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Öğe Abnormal origin of the right coronary artery from the left anterior descending artery(2010) Cansel, Mehmet; Kurtoğlu, Ertuğrul; Yağmur, Jülide; Taşolar, Mehmet Hakan; Ermiş, Necip; Açıkgöz, Nusret; Bayramoğlu, AdilAbstract: Koroner arter anomalileri seyrek görülmekle birlikte önemli sonuçlara neden olabilmektedir. Bu yüzden bu anomalileri açığa kavuşturmak ve uygun tedaviyi vermek çok önem arz etmektedir. Koroner anomaliler arasında ise sol ön inen arterden köken alan anormal orijinli sağ koroner arter anomalisine daha nadir rastlanmaktadır. Bu vakamızda non-st elevasyonlu miyokard enfarktüsü ile başvuran bir hastada sol ön inen arterden çıkan anormal sağ koroner arter anomalisine sahip bir hastayı sunduk.Öğe Acute pulmonary embolism in a patient with symptomatic coronary artery disease(Turgut Özal Tıp Merkezi Dergisi, 2016) Ermiş, Necip; Doğan, Cem; Akpınar, Suzan HatipoğluAbstract Pulmonary embolism (PE) is a life-threatening emergency that is sometimes difficult to diagnose due to nonspecific symptomatology and laboratory findings. A 65 years old women who has past stable angina pectoris history was admitted to the our emergency department with severe acute dyspnea and chest pain. The ECG revealed negative T waves in leads V1 through V6 and initial troponin was 16.8 ng/ml and Ddimer 897μg/L. Since these both laboratory and echocardiographic findings and clinical presentation did not let us establish a definite diagnosis, we sent the patient to the catheterization laboratory in order to perform both coronary and pulmonary angiography. We detected severe stenosis of proximal-mid left anterior descending artery and partially occluded left main pulmonary artery by large thrombo-emboli at the catheterization laboratory and treated successfully. Keywords: Coronary Artery Disease; Acute Pulmonary Embolism; Catheterization Laboratory.Öğe Anomalous lad and cx artery arising separately from the proximal right coronary artery a case report of single coronary artery with coronary artery disease(Journal of Cardiac Surgery, 2006) Koşar, Feridun; Ermiş, Necip; Erdil, Nevzat; Battaloğlu, BektaşCoronary artery anomaly has been reported at a rate of 0.6% to 1.3% in routine angiographic se-ries. Moreover, single coronary artery is one of the rarest anomalies among coronary anomalies. Eventhoughpatients with coronary anomalies are usually asymptomatic, they may also be associated with myocardialischemia, ventricular fibrillation, syncope, congestive heart failure, and sudden death. In this article, wereport a case of single coronary artery anomaly with the left anterior descending (LAD) and left circumflex(LCx) coronary artery arising separately from the proximal right coronary artery. Since the presented casewas associated with ischemic heart disease, coronary artery bypass grafting was carried out. He is currentlywell.Öğe Atriyoventriküler nodal reentrant taşikardili hastaların klinik ve ekokardiyografik özelliklerinin değerlendirilmesi(MN Kardiyoloji, 2010) Açıkgöz, Nusret; Ermiş, Necip; Yağmur, Julide; Karakuş, Yasin; Müezzinoğlu, Kübra; Cansel, Mehmet; Pekdemir, Hasan; Özdemir, RamazanÖz: Amaç: Atriyoventriküler nodal reentrant taşikardi (AVNRT) klinikte en sık görülen düzenli ritim bozukluğudur. Bu çalışmada AVNRT’li hastaların klinik ve ekokardiyografik yönden değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya elektrofizyolojik çalışması (EFÇ) yapılan ve AVNRT tanısı konulan 30 hasta ile EFÇ’si yapılan ve normal saptanan 30 kontrol birey alındı. Çalışmaya tüm katılanların klinik ve ekokardiyografik değerlendirilmesi yapıldı. Bulgular: Her iki grup arasında yaş, cinsiyet ve diğer demografik özellikler açısından fark saptanmadı (p>0.05). Ancak vücut kitle indeksi (VKİ) AVNRT’li hasta grubunda kontrol grubuna göre anlamlı olarak daha yüksek bulundu (28,7 ± 2,7’e karşın 24,6 ± 3,5 kg/m2; p<0,0001). Ekokardiyografik olarak değerlendirilen sol ventrikül duvar kalınlıkları, sol atriyum çapı, sol ventrikül çapları ve sol ventrikül ejeksiyon fraksiyonu her iki grupta benzerdi (p>0,05). Ancak Doppler mitral akım parametrelerinden geç diyastolik akım velositesi (A) (p=0,012), deselerasyon zamanı (p=0,002) ve izovolümetrik gevşeme (p=0,001) zamanı AVNRT’li hasta grubunda kontrol grubuna göre anlamlı olarak daha yüksek bulundu. Ayrıca E/A oranı AVNRT’li hasta grubunda kontrol grubuna göre anlamlı olarak daha düşük bulundu (p<0,0001). Sonuç: AVNRT’li hastalarda diyastolik fonksiyonlar kontrol grubuna göre bozulmuştur. Artmış VKİ AVNRT gelişiminde önemli bir faktör olabilir.