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Aydogan M, Pehlivanoglu T, Erdag Y, Akturk UD, Akar A. Flexible posterior vertebral tethering for the management of Scheuermann's kyphosis: correction by using growth modulation-clinical and radiographic outcomes of the first 10 patients with at least 3 years of follow-up. Eur Spine J 2024:10.1007/s00586-024-08297-4. [PMID: 38740612 DOI: 10.1007/s00586-024-08297-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 04/14/2024] [Accepted: 05/01/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE The present prospective cohort study was intended to present the minimum 3 years' results of flexible posterior vertebral tethering (PVT) applied to 10 skeletally immature patients with SK to question, if it could be an alternative to fusion. METHODS Ten skeletally immature patients with radiographically confirmed SK, who had flexible (minimum 35%) kyphotic curves (T2-T12), were included. A decision to proceed with PVT was based on curve progression within the brace, and/or persistent pain, and/or unacceptable cosmetic concerns of the patient/caregivers, and/or non-compliance within the brace. RESULTS Patients had an average age of 13.1 (range 11-15) and an average follow-up duration of 47.6 months (range 36-60). Posterior vertebral tethering (PVT) was undertaken to all patients by utilizing Wiltse approach and placing monoaxial pedicle screws intermittently. At the final follow-up: mean pre-operative thoracic kyphosis and lumbar lordosis improved from 73.6°-45.7° to 34.7°-32.1°. Mean sagittal vertical axis, vertebral wedge angle and total SRS-22 scores improved significantly. A fulcrum lateral X-ray obtained at the latest follow-up, showed that the tethered levels remained mobile. CONCLUSION This study, for the first time in the literature, concluded, that as a result of growth modulation applied to skeletally immature patients with SK, flexible PVT was detected to yield gradual correction of the thoracic kyphosis by reverting the pathological vertebral wedging process, while keeping the mobility of the tethered segments in addition to successful clinical-functional results. The successful results of the present study answered the role of the PVT as a viable alternative to fusion in skeletally immature patients with SK. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Mehmet Aydogan
- Department of Orthopaedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Surgical Spine Center of Excellence Certified By EUROSPINE, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi; No:22, Pendik, 34912, Istanbul, Turkey
| | - Tuna Pehlivanoglu
- Department of Orthopedic Surgery and Traumatology, Liv Spine Center, Liv Hospital Ulus, Ulus Mahallesi, Ahmet Adnan Saygun Caddesi, Canan Sokak, No:4, Beşiktaş, 34340, Istanbul, Turkey.
- Department of Ortopedic Surgery and Traumatology, Faculty of Medicine, Istinye University, Hamidiye, Kâğıthane, 34408, Istanbul, Turkey.
| | - Yigit Erdag
- Department of Orthopedic Surgery and Traumatology, Medar Hospital, Osman Yılmaz Mahallesi, İstanbul Caddesi, No:26, Gebze, 41400, Kocaeli, Turkey
| | - Umut Dogu Akturk
- Department of Neurosurgery, Emsey Advanced Spine Surgery Center, Surgical Spine Center of Excellence Certified By EUROSPINE, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
| | - Abdulhalim Akar
- Department of Orthopaedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Surgical Spine Center of Excellence Certified By EUROSPINE, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi; No:22, Pendik, 34912, Istanbul, Turkey
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Tor YB, Habibov I, Altinkaynak M, Aydogan M, Baykiz D, Tayfur M, Gonenli MG, Onur I, Kalayoglu-Besisik S, Saka B, Erten SN, Akpinar TS. Assessment of Tp-Te interval in patients with cardiac AL amyloidosis. Cardiovasc J Afr 2024; 34:1-5. [PMID: 38270525 DOI: 10.5830/cvja-2023-059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 11/07/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Prolonged Tp-Te interval is strongly associated with fatal ventricular arrhythmias and mortality. This association has been demonstrated in various diseases. However, the current literature does not give any information on Tp-Te interval in cardiac amyloid light-chain (AL) amyloidosis. METHODS We retrospectively screened 116 cardiac AL amyloidosis patients and 35 patients were included in the study. Demographic, laboratory, 12-lead electrocardiographic (QTc, Tp-Te V1-V6) and transthoracic echocardiographic data of the patients were analysed and compared with 35 healthy controls. RESULTS QTc and Tp-Te V2-V5 were significantly prolonged in the cardiac AL amyloidosis group (p < 0.05). Also, there was a positive and statistically significant correlation between the parameters of QTc and Tp-Te V3-V6, and also between the parameters of interventricular septum thickness at enddiastole and Tp-Te V2-V5. CONCLUSION We present the first strong evidence of prolonged Tp-Te intervals in patients with cardiac AL amyloidosis. There may also be a relationship between prolonged Tp-Te interval and the development of arrhythmia in this patient group, as in some other groups. There is a need for prospective studies examining the relationship of prolonged Tp-Te interval with arrhythmias and its prognostic significance in cardiac AL amyloidosis.
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Affiliation(s)
- Yavuz B Tor
- Department of Internal Medicine, Memorial Bahcelievler Hospital, Istanbul, Turkey.
| | - Ismat Habibov
- Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mustafa Altinkaynak
- Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Aydogan
- Department of Cardiology, Bitlis Tatvan State Hospital, Bitlis, Turkey
| | - Derya Baykiz
- Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Tayfur
- Department of Internal Medicine, Health Sciences University, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Mehmet G Gonenli
- Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Imran Onur
- Department of Internal Medicine, Memorial Bahcelievler Hospital, Istanbul, Turkey
| | - Sevgi Kalayoglu-Besisik
- Division of Haematology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Bulent Saka
- Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Sebile N Erten
- Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Timur S Akpinar
- Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Aydogan M, Kumet O, Ozcan A, Ozcan I, Tas A, Umman S. A novel method that can be used in both the diagnosis and treatment of peripheral arterial disease in diabetics: vibration-mediated dilation. Cardiovasc J Afr 2023; 34:1-9. [PMID: 38032711 DOI: 10.5830/cvja-2023-058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE The growing incidence of diabetes and the increasing life expectancy of the diabetic population worldwide has increased the number of diabetic vascular complications occurring in cardiology practice. As current treatment and prevention methods are less effective in this patient group, there is a need for new treatment methods in this area. Exercise, which reduces metabolic and vascular problems associated with diabetes, often becomes impossible, especially in advanced-stage patients who need exercise the most. Since exercise and flow-mediated dilation (FMD) are effective by stimulating mechanotransduction mechanisms on the endothelium, it can be expected that the same mechanisms could also be stimulated by direct vibration. METHODS In order to test this hypothesis, in this study, a group of 20 type 2 diabetes patients (11 males, age 56.80 ± 11.05 years and diagnosed for 15.35 ± 8.61 years) were examined via the application of FMD and vibration-mediated dilation (VMD). We performed vibration for five minutes with 20-Hz frequency and 3-mm vertical amplitude, to the same side forearm, with a 30-minute interval. Using a 10-MHz linear echo probe, brachial artery diameter and flow velocities were recorded for 10 minutes before and at two-minute intervals after the FMD and VMD applications. Then brachial artery flow and resistance were calculated at each stage. RESULTS In the first minute after FMD and VMD applications, brachial artery diameter and flow velocities increased significantly, and vascular resistance decreased significantly. None of the corresponding FMD or VMD parameters in the first minute was different. The artery diameters in the first minute after FMD and VMD were increased by 6.04 ± 5.29 and 5.49 ± 5.21%, respectively. At the tenth minute, these values decreased to 1.73 ± 3.21 and 2.05 ± 3.31%. In the FMD series, all parameters except brachial artery diameter returned to their baseline values after the fourth minute. After VMD, all parameters also decreased after the first minute, but the recovery was much slower. At each stage after the first minute, the VMD averages were higher than the baseline value and their corresponding FMD values. CONCLUSION The results of this study indicated that vibration may be a powerful, long-lasting and feasible treatment option in patients with peripheral perfusion failure, developed due to diabetic macro- and microvascular complications.
