DSpace Arşivi :: by Yazar "Karapinar, Hekim" değerine göre listeleniyor

Yazar "Karapinar, Hekim" seçeneğine göre listele

Listeleniyor 1 - 20 / 41

A multicenter study on experience of 13 tertiary hospitals in Turkey in patients with infective endocarditis
(2013) Elbey, Mehmet Ali; Akda?, Serkan; Kalkan, Mehmet Emin; Kaya, Mehmet G.; Raşit Sayin, M.; Karapinar, Hekim; Bulur, Serkan
Objective: The aim of this retrospective multicenter study was to investigate the clinical manifestations, microbiological profile, echocardiographic findings and management strategies of infective endocarditis (IE) in Turkey. Methods: The study population consisted of 248 Turkish patients with IE treated at 13 major hospitals in Turkey from 2005 to 2012 retrospectively. All hospitals are tertiary referral centers, which receive patients from surrounding hospitals. Data were collected from the medical files of all patients hospitalized with IE diagnosed according to modified Duke Criteria. Results: One hundred thirty seven of the patients were males. Native valves were involved in 158 patients while in 75 participants there was prosthetic valve endocarditis. Vegetations were detected in 223 patients (89%) and 52 patients had multiple vegetations. Mitral valve was the most common site of vegetation (43%). The most common valvular pathology was mitral regurgitation. The most common predisposing factor was rheumatic valvular disease (28%). Positive culture rate was 65%. Staphylococci were the most frequent causative microorganisms isolated (29%) followed by enterococci (11%). In-hospital mortality rate was 33%. Conclusions: Compared to IE in developed countries younger age, higher prevalence of rheumatic heart disease, more frequent enterococci infection and higher rates of culture negativity were other important aspects of IE epidemiology in Turkey. © 2013 by AVES Yayi{dotless}nci{dotless}li{dotless}k Ltd.
Abnormal Heart Rate Recovery in Stable Heart Failure Patients
(WILEY, 2013) Yilmaz, Ahmet; Erdem, Alim; Kucukdurmaz, Zekeriya; Karapinar, Hekim; Gul, Ibrahim; Sarikaya, Savas; Dizman, Rafet
Background Heart rate decrease after exercise, that is associated with reactivation of parasympathetic system, is important, as it is also associated with mortality. Previous studies have shown that this is an independent mortality predictor in patients having no coronary artery disease and having normal left ventricular function. In our study, we aimed to study heart rate recovery (HRR) after exercise in patients having impaired left ventricular function. Methods One hundred and two consecutive patients (68 males, 34 females) requested to perform an exercise stress test were included in our study. Patients were divided into two groups as those having a normal heart rate reserve (Group1, n = 72) and those having an abnormal heart rate reserve (Group2, n = 30). Results In Group1 and Group2, resting heart rate averages were found to be 83.61 +/- 18.01/min and 85.10 +/- 13.40/min, respectively (P > 0.05), and maximum heart rates during exercise were 141.42 +/- 19.70/min and 121.17 +/- 19.01/min while those in Group1 had statistically significantly higher heart rates (P < 0.001). A statistically significant positive association was found in the correlation test carried out between the maximum heart rate during the treadmill exercise test and ejection fraction (EF) value (r = 0.201; P < 0.05). Metabolic equivalents of task values obtained during the treadmill exercise test in Group1 and Group2 were 9.48 +/- 2.28 and 8.36 +/- 2.50, respectively, and the difference between the said values was statistically significant (P < 0.05). Conclusions We believe that the association between low EF and abnormal HRR is worth studying and randomized large-scale studies are needed to determine mortality risk.