Öğe Cardiovascular effects of JWH 018 from synthetic cannabinoids(Medicine Science | International Medical Journal, 2016) Parlakpınar, Hakan; Celbiş, Osman; Özhan, Onural; Petekkaya, Semih; Şamdancı, Emine; Ermiş, Necip; Koparır, Pelin; Soylu, Özcan; Acet, Hacı AhmetThe content of synthetic cannabinoids (SC) which are known in Europe as ‘Spice’, in the U.S.A. as K2’, and in Turkey as ‘Bonsai’ or ‘Jamaica’ is not standardized. Also SC are known to contain approximately 400 chemical compounds which vary from country to country. SC mimics the effect of ?9 - tetrahydrocannabinol (THC) which is the major effective content of Cannabis or Marijuana by cannabinoid-1 (CB1) and cannabinoid-2 (CB2) receptors in the body cell. Although the new SCs are synthesized and the number of new derivatives is increased in every day; JWH-018 among these derivatives exerts full agonist effect on both CB1 and CB2 receptors also it has a short-term effect as 2 hours. For this reason, JWH-018 is the most commonly used as SC. There are a few data in the literature regarding to the pharmacokinetic and pharmacodynamic effects of SC. Furthermore, most of the existing data are based on in vitro experiments. In the JWH-018 report, at Critical Review Report Agenda item 4.5 Expert Committee on Drug Dependence of World Health Organization (WHO), Thirty-sixth Meeting Geneva, 16-20 June 2014, is declared that despite a marked elevation of the heart rate is one of the clinical signs very often seen after intoxication with SC, there is no available study data regarding effects of SCs on cardiovascular, respiratory, gastrointestinal, genitourinary systems, liver and kidney tissues . The aim of this review is to highlight cardiovascular effects of JW-018 which is considered to be the prototype for synthetic cannabinoids to prepare the ground for new work to be done.Öğe Cardiovascular effects of panax ginseng(2016) Ozhan, Onural; Acet, Hacı Ahmet; Ermiş, Necip; Parlakpınar, HakanDünyada farklı ırk, yaş ve cinsiyetten yaklaşık 400 milyon insanda görülen kardiyovasküler hastalıklar (KVH), Dünya Sağlık Örgütü'nün "Bulaşıcı Olmayan Hastalıklar 2013-2020 Eylem Planı" içerisinde yer alan önemli bir hastalık grubudur. KVH' nın neden olduğu ölümler dünyada ve ülkemizde ilk sıradadır.Ülkemizde "Ginseng" olarak bilinen Panax ginsengbitkisinin kökleri yorgunluk, bitkinlik, konsantrasyon kaybı gibi durumlarda, iyileşme dönemlerinde mental ve fiziksel kapasitenin artırılmasında, anti-stres etki ile adaptojen olarak davranıp vücutta stresin oluşturduğu dejeneratif etkilerin azaltılmasında, diyabetik hastalarda kan şekerinin düzenlenmesinde, erektil disfonksiyonlu olgularda ereksiyon kapasitesinin ve libidonun artırılmasında tıbbi olarak kullanılmaktadır. Ayrıca hipertansiyon, hiperkolestrolemi ve oksidatif hasar gibi kardiyovasküler risk faktörleri bulunan bireyler arasında Ginseng'in gıda takviyesi olarak kullanımı gün geçtikçe artmaktadır. Literatürde Panax ginseng'in kardiyovasküler sistem üzerindeki farmakolojik etkinliğiyle ilgili tartışmalı veriler mevcuttur. Ginseng'in nitrik oksit sentezini artırarak hem hipertansif hem de hipotansif etki gösterdiği gözlenmiştir. Ginseng içeren gıda takviyelerinin otonom sinir sistemini etkileyerek kalp hızını azalttığı belirtilirken; aynı zamanda kan basıncını artırdığı, azalttığı veya kan basıncında herhangi bir değişiklik yapmadığı yönünde tartışmalı bulgular elde edilmiştir. Bu çelişkili verilerden, kan basıncını önce azaltıp daha sonra artırarak bifazik aktivite gösteren ginsenozitlerin sorumlu olduğu düşünülmektedir. Ayrıca akut ve kronik Ginseng kullanımına bağlı olarak çeşitli