiyonu ventriküler aritmiler için bir göstergedir. Bu çalışmanın amacı diyet ve medikal tedavi ile kilo kaybı programı sonrası QTc dispersiyonunun azalmasını araştırmaktır. Yöntemler: Bu çalışmaya 12 haftalık kilo kaybı programı sonrası mevcut kilolarının en az %10'nu veren 30 (24 kadın ve 6 erkek, ort. yaş: 44±8 yıl) obez birey dahil edildi. Obezite vücut kitle indeksi'nin (VKİ) ?30 kg/m2 olarak tarif edildi. Normal kilo ise VKİ'nin ? 25 kg/m2 olarak tarif edildi. Bulgular: On iki haftalık kilo kaybı programı sonrası, VKİ 42±5 kg/m2'den 36±4 kg/m2 (p<0.001) azaldı ve obez bireylerin ortalama ağırlığı 110±17 kg'dan 95±15 kg (p<0.001) azaldı. Kilo kaybının ortalama miktarı 14.5±5.0 kg (9-32 kg arasında) idi. Kilo kaybının ortalama yüzdesi ise 13% (10.0%-20.3%) idi. Maksimum QTc interval (446±19 ms'den 433±27 ms, p=0.024) ve QTc dispersiyonu (66±18 ms'den 52±25 ms, p=0.024) kilo kaybı programı sonrası önemli oranda azaldı. QTc dispersiyonun seviyesindeki azalma ile kilo kaybının miktarı arasında istatistiksel olarak anlamlı ilişki bulundu (r=0.487, p=0.007). Sonuç: Obez bireylerde önemli kilo kaybı QTc dispersiyon seviyesini önemli oranda azaltmıştır. QTc dispersiyon azalmasının derecesi kilo kaybının miktarı ile ilişkilidir.
An epidemiological study to evaluate the use of vitamin K antagonists and new oral anticoagulants among non-valvular atrial fibrillation patients in Turkey- AFTER*-2 study design
(2015) Ertaş, Faruk; Kaya, Hasan; Yıldız, Abdulkadir; Davutoğlu, Vedat; Kiriş, Abdulkadir; Çil, Habib; Yüksel, Murat; Acet, Halit; Alan, Sait; Toprak, Nizamettin; Dinç, Lale; Kafes, Habibe; Avcı, Anıl; Calapkorur, Bekir; Ertaş, Gökhan; Gül, Mehmet; Kahraman Ay, Nuray; Bulur, Serkan; Durukan, Mine; Eren, Murat; İlhan, İbrahim; Küçük, Murathan; Özpelit, Ebru; Şimşek, Hakkı; Uçar, Mehmet; Yıldız, Ahmet; Şahin, Yıldıray; Ayhan, Erkan; Çağlayan, Emre; Güngör, Hasan; Özyurtlu, Ferhat; Şen, Nihat; Vatan, Bülent; Vatansever, Fahriye; Kobat, Mehmet Ali; Temiz, Ahmet; Taylan, Gökay; Dönmez, İbrahim; Erkuş, Emre; Söylemez, Selami; Zengin, Halit; Gündüz, Mahmut; Tuncez, Abdullah; Karavelioğlu, Yusuf; Gökdeniz, Tayyar; Koza, Yavuzer; Aktop, Ziyeddin; Katlandur, Hüseyin; Özer Karaca, Pelin
Amaç: Atriyum fibrilasyonu (AF) önlenebilir iskemik inmenin en sık nedenlerinden biri olup artmış kardiyovasküler morbidite ve mortaliteyle ilişkilidir. Ülkemizde yeni oral antikoagülan kullanım sıklığı, vitamin K antagonisti kullanan hastalarda Uluslararası Düzeltme Oranı’nın (INR) etkin düzeyde kalma oranı ve AF tedavi yönetimi ile ilgili büyük bir çalışma mevcut değildir. Bu çok merkezli çalışmada amacımız nonvalvüler AF hastalarında epidemiyolojik verilerin analizi, takibi ve değerlendirilmesidir. Çalışma planı: Kırk iki merkezden elektrokardiyografisinde en az bir defa AF atağı tespit edilmiş ardışık 4100 erişkin hasta çalışmaya alınacaktır. Romatizmal mitral darlığı ve protez kapak hastalığı olan AF hastaları çalışmaya alınmayacaktır. Hastalar birinci yılın sonunda majör kardiyak sonlanım noktaları (ölüm, geçici iskemik atak, inme, sistemik tromboembolizm, majör kanama ve hastane yatışı) açısından değerlendirilecektir. Bulgular: İlk sonuçlar Haziran 2015 yılında bekleniyor. Majör kardiyak sonlanım noktaları açısından veriler Ocak 2016’da elde edilecektir. Sonuç: AFTER-2 çalışması ile ülkemizdeki non-valvüler AF hastalarının oral antikoagülan tedavi kullanım sıklığı ve çeşidi, varfarin alan hastalarda etkin INR düzeylerinde kalma oranı ve benimsenen tedavi yönetimi belirlenecektir. Ayrıca, ülkemizde AF’li hastalarda majör istenmeyen olay sıklığı ve bu olayların bağımsız belirteçleri de ortaya çıkarılacaktır (AFTER-2 Study ClinicalTrials.gov number, NCT02354456). Anahtar Kelimeler: Antikoagülan ilaç; atriyum fibrilasyonu/epidemiyoloji; ilaç kullanımı; elektrokardiyografi; uluslararası düzeltme oranı; varfarin.