Acute Effects of Passive Smoking on Endothelial Function
(SAGE PUBLICATIONS INC, 2011) Guel, Ibrahim; Karapinar, Hekim; Yarlioglues, Mikail; Ozdogru, Ibrahim; Kaya, Mehmet Gungor; Yilmaz, Ahmet; Turgut, Okan Onur; Tandogan, Izzet; Eryol, Namik Kemal
Impairment of endothelial functions has been shown to occur after acute and chronic exposure to passive smoking (PS), as assessed by flow-mediated dilatation (FMD) of the brachial artery. A total of 61 participants, 30 male and 31 female, mean ages 26 (18-36) were enrolled in the study. All were clinically well and nonsmokers. All participants stayed for 30 minutes in the smoking room. Carbon monoxide (CO) level was 7.42 +/- 0.98 ppm (4.71-10.50). Mean carboxyhemoglobin (COHb) levels of participants were significantly elevated after PS. Mean FMD was 18.6% +/- 9% and decreased to 12.4% +/- 7% after PS (P < .001). In the current study, with more number of participants at lower CO concentrations (7.42 ppm) and with smaller increase in COHb (51%) significant reduction (33%, P < .001) in FMD was observed.
Alterations of serum brain type natriuretic peptide (BNP) in patients with Crimean-Congo hemorrhagic fever
(E-CENTURY PUBLISHING CORP, 2015) Uysal, Elif Bilge; Sancakdar, Enver; Seker, Ayse; Deveci, Koksal; Tuzcu, Nevin; Karapinar, Hekim
Background: Crimean-Congo hemorrhagic fever (CCHF) is known to be associated with cardiac damage. Brain type natriuretic peptide (BNP) is secreted from stressed myocardium. Objectives: This study investigated that BNP levels in CCHF and its association with clinical course of disease. Methods: Consecutive CCHF diagnosis confirmed patients were enrolled to the study. Results of patients were compared with age-sex-matched healthy volunteers. Blood samples for BNP levels were collected from the patients during emergency room applications. Mortality, hospitalization duration and other disease severity predictors (thrombocyte count, hemoglobin, white blood cell count, alanine aminotransferase, aspartate aminotransferase, prothrombin time, lactate dehydrogenase, international normalized ratio, activated partial thromboplastin time) were recorded. These parameters' correlations with BNP levels were analyzed. Result: Forty-three CCHF patients and 28 control subjects recruited to the study. Groups were similar for age and gender. There was no mortality. Levels of BNP were found to be significantly higher in patients than control subjects (100.4 +/- 45.4 vs. 78.0 +/- 40.4, P=0.033). But BNP levels were not correlated with duration of hospitalization and disease severity predictors (P > 0.05). Conclusions: This study showed that BNP levels are modestly increased in CCHF but this increase does not correlated with disease severity predictors.
The assessment of subsegmental branches of the pulmonary artery by intravascular ultrasound in patients with mitral stenosis
(TERMEDIA PUBLISHING HOUSE LTD, 2012) Karapinar, Hekim; Kaya, Zekeriya; Acar, Goksel; Esen, Ozlem Batukan; Bulut, Mustafa; Kucukdurmaz, Zekeriya; Gul, Ibrahim; Yazicioglu, Mehmet; Esen, Ali; Kirma, Cevat
Background: There are limited data that examine the assessment of subsegmental branches of the pulmonary artery by intravascular ultrasound (IVUS). Aim: To assess the structural characteristics of pulmonary arteries by IVUS in the setting of severe mitral stenosis. Material and methods: Twenty-one consecutive patients (3 men and 18 women; mean age: 38 11 years) who were selected for percutaneous mitral balloon valvuloplasty entered the study. Subsegmental branches of the right lower lobe pulmonary artery were imaged by 40 MHz IVUS when the patients underwent right heart catheterization. Minimal lumen diameter (MLD), external elastic membrane diameter (EEMD), lumen area (LA), and area circumscribed by the external elastic membrane (the total vessel area - TVA) were measured. From these measurements, wall area (WA = TVA - LA), intima-media wall thickness [IMT = (EEMD - MLD)/2], relative wall thickness (RWT = IMT/EEMD), and relative wall area (RWA = WA/TVA) were derived. Results: We were able to perform the IVUS examination in all patients without complications. Several IVUS anatomic indexes correlated with hemodynamic data. Pulmonary artery IMT, RWT, and RWA correlated significantly with pulmonary artery systolic pressure (r = 0.763, p = 0.002; r = 0.698, p = 0.001; r = 0.717, p = 0.006, respectively). However, there was no significant correlation between ultrasound measurements and echocardiographic parameters of the mitral valve. Conclusions: The subsegmental branches of the pulmonary artery can be assessed by IVUS. Patients with pulmonary hypertension in the setting of mitral stenosis have greater pulmonary arterial WT. The severity of WT is correlated with pulmonary artery pressure, but it is not associated with mitral valve area. Intravascular ultrasound may provide useful additional information in the management of patients with mitral stenosis.