farmakolojik aktivite farklılıkları olduğu gözlenmiştir.Bu yazıda Ginseng'in kardiyovasküler etkilerini sunmayı amaçladıkÖğe Cardiovascular effects of panax ginseng(Turgut Özal Tıp Merkezi Dergisi, 2016) Parlakpınar, Hakan; Özhan, Onural; Ermiş, Necip; Acet, AhmetCardiovascular Diseases (CVD), being present in 400 million people accross the globe in people of all races, ages and genders is amongst the more important types of diseases present in the World Health Organizations’ “2013-2020 Global Action Plan for the Prevention and Control of Non-communicable Diseases”. CVD are the leading cause of death in the World as well as in Turkey. Ginseng, also known as Panax ginseng root, is widely used in Turkey to prevent tiredness, fatique, and loss of concentration, to improve mental and physical capacity during recovery period, as well as to reduce the degenerative effects of stress. It also acts as adaptogen due to its anti-stress effect while regulating blood sugar in diabetic patients and increasing erectile capacity and libido in cases with erectile dysfunction. In addition, use of Ginseng as a dietary supplement is increasing day by day among individuals with cardiovascular risk factors such as hypertension, hypercholesterolemia, and oxidative damage. In the literature, there is controversial data concerning Panax ginseng’s pharmacological activity on the cardiovascular system. Increasing the synthesis of nitric oxide, it is observed that Ginseng has both hypertensive and hypotensive effects. While it is stated that dietary supplements containing Ginseng affect the autonomic nervous system, but also increases the blood pressure, reduces or making no change, controversial results were obtained. For these conflict data, ginsenoside, first reducing and then increasing the blood pressure, is thought to be responsible. Depending on the acute and chronic use of Ginseng, it has also been observed that various pharmacological activities exist. In this review, we aim to present the cardiovascular effects of Ginseng. Keywords: Alternative Medicine; Cardiovascular System; Panax ginsengÖğe Cardiovascular effects of panax ginseng panax ginseng in kardiyovaskuler etkileri(Journal of Turgut Ozal Medical Center, 2016) Parlakpınar, Hakan; Özhan, Onural; Ermiş, Necip; Acet, Hacı AhmetCardiovascular Diseases (CVD), being present in 400 million people accross the globe in people of all races, ages and genders is amongst the more important types of diseases present in the World Health Organizations’ “2013-2020 Global Action Plan for the Prevention and Control of Non-communicable Diseases”. CVD are the leading cause of death in the World as well as in Turkey. Ginseng, also known as Panax ginseng root, is widely used in Turkey to prevent tiredness, fatique, and loss of concentration, to improve mental and physical capacity during recovery period, as well as to reduce the degenerative effects of stress. It also acts as adaptogen due to its anti-stress effect while regulating blood sugar in diabetic patients and increasing erectile capacity and libido in cases with erectile dysfunction. In addition, use of Ginseng as a dietary supplement is increasing day by day among individuals with cardiovascular risk factors such as hypertension, hypercholesterolemia, and oxidative damage. In the literature, there is controversial data concerning Panax ginseng’s pharmacological activity on the cardiovascular system. Increasing the synthesis of nitric oxide, it is observed that Ginseng has both hypertensive and hypotensive effects. While it is stated that dietary supplements containing Ginseng affect the autonomic nervous system, but also increases the blood pressure, reduces or making no change, controversial results were obtained. For these conflict data, ginsenoside, first reducing and then increasing the blood pressure, is thought to be responsible. Depending on the acute and chronic use of Ginseng, it has also been observed that various pharmacological activities exist. In this review, we aim to present the cardiovascular effects of Ginseng.