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Affiliation(s)
- Mehmet Aydogan
- Bitlis Tatvan State Hospital, Ministry of Health, Bitlis, Turkey.
| | - Omer Kumet
- Van Training and Research Hospital, Ministry of Health, Van, Turkey
| | - Alp Ozcan
- Department of Cardiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ilke Ozcan
- Department of Cardiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Tas
- Department of Cardiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey; Goslar Asklepios Hospital, Goslar, Germany
| | - Sabahattin Umman
- Department of Cardiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Bugra Z, Emet S, Umman B, Ozer PK, Sezer M, Baykiz D, Atilgan D, Tireli E, Dursun M, Yılmazbayhan D, Karaayvaz EB, Elitok A, Bilge AK, Goren T, Umman S, Kumrular M, Yilmaz M, Sonsoz MR, Engin B, Ayduk E, Aydogan M, Cevik E, Kavak I, Orta H, Tasdemir M, Tuncozgur A, Topcak Z, Gorgun OD, Oztas DM. Intracardiac masses: Single center experience within 12 years: I-MASS Study. Am Heart J Plus 2022; 13:100081. [PMID: 38560087 PMCID: PMC10978191 DOI: 10.1016/j.ahjo.2021.100081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/27/2021] [Accepted: 12/07/2021] [Indexed: 04/04/2024]
Abstract
Objective The aim of this cross-sectional, retrospective, descriptive study was to review and classify cardiac masses systematically and to determine their frequencies. Methods The medical records of 64,862 consecutive patients were investigated within 12 years. Every patient with a cardiac mass imaged by transthoracic echocardiography (TTE) and confirmed with an advanced imaging modality such as transesophageal echocardiography (TEE), computed tomography (CT) and/or cardiac magnetic resonance imaging (CMR) was included. Acute coronary syndromes triggering thrombus formation, vegetations, intracardiac device and catheter related thrombi were excluded. Results Data demonstrated 127 (0.195%) intracardiac masses consisting of 33 (0.050%) primary benign, 3 (0.004%) primary malignant, 20 (0.030%) secondary tumors, 3 (0.004%) hydatid cysts and 68 (0.104%) thrombi respectively. The majority of primary cardiac tumors were benign (91.67%), predominantly myxomas (78.79%), and the less malignant (8.33%). Secondary cardiac tumors were common than the primary malignant tumors (20:3), with male dominancy (55%), lymphoma and lung cancers were the most frequent. Intracardiac thrombi was the majority of the cardiac masses, thrombi accompanying malignancies were in the first range (n = 17, 25%), followed by autoimmune diseases (n = 13, 19.12%) and ischemic heart disease with low ejection fraction (n = 12, 17.65%). Conclusions This retrospective analysis identified 127 patients with cardiac masses. The majority of benign tumors were myxoma, the most common tumors that metastasized to the heart were lymphoma and lung cancers, and the thrombi associated with malignancies and autoimmune diseases were the most frequent.
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Affiliation(s)
- Zehra Bugra
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Samim Emet
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Berrin Umman
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Pelin Karaca Ozer
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Murat Sezer
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Derya Baykiz
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Dursun Atilgan
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Emin Tireli
- Istanbul University, Istanbul Medical Faculty, Department of Cardiovascular Surgery, Turkey
| | - Memduh Dursun
- Istanbul University, Istanbul Medical Faculty, Department of Radiology, Turkey
| | - Dilek Yılmazbayhan
- Istanbul University, Istanbul Medical Faculty, Department of Pathology, Turkey
| | | | - Ali Elitok
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Ahmet Kaya Bilge
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Taner Goren
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Sabahattin Umman
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Collaborators
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
- Istanbul University, Istanbul Medical Faculty, Department of Cardiovascular Surgery, Turkey
- Istanbul University, Istanbul Medical Faculty, Department of Radiology, Turkey
- Istanbul University, Istanbul Medical Faculty, Department of Pathology, Turkey
| | - Merve Kumrular
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Mustafa Yilmaz
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Mehmet Rasih Sonsoz
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Berat Engin
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Elif Ayduk
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Mehmet Aydogan
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Erdem Cevik
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Ilyas Kavak
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Huseyin Orta
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Mucahit Tasdemir
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Asli Tuncozgur
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Zeynep Topcak
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Ozerk Dogus Gorgun
- Istanbul University, Istanbul Medical Faculty, Department of Pathology, Turkey
| | - Didem Melis Oztas
- Istanbul University, Istanbul Medical Faculty, Department of Cardiovascular Surgery, Turkey
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Senkal N, Kiyan E, Kocasoy-Orhan E, Demir A, Aydogan M, Yalçinkaya Y, Gul A, Inanc M, Ocal ML, Artim-Esen B. AB0331 PULMONARY INVOLVEMENT IN A SINGLE CENTER COHORT OF PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The prevalence of SLE pulmonary involvement varies depending on several factors, including diagnostic methods [1].Objectives:We aimed to determine the frequency of involvement with different diagnostic methods in a single center cohort.Methods:300 SLE patients were included. Chest x-ray (CXR), lung spirometry, carbonmonoxide diffusion test (DLCOc) and echocardiography were performed. High resolution thorax computed tomography (HRCT) was done for a definite diagnosis of interstitial lung disease (ILD) whilst diagram electromyography (EMG), ultrasonography (USG) and magnetic resonance imaging (MR) were utilized to diagnose shrinking lung syndrome (SLS).Results:The mean age and follow-up time were 43 and 11,5 years respectively. Of 300 patients, 16% had ILD, 6,7% had pulmonary hypertension (PHT), 3% had SLS, 0,3% had pulmonary infarction. At the start of the study, patients’ records showed that 4% had ILD, 5% PHT, 0,3% SLS and 0,3% pulmonary infarction. The median age, mean duration of disease and follow-up time were significantly higher and longer in patients with ILD compared to patients without (p<0.05). Forced expiratory volume (FEV1), forced vital capacity (FVC), DLCOc and total lung capacity (TLC) were significantly lower in patients with ILD and with SLS (p<0,001). Patients with ILD had significantly higher frequency of arthritis, serositis, Raynaud myositis and anti-Scl70 positivity. Avascular necrosis, diabetes and malignancy were significantly more frequent in those patients. All patients with suspected SLS undergone diagram EMG, USG and MR. Out of 10 suspected cases, in 6 EMG, in 5 USG and in 9 MR was compatible with SLS diagnosis. 5 patients had 3 of the diagnostic methods positive to diagnose SLS. Muscle atrophy and weakness, avascular necrosis were more frequent in this group of patients (p<0.05). There were more patients treated with mycophenolate mofetil (MMF) and cyclophosphamide in the SLS group whilst more with MMF in the ILD group. Significantly higher frequency of patients had stopped using hydroxychloroquine (HCQ) in the ILD group (p=0,04).Conclusion:Interstitial lung disease is common in patients with SLE and considerable number of patients have SLS [2]. Spirometry, DLCOc and CXR are simple but valuable to diagnose pulmonary involvement in SLE patients. Diaphragm MR, USG and EMG are complementary methods for definite diagnosis in SLS [2]. Considering the significant difference of prevalence between the start and the end of the study, one of the possibbilities is the underrecognition of SLE pulmonary disease due to its being part of a multisystemic presentation. Higher usage of immunosuppressives in these patients may support a multisystemic active disease. Although drug effect is another concern, it is hard to establish a causal relationship due to the study’s cross-sectional design. HCQ may have a role in ILD prevention.References:[1]Keane MP, Lynch JP. Pleuropulmonary manifestations of systemic lupus erythematosus. Thorax 2000;55:159-166.[2]Singh R, Huang W, Menon Y, Espinoza LR. Shrinking lung syndrome in systemic lupus erythematosus and Sjogren’s syndrome. J Clin Rheumatol. 2002 Dec;8(6):340-5.Table 1.Spirometry; DLCO; diaphragm EMG, USG and MRI results of patients with SLS.Patient/Age/Sex1/44/F2/57/F3/39/F4/38/M5/23/F6/60/F7/58/F8/37/F9/66/F10/28/FFEV1 (%)47655963676271537039FVC (%)56735962797072556237DLCO (%)45504465535547656245TLC (%)61716566786454636245USG deep inspiration (L)4,704,742,593,013,063,065,734,172,121,59USG deep inspiration (R)3,721,982,262,242,772,174,672,834,622,49USG diaphragm thickness (L)4,823,002,482,842,551,592,093,181,621,44USG diaphragm thickness R(R)1,231,041,841,802,191,311,791,972,081,63MR high sideRRRRRRRLLMR height difference4,926,192,872,641,672,451,730,950,78EMG resting AMP (R)0,20,30,60,50,60,40,10,80,90,7EMG resting LAT (R)76,47,166,786,154,7565,8EMG resting AMP (L)0,40,50,80,71,20,60,31,20,50,5EMG resting LAT (L)6,355,756,855,66,05664,355,26,15Disclosure of Interests:None declared
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Öztop N, Özer PK, Demir S, Beyaz Ş, Tiryaki TO, Özkan G, Aydogan M, Bugra MZ, Çolakoglu B, Büyüköztürk S, Nalçacı M, Yavuz AS, Gelincik A. Impaired endothelial function irrespective of systemic inflammation or atherosclerosis in mastocytosis. Ann Allergy Asthma Immunol 2021; 127:76-82. [PMID: 33775901 DOI: 10.1016/j.anai.2021.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/03/2021] [Accepted: 03/18/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Knowledge on endothelial dysfunction and its relation to atherosclerosis in mastocytosis is limited. OBJECTIVE To investigate the endothelial function in mastocytosis by flow-mediated dilatation (FMD) and biomarkers related to vascular endothelia and to evaluate its relationship with the presence of subclinical atherosclerosis by carotid intima media thickness (CIMT). METHODS A total of 49 patients with mastocytosis and 25 healthy controls (HCs) were included. The FMD and CIMT during transthoracic echocardiography biomarkers including endocan, endothelin-1, and vascular endothelial growth factor (VEGF) were measured in the sera of participants. Tumor necrosis factor-alpha, interleukin 6, and high-sensitive C-reactive protein were determined as inflammatory biomarkers. RESULTS The mean FMD % was lower in the patients than HCs (11.26% ± 5.85% vs 17.84% ± 5.27% P < .001) and was the lowest in the advanced systemic mastocytosis and smoldering systemic mastocytosis group among the patients (P = .03). The median value of VEGF was considerably higher in patients than HCs (73.30 pg/mL; minimum-maximum 32.46-295.29 pg/mL vs 46.64 pg/mL; minimum-maximum, 11.09-99.86 pg/mL; P = .001) and it was the highest in the advanced systemic mastocytosis and smoldering systemic mastocytosis group (P = .01). The FMD was inversely correlated with endocan (r = -0.390; P = .006), endothelin-1 (r = -0.363; P = .01) and VEGF (r = -0.402; P = .004) but there were no correlations between FMD and tumor necrosis factor-alpha, interleukin 6, and high-sensitive C-reactive protein. No differences in CIMT values between patients and HCs and no correlation between CIMT and the biomarkers were observed. CONCLUSION Endothelial dysfunction in mastocytosis becomes evident with decreased FMD and elevated serum VEGF in the absence of atherosclerosis or systemic inflammation and is related to disease severity.