Blood pressure response to exercise is exaggerated in normotensive diabetic patients
(Taylor & Francis Ltd, 2013) Karavelioglu, Yusuf; Karapinar, Hekim; Gul, Ibrahim; Kucukdurmaz, Zekeriya; Yilmaz, Ahmet; Akpek, Mahmut; Kaya, Mehmet Gungor
Introduction. The aim of this study was to investigate the blood pressure (BP) response to exercise in normotensive patients with type II diabetes mellitus (DM). Materials and methods. A cross-sectional study was carried out on 75 normotensive subjects with type 2 DM (group 1), and 70 age-gender matched normotensive healthy volunteers (group 2). Treadmill exercise test, 24-h ambulatory BP monitoring (ABPM) were performed for each patients and healthy volunteers. Results. There were 67 patients (mean age 52 +/- 9 years and 42% male) in group 1 and 68 healthy volunteers (mean age 51 +/- 7 years and 43% male) in group 2. Eight patients from group 1 and 2 subjects from group 2 were excluded because of high BP on ABPM. Groups were similar for systolic BP (SBP) and diastolic BP (DBP) on office measurements and on ABPM. Groups were similar for rest SBP, DBP, heart rate, exercise duration on exercise test. Peak SBP was significantly higher in group 1 than in group 2, but peak DBP was not (196.9 +/- 18 vs 165.9 +/- 18.6 mmHg, p < 0.001; 88.1 +/- 11.6 vs 86.2 +/- 8.7 mmHg, p = 0.283, respectively). Hypertensive response to exercise (HRE) was more frequent in group 1 than in group 2 [39 (58%) vs 6 (9%), p < 0.001]. Independent predictors of peak SBP were DM, office SBP and male gender, while independent predictors of HRE were DM, office SBP and age in multivariate analysis. Conclusions. SBP response to exercise is exaggerated in normotensive diabetic patients compared with non-diabetic subjects. DM, office SBP and male gender are independent predictors of peak SBP. DM, office SBP and age are independent predictors of HRE.
Bradycardia Seen In Children With Crimean-Congo Hemorrhagic Fever
(MARY ANN LIEBERT, INC, 2013) Oflaz, Mehmet Burhan; Kucukdurmaz, Zekeriya; Guven, A. Sami; Karapinar, Hekim; Kaya, Ali; Sancakdar, Enver; Deveci, Koksal; Gul, Ibrahim; Erdem, Alim; Cevit, Omer; Icagasioglu, F. Dilara
Introduction: Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease with a high mortality rate. In clinical practice, we observed bradycardia in some pediatric patients with CCHF during the clinical course. So we aimed to report CCHF cases that presented bradycardia during the clinical course and the relation of bradycardia with the clinical findings and ribavirin therapy. Methods: Charts of all hospitalized pediatric CCHF patients were reviewed with respect to age, sex, history of tick bite or history of removing a tick, other risk factors for CCHF transmission, and interval between the tick bite and the onset of symptoms. Outcomes and clinical and laboratory findings and medications were recorded for each patient. We searched the patient records for information regarding the existence of bradycardia. Bradycardia was accepted as the heart rate 2 standard deviations (SD) lower than the suspected heart rate based on age. Results: Fifty-two patients (mean age 11.24.4 years, 31 female) were enrolled into the study. Bradycardia was seen in seven patients. Six patients with bradycardia were male and only one was female, and the mean age was 13.1 +/- 1.6 years. It was observed that male gender is frequent among patients with bradycardia, as compared with those without bradycardia (p=0.01). Bleeding was found to be more frequent in patients with bradycardia (p=0.02). There were significant differences between the bradycardia and nonbradycardia groups with regard to the requirements for fresh frozen plasma transfusion, the number of platelet suspension given, requirement for intravenous immune globulin (IVIG) and in the days of stay in hospital (p=0.01, p=0.03, p=0.03, p=0.04, respectively). Conclusion: Reversible bradycardia might be seen in the clinical course of pediatric CCHF patients, and the clinicians must be aware of this finding. The possibility that ribavirin may potentiate bradycardia cannot be assessed without a placebo-control study. So further studies may help to reveal the cause of the bradycardia, the disease itself, or the ribavirin therapy. Hence this study supports the need for a randomized, placebo-controlled study to assess intravenous ribavirin in treating CCHF and to support approval of the drug.