Öğe Do spontaneous coronary artery dissections always need intervention in patients with no atherosclerosis? ( Author`s Reply )(2016) Ermiş, Necip[Abstract Not Acailable]Öğe Do spontaneous coronary artery dissections always need intervention in patients with no atherosclerosis? ( Authors Reply )(İnönü Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı Malatya, Türkiye, 2016) Ermiş, Necip[Abstract Not Acailable]Öğe Echocardiographic evaluation of aortic elasticity parameters in aortic stenosis patients with preserved ejection fractions undergoing transcatheter aortic valve implantation(2022) Bayramoğlu, Adil; Tasolar, Hakan; Ulutaş, Zeynep; Akaycan, Julide; Cansel, Mehmet; Ermiş, Necip; Yiğit, YakupAbstract Aim: Aortic stiffness is an important risk factor that reflects the mechanical tension and elasticity of the aorta and predicts cardiovascular mortality and morbidity. However, it has been found that aortic stiffness contributes to both symptom burden and clinical outcomes in patients with aortic stenosis (AS). In our study, we aimed to evaluate the effect of transcatheter aortic valve implantation (TAVI) on aortic elasticity parameters by echocardiography in patients with severe aortic stenosis, especially with preserved ejection fraction. Materials and Methods: A total of 55 consecutive patients with symptomatic severe AS who underwent TAVI were included in the study. Demographic data, echocardiographic and aortic elasticity measurements of all patients were measured before and 6 months after the procedure. To evaluate the elastic properties of the aorta, aortic strain, distensibility and stiffness index were calculated. Results: Left ventricular mass index (LVMI) (p < 0.001) and aortic stiffness (p < 0.001) were decreased, while aortic strain (p < 0.001) and aortic distensibility (p < 0.001) were found to be increased in the measurements performed at 6 months after TAVI. In the regression analysis, age and LVMI were found to be independent predictors for predicting improvement in aortic stiffness; on the other hand, LVMI also independently predicted the increase in aortic distensibility. Conclusion: Improvement in aortic elastic properties and left ventricular functions were found in patients who underwent TAVI. Age and LVMI were observed to predict the improvement in stiffness and distensibility of the aorta in patients undergoing TAVI, especially in AS patients with preserved ejection fraction.Öğe The effect of lactate levels on prognosis in patients with ST-segment elevation myocardial infarction(2020) Gür, Ali; Ulutaş, Zeynep; Turgut, Kasım; Güven, Taner; Yücel, Neslihan; Ermiş, NecipAbstract: Aim: The prognostic role of lactate for early mortality in patients with ST-segment elevation myocardial infarction (STEMI) submitted to primary percutaneous transluminal coronary angiography (PTCA) is not elucidated clearly. This study was conducted with patients that presented to the emergency department (ED) with STEMI and underwent PTCA to investigate whether the changes in lactate values from ED admission to 24 hours after PTCA affected mortality. Material and Methods: This prospective observational study on 143 patients with STEMI was conducted at emergency service and tertiary-level cardiology clinic in a public university hospital. The documentation for each patient included detailed information on demographics, type of myocardial infarction according to electrocardiography and PTCA results, duration of hospital stay, vital signs, laboratory fidings on admission, lactate levels 24 hours after PTCA, and outcome (hospital discharge or death). Results: The lactate values are higher in non-surviving groups measured 24 hours after PTCA (P < 0.001). The differences in the lactate levels from the time of admission to 24 hours after PTCA were signifiantly lower in the non-surviving group (P < 0.001). Conclusion: Among patients presenting to the ED with STEMI, a high lactate level is associated with mortality. Also, the difference between lactate values of the patients after PTCA is associated with the risk of mortality. Therefore, we consider that fist lactate levels in ED