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Demircelik M.B.,Ankara University | Yilmaz O.C.,Ankara Occupational Diseases Hospital | Gurel O.M.,Ankara University | Selcoki Y.,Ankara University | And 4 more authors.
Clinics | Year: 2014

OBJECTIVE: The aim of the present study was to investigate the relationship between pericoronary fat and the severity and extent of atherosclerosis, quantified using 64-multidetector computed tomography, in patients with suspected coronary artery disease. METHODS: The study population consisted of 131 patients who were clinically referred for noninvasive multislice computed tomography coronary angiography for the evaluation of coronary artery disease. Patients were classified as follows: no atherosclerosis, Group 1; nonobstructive atherosclerosis (luminal narrowing < 50% in diameter), Group 2; and obstructive atherosclerosis (luminal narrowing ≥ 50%) in a single vessel or obstructive atherosclerosis in the left main coronary artery and/or multiple vessels, Group 3. Epicardial adipose tissue was defined as the adipose tissue between the surface of the heart and the visceral layer of the pericardium (visceral epicardium). Epicardial adipose tissue thickness (mm) was determined in the right ventricular anterior free wall. The mean thickness of the pericoronary fat surrounding the three coronary arteries was used for the analyses. RESULTS: The average thickness over all three regions was 13.2 ± 2.1 mm. The pericoronary fat thickness was significantly increased in Group 3 compared with Groups 2 and 1. The epicardial adipose tissue thickness was significantly increased in Group 3 compared with Groups 2 and 1. A receiver operating characteristic curve for obstructive coronary artery disease was assessed to verify the optimum cut-off point for pericoronary fat thickness, which was 13.8 mm. A receiver operating characteristic curve for obstructive coronary artery disease was also assessed to verify the optimum cut-off point for epicardial adipose tissue, which was 6.8 cm. CONCLUSION: We showed that the epicardial adipose tissue and pericoronary fat thickness scores were higher in patients with obstructive coronary artery diseases. © 2014 CLINICS.

Yoldas O.,Ordu State Hospital | Karaca T.,Ankara Occupational Diseases Hospital | Tez M.,Ankara Numune Training and Research Hospital
International Journal of Surgery | Year: 2012

Purpose: The aim of this study was to evaluate the predictive accuracy of Lintula score in Turkish appendicitis patients. Materials and methods: Data from a total of 156 patients operated with the diagnosis of acute appendicitis were collected retrospectively. The Lintula score was constructed from nine variables (gender, intensity of pain, relocation of pain, pain in the right lower abdominal quadrant, vomiting, body temperature, guarding, bowel sounds and rebound tenderness) with independent diagnostic value in 156 patients. Lintula score was calculated for all patients. Pathological results of the resected specimen were determined and the diagnostic performance of the Lintula score was compared. Results: Hoshmer-Lemeshow and ROC curve analysis was performed and area under the curve was 0.922. Predictive accuracy of Lintula score among Turkish appendicitis patients was statistically significant. Conclusion: Lintula score seems to be useful method to diagnose acute appendicitis among Turkish patients and may reduce the rate of negative appendectomy. © 2011 Surgical Associates Ltd.

Karakulak U.N.,Ankara Occupational Diseases Hospital
Journal of Human Hypertension | Year: 2016