Cardiac findings in children with Crimean-Congo hemorrhagic fever
(INT SCIENTIFIC LITERATURE, INC, 2011) Gul, Ibrahim; Kaya, Ali; Guven, Ahmet Sami; Karapinar, Hekim; Kucukdurmaz, Zekeriya; Yilmaz, Ahmet; Icagasioglu, Fusun Dilara; Tandogan, Izzet
Background: Crimean-Congo hemorrhagic fever (CCHF) involves the multi-organ systems. The involvement of the heart in adult patients has been described previously. We investigated the electrocardiographic and echocardiographic findings of pediatric patients with CCHF. Material/Methods: Patients younger than 16 years of age diagnosed with CCHF were enrolled in the study. The diagnosis of CCHF infection was based upon typical clinical and epidemiological Findings and serological tests. All patients underwent a thorough cardiologic evaluation. A standard 12-lead electrocardiography and echocardiography were performed. Results: Twenty-three consecutive patients who were hospitalized with diagnosis of CCHF were enrolled in the study (mean age: 12 2 years, 6 female). All electrocardiographic parameters were within normal ranges according to age. Seven patients (30%) had minimal (<1 cm) pericardial effusion. Fifteen (65%) patients had segmental wall motion abnormalities (hypokinesia). A second echocardiography revealed that all wall motion abnormalities had disappeared; the pericardial effusion persisted in only 2 of 7 patients (28%). Conclusions: Cardiac involvement appears to be more frequent in children with CCHF disease than in adults, but it is slighter and almost totally reversible; however, the course of the disease in children is milder than it is in adults.
Carney complex in association with atrial myxoma: Case report
(Turkiye Klinikleri, 2013) Aşker, Müntecep; Aşker, Selvi; Timuçin, Özgür Bülent; Gür, Ali Kemal; Karapinar, Hekim
Carney complex is an autosomal dominantly inherited disease complex including myxomas, pigmented skin lesions and endocrine neoplasias. It was first defined by J. Aidan Carney in 1985. Myxomas can be observed in the heart, skin and breast. Familial myxomas were seen at younger ages than sporadic forms. The most common endocrine gland manifestations acromegaly, thyroid and testicular tumors, and adrenocorticotropic hormone-independent Cushing's syndrome. A cardiac myxoma requires surgical removal. In this study, we present a case of left atrial myx-oma with Carney syndrome who was early diagnosed and successfully treated with surgery. Copyright © 2013 by Türkiye Klinikleri.
Closure of patent ductus arteriosus with oversized Amplatzer occluder in a patient with pulmonary hypertension
(TERMEDIA PUBLISHING HOUSE LTD, 2013) Karapinar, Hekim; Kucukdurmaz, Zekeriya; Oflaz, Mehmet Burhan; Gul, Ibrahim; Yilmaz, Ahmet
Diagnosis of patent ductus arteriosus is rare in adulthood. Closure of ductus is difficult when diagnosed at an adult age due to the development of pulmonary hypertension and pulmonary arterial disease that generally occurs. Closure of the ductus might be contraindicated, as it may lead to deterioration of the pulmonary arterial perfusion or to a pulmonary hypertensive crisis. In addition, another risk associated with percutaneous closure for these patients is the risk of embolism of the asymmetrically shaped device to the systemic circulation. We present in this manuscript a case with patent ductus arteriosus diagnosed at an adult age that underwent successful closure by the percutaneous method. During closure, an oversized Amplatzer duct occluder device was used to reduce the risk of device embolism.