and last lactate levels after PTCA in patients with STEMI can provide physicians with an insight into the possibility of mortalityÖğe Effects of electromagnetic radiation from 3G mobile phone on heart rate blood pressure and ECG parameters in rats(Toxicology and Industrial Health, 2012) Çolak, Mehmet Cengiz; Parlakpınar, Hakan; Ermiş, Necip; Çolak, Cemil; Sarıhan, Mehmet Ediz; Of, Dilek; Turan, Bahadır; Bakır, Sevtap; Acet, Hacı AhmetEffects of electromagnetic energy radiated from mobile phones (MPs) on heart is one of the research interests. The current study was designed to investigate the effects of electromagnetic radiation (EMR) from thirdgeneration (3G) MP on the heart rate (HR), blood pressure (BP) and ECG parameters and also to investigate whether exogenous melatonin can exert any protective effect on these parameters. In this study 36 rats were randomized and evenly categorized into 4 groups: group 1 (3G-EMR exposed); group 2 (3G-EMR exposed þ melatonin); group 3 (control) and group 4 (control þ melatonin). The rats in groups 1 and 2 were exposed to 3G-specific MP’s EMR for 20 days (40 min/day; 20 min active (speech position) and 20 min passive (listening position)). Group 2 was also administered with melatonin for 20 days (5 mg/kg daily during the experimental period). ECG signals were recorded from cannulated carotid artery both before and after the experiment, and BP and HR were calculated on 1st, 3rd and 5th min of recordings. ECG signals were processed and statistically evaluated. In our experience, the obtained results did not show significant differences in the BP, HR and ECG parameters among the groups both before and after the experiment. Melatonin, also, did not exhibit any additional effects, neither beneficial nor hazardous, on the heart hemodynamics of rats. Therefore, the strategy (noncontact) of using a 3G MP could be the reason for ineffectiveness; and use of 3G MP, in this perspective, seems to be safer compared to the ones used in close contact with the head. However, further study is needed for standardization of such an assumption.Öğe Effects of electromagnetic radiation from 3G mobile phone on heart rate blood pressure and ECG parameters in rats(Toxicology and Industrial Health, 2012) Çolak, Cemil; Parlakpınar, Hakan; Ermiş, Necip; Tağluk, Mehmet Emin; Çolak, Cengiz; Sarıhan, Ediz; Dilek, Ömer Faruk; Turan, Bahadır; Bakır, Sevtap; Acet, AhmetEffects of electromagnetic energy radiated from mobile phones (MPs) on heart is one of the research interests. The current study was designed to investigate the effects of electromagnetic radiation (EMR) from thirdgeneration (3G) MP on the heart rate (HR), blood pressure (BP) and ECG parameters and also to investigate whether exogenous melatonin can exert any protective effect on these parameters. In this study 36 rats were randomized and evenly categorized into 4 groups: group 1 (3G-EMR exposed); group 2 (3G-EMR exposed þ melatonin); group 3 (control) and group 4 (control þ melatonin). The rats in groups 1 and 2 were exposed to 3G-specific MP’s EMR for 20 days (40 min/day; 20 min active (speech position) and 20 min passive (listening position)). Group 2 was also administered with melatonin for 20 days (5 mg/kg daily during the experimental period). ECG signals were recorded from cannulated carotid artery both before and after the experiment, and BP and HR were calculated on 1st, 3rd and 5th min of recordings. ECG signals were processed and statistically evaluated. In our experience, the obtained results did not show significant differences in the BP, HR and ECG parameters among the groups both before and after the experiment. Melatonin, also, did not exhibit any additional effects, neither beneficial nor hazardous, on the heart hemodynamics of rats. Therefore, the strategy (noncontact) of using a 3G MP could be the reason for ineffectiveness; and use of 3G MP, in this perspective, seems to be safer compared to the ones used in close contact with the head. However, further study is needed for standardization of such an assumption.