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Affiliation(s)
- Nida Öztop
- Division of Immunology and Allergic Diseases, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Pelin Karaca Özer
- Department of Cardiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Semra Demir
- Division of Immunology and Allergic Diseases, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Şengül Beyaz
- Division of Immunology and Allergic Diseases, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Tarık Onur Tiryaki
- Division of Hematology, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Gülkan Özkan
- Division of Hematology, Department of Internal Medicine, Yeditepe University Faculty of Medicine, İstanbul, Turkey
| | - Mehmet Aydogan
- Department of Cardiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Melike Zehra Bugra
- Department of Cardiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Bahauddin Çolakoglu
- Division of Immunology and Allergic Diseases, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Suna Büyüköztürk
- Division of Immunology and Allergic Diseases, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Meliha Nalçacı
- Division of Hematology, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Akif Selim Yavuz
- Division of Hematology, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Aslı Gelincik
- Division of Immunology and Allergic Diseases, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
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Pehlivanoglu T, Erdag Y, Oltulu I, Akturk UD, Korkmaz E, Yildirim K, Sarioglu E, Gun K, Ofluoglu E, Aydogan M. Unilateral Posterior Surgery for Severe Osteoporotic Vertebrae Fractures' Sequelae in Geriatric Population: Minimum 5-Year Results of 109 Patients. Neurospine 2021; 18:319-327. [PMID: 33657776 PMCID: PMC8255769 DOI: 10.14245/ns.2040812.406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/25/2021] [Indexed: 11/21/2022] Open
Abstract
Objective This study aimed to evaluate the efficacy and safety of modified posterior vertebral column resection (PVCR) combined with anterior column restoration in elderly patients presenting with thoracic or thoracolumbar osteoporotic fractures with spinal cord compression and severe pain.
Methods One hundred nine patients with one level thoracolumbar osteoporotic fracture and at least 5 years of follow-up were included. They underwent posterior instrumentation performed with polymethymetachrylate augmented pedicle screws. A modified PVCR (unilateral costotransversectomy+hemilaminectomy) combined with the insertion of an expandable titanium cage for anterior column restoration was undertaken. Patients were evaluated clinically and radiographically.
Results Patients had a mean age of 74.1 and a follow-up duration of 92.3 months. Mean duration of operations, hospital stays, and mean loss of blood were 172.3 minutes, 4.3 days, and 205.4 mL. All of the patients were mobilized immediately after surgery. The mean preoperative local kyphosis angle improved from 39.3° to 4.7° at the last follow-up (p = 0.003). Patients preoperative mean visual analogue score, Japanese Orthopaedic Association, and Oswestry Disability Index scores improved from 7.7/8.6/76.3 to 1.6/26.1/17.4 (p < 0.001 for all), respectively. The average 36-item Short-Form survey physical component summary/mental component summary scores at the last follow-up were 55.1/56.8. A dural tear was detected intraoperatively in 1 patient and repaired immediately.
Conclusion Subtotal PVCR combined with the insertion of an expandable titanium cage was detected as a safe and effective method for osteoporotic vertebrae fractures’ sequelae in the older population involving spinal cord compression by enabling the decompression of the spinal canal and reconstruction of the resected segment, resulting in significant improvement in clinical and radiographic outcomes.
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Affiliation(s)
- Tuna Pehlivanoglu
- Yeni Yuzyil University, Faculty of Health Sciences, Istanbul, Turkey.,Emsey Hospital, Advanced Spine Surgery Center, Istanbul, Turkey
| | - Yigit Erdag
- Emsey Hospital, Advanced Spine Surgery Center, Istanbul, Turkey
| | - Ismail Oltulu
- Emsey Hospital, Advanced Spine Surgery Center, Istanbul, Turkey
| | | | - Emre Korkmaz
- Emsey Hospital, Advanced Spine Surgery Center, Istanbul, Turkey
| | - Kerem Yildirim
- Emsey Hospital, Advanced Spine Surgery Center, Istanbul, Turkey
| | - Ender Sarioglu
- Emsey Hospital, Advanced Spine Surgery Center, Istanbul, Turkey
| | - Kerem Gun
- Emsey Hospital, Advanced Spine Surgery Center, Istanbul, Turkey
| | - Ender Ofluoglu
- Emsey Hospital, Advanced Spine Surgery Center, Istanbul, Turkey
| | - Mehmet Aydogan
- Emsey Hospital, Advanced Spine Surgery Center, Istanbul, Turkey
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Medetalibeyoglu A, Emet S, Senkal N, Aydogan M, Kose M, Tukek T. Cardiovascular view of intermediate and high-risk COVID-19 patients: single-centre experience with low mortality and intensive care hospitalisation rates. Cardiovasc J Afr 2021; 32:79-86. [PMID: 33165497 PMCID: PMC8756026 DOI: 10.5830/cvja-2020-041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/30/2020] [Indexed: 11/06/2022] Open
Abstract
AIM The purpose of this article was to report the low rates of intensive care unit admission and mortality in intermediate- and high-risk COVID-19 patients, and to share our clinical approach with other colleagues. In addition, we sought to reveal the relationship between myocardial injury and clinical outcomes such as death, intensive care unit uptake and hospital stay, and the relationship between inflammatory parameters and cardiac biomarkers in a cardiovascular perspective. METHODS Patients admitted to the emergency department in the Department of Internal Medicine, Faculty of Medicine, Istanbul University, with laboratory or clinically and radiologically confirmed COVID-19 were included in this retrospective cross-sectional study, which was conducted from 11 March to 10 April 2020. The demographic (age and gender) and clinical (symptoms, co-morbidities, treatments, complications and outcomes) characteristics, laboratory findings, and results of cardiac examinations (cardiac biomarkers and electrocardiography) of patients during hospitalisation were collected from their medical records by two investigators. Data were analysed using SPSS version 25.0 (IBM). A two-sided p < 0.05 was considered statistically significant. Analysis began on 11 April 2020. RESULTS Mortality and intensive care unit admission rates were statistically significantly higher in patients with cardiac injury than in those without. There was a positive correlation between levels of high-sensitivity TNT and fibrinogen, D-dimer, ferritin, procalcitonin and C-reactive protein (r = 0.24, p < 0.01; r = 0.37, p < 0.01; r = 0.25, p < 0.01, r = 0.34, p < 0.01; r = 0.31, p < 0.01). CONCLUSIONS The first general data of our 309 patients regarding low mortality and intensive care admission rates, and particular treatment algorithms specific to our centre should be helpful in determining better treatment strategies in the future. Our study emphasises the importance and frequency of cardiovascular outcomes, and the significance of some cardiac biomarkers in predicting COVID-19 prognosis.
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Affiliation(s)
- Alpay Medetalibeyoglu
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Samim Emet
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Naci Senkal
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Aydogan
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Kose
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tufan Tukek
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Pehlivanoglu T, Oltulu I, Erdag Y, Korkmaz E, Sarioglu E, Ofluoglu E, Aydogan M. Double-sided vertebral body tethering of double adolescent idiopathic scoliosis curves: radiographic outcomes of the first 13 patients with 2 years of follow-up. Eur Spine J 2021; 30:1896-1904. [PMID: 33611658 DOI: 10.1007/s00586-021-06745-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 12/16/2020] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE In skeletally immature patients with adolescent idiopathic scoliosis (AIS), vertebral body tethering (VBT) as a fusionless minimally invasive treatment option has been shown to correct the deformity by growth modulation. This prospective cohort study aimed to present the minimum 2 years' results of double-sided VBT applied to double curves of 13 skeletally immature patients with AIS. METHODS Thirteen skeletally immature patients with AIS and double curves were included. All patients were followed up within a brace for at least 6 weeks. A decision to proceed with surgery was established after the detection of curve progression within the brace (> 40° thoracic, > 35° lumbar) with a minimum curve flexibility of 30%. RESULTS Patients had an average age of 11.8 years, average follow-up duration of 36.4 months (range 24 to 46), average preoperative main thoracic/thoracolumbar or lumbar curve magnitudes of 48.2°/45.3°. An average of 11.8 levels of tethering was undertaken. Thoracic screws were placed thoracoscopically, while mini-thoracotomy/lumbotomy was added for thoracolumbar levels. Postoperatively, an average first erect thoracic/thoracolumbar major curve magnitudes of 17.3°/14.3° were acquired, while they improved to 9.7°/8.2° at the last follow-up. No neurologic or implant-related complications were acquired. CONCLUSION Double-sided VBT was detected to provide 80% of thoracic (48.2° to 9.7°) and 82% of thoracolumbar-lumbar curve correction (45.3° to 8.2°) as a result of average two years. As being a growth modulating treatment option, double-sided VBT as applied under strict inclusion criteria was shown to be safe and effective for the correction of double curves in skeletally immature patients with AIS, by yielding a gradual, growth-assisted correction of both curves together with the preservation of coronal-sagittal balance without any major complications.