One of the major complications of arsenic on human health is hypertension. Arsenic-related hypertension and negative effects of arsenic on arterial system such as oxidative stress and vasoconstriction/vasorelaxation imbalance may lead to impair aortic elasticity. The aim of this study was to evaluate the effects of arsenic on aortic elasticity parameters including aortic strain and distensibility. One hundred twelve (112) workers were occupationally exposed to arsenic and 60 healthy control subjects were enroled. All patients underwent transthoracic echocardiography for detecting aortic strain and aortic distensibility. There were no differences in baseline demographic and echocardiographic characteristics between the groups. Aortic strain (10.3±3.9 vs 12.1±2.7%, P=0.001) and aortic distensibility (0.45±0.17 vs 0.54±0.15 cm2 per dyn, P=0.001) were decreased in arsenic-exposure group compared with controls. Urinary arsenic level was found to be negatively and significantly correlated with aortic strain (r=−0.306, P=0.001) and aortic distensibility (r=−0.259, P=0.006). Duration of arsenic exposure was also found to be negatively and significantly correlated with aortic strain (r=−0.386, P<0.001) and aortic distensibility (r=−0.333, P<0.001). This study suggests that arsenic exposure is related to impairment of aortic elasticity parameters even in subjects without overt cardiovascular disease.Journal of Human Hypertension advance online publication, 21 January 2016; doi:10.1038/jhh.2015.128. © 2016 Macmillan Publishers Limited

Alici I.O.,Ankara Occupational Diseases Hospital | Demirci N.Y.,Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital | Yilmaz A.,Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital | Demirag F.,Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital | Karakaya J.,Hacettepe University
Virchows Archiv | Year: 2013

We compared the diagnostic performances of conventional smears and cell block preparations of tissue samples obtained with endobronchial ultrasound-guided transbronchial needle aspiration. We retrospectively analysed 451 patients (926 lymph nodes) who had undergone endobronchial ultrasound and for whom both smears and cell blocks were available and compared the diagnostic performances of these techniques when used alone and combined. Cell block preparations showed higher diagnostic performance over smears, but the combination was superior to either alone. The combination of smear and cell block techniques achieved a sensitivity, specificity and positive and negative predictive values of 92.5, 100, 100, 97.7 and 99.4, 95.0, 98.6, and 97.9 % for malignant and benign diseases, respectively. We recommend cell block preparations during endobronchial ultrasound-guided transbronchial needle aspiration. © 2013 Springer-Verlag Berlin Heidelberg.

Carman K.B.,Gaziantep Childrens Hospital | Tutkun E.,Ankara Occupational Diseases Hospital | Yilmaz H.,Ankara Occupational Diseases Hospital | Dilber C.,Kahramanmaras Sutcu Imam University | And 5 more authors.
European Journal of Pediatrics | Year: 2013

Elemental mercury exposure occurs frequently and is potentially a toxic, particularly in children. Children are often attracted to elemental mercury because of its color, density, and tendency to form beads. Clinical manifestations of elemental mercury intoxication vary depending on its form, concentration, route of ingestion, and the duration of exposure. We present data on 179 pediatric cases of elemental mercury poisoning from exposure to mercury in schools in two different provinces of Turkey. Of all patients, 160 children had both touched/played with the mercury and inhaled its vapors, while 26 children had only inhaled the mercury vapor, two children reported having tasted the mercury. The median duration of exposure was 5 min (min 1-max 100), and 11 (6 %) children were exposed to the mercury for more than 24 h at home. More than half of the children (51.9 %) were asymptomatic at admission. Headache was the most common presenting complaint. The results of physical and neurological examinations were normal in 80 (44.6 %) children. Mid-dilated/dilated pupils were the most common neurological abnormality, and this sign was present in 90 (50.2 %) children. Mercury levels were measured in 24-h urine samples daily, and it was shown that the median urinary level of mercury was 29.80 μg/L (min, 2.40 μg/L; max, 4,687 μg/L). A positive correlation was also found between the duration of exposure and urinary mercury levels (r = 0.23, p = 0.001). All patients were followed up for 6 months. On the first follow-up visit performed 1 month after discharge, the neurological examinations of all patients were normal except for those patients with peripheral neuropathy and visual field defects. On the last follow-up visit at the sixth month, only two children still experienced visual field defects. In conclusion, this study is one of the largest case series of mercury intoxication of students in schools. Elemental mercury exposure can be potentially toxic, and its symptomatology is variable, particularly in children. Therefore, school staff and children should be aware of the risk of mercury toxicity. Pediatricians also need to warn parents and children about the hazards of playing with any chemical. © 2013 Springer-Verlag Berlin Heidelberg.

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