Öğe Elevated monocyte to high-density lipoprotein cholesterol ratio and endothelial dysfunction inbehcet disease(SAGE PUBLICATIONS INC, 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA, 2018) Açıkgöz, Nusret; Kurtoğlu, Ertuğrul; Yağmur, Jülide; Kapıcıoğlu, Yelda; Cansel, Mehmet; Ermiş, NecipBehcet disease (BD) is a multisystemic disorder characterized by endothelial dysfunction and inflammation. Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a recently emerged indicator of inflammation and oxidative stress. Sixty patients with BD and 50 control individuals were included to investigate the relationship between MHR and endothelial dysfunction. Endothelial function was assessed by flow- and nitroglycerin-mediated dilatation technique (FMD and NMD, respectively). Serum high-sensitivity C-reactive protein (hsCRP) levels were measured in all study participants. The MHR and hsCRP levels were significantly higher in patients with active BD than in controls. Brachial artery FMD was significantly lower in patients with active BD than in controls. Brachial artery NMD was similar between groups. There was a strong inverse correlation between MHR and FMD and a strong positive correlation between MHR and serum hsCRP levels. Thus, elevated MHR may be a useful marker reflecting impaired endothelial function and systemic inflammation in patients with BD.Öğe The evaluation of mean platelet volume levels in patients with idiopathic and ischemic cardiomyopathy: An observational study(Anadolu Kardiyoloji Dergisi, 2011) Açıkgöz, Nusret; Ermiş, Necip; Cansel, Mehmet; Ataş, Halil; Pekdemir, Hasan; Özdemir, RamazanÖz: Amaç: Kardiyomiyopati (KMP) kan stazı, trombosit aktivasyonu ve değişen koagülasyon durumu nedeniyle, artmış tromboemboli ile ilişkili bir hastalıktır. Biz, bu çalışmada iskemik ve idiyopatik KMP’li hastalarda ortalama trombosit hacmini (OTH) belirlemeyi ve onları kontrol grubuyla kıyaslamakla birlikte, KMP’li hastalarda OTH ile ekokardiyografik parametreler arasında bir ilişki olup olmadığını da belirlemeyi amaçladık. Yöntemler: Bu çalışma gözlemsel enine-kesitli çalışma olarak dizayn edildi. Çalışmaya idiyopatik KMP’li 35 hasta, iskemik KMP’li 35 hasta ve kontrol grubu 30 kişi olmak üzere toplam 100 birey dahil edildi. Çalışmaya katılan tüm bireylerin OTH değerleri ölçüldü ve tüm katılanlara transtorasik ekokardiyografi ve anjiyografik değerlendirme yapıldı. İstatistiksel analizler için Ki-kare testi, tek yönlü ANOVA ve Pearson korelasyon testleri kullanıldı. Bulgular: Çalışmamızda OTH değeri idiyopatik ve iskemik KMP’li hastalarda kontrol grubuna göre anlamlı olarak daha yüksek bulundu (9.03±1.3‘e karşın 8.77±0.9 ve 7.95±1.0 fl, sırasıyla, p<0.001). Ayrıca OTH değeri idiyopatik KMP’li hastalarda iskemik KMP’li hastalara göre daha yüksekti, ancak bu yükseklik istatistiksel olarak anlamlı değildi (p=0.328). Çalışmamızda OTH değeri ile sol ventrikül diyastol sonu ve sistol sonu çap (r=0.369, p<0.0001; r=0.325, p=0.001, sırasıyla) ve sol atriyal çap (r=0.403, p<0.0001) değerleri arasında pozitif ilişki sol ventrikül ejeksiyon fraksiyonu arasında negatif ilişki bulundu (r=-0.392, p<0.0001). Sonuç: Hem idiyopatik hem iskemik KMP’li hastalarda kontrollerle kıyaslandığında daha yüksek olan OTH değerleri, KMP’li hastaların etiyolojisi ne olursa olsun, trombosit agregasyonuna eğilimini gösterir. Ayrıca, bu hastalarda genişlemiş ve bozulmuş sol ventrikül ile artmış OTH değerleri arasında bir ilişki olabilir.Öğe Genç ve yaşlı pulmoner embolili olgularımız: Klinik özellikler, laboratuvar ve instrumental bulgular ve yaş gruplarına göre farklılıklar(2010) Şen, Nazan; Ermiş, Hilal; Altınkaya, Naime; Ermiş, Necip; Karataşlı, Meltem; Ulubey, GayeÖz: Amaç: Mortalitesi ve insidansı yaşla birlikte artış gösteren pulmoner emboli (PE), son yıllarda tanı yöntemlerindeki gelişmelere rağmen, özellikle yaşlılarda tanı konulması zor bir hastalık olmaya devam etmektedir. Bu çalışmada amacımız PE klinik seyrini yaşlı ve genç hastalarda karşılaştırmalı olarak değerlendirmek, risk ve prognozu belirleyen parametreleri inceleyerek mortalitenin azaltılmasına katkıda bulunmaktır. Gereç ve Yöntem: Çalışmamıza PE tanısı