Echocardiographic assessment of right ventricular functions in nondiabetic normotensive hemodialysis patients
(AKADEMIAI KIADO RT, 2015) Karavelioglu, Yusuf; Ozkurt, Sultan; Kalcik, Macit; Karapinar, Hekim; Arisoy, Arif
Purpose: Heart is affected structurally and functionally in end-stage renal disease (ESRD). However, the data available about adverse effects of ESRD on right ventricle (RV) is scarce. We aimed to evaluate echocardiographic parameters of RV in nondiabetic, normotensive patients with ESRD undergoing hemodialysis (HD). Methods: A total of 45 (24 women; mean age 52.4 +/- 12.4 years) consecutive nondiabetic, normotensive patients with ESRD undergoing HD and 39 healthy age and sex-matched control subjects (22 women; mean age 50.3 +/- 6.6 years) were enrolled in the study. M-mode and two dimensional images, color, pulsed and continuous wave Doppler, and tissue Doppler measurements were acquired from all subjects. Echocardiographic evaluation was performed in the days between HD dates of the patients. Results: RV fractional area change, tricuspid annular plane systolic excursion, tricuspid E velocity, E/A ratio, tricuspid annular E' velocity, and E'/A' ratio were lower in patients than controls (p < 0.001, p = 0.003, p = 0.007, p = 0.005, p < 0.001, and p = 0.034, respectively). However, RV diastolic area, RV myocardial performance index, E/E' ratio, and mean and systolic pulmonary artery pressure were higher in patients than controls (p < 0.001, p = 0.007, p = 0.005, p < 0.001, p = 0.006, respectively). Conclusions: RV systolic and diastolic functions of nondiabetic, normotensive HD patients are deteriorated as compared to healthy controls.
Effect of Blood Donation Mediated Volume Reduction on Right Ventricular Function Parameters in Healthy Subjects
(WILEY-BLACKWELL, 2012) Kucukdurmaz, Zekeriya; Karapinar, Hekim; Karavelioglu, Yusuf; Acar, Goksel; Gul, Ibrahim; Emiroglu, Mehmet Yunus; Bulut, Mustafa; Esen, Ali Metin
Purpose: We aimed to investigate the effect of controlled and limited volume change by the blood donation model to the right ventricular (RV) function via different echocardiographic parameters in healthy adults. Methods: Study population was composed of 71 healthy subjects who were volunteers for blood donation and evaluated before and after 450 mL blood donation. Pulsed-wave Doppler of the RV inflow and tissue Doppler of tricuspid lateral annulus, and tricuspid annular plane systolic excursion (TAPSE) were assessed. Results: E velocity of inflow decreased significantly (67.6 +/- 15.9 vs 60.9 +/- 12.2, P = 0.006). S and A velocities did not change (15.3 +/- 3.2 vs 15.2 +/- 2.5 cm/s, P = NS; 14.1 +/- 3.3 vs 13.4 +/- 3.1 cm/s, P = NS, respectively) but E showed significant decrease (13.7 +/- 2.9 vs 12.2 +/- 3.2 cm/s, P = 0.011). E/A ratio and E/E ratio were found to be unchanged (1.0 +/- 0.3 vs 1.0 +/- 0.4, P = NS; 5.1 +/- 2 vs 5.3 +/- 2, P = NS, respectively). Myocardial performance index (MPI) was found to be increased but ejection time obtained from the tricuspid annulus did not change (0.50 +/- 0.13 vs 0.54 +/- 0.11, P = 0.040; 243 +/- 37 vs 240 +/- 27, P = NS, respectively). Isovolumetric relaxation and contraction times showed difference close to the significance limit (56 +/- 19 vs 64 +/- 23 ms, P = 0.055; 61 +/- 16 vs 67 +/- 16 ms, P = 0.062, respectively). TAPSE decreased significantly (2.62 +/- 0.29 vs 2.41 +/- 0.27 mm, P = 0.005). Conclusion: E velocity and TAPSE were sensitive to a volume reduction as little as 450 mL in healthy subjects. MPI index of the tricuspid annulus is less sensitive than E and TAPSE but need much care under changing volume state. However S and A velocity and E/A ratio were found to be resistant to the effects of volume depletion. (Echocardiography 2012;29:451-454)