Funduscopic examination has limited benefit for management of hypertension
(Int Heart Journal Assoc, 2007) Helvaci, Mehmet Rami; Ozcura, Fatib; Kaya, Hasan; Yalcin, Atilla
Hypertension (HT) increases the risks of major cardiovascular events and affects a majority of elderly populations. Thus, blood pressure control is the mainstay for prevention of cardiovascular diseases. However, there is only a limited number of parameters for management of HT. This study was performed on consecutive patients between the ages of 35 and 70 years with normotension (NT) and HT in order to determine the possible consequences of HT on retinal vasculature and to avoid debility-induced weight loss. We studied 120 patients (64 females, 54 +/- 9.3 years) with NT and 147 (81 females, 57.3 +/- 11.0 years) with HT. No case of grade III or IV hypertensive retinopathy (HR) was detected in the groups. Although the prevalences of grades I and 11 HR were higher and grade 0 HR was lower in the hypertensive group, respectively (P < 0.001 for all), differences according to obesity, diabetes mellitus, hypertriglyceridemia (P < 0.001 for all), and dyslipidemia (P < 0.01) were also significant between the 2 groups. Therefore, only 18.3% (27 cases) of the hypertensives, even in whom the effect of aging could not be excluded, had HT only in the absence of any other risk factor of atherosclerosis. Despite the relatively higher specificities of grades III and IV HR for HT, particularly for hypertensive crisis, funduscopic examination has limited benefit in the management of HT due to the very low prevalences of grades III and IV HR, the multifactorial backgrounds of grades I and 11 HR, and the association of the multiple risk factors of atherosclerosis in a majority of the hypertensive cases.
Gender differences in coronary heart disease in Turkey
(Professional Medical Publications, 2012) Helvaci, Mehmet Rami; Kaya, Hasan; Gundogdu, Mehmet
Objectives: 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.
Gender differences in patients with metabolic syndrome in coronary artery interventions
(Medical Association of Zenica-Doboj Canton, 2013) Helvaci, Mehmet Rami; Kaya, Hasan; Gundogdu, Mehmet
Aim 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.
Hemoglobinopathy awareness among high school students in Antakya (Antioch), Turkey
(Springer Japan Kk, 2010) Savas, Nazan; Turhan, Ebru; Inandi, Tacettin; Kaya, Hasan
Hemoglobinopathy is a major public health problem in Eastern Mediterranean, Turkey, where homozygote babies continue to be born. We wanted to present the knowledge of high school students and their attitudes on hemoglobinopathy in Antakya (center of Hatay).The study was performed on 11th grade students in 17 high schools and 486 students in the center at Antakya. We used a questionnaire and frequency tables and chi-square tests were used. Of the students who took part, 37.7% were previously informed about hemoglobinopathies, while 62.3% were not. There was no significant relationship between the school types and their being previously informed (p > 0.05). There was an index case for 28% of the students, and 25.4% of the students who did not have any diseased person around them were previously informed (p < 0.01). While the range of percentage of correct answers was between 17.5% (about treatment of the diseases) and 73.3% (about the carrier status), these percentages seemed to be higher for those who stated that they were previously informed (22.2% about treatment and 85.8% about the carrier status). As much as 83.7% of the students stated that they wanted to be educated about hemoglobinopathies in the school and 89.1% wanted to know if they were carriers. Our study suggests that there is an urgent need to revise the Hemoglobinopathy Control Programme especially with regard to the enlightenment of the students and public.
Hepatitis C virus infection is probably associated with autoimmune disorders and malignancies but not with autoimmune thyroiditis
(Asian Network for Scientific Information, 2007) Kuvandik, Guven; Helvaci, Mehmet Rami; Ozer, Cahit; Altintas, Engin; Kaya, Hasan; Duru, Mehmet
In this study initially consecutive patients with Autoimmune Thyroiditis (AT) were taken in the Endocrinology Polyclinics. Beside that age and sex-matched patients with HCV infection and control cases were randomly studied in the Gastroenterology and Internal Medicine Polyclinics, respectively. One hundred and seventy-two patients with AT, 62 with HCV infection and 110 control cases were studied. AT was diagnosed in eight (12.9%) cases of the HCV infecteds' group and this ratio was 11.8% (13 cases) in the control group (p>0.05). Similarly, HCV infection was detected in one (0.5%) case of AT group and this ratio was 0.9% (one case) in the control group (p>0.05). Parallel to these results, prevalences of antithyroid peroxidase and/or antithyroglobulin antibodies were detected as 29.0% (18 cases) and 32.7% (36 cases) in the HCV infecteds' and control groups, respectively (p>0.05). As another face of the results, it was detected one case of monoclonal gammopathy of undetermined significance and one case of lichen planus in the HCV infecteds' group. As a conclusion, HCV infection may be associated with autoimmune disorders and malignancies but not with AT.

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