alan 141 hasta alındı. Hastalar <65 yaş (genç grup) ve ?65 yaş (yaşlı grup) şeklinde iki gruba ayrılarak klinik özellikler, laboratuvar ve instrumental bulgular açısından retrospektif olarak değerlendirildi. Bulgular: Her iki grupta da en sık görülen risk faktörleri immobilite ve yakın zamanda geçirilmiş cerrahi girişimdi. Göğüs ağrısı ve hemoptizi görülme sıklığı yaşlı hastalarda anlamlı düşük düşük bulunurken, taşikardi yaşlı hastalarda daha sık görüldü (sırasıyla p<0.001, p=0.013, p=0.047). Masif PE'li olgularda D-Dimer düzeyi ve elektrtokardiyografi (EKG) skoru masif olmayan PE'li olgulara göre anlamlı yüksekti (sırasıyla p=0.01, p<0.001). D-Dimer ve kardiyak troponin düzeyleri ile EKG skoru hastanede ölümün gerçekleştiği hastalarda yaşayanlarla karşılaştırıldığında anlamlı yüksek bulundu (sırasıyla p=0.02, p=0.018, p=0.008). Sonuç: Pulmoner emboli'nin yaşlı hastalarda atipik klinik bulgularla seyredebilmesi nedeniyle, tanı için öncelikle yüksek klinik kuşku gerekir. Hastalığın ağırlık, risk ve prognozunu erken dönemde belirleyebilecek parametrelerin kullanılması ile uygun tedaviye daha erken başlanarak mortalitenin azaltılmasına katkıda bulunulabilir.Öğe Hipertansiyonu olan ve olmayan koroner arterleri normal hastalarda ortalama trombosit hacminin karşılaştırılması(MN Kardiyoloji, 2010) Açıkgöz, Nusret; Ermiş, Necip; Yağmur, Julide; Çuğlan, Bilal; Ataş, Halil; Özdemir, RamazanÖz: Hipertansiyon (HT) vasküler hastalıklar için bilinen önemli bir risk faktörüdür. HT’da trombosit aktivasyonunun varlığı iyi bilinmektedir. Ortalama trombosit hacmi (OTH) trombosit aktivasyonunun bir göstergesidir. Biz bu çalışmada, HT’u olan hastalarda trombosit aktivasyonunun varlığını desteklemek için anjiyografik olarak koroner arterleri normal HT’u olan ve olmayan hasta gruplarında OTH’ ni kıyaslamayı amaçladık. Gereç ve Yöntem: Çalışmaya anjiyografik olarak kanıtlanmış normal koroner arterleri olan 80 hasta alındı. Bu hastalar HT’u olan (n=40) ve olmayan (n=40) şeklinde iki gruba ayrıldı. Tüm hastaların OTH değerleri ölçüldü. Bulgular: Her iki grup arasında yaş, cinsiyet ve diğer demografik özellikler açısından fark saptanmadı (p>0,05). Ayrıca her iki grup OTH değeri açısından kıyaslandığında gruplar arasında istatistiksel olarak fark saptanmadı (8,21± 0,63 karşın 8,17±0,69 fl, sırasıyla; p=0,81). Sonuç: Koroner arter hastalığı gelişmemiş HT hastalarında sadece OTH değeri trombosit aktivasyonun varlığını göstermede yetersiz gibi gözükmektedir. Başlık (İngilizce): The comparison of mean platelet volume in patients with normal coronary arteries with and without hypertension Öz (İngilizce): Hypertension (HT) is an important risk factor known for vascular diseases. The presence of platelet activation in hypertension is well known. Mean platelet volume (MPV) is an indicator of platelet activation. In this study, we aimed to compare MPV in patients with or without HT all having angiographically proven normal coronary arteries, in order to confirm the presence of platelet activation in HT. Material and Method: 80 patients having angiographically proven normal coronary arteries were included in the study. The patients were classified into two groups according to the presence of HT, as the hypertensive group (HTG, n=40) and the non-hypertensive group (NHTG, n=40). MPV values were obtained from all patients. Results: No significant difference was found between the groups in terms of age, gender and other demographic characteristics (p>0.05). Both groups were also compared in terms of MPV value and no statistically significant difference was detected between the groups (8.21 ± 0.63 to 8: 17 ± 0.69 fl, respectively; p = 0.81). Conclusion: MPV value alone remains inadequate in showing the presence of platelet activation in patients with hypertension not having coronary artery diseaseÖğe Investigating optimal number of cross validation on the prediction of postoperative atrial fibrillation by voting ensemble strategy(Turkiye Klinikleri Journal of Biostatistics, 2016) Çolak, Mehmet Cengiz; Çolak, Cemil; Erdil, Nevzat; Arslan, Ahmet Kadir; Ermiş, Necip; Özdemir, RamazanObjective: Atrial fibrillation (AF) is the most widely recognized cardiovascular arrhythmia. Symptomatic AF can decrease quality of life, functional condition, and performance of the heart. In order to make a clinical decision strategy, the present study attempts to investigate the optimal number of cross validation (CV) [NOCV] on the prediction of postoperative AF based on the several data mining and voting ensemble approaches. Material and Methods: The retrospective dataset included complete medical records of 2888 individuals after coronary artery bypass grafting. The subjects were divided into two groups: AF group (n=360) and non-AF group (n=2528), respectively. Data mining approaches including artificial neural networks (ANN), Naïve Bayes (NB) and logistic regression (LR) were constructed for the prediction of the presence or absence of AF. Additionally, voting ensemble strategy was employed in order to improve predictive accuracy. NOCV was optimized by Grid search. For evaluating the predictive performance, accuracy and area under curve (AUC) of the receiver operating characteristics (ROC) graph were considered as evaluation index. Results: After removing the missing values and outliers, this research consisted of 2694 subjects; 327 (12.1%) in AF group and 2367 (87.9%) in non-AF group, respectively. The largest accuracy of 87.8% for LR was observed in the 8-fold CV. Similarly, voting ensemble yielded the highest AUC value of 0.896 in the 10-fold CV. The highest accuracy and AUC were 87.2% and 0.896 for voting, 87.8% and 0.729 for LR, 87.1% and 0.668 for ANN, and 79.4% and 0.675 for NB, consecutively. Conclusion: The results of the current research demonstrated that the constructed models yielded different results for predicting postoperative AF in the determination of the optimal NOCV. It is recommended to determine the optimal NOCV by optimization techniques. The proposed voting was an acceptable and promising approach for predicting AF, and thence, can support clinicians in the clinical decision making.Öğe Isolated coronary artery bypass surgery in patients with mild to moderate ischemic mitral regurgitation: Early results(2018) Erdil, Nevzat; Battaloğlu, Bektaş; Çolak, Cemil; Ermiş, Necip; Dişli, Olcay Murat; Çolak, Mehmet Cengiz; Akça, BarışAbstract: The optimal management of moderate ischemic mitral regurgitation (MR) remains controversial. Some surgeons advocate coronary artery bypass alone, while others suggest concomitant mitral valve annuloplasty. We aimed to evaluate the early results of isolated coronary artery bypass operation on the cases with mild-to-moderate ischemic MR. Between May 2010 and May 2011, 59 patients (64% male, mean age: 50.5 years) with a preoperative diagnosis of mild-to-moderate ischemic MR underwent a coronary bypass operation. Patients evaluated with preoperative and postoperative (in twelve-month period with an average of five months) transthoracic echocardiogram (TTE). Postoperative mortality was not observed in study group. The preoperative functional capacity of the patients as well as the variables of mild MR and moderate MR showed a statistically significant difference in a positive way when compared with the postoperative functional capacity and MR variables. Postoperative TTE evaluation revealed that only 2 cases have severe MR (3,4%) also 62,7 % of patients have mild and 33.9% of patients have moderate MR. While there was a significant difference in a positive way between the preoperative and postoperative period in terms of left atrial diameter, no significant difference was found for the variables of ejection fraction and pulmonary artery pressure. Among the patients whom undergoing coronary bypass surgery, if there is mild or moderate MR revealed with the TTE prior to the operation, performing only coronary bypass operation will be adequate, and our early results in this matter are satisfactory. But, if severe MR revealed with TTE, performance of mitral valve repair or replacement should be evaluated additional to coronary bypass operation.
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