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    Comparison of the echocardiographic and pulmonary function test findings in orderly treated and untreated essential hypertensive patients
    (Taylor & Francis Ltd, 2003) Guven, A; Koksal, N; Sokmen, G; Özdemir, R
    Objective: Although it has been well established that hypertension effects pulmonary functions negatively, the effect of regular antihypertensive therapy on pulmonary functions is not known. In this study, we aimed to compare the pulmonary function tests of the hypertensive patients taking regular antihypertensive therapy with those of the ones not taking any antihypertensive medicine, to document the differences in pulmonary functions of both hypertensive groups. Materials and Methods: Patients who had received antihypertensive treatment (Group I: 29 males, 24 females, mean age 42.3 +/- 8.2 years), and untreated cases (Group II: 28 males, 22 females, mean age 43.4 +/- 6.4 years) were included in the study. Patients with a history of coronary heart disease, respiratory diseases, smokers and those who were obese were excluded from the study. Results: Forced vital capacity (FVC) and forced expiratory volume at the first second (FEV1) levels were found significantly lower in Group II ( p < 0.05). In echocardiographic evaluation, the mitral E/A ratio of Group II was lower than that of Group I ( p < 0.05). Isovolumetric relaxation time and deceleration time was higher in Group II than in Group I ( p < 0.05). There was a significant association between pulmonary function tests and impaired left ventricular diastolic parameters; especially, mitral E/A ratio was significantly associated with decreased FVC and FEV1 in Group II (respectively r = -0.695, p = 0.01 and r = -0.591, p = 0.03). Conclusion: FVC and FEV1 levels in untreated hypertensive cases were lower than in those of treated hypertensive cases, and this may be caused by diastolic function rather than the systolic function. In the evaluation of dyspnea in hypertensive patients, it would be useful to examine respiratory function in addition to echocardiographic investigation.
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    Effects of the sibutramine therapy on pulmonary artery pressure in obese patients
    (Blackwell Publishing Ltd, 2004) Guven, A; Koksal, N; Cetinkaya, A; Sokmen, G; Ozdemir, R
    Aim: Obesity is a major global public health problem. Previous drugs (dexfenfluramine and fenfluramine) used for the treatment of obesity have been withdrawn due to various cardiac side effects. Sibutramine is an anti-obesity agent. The purpose of this study was to assess cardiac valve disease and pulmonary artery pressure (PAP) of the patients who used once daily doses of sibutramine. Methods: One hundred and six obese patients (51 men and 55 women) determined to have minimal tricuspid regurgitation (TR) on echocardiographic examination were included in the study. All patients had a complete physical examination, complete blood count and measurement of lipid parameters, and echocardiography was performed by which cardiac valves and PAP were evaluated. After the mean duration of 24-week of follow up, all examinations were repeated for each patient. Results: The drug was well tolerated by all patients for the follow-up period. A significant weight loss was recorded in all patients compared to the baseline values (93.1 +/- 9.6 kg vs. 85.8 +/- 7.7 kg, p < 0.001). Blood pressures and heart rate of the patients increased compared to the baseline measurements (systolic 122.3 +/- 8.5 vs. 124 +/- 10.2 mmHg, p = 0.128, diastolic 79.3 +/- 4.7 vs. 80 +/- 5.7 mmHg, p = 0.42 and heart rate 79.5 +/- 6.5 vs. 85 +/- 5.7 beats/min, p < 0.001). Echocardiographically determined aortic or mitral valve dysfunction appeared in none of the patients. PAP lightly increased after the treatment but the difference between pre and post-treatment values was not found statistically significant (14.7 +/- 1.8 vs. 16.3 +/- 1.6 mmHg, p = 0.06). Conclusions: A 24-week treatment with sibutramine does not affect heart valves and pulmonary artery pressure.
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    Impact of hemodialysis on comprehensive ventricular repolarization
    (Acta Cardiologica, 1997) Tuncer, C; Kulan, K; Komsuoglu, B; Ozdemir, R; Guven, A; Pekdemir, H; Sezgin, AT
    Impact of hemodialysis on comprehensive ventricular repolarization - Cardiac arrhythmia are one of the most important problems in haemodialysis patients. An important cause of the arrhythmias is inhomogenous myocardial repolarization. In this study, the ventricular repolarization parameters (QT, QTc, JT and JTc) and dispersions (d) of the parameters (QT-d, QTc-d, JT-d and JTc-d) were evaluated. Also, were recorded the right-sided lends (RV3-6) and posterior leads (V7-9) in addition to the standard 12 lead ECG to assess comprehensive ventricular repolarization. The leads were divided in three groups: Group A (Standard ECG leads), Group B (Right-sided leads) and Group C (All of the leads). Among the above mentioned parameters, only JT and JTc intervals decreased significantly in all groups. There was no significant difference between the groups in evaluation of the parameters. It was concluded that in assessment of ventricular repolarization, the most important ECG intervals may be JT and JTc intervals, and the standard 12 lead ECG record is sufficient in evaluation of ventricular repolarization in hemodialysis patients.
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    Organophosphate intoxication as a consequence of mouth-to-mouth breathing from an affected case
    (Elsevier, 2002) Koksal, N; Buyukbese, MA; Guven, A; Cetinkaya, A; Hasanoglu, HC
    We report three cases of organophosphate (OP) poisoning. One patient was a 19-year-old woman who drank OP compounds in an attempt at suicide. The other two patients became intoxicated on the way to the hospital during mouth-to-mouth breathing. The first patient died in the emergency department, and the other two were taken to the ICU. There, they were treated with atropine and pralidoxime. Three days later, all symptoms and signs had disappeared, and they, were discharged from the hospital satisfactorily.
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    Relationship between oxidative stress in cord blood and route of delivery
    (Karger, 2005) Inanc, F; Kilinc, M; Kiran, G; Guven, A; Kurutas, EB; Cikim, IG; Akyol, O
    Objective: To investigate the effect of route of delivery on the antioxidant system of newborns. Methods: We used the cord blood taken during labor of 56 vaginal deliveries and 50 elective cesarean sections. The specimens were analyzed for the plasma malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT) and glucose 6-phosphate dehydrogenase (G6PD) activity and leukocyte count. Results: SOD and CAT activities were significantly higher in the elective cesarean group than the vaginal delivery group (p < 0.01 and p < 0.005, respectively), but G6PD activity was similar between the groups. Plasma MDA level was lower in the cesarean group compared to the vaginal delivery group (p < 0.001). Leukocyte count was higher in the vaginal delivery group (p < 0.005). Conclusion: Our findings suggest that the route of delivery has an effect on oxidative stress in newborns exposed to oxidative stress during delivery. It can be suggested that the antioxidant system works more efficiently to overcome oxidative stress in newborns delivered via cesarean section. Copyright (c) 2005 S. Karger AG, Basel.