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Affiliation(s)
- Tuna Pehlivanoglu
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey. .,Faculty of Health Sciences, Yeni Yüzyıl University, Maltepe Mahallesi, Yılanlı Ayazma Caddesi, No: 26, Cevizlibağ, Zeytinburnu, 34010, İstanbul, Turkey.
| | - Ismail Oltulu
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
| | - Yigit Erdag
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
| | - Emre Korkmaz
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
| | - Ender Sarioglu
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
| | - Ender Ofluoglu
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
| | - Mehmet Aydogan
- Department of Orthopedic Surgery and Traumatology, Emsey Advanced Spine Surgery Center, Emsey Hospital, Çamlık Mahallesi, Selçuklu Caddesi, No:22, Pendik, 34912, Istanbul, Turkey
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10
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Elitok A, Emet S, Karaayvaz EB, Erdogan O, Aydogan M, Engin B, Cevik E, Orta H, Okumus G, Bilge AK. The relationship between T-wave peak-to-end interval and hemodynamic parameters in patients with pulmonary arterial hypertension. Ann Noninvasive Electrocardiol 2020; 25:e12764. [PMID: 32304627 PMCID: PMC7507547 DOI: 10.1111/anec.12764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 12/31/2022] Open
Abstract
Background T‐wave peak‐to‐end interval (TPEI) is a measure of repolarization dispersion on surface electrocardiogram (ECG). TPEI has been reported as a prognostic parameter with heart disorders. In this study, we aimed to evaluate the relationship between echocardiogram‐derived right heart parameters, right heart catheterization (RHC) measurements, and TPEI in patients with precapillary pulmonary arterial hypertension (PAH). Methods Thirty‐eight patients (29 females and 9 males, mean age of 54.9 ± 10.9 years) who had undergone RHC for a preliminary diagnosis of pulmonary hypertension (PH) were included in the study. We performed transthoracic echocardiography (TTE), and resting 12‐lead ECG was recorded before RHC. TPEI was measured from leads of V1‐V6, DII, DIII, and aVF, and these values are averaged to obtain the global TPEI. Results Duration of TPEI was significantly correlated with mean PAP, pulmonary vascular resistance (PVR), and cardiac index (CI). Longer TPEI was associated with higher N terminal probrain natriuretic peptide (NT pro‐BNP) level, lower 6‐min walk distance (6MWD), and lower tricuspid annular plane systolic excursion (TAPSE). Conclusion Prolongation of TPEI could be a new predictor of adverse outcome in PAH and may provide additional prognostic information for patients with PAH.
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Affiliation(s)
- Ali Elitok
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Samim Emet
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ekrem Bilal Karaayvaz
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Onur Erdogan
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Aydogan
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Berat Engin
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erdem Cevik
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Huseyin Orta
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Department of Chest Disease, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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11
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Guler N, Cokugras F, Sapan N, Selimoglu A, Turktas I, Cokugras H, Aydogan M, Beser O. Diagnosis and management of cow's milk protein allergy in Turkey: Region-specific recommendations by an expert-panel. Allergol Immunopathol (Madr) 2020; 48:202-210. [PMID: 31477392 DOI: 10.1016/j.aller.2019.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 05/06/2019] [Indexed: 01/12/2023]
Abstract
Cow's milk protein allergy (CMPA) is the most common type of food-allergy in younger children. Prognosis is usually good, with most children developing tolerance before school age. Children may present with a wide spectrum of symptoms that range from mild to severe; skin reactions such as angioedema and urticaria and gastrointestinal symptoms are the most common presentations of CMPA. Approximately one-third of CMPA patients suffer from multiple food-allergies; severe conditions such as anaphylactic shock (9%), eosinophilic esophagitis (4.7%), and food-protein induced enterocolitis (1%) may also develop in some children. Timely and accurate diagnosis and management is essential for proper growth and development of children with CMPA. In this expert consensus report, we aimed to adapt current understandings in the CMPA field to the specific conditions in Turkey and health system to help physicians with their day-to-day decision making.
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12
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Uncuoglu A, Cogurlu MT, Eser Simsek I, Ergul N, Baydemir C, Aydogan M. Predicting outgrowth of IgE-mediated cow's milk allergy: Diagnostic tests in children under two years of age. Allergol Immunopathol (Madr) 2019; 47:449-456. [PMID: 30745248 DOI: 10.1016/j.aller.2018.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/09/2018] [Accepted: 12/04/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Limited studies conducted on children <2 years old and/or involving a skin prick test (SPT) for fresh milk (FM) have examined the predictive value of allergometric tests for outgrowth of cow's milk allergy (CMA). We investigated the optimal decision points for outgrowth (ODPfo) with SPT for commercial cow's milk extract (CE) and FM and specific immunoglobulin E (sIgE) levels for milk proteins to predict outgrowing allergy in children <2 years old. METHODS SPTs for CE and FM, tests for sIgEs (cow's milk, casein, α-lactoalbumin, β-lactoglobulin) and oral food challenges (OFC) were performed in children referred for evaluation of suspected CMA, and 15 months after diagnosis. RESULTS Fifty-one children (median age, 7.5 months; range, 2-23 months) were enrolled. Five had a history of anaphylaxis and 26 of 48 children with a positive initial challenge underwent milk elimination. The last OFC was performed in 28 children of whom 13 reacted to milk. The initial SPT responses to CE and FM and milk sIgE levels of the patients with persistent CMA were higher at diagnosis, with ODPfo of 7mm, 9mm, and 10.5kU/L, respectively; these values remained higher with ODPfo of 4mm, 11mm, and 10.5kU/L at the last OFC. CONCLUSION Higher initial SPTs for FM and CE and higher initial sIgE levels for cow's milk proteins are associated with a reduced likelihood of outgrowth. Initial milk sIgE level <10.5kU/L and initial SPT for fresh milk <9mm are related to the acquisition of tolerance in the follow-up period.
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Affiliation(s)
- A Uncuoglu
- Division of Pediatric Gastroenterology Hepatology and Nutrition, Kocaeli University Faculty of Medicine, Turkey
| | - M T Cogurlu
- Division of Pediatric Allergy and Immunology, Kocaeli University Faculty of Medicine, Turkey
| | - I Eser Simsek
- Division of Pediatric Allergy and Immunology, Kocaeli University Faculty of Medicine, Turkey
| | - N Ergul
- Department of Pediatrics, Kocaeli University Faculty of Medicine, Turkey
| | - C Baydemir
- Biostatistics and Medical Informatics Department, Kocaeli University Faculty of Medicine, Turkey
| | - M Aydogan
- Division of Pediatric Allergy and Immunology, Kocaeli University Faculty of Medicine, Turkey.
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13
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Emet S, Elitok A, Karaayvaz EB, Engin B, Cevik E, Tuncozgur A, Aydogan M, Mercanoglu F, Ozcan M, Oncul A. Predictors of left ventricle ejection fraction and early in-hospital mortality in patients with ST-segment elevation myocardial infarction: Single-center data from a tertiary referral university hospital in Istanbul. SAGE Open Med 2019; 7:2050312119871785. [PMID: 31467677 PMCID: PMC6704412 DOI: 10.1177/2050312119871785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 08/02/2019] [Indexed: 12/03/2022] Open
Abstract
Background: Little is known about the management and mortality rates of ST-segment elevation myocardial infarction patients in developing countries. In this study, to expose independent predictors of early (24 h) in-hospital mortality and ejection fraction, we report our experience with 362 ST-segment elevation myocardial infarction patients admitted to the Istanbul Medical Faculty, Istanbul University, a tertiary referral university hospital, and treated with primary percutaneous intervention. Methods: This is a retrospective study that enrolled all patients (362) admitted with ST-segment elevation myocardial infarction to Department of Cardiology, Istanbul Medical Faculty, Istanbul University, between January 2015 and December 2016. The clinical characteristics of patients were collected retrospectively from medical chart review. Collected data were analyzed using IBM SPSS Statistics (version 21). Results: In the forward stepwise logistic regression analysis, target vessel diameter (p = 0.001), systolic blood pressure (p < 0.001), and troponin T levels (p = 0.007) were independent predictors for early in-hospital mortality, while target vessel diameter (p = 0.03), troponin T level (p < 0.001), heart rate (p = 0.001), and chest pain (p = 0.001) duration were the independent predictors for ejection fraction of 50% and above. Conclusion: Our study is one of the few studies to investigate the predictors of early in-hospital mortality among patients hospitalized with ST-segment elevation myocardial infarction in a tertiary referral university hospital in a developing country. The identified predictors for mortality (including left ventricle ejection fraction and troponin T levels), left ventricle ejection fraction (including troponin T level, chest pain duration), and heart rate are consistent with what has been described in large registries in the United States and Europe.
