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Öğe Advanced age and apnea-hypopnea index predict subclinical atherosclerosis in patients with obstructive sleep apnea syndrome(BIOMED CENTRAL LTD, 2013) Arik, Bilal; Inci, Mehmet Fatih; Gumus, Cesur; Varol, Kenan; Ege, Meltem Refiker; Dogan, Omer Tamer; Zorlu, AliBackground: Both obstructive sleep apnea syndrome (OSAS) and coronary artery calcification (CAC) are considered to be related with the presence of coronary artery disease (CAD). In this study we evaluate the association between OSAS and presence of subclinical atherosclerosis assessed by tomographic coronary calcium score in patients who had OSAS but no history of known CAD. Methods: Seventy-three patients who were asymptomatic for CAD and had suspected OSAS were referred to overnight attended polysomnography. Patients were classified into 4 groups according to the Apnea-Hypopnea Index (AHI). All patients underwent computed tomographic examination for tomographic coronary calcification scoring. Physical examination, sleep study recordings, complete blood count and serum biochemistry were obtained from all patients. Results: In the whole group, AHI levels were weakly correlated with coronary calcium score (r = 0.342, p = 0.003) and body mass index (r = 0.337, p = 0.004), moderately correlated with basal oxygen saturation (r = -0.734, p < 0.001), and strongly correlated with oxygen desaturation index (r = 0.844, p < 0.001). In an univariate analysis, age, AHI, basal oxygen saturation, and oxygen desaturation index were associated with CAC in patients with OSAS. In a multiple logistic regression model, age (OR 1.108,% 95 CI 1.031-1.191, p = 0.005) and AHI (OR 1.036,% 95 CI 1.003-1.070, p = 0.033) were only independent predictors of CAC in patients with OSAS with a sensitivity of 88.9% and 77.8% and a specificity of 54.3% and 56.5% respectively. Conclusions: Our findings suggest that in patients with moderate or severe OSAS and advanced age, physicians should be alert for the presence of subclinical atherosclerosis.Öğe Akut pulmoner embolizmde ÇKBT ile sağ ventrikül disfonksiyonunun değerlendirilmesi ve ekokardiyografi ile karşılaştırılması(Cumhuriyet Üniversitesi, 2013) Varol, Kenan; Gümüş, CesurPulmoner emboli; mortalite ve morbiditesi yüksek, tekrarlayabilen, tanısı güç olabilen ancak önlenebilir bir hastalıktır.Çalışmamızda Çok Kesitli Bilgisayarlı Tomografi Anjiografi (ÇKBTA) ile pulmoner emboli saptanan hastalarda sağ ventrikül disfonksiyonunu (SVD) destekleyen Bilgisayarlı Tomografi (BT) bulgularını ve Pulmoner Arter Bilgisayarlı Tomografi Obstrüksiyon İndeksi Oranını (PABTOİO) belirlemek, ekokardiyografi ile karşılaştırıp ÇKBTA'nin etkinliğini araştırmayı amaçladık.Bu çalışmada Ekim 2011 ile Kasım 2012 tarihleri arasında Cumhuriyet Üniversitesi Tıp Fakültesi Hastanesi Radyoloji Anabilim Dalına pulmoner emboli şüphesi ile gönderilen ve yapılan ÇKBTA değerlendirmesi sonucu pulmoner emboli saptanan, dosya taramasında ekokardiyografi bulguları mevcut olan 100 (50 erkek,50 kadın) hasta retrospektif olarak incelenmiştir. Hastaların yapılmış olan Bilgisayarlı Tomografi Pulmoner Anjiyografi görüntüleri daha önceden toplanmış olan CD'lerden elde edildi.Çalışmamızda akut pulmoner emboli bulunan hastalarda Qanadli obstrüksiyon indeksi oranı ve 3 farklı Bilgisayarlı Tomografi parametresi (RV/LV oranı, septum deviasyonu, vena kava inferior reflüsü) ile ekokardiyografi arasındaki korelasyonu inceledik. Bilgisayarlı Tomografi parametrelerinin sensitivite ve spesifisite değerilerini sırasıyla RV/LV>1 oranı için %84.61, %81.25, Septal deviasyon için 86.53, %68.75 ve Vena kava inferior reflüsü için %76.92, %83.33 olarak bulduk. Qanadli Pulmoner Arter Bilgisayarlı Tomografi Obstrüksiyon İndeksi Oranı için kesme değer araştırdık ve %37.5 olarak saptadık.Sonuçlarımız akut pumoner emboli bulunan hastalarda ÇKBTA parametrelerinin sağ ventrikül disfonksiyonu bulunan hastaların tanımlanmasında önemli olduğunu göstermektedir. Ayrıca Pulmoner Arter Bilgisayarlı Tomografi Obstrüksiyon İndeksi Oranı sağ ventrikül disfonksiyonu