The effect of percutaneous mitral balloon valvuloplasty on left atrial systolic functions
(TERMEDIA PUBLISHING HOUSE LTD, 2011) Karapinar, Hekim; Emiroglu, Mehmet Y.; Aung, Soe M.; Kaya, Zekeriya; Karavelioglu, Yusuf; Kucukdurmaz, Zekeriya; Gul, Ibrahim; Esen, Ali M.; Kirma, Cevat
Background: Conventional echocardiographic methods have already shown that successful mitral balloon valvuloplasty (MBV) can effectively increase left atrial (LA) functions. Aim: To evaluate LA functions after MBV using colour tissue Doppler imaging. Material and methods: Sixty-eight patients (58 females, mean age: 38 +/- 12 years) were included in the study. Within 24 h before MBV, all the patients underwent colour tissue Doppler study in addition to routine conventional echocardiographic examinations. Late diastolic velocities (A') measured at the LA wall adjacent to the septal and lateral annuli were recorded. All the measurements were repeated 24 h after MBV. The MBV was done using the Inoue technique. Successful MBV patients were included in group A and those who developed severe mitral regurgitation (MR) were included in group B. Results: Sixty-one patients underwent successful MBV while 7 developed MR. Mitral valve areas (MVA) in both groups were significantly increased. Maximum and mean gradients, LA diameter, systolic pulmonary arterial pressure and mean LA pressures were decreased while septal and lateral A' were significantly increased in group A. In group B, no significant change in any variable was found except for the increase in MVA Conclusions: After successful MBV, increase in A' velocity was seen in parallel to the recovery of LA functions. Early improvements in left atrial systolic functions after successful MBV can easily be determined by colour tissue Doppler as a quick and reliable method.
Evaluation of Atrial Electromechanical Coupling Times in Hemodialysis Patients
(WILEY, 2014) Karavelioglu, Yusuf; Karapinar, Hekim; Ozkurt, Sultan; Sarikaya, Savas; Kucukdurmaz, Zekeriya; Arisoy, Arif; Kurt, Recep; Yilmaz, Ahmet; Kaya, Mehmet G.
BackgroundThere are no definite data about the atrial electromechanical coupling times (AEMCT) in patients with end stage renal failure (ESRF). The aim of this study was to investigate the AEMCT in ESRF patients without hypertension (HT) and diabetes mellitus.MethodsThe study population consisted of 47 normotensive, nondiabetic ESRF patients and 41 healthy age/gender-matched control subjects. The time intervals from the onset of P-wave on the surface electrocardiogram to the beginning of late diastolic A-wave (PA) were obtained from the lateral mitral annulus (PA-lateral, maximum AEMCT), septal annulus (PA-septal), and tricuspid lateral annulus (PA-tricuspid). Time intervals were corrected according to the heart rate. The difference between PA-septal and PA-tricuspid (right AEMCT), PA-lateral and PA-septal (left AEMCT), and PA-lateral and PA-tricuspid (inter AEMCT) were calculated. Corrected time intervals were used for calculations.ResultsGroups were similar for age (5212.3 vs. 49.9 +/- 6years, P>0.05) and gender. Maximum (61 +/- 20 vs. 47 +/- 13ms; P<0.001) AEMCT was significantly higher in the patients compared with the control group, but septal and tricuspid EMCT were not different (P>0.05). Both inter-atrial (37 +/- 21 vs. 24 +/- 16ms, P=0.002) and left atrial (25 +/- 18 vs. 12 +/- 9ms; P<0.001) EMCT were significantly higher in patients when compared with the controls but intra-right atrial EMCT was not different.ConclusionsAtrial conduction parameters such as maximal EMCT, left atrial, and inter-atrial EMCTs were prolonged in ESRF patients. This prolongation is seen in ESRF patients even in the absence of factors that affect atrial coupling, such as HT.