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Affiliation(s)
- Samim Emet
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Ali Elitok
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Ekrem Bilal Karaayvaz
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Berat Engin
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Erdem Cevik
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Asli Tuncozgur
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mehmet Aydogan
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Fehmi Mercanoglu
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mustafa Ozcan
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Aytac Oncul
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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14
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Saka G, Altun G, Burc H, Aydogan M. A new radiographic acetabular cup anteversion measurement method in total hip arthroplasty: a clinical study. Eur J Orthop Surg Traumatol 2019; 29:813-818. [PMID: 30656431 DOI: 10.1007/s00590-019-02384-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/11/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND The acetabular cup positioning is one of the most crucial steps affecting stability and wear rates in total hip arthroplasty. Different methods have been described for determining the anteversion of the acetabular cup in the literature. But there is still not a widely accepted method to assess the acetabular anteversion radiography. The aim of this study is to measure the acetabular anteversion angle on a single pelvis AP radiography with our method which was proven with an experimental study before. MATERIALS AND METHODS A total of 15 patients (8 males, 7 females) who underwent total hip arthroplasty and have had a pelvis computed tomography scans in our outpatient clinic were evaluated retrospectively. The anteversion angle was calculated in all of pelvis CT scans. For radiological measurement, the formula defined by the authors in an experimental model previously was used. RESULTS Statistically significant difference was not determined between radiographic and CT-based measurements (p = 0.207; p > 0.05). A statistically significant agreement was observed at a level of 98.8% between radiographic and CT-based measurements (ICC = 0.988; 95% CI 0.966-0.996; p < 0.01). CONCLUSION Assessment of the acetabular cup anteversion is very important to predict the possible complications after total hip arthroplasty. Although many methods have been defined for this purpose, each of these has advantages and disadvantages. In particular, with computed tomography method, the patient is exposed to excessive radiation, whereas we think that our method is a preferred method due to features not requiring additional equipment, low radiation exposure, being simple, cost-effectiveness, easily applicable and almost 100% accurate.
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Affiliation(s)
- G Saka
- Department of Orthopaedics and Traumatology, Hisar İntercontinental Hospital, Istanbul, Turkey
| | - G Altun
- Department of Orthopedics and Traumatology, Ümraniye Research and Education Hospital, Istanbul, Turkey.
| | - H Burc
- Department of Orthopedics and Traumatology, Beykent University Faculty of Medicine, Istanbul, Turkey
| | - M Aydogan
- Department of Orthopedics and Traumatology, Bosphorus Spine Center, Istanbul, Turkey
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15
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Erdem MN, Oltulu I, Karaca S, Sari S, Aydogan M. Intraoperative Halo-Femoral Traction in Surgical Treatment of Adolescent Idiopathic Scoliosis Curves between 70° and 90°: Is It Effective? Asian Spine J 2018; 12:678-685. [PMID: 30060376 PMCID: PMC6068402 DOI: 10.31616/asj.2018.12.4.678] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/19/2017] [Indexed: 11/30/2022] Open
Abstract
Study Design A retrospective clinical study. Purpose To analyze the surgical outcomes of intraoperative halo-femoral traction (HFT) in patients with adolescent idiopathic scoliosis (AIS) with Cobb angles between 70° and 90° and flexibility <35%. Overview of Literature Numerous methods have been described to achieve adequate correction and successful results in the surgical treatment of AIS patients with a Cobb angle >70°. However, few studies have evaluated the results of HFT in AIS patients with Cobb angles between 70° and 90° and flexibility <35%. Methods The study comprised 24 AIS patients (18 females, six males; mean age, 17.4 years; mean preoperative Cobb angle, 80.1°; range, 70°–90°) who underwent surgery using intraoperative HFT. Neurological status was constantly assessed during the surgery using intraoperative neurophysiological monitoring. Results The mean follow-up period was 33.5 months. Radiographic outcomes demonstrated 85.7% correction of the major Cobb angle. Coronal and sagittal balance was achieved in all the patients, and shoulder levels were equalized. The traction was discontinued when a decrease in spinal cord potentials was observed during the surgery. Conclusions Intraoperative HFT is an effective and reliable method for the management of scoliosis curves between 70° and 90°. The most significant advantages of the method are avoidance of the morbidities related to anterior surgery, osteotomy, or vertebral column resection; its contribution in helping achieve adequate reduction and optimum balance by the gradually increased corrective force, lack of any need for extreme correction force during instrumentation; and the high correction rates achieved.
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Affiliation(s)
- Mehmet Nuri Erdem
- Department of Orthopaedics and Traumatology, Hisar Intercontinental Hospital, İstanbul, Turkey
| | - Ismail Oltulu
- Fulya Orthopaedic and Spine Center, İstanbul, Turkey
| | - Sinan Karaca
- Department of Orthopaedics and Traumatology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Seçkin Sari
- Fulya Orthopaedic and Spine Center, İstanbul, Turkey
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Erdem MN, Erken HY, Aydogan M. The effectiveness of non-surgical treatments, re-discectomy and minimally invasive transforaminal lumbar interbody fusion in post-discectomy pain syndrome. J Spine Surg 2018; 4:414-422. [PMID: 30069537 DOI: 10.21037/jss.2018.04.02] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background There have been many studies that reported various treatment options about recurrent disc herniation, recurrent sciatica, and low back pain following discectomy. However, evaluation and treatment algorithm of post-discectomy pain syndrome (PDPS) could not be standardized. The purpose of this study was to report the results of patients with PDPS who were treated with various treatment options with a minimum 2-year follow-up. Methods We retrospectively evaluated 54 of 75 patients with PDPS who had no response to 12 weeks of conservative treatment between 2009 and 2014. Fifteen of 21 patients with re-herniation who did not respond to non-surgical treatments benefited from re-discectomy. Twenty-seven patients eventually underwent minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) surgery and 12 patients, who had no need for surgery, responded well to the non-surgical treatments. All patients were evaluated using the 10-point visual analog scale (VAS) and Oswestry Disability Index (ODI) preoperatively and at the post-treatment or postoperative follow-ups. Results Pre-treatment mean VAS score of the patients who benefited from non-surgical treatments was 7.9. The mean VAS score decreased to 2.1 at the final follow-up. The mean pre-treatment ODI was 46%, which decreased to 25.9% at the final follow-up. Preoperative mean VAS score of the patients who were treated with MIS-TLIF surgery was 8.1. The average VAS score decreased to 1.8 at the final follow-up. The mean preoperative ODI was 48%, which decreased to 24.2% at the final follow-up. Conclusions Twelve of 54 patients with PDPS regardless of underlying etiology benefited from non-surgical treatments. Fifteen of 21 patients with re-herniation benefited from re-discectomy. MIS-TLIF is found as a highly effective procedure for the relief of post-discectomy pain that is resistant to non-surgical treatment options and for patients who had a second re-herniation.
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Affiliation(s)
- Mehmet Nuri Erdem
- Department of Orthopaedic Surgery, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Halil Yener Erken
- Department of Orthopaedic Surgery, Okan University, Istanbul, Turkey
| | - Mehmet Aydogan
- Department of Orthopaedic Surgery, Hisar Intercontinental Hospital, Istanbul, Turkey
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Uncuoglu A, Yologlu N, Simsek I, Uyan Z, Aydogan M. Tolerance to baked and fermented cow's milk in children with IgE-mediated and non-IgE-mediated cow's milk allergy in patients under two years of age. Allergol Immunopathol (Madr) 2017; 45:560-566. [PMID: 28720381 DOI: 10.1016/j.aller.2017.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 02/18/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND IgE-mediated cow's milk allergy (CMA) has been shown consistent in milder heated-milk tolerant and severe heated-milk reactant groups in patients older than two years. Little is known whether fermentation of milk gives rise to similar clinical phenotypes. We aimed to determine the influence of extensively heated and fermented cow's milk on the IgE-mediated and non-IgE-mediated CMA in children younger than two years. METHODS Subjects followed with the diagnosis of IgE-mediated and non-IgE-mediated CMA for at least six months underwent unheated milk challenge. IgE-mediated and non-IgE-mediated groups were categorised as unheated milk-reactive and tolerant, separately. Unheated milk-reactive groups were further challenged sequentially with fermented milk (yoghurt) and baked milk, 15 days apart. Allergy evaluation with skin tests, prick-to-prick tests and atopy patch tests were performed. RESULTS Fifty-seven children (median age: 14 months; range: 7-24 months) underwent unheated milk challenge. Eleven of 27 children with IgE-mediated CMA and 14 of 30 children with non-IgE-mediated CMA tolerated unheated milk. Among subjects who reacted to unheated milk; 15 of 16 subjects (93%) with IgE-mediated CMA also reacted to yoghurt, whereas 11 of 16 subjects (68%) with non-IgE-mediated CMA tolerated fermented milk. Thirteen subjects (81%) of the unheated milk-reactive IgE-mediated group tolerated to heated milk. None of 16 subjects of unheated milk-reactive non-IgE-mediated group reacted to baked milk. CONCLUSION The majority of children under the age of two years with both IgE-mediated and non-IgE-mediated CMA tolerated baked-milk products. Yoghurt was tolerated in two thirds of unheated milk reactive patients suffering from non-IgE-mediated CMA.