bulunan ve bulunmayan hastaları ayırt edebilmektedir. Radyoloji raporları genellikle embolinin yerini bildirmekle birlikte pıhtı yüküne ilişkin bilgi vermez. Raporlarda Pulmoner Arter Bilgisayarlı Tomografi Obstrüksiyon İndeksi Oranının belirtilmesi tedavinin planlanmasında ve prognozun öngörülmesinde önemli bir veri olacaktır.Anahtar Kelimeler : Pulmoner Emboli, ÇKBTA, Ekokardiyografi, PABTOİOÖğe Correlation of right ventricular dysfunction on acute pulmonary embolism with pulmonary artery computed tomography obstruction index ratio (PACTOIR) and comparison with echocardiography(SPRINGER, 2015) Varol, Kenan; Gumus, Cesur; Yucel, Hasan; Sezer, Ferhat; Seker, Emrah; Inci, Mehmet Fatih; Yucel, Selma; Kaya, Hakki; Berk, Serdar; Yilmaz, Mehmet BirhanThe aim of this study was to determine the pulmonary artery computed tomography obstruction index ratio (PACTOIR) in patients who have been diagnosed with acute pulmonary embolism (APE) with multi-slice computed tomography (MSCT) and to research the predetermination efficiency of right ventricular dysfunction (RVD) compared with echocardiography (ECHO). One hundred patients (50 males, 50 females), who had ECHO findings and were diagnosed with APE, were subsequently examined in this study. Patients who had RVD on ECHO, tricuspid regurgitation, and pulmonary hypertension parameters that were completely positive were accepted to have RVD. RVD was identified in 52 patients (52 %) on echocardiography. The PACTOIR value for patients with RVD were evaluated to be significantly higher than those without RVD (41 +/- A 17 vs 20 +/- A 12 %, p < 0.001). In the ROC analysis, the PACTOIR cut-off value was 37.5 %, the sensitivity value was 67.3 %, and specificity value was 93.7 % (AUC 0.839, 95 % CI 0.752-0.905). We determined that the patients with RVD and PACTOIR values over 37.5 % can be recognized with a 92.1 % positive predictive value. Our conclusions indicated that the PACTOIR rate in RVD diagnosis in patients with APE can recognize the patients with and without RVD.Öğe The evaluation of renal hemodynamics changes in Familial Mediterranean fever with color Doppler sonography(TAYLOR & FRANCIS LTD, 2016) Sezer, Ferhat; Uslu, Ali Ugur; Egilmez, Hulusi; Balta, Sevket; Varol, Kenan; Arik, Bilal; Seker, Emrah; Gunes, Hakan; Yonem, OzlemBackground: Renal resistive index (RRI) scanned through renal Doppler is a practical marker employed in measuring blood flow in renal and intrarenal arteries and in noninvasive evaluation of renal vascular resistance. We aimed to investigate the renal hemodynamic variations in patients with Familial Mediterranean Fever (FMF).Material and methods: Seventy-nine FMF patients and 51 healthy subjects suitable for age and sex were included. Patients were divided into two groups according to their urinary albumin excretion. Fifty-two patients with 0-29mg/day albuminuria were included in the normoalbuminuric group while 27 patients with 30-299mg/day albuminuria were included in the microalbuminuric group.Results: RRI values were higher in patients with FMF compared to the healthy subjects (p<0.0001). Additionally, RRI values were found to be higher in the microalbuminuric patients group compared to the normoalbuminuric patients group, and RRI values were also higher in normoalbuminuric patients group compared to the control group (p=0.002, p<0.0001). The ROC curve analysis suggested that the optimum RRI cutoff value for microalbuminuria in patients was 0.63, sensitivity of 66%, specificity of 60%, and p=0.013.Conclusion: RRI may be a marker that may be used in assessing resistance to renal blood flow, early renal damage, and progression of renal damage in FMF patients.Öğe Final Diagnosis of Resisting Asthma: Incomplete Double Aortic Arch with Distal Left Arch Atresia(Derman Medical Publ, 2013) Seker, Emrah; Atalar, Mehmet H.; Yucel, Selma; Varol, Kenan; Sezer, FerhatIncomplete double aortic arch is a rare vascular anomaly. We describe a case of distinctive imaging features of incomplete double aortic arch misdiagnosed as asthma that admitted with dyspnea and dysphagia.