Evaluation of cytokines as Th1/Th2 markers in pathogenesis of children with Crimean-Congo hemorrhagic fever
(E-CENTURY PUBLISHING CORP, 2014) Sancakdar, Enver; Guven, Ahmet Sami; Uysal, Elif Bilge; Kaya, Ali; Deveci, Koksal; Karapinar, Hekim; Akkar, Ismail
Cytokine networks play a key role in the pathogenesis of the disease in Crimean-Congo Hemorrhagic Fever (CCHF) patients. Therefore, our aim was to study the effects of cytokine levels on the pathogenesis and severity of the disease in children with CCHF. Fifty-two patients diagnosed with CCHF and 34 healthy controls (HC) were included in the study. The patients with CCHF were divided into two groups (severe and non-severe). The levels of the Interleukin-10 (IL-10), IL-12, IL-6, Endothelin-1 (ET-1) and tumor necrosis factor-alpha (TNF-alpha) were measured in all groups. IL-12 levels did not show any difference between the CCHF and HC groups and among the severe, non-severe and HC groups. IL-10 and ET-1 levels were significantly higher in the severe group when compared to the non-severe group and the HC group. Moreover, IL-10 and ET-1 levels were significantly higher in the non-severe group when compared to the HC group. In terms of IL-6 and TNF-alpha levels, there was no difference between the severe and non-severe groups while the said levels were significantly higher in the severe group when compared to the HC group. The results of the present study showing significantly higher IL-10 and ET-1 levels in the severe group suggest that Th2-mediated humoral immunity is more effective in the pathogenesis and severity of CCHF in children.
Evaluation of Endothelium Functions by Flow-mediated Dilatation in Pediatric Patients With Crimean-Congo Hemorrhagic Fever
(LIPPINCOTT WILLIAMS & WILKINS, 2015) Karapinar, Hekim; Kaya, Ali; Uysal, Elif Bilge; Kucukdurmaz, Zekeriya; Deveci, Koksal; Guven, Ahmet Sami; Sancakdar, Enver; Yilmaz, Ahmet
Background: Crimean-Congo hemorrhagic fever (CCHF) is a systemic viral disease that also affects the endothelium. Thrombocytopenia and hemorrhage are seen in this disease. But, the cause of thrombocytopenia is not clear. We hypothesized that endothelium dysfunction may be the cause of thrombocytopenia. We evaluated the endothelium functions by flow-mediated dilatation (FMD) in CCHF. Methods: Consecutive children with suspected CCHF who applied to our hospital were evaluated for recruitment into the study. FMD analysis was done in the active and healing period of the disease. Diagnosis was confirmed or ruled out by polymerase chain reaction and/or ELISA test. Basal brachial artery diameter (BBAD) and dilated brachial artery diameter (DBAD) after ischemic period were measured and percent dilatations [(DBAD-BBAD)/BBAD, FMD%] were computed from all subjects. Results: Fifty-four children (40 male, mean age 12.4 +/- 4.4 years) were recruited into the study. CCHF diagnosis was confirmed in 28 children and ruled out in 26 children. Groups were similar for age and gender. FMD% was significantly decreased in CCHF patients when comparing this with the control patients in the active period (2.65 +/- 2.76 vs. 13.76 +/- 7.95, P < 0.001). FMD% was correlated with platelet count in the active period of the disease (r = 0.599, P = 0.004). FMD% was recovered in the healing period (2.65 +/- 2.76 vs. 14.72 +/- 2.66, P < 0.001) and was not significantly different from basal values of control patients (P > 0.05). Conclusions: FMD is significantly decreased in CCHF and recovers in the healing period. So, endothelium functions are disturbed, and disturbance is correlated with thrombocytopenia in CCHF.
Evaluation of left ventricular diastolic function in nonhypertensive nondiabetic hemodialysis patients
(LIPPINCOTT WILLIAMS & WILKINS, 2013) Karavelioglu, Yusuf; Ozkurt, Sultan; Karapinar, Hekim; Kucukdurmaz, Zekeriya; Arisoy, Arif; Kurt, Recep; Yilmaz, Ahmet; Yarlioglues, Mikail; Akpek, Mahmut; Kaya, Mehmet G.