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Ofluoglu AE, Aydogan M, Erdogan U, Ofluoglu O. Epithelioid hemangioendothelioma of the craniocervical junction; case report and review. Acta Orthop Traumatol Turc 2017; 51:342-346. [PMID: 28478911 PMCID: PMC6197577 DOI: 10.1016/j.aott.2017.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/27/2015] [Accepted: 12/24/2015] [Indexed: 11/26/2022]
Abstract
Epithelioid hemangioendotheliomas are uncommon vascular neoplasms and their spinal location is even rarer. We report clinical course of a 31-year-old man with an epithelioid hemangioendothelioma at the cranio-cervical junction. A cervical magnetic resonance imaging revealed tumor that caused posterior cervical cord compression. C1,2,3 total laminectomy and surgical excision of the tumor was performed. Postoperative external beam radiation was performed on the surgical field especially around the right vertebral artery. At 2-year follow-up there was no neurological deficit and no tumor recurrence.
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Ofluoglu AE, Erdogan U, Aydogan M, Cevik OM, Ofluoglu O. Anterior cervical fusion with interbody cage containing beta-tricalcium phosphate: Clinical and radiological results. Acta Orthop Traumatol Turc 2017; 51:197-200. [PMID: 28351516 PMCID: PMC6197468 DOI: 10.1016/j.aott.2017.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/26/2016] [Accepted: 11/01/2016] [Indexed: 12/11/2022]
Abstract
Aim Beta tricalcium phosphate (beta-TCP) is an osteoconductive, resorbable material. Its clinical effectiveness has been proved in many indications. This study was clinical and radiographic study report obtained in patients undergoing anterior cervical discectomy and fusion ACDF in which PEEK cages were filled beta-TCP in an injectable form. Material and methods Between January 2010 and June 2011, 16 consecutive patients underwent ACDF using PEEK cages with beta-TCP. The cohort compromised 10 men and 6 women with a mean age of 45.2 years. The surgery was performed when the patient had myelopathy or radiculopathy with progressive neurological deficit, or failure of conservative treatment (a minimum of 3 months). The patients were evaluated by Odom criteria preoperatively and postoperative 3rd, 6th, 12th and 24th months. Preop and postop pain was evaluated with visual analogue scala (VAS). Disc height and fusion success rates were evaluated. Results Preoperative average VAS score was 7.9 (7–10) for neck pain and 8 (7–10) for arm pain. At the final follow-up, these scores became 1.5 and 1.4 for neck and arm pain, respectively. The average improvement rate was 81% for neck pain and 82.5% for arm pain. Postop ODOM's criteria main rate was 3.4. Bone fusion was achieved in 14 segments (70%) at 3rd month, 19 segments (95%) at 12th month follow-up assessment. Conclusion Clinical and radiological results revealed that B-TCP is a good alternative synthetic fusion material for cervical interbody fusion. Level of evidence: Level IV, therapeutic study.
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Affiliation(s)
- Ali Ender Ofluoglu
- Bakirkoy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry, Neurosurgery Clinic, Istanbul, Turkey
| | - Uzay Erdogan
- Department of Neurosurgery, Bakirkoy Research and Training Hospital for Neurology Neurosurgery and Psychiartry, Istanbul, Turkey.
| | | | - Orhun Mete Cevik
- Bakirkoy Prof.Dr. Mazhar Training and Research Hospital for Neurology, Neurosurgery and Psychiatry, Bakirkoy, Istanbul, Turkey
| | - Onder Ofluoglu
- Bahcesehir University, Göztepe Medical Park Hospital, Orthopedic and Traumatology Department, Istanbul, Turkey
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Erdem MN, Karaca S, Sarı S, Yumrukcal F, Tanli R, Aydogan M. Application of cement on strategic vertebrae in the treatment of the osteoporotic spine. Spine J 2017; 17:328-337. [PMID: 27720864 DOI: 10.1016/j.spinee.2016.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 08/07/2016] [Accepted: 10/03/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The application of pedicle screws with cement to strengthen the fixation of the osteoporotic spine has increasingly gained popularity. However, the technique has also led to an increase in cement-related complications. PURPOSE The aim of the present study was to compare the clinical and radiological results of the patients with degenerative spinal pathologies who were treated with pedicle screws and cement injections on all segments versus those who were treated with cement injections only on the strategic vertebrae selected. STUDY DESIGN A retrospective clinical study. PATIENT SAMPLE The sample consists of 31 patients who underwent spinal surgery due to degenerative spinal pathologies. OUTCOME MEASURES Patients were assessed for the adequate spinal fusion and cement-related complication parameters. METHODS Thirty-one patients with a minimum follow-up period of 2 years were divided into two groups and evaluated. Group A consisted of 17 patients (14 females, 3 males; mean age: 68.1 years) with cemented pedicle screws and Group B consisted of 14 patients (12 females, 2 males; mean age: 67.2 years) with cemented screws on selected vertebrae alone. Selection of the strategic vertebrae was made by taking the most stressed regions in the fusion site into account. Prophylactic vertebroplasty was performed in all patients in Group A and on strategic segments in Group B to avoid an adjacent segment fracture. Early- and late-term complications during the follow-up period were recorded. RESULTS Mean follow-up period was 51.8 (range: 31 to 80) months in Group A and 41.2 (range: 26 to 61) months in Group B. Cemented pedicle screws were bilaterally placed on 94 vertebrae in Group A. In Group B, cement was applied on 28 of 80 vertebrae. Including the prophylactic vertebroplasties, a total of 111 cement applications were performed in Group A and 38 in Group B. Cement embolism, symptomatic chest discomfort, and duration of surgery were significantly higher in Group A (p<.05). No adjacent segment fracture in the proximal or distal vertebra, implant failure, or loss of correction was seen throughout the follow-up period. CONCLUSIONS The application of cemented pedicle screws on all segments of the osteoporotic spine increases the cement volume and rate of cement-related complications. Cementing the strategic vertebrae alone will enhance the fixation strength and endurance and decrease the complications caused by cement application.
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Affiliation(s)
- Mehmet Nuri Erdem
- Department of Orthopaedics and Traumatology, Hisar Intercontinental Hospital, Site Yolu Cad. No:7 34768, Umraniye, Istanbul, Turkey.
| | - Sinan Karaca
- Department of Orthopaedics and Traumatology, Fatih Sultan Mehmet Education and Research Hospital, E5 Karayolu 34752, Icerenkoy, Atasehir, Istanbul, Turkey
| | - Seckin Sarı
- Department of Orthopaedics and Traumatology, Memorial Hospital, Piyalepasa Bulvarı 34385, Sisli, Istanbul, Turkey
| | - Feridun Yumrukcal
- Department of Orthopaedics and Traumatology, Memorial Hospital, Piyalepasa Bulvarı 34385, Sisli, Istanbul, Turkey
| | - Ruhat Tanli
- Bosphorus Spine Center, Yesil Cimen Sokak No:9, Besiktas, Istanbul, Turkey
| | - Mehmet Aydogan
- Bosphorus Spine Center, Yesil Cimen Sokak No:9, Besiktas, Istanbul, Turkey
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Eser I, Yologlu N, Baydemir C, Aydogan M. The predictive factors for remission of chronic spontaneous urticaria in childhood: Outcome from a prospective study. Allergol Immunopathol (Madr) 2016; 44:537-541. [PMID: 27477033 DOI: 10.1016/j.aller.2016.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 04/07/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND There are few studies in children on the natural course of chronic spontaneous urticaria (CSU) because of its relative infrequency in childhood. OBJECTIVE To estimate the rate of remission and evaluate the prognostic factors in children with CSU. METHOD A total of 52 children with CSU were prospectively followed over a period of three years. RESULTS The remission rates at 12 months and 36 months were 32.7% and 48.1%. The mean duration of disease at the first visit in the non-remission group was higher than in the remission group at the end of the study (P=0.016). The remission rate of the patients who had been treated by standard dose antihistamine was higher than that of the patients who had been treated with the high-dose antihistamine and combination medications (P=0.004, P<0.001). The treatment steps were independent prognostic factors for remission by logistic regression analysis. CONCLUSION Our study indicates that urticaria controlled by a standard dose of antihistamine can predict a good prognosis independently from disease duration at first visit.
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Karaca S, Akpolat AO, Oztermeli A, Erdem MN, Aydogan M. Discrepancy between cervical disc prostheses and anatomical cervical dimensions. Acta Orthop Traumatol Turc 2016; 50:544-547. [PMID: 27776930 PMCID: PMC6197307 DOI: 10.1016/j.aott.2016.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 02/20/2016] [Accepted: 03/02/2016] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this study was to assess appropriateness of the sizes of available cervical disc prostheses based on tomographic measurement of human cervical vertebrae. METHODS The anatomic dimensions of the C3-C7 segments were measured on 50 patients (age range 26-47 years) with computerized tomography scan and compared with the sizes of the popular cervical total disc prostheses (CTDP) at the market [Bryan (Medtronic), Prodisc-C (Synthes), Prestige LP (Medtronic), Discover (DePuy)]. The mediolateral and anteriorposterior diameters of the upper and lower endplates were measured with a digital measuring system. RESULTS Overall, 43.7% of the largest implant footprints were smaller in the anterior-posterior diameter and 42.6% in the mediolateral diameter were smaller than cervical endplate measurements. Discrepancy of the level C5/C6 and C6/C7 was calculated as 56.2% at the anteroposterior diameter and 43.8% at the center of mediolateral diameter. CONCLUSION Large disparity has been found between the sizes of devices and cervical anatomic data. Companies that produce CTDP should take care of the anatomical dimensions and generate different sizes of CTDP. Spine surgeon should be familiar with the size mismatch in CTDP that may affect the clinical and radiological outcome of the surgery.
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Dogan D, Ocal N, Aydogan M, Tasci C, Arslan Y, Tapan S, Yetkin S, Bilgic H. Assessment of the role of serum ischemia-modified albumin in obstructive sleep apnea in comparison with interleukin-6. Postgrad Med 2016; 128:603-8. [PMID: 27346160 DOI: 10.1080/00325481.2016.1203237] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES There is limited and contradictory information regarding the role of serum ischemia-modified albumin (IMA) in obstructive sleep apnea (OSA). In this study we examine the effects of OSA and obesity on IMA and interleukin-6 (IL-6), and detect whether IMA and IL-6 may be potential biomarkers in OSA. METHODS Fifty-one males who underwent all night polysomnography test were included into the study. Body-mass index (BMI) and apnea-hypopnea index (AHI) of all patients were determined. Serum IMA and IL-6 levels, erythrocyte sedimentation rate (ESR), complete blood count, routine blood biochemistry and thyroid function tests were performed. RESULTS Mean IMA [0.36 (± 0.04) U/ml, 0.89 (± 0.15) U/ml], mean IL-6 [1.01 (± 0.19) pg/ml, 2.02 (± 1.19) pg/ml] and mean ESR [4.14 (± 2.5) mm/h, 14.35 (± 13.7) mm/h] levels showed significant difference between non-OSA and OSA groups (P = 0.005, P < 0.001, P < 0.001, respectively). Sensitivity of IMA in distinction of non-OSA/OSA was equal to IL-6 and higher than ESR. IMA was also a stronger predictive factor than IL-6 and ESR in the evaluation of OSA groups (severe/mild/moderate OSA and non-OSA). IMA was the sole distinctive biomarker in assessment of obese and non-obese cases. IMA correlated with IL-6, AHI and ESR. CONCLUSION Serum IMA may be a valuable oxidative stress indicator for OSA and could act as a better biomarker than IL-6 for reflecting the presence and the severity of OSA.
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Affiliation(s)
- Deniz Dogan
- a Department of Chest Diseases , Gulhane Military Medical Faculty , Ankara , Turkey
| | - Nesrin Ocal
- b Department of Intensive Care , Gulhane Military Medical Faculty , Ankara , Turkey
| | - Mehmet Aydogan
- c Department of Chest Diseases , Isparta Military Hospital , Isparta , Turkey
| | - Canturk Tasci
- a Department of Chest Diseases , Gulhane Military Medical Faculty , Ankara , Turkey
| | - Yakup Arslan
- a Department of Chest Diseases , Gulhane Military Medical Faculty , Ankara , Turkey
| | - Serkan Tapan
- d Department of Biochemistry , Gulhane Military Medical Faculty , Ankara , Turkey
| | - Sinan Yetkin
- e Department of Psychiatry , Gulhane Military Medical Faculty , Ankara , Turkey
| | - Hayati Bilgic
- a Department of Chest Diseases , Gulhane Military Medical Faculty , Ankara , Turkey
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Aydogan M, Balta S, Demirkol S, Gumus S. The Pivotal Roles of Risk Factors for Acute Respiratory Distress Syndrome. J Emerg Med 2016; 50:e67-e68. [PMID: 26589569 DOI: 10.1016/j.jemermed.2013.08.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 08/25/2013] [Indexed: 06/05/2023]
Affiliation(s)
- Mehmet Aydogan
- Department of Respiratory Medicine, Gulhane Medical Academy, Ankara, Turkey
| | - Sevket Balta
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
| | - Sait Demirkol
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
| | - Seyfettin Gumus
- Department of Respiratory Medicine, Gulhane Medical Academy, Ankara, Turkey
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Balta S, Aydogan M, Aparci M, Ozturk C, Demirkol S. Red cell distribution width in patients with sarcoidosis. Clin Respir J 2014; 10:129-30. [PMID: 25315046 DOI: 10.1111/crj.12182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sevket Balta
- Department of Cardiology, Etimesgut Military Hospital, Ankara, Turkey
| | - Mehmet Aydogan
- Department of Pulmonary Medicine, Isparta Military Hospital, Isparta, Turkey
| | - Mustafa Aparci
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
| | - Cengiz Ozturk
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
| | - Sait Demirkol
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
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Abstract
BACKGROUND The goal of this study was to report the results of selective open reduction and internal fixation of fractures of the posterior malleolus with a posterolateral approach and to compare the results of the 2 techniques. METHODS We prospectively evaluated 40 patients who underwent posterior malleolar fracture fixation between 2008 and 2012. The patients were treated with a posterolateral approach. We assigned alternating patients to receive plate fixation and the next screw fixation, consecutively, based on the order in which they presented to our institution. Fixation of the posterior malleolus was made with lag screws in 20 patients and a buttress plate in 20 patients. We used American Orthopaedic Foot and Ankle Society (AOFAS) scores, range of motion (ROM) of the ankle, and radiographic evaluations as the main outcome measurements. The mean follow-up was 38.2 (range, 24-51) months. RESULTS Full union without any loss of reduction was obtained in 38 of the 40 patients. We detected a union with a step-off of 3 mm in 1 patient in the screw group and a step-off of 2 mm in 1 patient in the plate group. At the final follow-up, the mean AOFAS score of the patients regardless of fixation type was 94.1 (range, 85-100). The statistical results showed no significant difference between the patients regardless of the fixation type of the posterior malleolus in terms of AOFAS scores and ROM of the ankle (P > .05). CONCLUSIONS Good (AOFAS score of 94/100) and equivalent (within 3 points) results were obtained using the 2 techniques (screws or plate) for fixation after open reduction of posterior malleolar fragments. LEVEL OF EVIDENCE Level II, prospective case series.
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Affiliation(s)
- Mehmet Nuri Erdem
- Department of Orthopaedic Surgery, International Kolan Hospital, Istanbul, Turkey
| | - H Yener Erken
- Department of Orthopaedic Surgery, Anadolu Medical Center, Istanbul, Turkey
| | - Halil Burc
- Department of Orthopaedic Surgery, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Gursel Saka
- Department of Orthopaedic Surgery, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Fatih Korkmaz
- Department of Orthopaedic Surgery, Inonu University School of Medicine, Malatya, Turkey
| | - Mehmet Aydogan
- Department of Orthopaedic Surgery, Bosphorus Spine Center, Istanbul, Turkey
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Erken HY, Burc H, Saka G, Aydogan M. Disagreements in surgical planning still exist between spinal surgeons in adolescent idiopathic scoliosis: a multisurgeon assessment. Eur Spine J 2014; 23:1258-62. [DOI: 10.1007/s00586-014-3278-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 03/11/2014] [Accepted: 03/13/2014] [Indexed: 11/28/2022]
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Balta S, Aydogan M, Demirkol S, Cakar M, Akgul EO, Sarlak H. Red cell distribution width: a novel and simple predictor of mortality in chronic obstructive pulmonary disease. COPD 2014; 11:475-6. [PMID: 24568244 DOI: 10.3109/15412555.2013.813449] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Sevket Balta
- 1Department of Cardiology, Gulhane Medical Academy Ankara/Turkey
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Gulleroglu K, Baskin E, Bayrakci U, Aydogan M, Alehan F, Kantar A, Karakayali F, Moray G, Haberal M. Neurocognitive Functions in Pediatric Renal Transplant Patients. Transplant Proc 2013; 45:3511-3. [DOI: 10.1016/j.transproceed.2013.08.105] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Balta S, Demirkol S, Aydogan M, Celik T. Higher N-terminal pro-B-type natriuretic peptide may be related to very different conditions. J Am Coll Cardiol 2013; 62:1634-5. [PMID: 23892257 DOI: 10.1016/j.jacc.2013.04.093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 04/30/2013] [Indexed: 11/18/2022]
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Gündogan A, Aydogan M, Ozkisa T, Özgür G, Öngörü Ö, Uçar E, Öncül O, Bilgiç H. A Case of Thalidomide Induced Organizing Pneumonia. Chest 2013. [DOI: 10.1378/chest.1703244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Aydogan M, Balta S, Demirkol S, Gumus S, Celik T. Further studies on diastolic dysfunction in patients with airway obstruction should be kept in mind. Int J Cardiol 2013; 168:2992. [DOI: 10.1016/j.ijcard.2013.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 04/04/2013] [Indexed: 11/16/2022]
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Aydogan M, Gündogan A, Uçar E, Çaylak H, Yücel O, Tozkoparan E, Gürkök S, Bilgiç H. One-way Endobronchial Valve Replacement for a Bronchopleural Fistula Due to Tuberculosis. Chest 2013. [DOI: 10.1378/chest.1703774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Aydogan M, Balta S, Demırkol S, Gumus S, Unlu M, Arslan Z. Closest friends: Chronic pulmonary disease and systolic heart failure. Int J Cardiol 2013; 168:2965. [DOI: 10.1016/j.ijcard.2013.03.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 03/31/2013] [Indexed: 11/29/2022]
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Balta S, Aydogan M, Kurt O, Karaman M, Demirkol S, Akgul EO. Red cell distribution width as a novel, simple, inexpensive predictor of mortality in patients with chronic heart failure. Int J Cardiol 2013; 168:3049-50. [DOI: 10.1016/j.ijcard.2013.04.127] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 04/06/2013] [Indexed: 11/29/2022]