Aim Diastolic dysfunction (DD) is common in hemodialysis (HD) patients. Because diabetes mellitus (DM) and hypertension (HT) are also common in this patient group, the exact reason for DD in HD patients is not clear. The present study evaluated left ventricular (LV) diastolic function in HD patients without DM and HT. Methods Fifty patients on HD and 34 age-matched and sex-matched healthy control individuals were enrolled. Echocardiography was performed in all participants. LV systolic and diastolic functions were evaluated by B-mode echocardiography, pulsed wave, and tissue Doppler imaging. The HD patients were divided into two groups according to the presence or absence of left ventricular hypertrophy (LVH) in echocardiography. Results LV dimensions and systolic function were within normal limits and similar between groups. However, the HD patients had significantly worse diastolic function (E/A: 0.78 +/- 0.26 vs. 1.19 +/- 0.28, P < 0.001, e '/a ' septal: 0.77 +/- 0.36 vs. 1.04 +/- 0.21, P < 0.001) and increased filling pressure (E/e ': 8.55 +/- 3.2 vs. 5.79 +/- 1.93, P < 0.001). Thirty-one (62%) patients had LVH, whereas 19 (38%) patients did not have LVH. LV systolic and diastolic functions were similar in HD patients with and without LVH. Seventeen (55%) hypertrophies were concentric and 14 (45%) were eccentric. Diastolic functions were similar in patients with either concentric or eccentric hypertrophy. Conclusion Diastolic function is impaired in HD patients even in the absence of diseases that can cause DD such as HT and DM.
Evaluation of Serum Perforin, Caspase-3, sFasL and M-30 Levels as Apoptotic Markers in Children With Crimean-Congo Hemorrhagic Fever
(LIPPINCOTT WILLIAMS & WILKINS, 2015) Guven, Ahmet S.; Sancakdar, Enver; Uysal, Elif B.; Kaya, Ali; Oflaz, Mehmet B.; Karapinar, Hekim; Bolat, Fatih; Tuzcu, Nevin; Deveci, Koksal; Cevit, Omer; Icagasioglu, Fusun D.
Background: Apoptosis is a main regulator in responses of cellular immunity throughout systemic viral infections. Perforin, soluble Fas ligand, caspase-3 and caspase-cleaved cytokeratin-18 (M-30) are mediators of apoptosis. The aim of this study is the evaluation of Crimean-Congo hemorrhagic fever (CCHF) disease changes in the levels of these apoptotic markers and the relation of these changes with disease severity. Methods: Forty-nine hospitalized children with CCHF and 36 healthy controls were enrolled in this prospective study. The CCHF patients were classified into 2 groups based on disease severity (severe group and nonsevere group). Demographic characteristics and clinical and laboratory findings of all patients were recorded on admission. Results: Serum perforin, caspase-3 and soluble Fas ligand levels were found to be significantly higher both in the severe and nonsevere CCHF groups than the healthy control group (P < 0.05), but there was no significant difference in these apoptotic markers between severe and nonsevere CCHF groups (P > 0.05). In addition, serum M-30 levels did not differ significantly among all groups (P > 0.05). There was a positive correlation between serum values for perforin, caspase-3 and M-30 and the disease's severity criteria such as aspartate aminotransferase and/or alanine aminotransferase. The serum levels of all these markers were negatively correlated with disease severity criteria such as the platelet count. Conclusions: In this study, we concluded that the interactions of cytolytic granules containing perforin and caspase cascade and Fas-FasL may play an important role in the pathogenesis of CCHF in children.
External iliac artery pseudo-stenosis associated with catheterization: report of two cases
(TERMEDIA PUBLISHING HOUSE LTD, 2012) Karapinar, Hekim; Gul, Ibrahim; Kucukdurmaz, Zekeriya; Gumrukcuoglu, Hasan Ali; Yilmaz, Ahmet
In invasive cardiology practices, the most commonly used vascular access site is the femoral artery. Atherosclerotic stenoses on the femoral and iliac arteries create difficulties in these practices. Vasospasm rarely occurs on large arteries like these. This paper reports stenosis encountered during coronary angiography on iliac arteries in 2 patients. The stenoses caused difficulties for guidewire and catheter insertion in catheterization. In the revisualization of these arteries at the next session, the stenoses had disappeared, but the arteries were tortuous. The patients did not have peripheral ischemia signs previously, nor did they appear after the procedure. These transient stenoses might have occurred due to vasospasm and the accordion effects caused by the guidewire and/or catheter.
Giant Left Atrium
(WILEY-BLACKWELL, 2013) Kucukdurmaz, Zekeriya; Gunes, Hakan; Kurt, Recep; Karapinar, Hekim
…

Yazar "Karapinar, Hekim" seçeneğine göre listele

Sayfa Başına Sonuç

Sıralama seçenekleri