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Balta S, Aydogan M, Kucuk U, Demirkol S, Unlu M, Arslan Z. Red cell distribution width without additional cost compared with a relatively expensive test measurement in clinical practice. Int J Cardiol 2013; 168:4899-900. [DOI: 10.1016/j.ijcard.2013.07.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 07/01/2013] [Accepted: 07/03/2013] [Indexed: 11/28/2022]
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Kaito T, Johnson J, Ellerman J, Tian H, Aydogan M, Chatsrinopkun M, Ngo S, Choi C, Wang JC. Synergistic effect of bone morphogenetic proteins 2 and 7 by ex vivo gene therapy in a rat spinal fusion model. J Bone Joint Surg Am 2013; 95:1612-9. [PMID: 24005203 DOI: 10.2106/jbjs.l.01396] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Previous studies have suggested that the co-expression of two different bone morphogenetic protein (BMP) genes can result in the production of heterodimeric BMPs that may be more potent than homodimers. In this study, combined BMP-2 and BMP-7 gene transfer was performed ex vivo to compare the resulting new bone formation with that of single-BMP gene transfer in a rat spinal fusion model. METHODS Forty-four athymic rats underwent posterolateral fusion at L4-L5 and were implanted with a collagen sponge containing human adipose-derived stem cells. Group A received untreated cells, and the remaining groups received cells transfected with various genes in a lentivirus vector. The transferred genes were GFP (green fluorescent protein) in Group B, BMP-2 in Group C, BMP-7 in Group D, and both BMP-2 and BMP-7 in Group E. In vitro production of BMP-2 and BMP-7 was quantified by means of an enzyme-linked immunosorbent assay (ELISA) specific to BMP-2 or BMP-7. Osseous fusion was quantified with use of radiography and microcomputed tomography. RESULTS ELISA demonstrated that Group E, which was treated with both BMP-2 and BMP-7, produced less than one-fourth as much BMP as the groups treated with a single transfected BMP (Groups C and D). Radiographs showed that all of the spines in Groups C, D, and E appeared to be fused by eight weeks; the spines in Groups A and B showed minimal evidence of new bone formation. Measurements confirmed that the mean bone formation area was significantly greater in Groups C, D, and E compared with Groups A and B (p < 0.001). In addition, the bone formation area was significantly greater in Group E compared with Groups C and D (p < 0.001). CONCLUSIONS Combined BMP-2 and BMP-7 ex vivo gene transfer was found to be significantly more effective for inducing new bone formation compared with ex vivo gene transfer of an individual BMP in a rat spinal fusion model. CLINICAL RELEVANCE Combined BMP-2 and BMP-7 therapy may lead to efficient bone regeneration.
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Affiliation(s)
- Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
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Balta S, Demirkol S, Cakar M, Aydogan M, Akhan M. The red cell distribution width may be affected by many factors in the clinical practice. J Clin Diagn Res 2013; 7:1830. [PMID: 24086930 DOI: 10.7860/jcdr/2013/6007.3294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Accepted: 05/18/2013] [Indexed: 11/24/2022]
Affiliation(s)
- Sevket Balta
- Department of Cardiology, Gulhane Medical Academy Ankara , Turkey
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Balta S, Demirkol S, Hatipoglu M, Ardic S, Aydogan M, Celik T. Other inflammatory indicators should be kept in mind when assessing red cell distribution width in patients with pneumonia. Am J Emerg Med 2013; 31:1144-5. [DOI: 10.1016/j.ajem.2013.03.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 03/26/2013] [Accepted: 03/26/2013] [Indexed: 01/06/2023] Open
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Balta S, Aydogan M, Demirkol S, Celik T, Gumus S, Unlu M, Kucuk U. Nocturnal intermittent hypoxemia and metabolic dyslipidemia. Chest 2013; 144:357. [PMID: 23880688 PMCID: PMC3707178 DOI: 10.1378/chest.12-3109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
- Sevket Balta
- Department of Cardiology, Gulhane Medical Academy Ankara, Ankara, Turkey.
| | - Mehmet Aydogan
- Department of Pulmonary Medicine, Gulhane Medical Academy Ankara, Ankara, Turkey
| | - Sait Demirkol
- Department of Cardiology, Gulhane Medical Academy Ankara, Ankara, Turkey
| | - Turgay Celik
- Department of Cardiology, Gulhane Medical Academy Ankara, Ankara, Turkey
| | - Seyfettin Gumus
- Department of Pulmonary Medicine, Gulhane Medical Academy Ankara, Ankara, Turkey
| | - Murat Unlu
- Department of Cardiology, Gulhane Medical Academy Ankara, Ankara, Turkey
| | - Ugur Kucuk
- Department of Cardiology, Gulhane Medical Academy Ankara, Ankara, Turkey
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Aydogan M, Balta S, Turhan U, Demirkol S, Unlu M, Gumus S. Re: prevalence of pulmonary hypertension in patients undergoing hemodialysis: evaluation all affecting factors otherwise freak of nature! Iran J Kidney Dis 2013; 7:240-241. [PMID: 23689160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 02/19/2013] [Indexed: 06/02/2023]
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Balta S, Aydogan M, Kucuk U, Demırkol S, Unlu M, Arslan Z. Further studies should evaluate cardiac output measurement by the Nexfin device. J Cardiothorac Vasc Anesth 2013; 27:e35-6. [PMID: 23672872 DOI: 10.1053/j.jvca.2013.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Indexed: 11/11/2022]
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Aydogan M, Balta S, Demirkol S, Gumus S, Arslan Z, Unlu M. Heart failure: Not only reduced left ventricular ejection fraction but also reserved ejection fraction! Heart Lung 2013; 42:229. [DOI: 10.1016/j.hrtlng.2013.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 01/02/2013] [Indexed: 10/27/2022]
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Aydogan M, Balta S, Kucuk U, Demirkol S, Unlu M, Gumus S. Future studies should consider multiple predisposing conditions in predicting weaning failure from mechanical ventilation in patients after cardiac surgery. Clinics (Sao Paulo) 2013; 68:725. [PMID: 23778409 PMCID: PMC3654291 DOI: 10.6061/clinics/2013(05)23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Aydogan M, Balta S, Demirkol S, Unlu M, Arslan Z, Gumus S. Further studies should evaluate multiple predispositions in heart failure prognosis. Cardiol J 2013; 20:211. [DOI: 10.5603/cj.2013.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 04/05/2013] [Indexed: 11/25/2022] Open
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Aydogan M, Balta S, Demirkol S, Cakar M, Kucuk U, Gumus S. Pentraxin 3: An early marker of severity in higher mortality disease. Heart Lung 2013; 42:155-6. [DOI: 10.1016/j.hrtlng.2012.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 12/31/2012] [Indexed: 12/01/2022]
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Balta S, Demirkol S, Aydogan M, Unlu M. Red cell distribution width is a predictor of mortality in patients undergoing coronary artery bypass surgery. Eur J Cardiothorac Surg 2013; 44:396-7. [PMID: 23428577 DOI: 10.1093/ejcts/ezt073] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Balta S, Aydogan M, Demirkol S, Cakar M, Unlu M, Kucuk U. Prolonged ventilation after adult heart valve surgery. Heart Lung 2013; 42:231. [PMID: 23403218 DOI: 10.1016/j.hrtlng.2012.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 12/18/2012] [Indexed: 11/19/2022]
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Ors F, Gumus S, Aydogan M, Sari S, Verim S, Deniz O. HRCT findings of pulmonary sarcoidosis; relation to pulmonary function tests. Multidiscip Respir Med 2013. [DOI: 10.4081/mrm.2013.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Chest-X-ray has several limitations in detecting the extent of pulmonary disease in sarcoidosis. It might not reflect the degree of pulmonary involvement in patients with sarcoidosis when compared to computed tomography of the thorax. We aimed to investigate the HRCT findings of pulmonary sarcoidosis and to find out the existence of possible relations between HRCT findings and PFTs. In addition, we aimed to investigate the accordance between HRCT findings and conventional chest-X-ray staging of pulmonary sarcoidosis. Method: 45 patients with sarcoidosis with a mean age 29.7+/− 8.4 years were evaluated. Six of them were female and 39 were male. The type, distribution and extent of the parameters on HRCT/CTs were evaluated and scored. Chest-X-rays were evaluated for the stage of pulmonary sarcoidosis. Correlations were investigated between HRCT/ CT parameter scores, Chest X-Ray stages and pulmonary function parameters. Results: Nodule, micronodule, ground glass opacity and consolidation were the most common HRCT findings. There were significant correlations between pulmonary function parameters, HRCT pattern scores, and chest-X-ray stages. A significant correlation between chest-x-ray score and total HRCT score was found. Conclusions: Pulmonary sarcoidosis patients might have various pulmonary parenchymal changes on HRCT. Thorax HRCT was superior to chest-X-ray in detecting pulmonary parenchymal abnormalities. The degree of pulmonary involvement might be closely related to the loss of pulmonary function measured by PFTs. Chest-X-ray is considered to have a role in the evaluation of pulmonary sarcoidosis.
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