Yozgat Sorgun State Hospital

Yozgat, Turkey

Yozgat Sorgun State Hospital

Yozgat, Turkey
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Kaya M.G.,Erciyes University | Akpek M.,Erciyes University | Elcik D.,Erciyes University | Kalay N.,Erciyes University | And 7 more authors.
American Journal of Cardiology | Year: 2012

Spontaneous echocardiographic contrast (SEC) is the presence of smoke-like echoes with a characteristic swirling motion of blood in echocardiography. Previous clinical studies have demonstrated that SEC is a risk factor for left atrial thrombus formation and an important indicator of potential systemic embolism originated from heart. An established relation exists between the inflammatory status and the prothrombotic state. Therefore, we investigated the role of inflammatory status on SEC in patients with mitral stenosis (MS). A total of 62 consecutive patients with MS who undergoing mitral balloon valvuloplasty were enrolled in the present study. The patients were divided into 2 groups according to the formation of SEC in the left atrium. Of the 62 patients, 32 (mean age 45 ± 12 years; 75% women) were in the SEC-negative group and 30 patients (mean age 45 ± 11 years; 63% women) were in the SEC-positive group. The high-sensitive C-reactive protein levels were significantly greater in the SEC-positive group than in the SEC-negative group (3.9 ± 2.2 vs 10.6 ± 6.3, p = 0.024). The neutrophil levels (64.6 ± 9.4 vs 72.6 ± 8.6) were significantly greater in the SEC-positive group, and the lymphocyte levels (24.4 ± 6.9 vs 18.3 ± 6.0) were significantly greater in the SEC-negative group (p = 0.001 for each). The neutrophil/lymphocyte (N/L) ratio was also significantly greater in the SEC-positive group (3.0 ± 1.8 vs 4.5 ± 1.8, p = 0.003). In the receiver operating characteristics curve analysis, a N/L ratio >3.1 mg/dl had a 80% sensitivity and 72% specificity in predicting SEC in patients with MS. On multivariate analysis, high-sensitive C-reactive protein (odds ratio [OR] 1.235, 95% confidence interval [CI] 1.040 to 1.466; p = 0.016), N/L ratio (OR 1.461, 95% CI 0.977 to 2.184; p = 0.02), left atrial volume (OR 3.012, 95% CI 1.501 to 5.611; p = 0.001), and mitral valve area (OR 0.135, 95% CI 0.020 to 0.503; p = 0.017) were independent risk factors of SEC in patients with MS. In conclusion, the high-sensitive C-reactive protein and N/L ratio were independently associated with SEC in patients with MS. Copyright © 2012 Published by Elsevier Inc. All rights reserved.

Akpek M.,Erciyes University | Elcik D.,Erciyes University | Kalay N.,Erciyes University | Yarlioglues M.,Yozgat Sorgun State Hospital | And 6 more authors.
Angiology | Year: 2012

We assessed the association between serum gamma glutamyl transferase (GGT) activity with postprimary percutaneous coronary intervention (PCI) coronary flow and in-hospital major advanced cardiac events (MACEs) in patients with ST elevation myocardial infarction (STEMI). Patients with STEMI (n = 425; males 78%; mean age 60 ± 13 years) were enrolled. Patients were divided into 3 GGT tertiles and 2 groups according to thrombolysis in myocardial infarction (TIMI) flow grade. The TIMI flow percentages were similar in the 3 GGT tertiles (32%, 45%, and 42%, respectively, P =.336). Total MACE increased with GGT tertiles (among tertiles, respectively; P <.001). The total MACE was significantly higher in impaired flow group than in normal flow group (23% vs 7%; P <.001). At multivariate analyses, serum GGT activity was an independent predictor of in-hospital MACE (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.01-1.33; P <.001). In conclusion, serum GGT activity is associated with in-hospital MACE in patients with STEMI undergoing primary PCI. © The Author(s) 2012.

Yesilyurt M.,Yozgat Sorgun State Hospital | Kilic S.,Refik Saydam National Public Health Agency | Celebi B.,Refik Saydam National Public Health Agency | Gul S.,Yozgat Sorgun State Hospital
Mikrobiyoloji Bulteni | Year: 2012

The aim of this study was to investigate the tularemia seroprevalence among hunters mainly hunting in districts with emerging tularemia cases in Yozgat province located at the Central Anatolia region of Turkey. A total of 64 serum samples were collected from the subjects (all were male; age range: 18-67 years; mean age: 42.7 years) registered to Hunting and Shooting Clubs in Yozgat province and it's two districts, during January-April 2010 and anamnestic data were obtained using a questionnaire. The presence of Francisella tularensis antibodies in serum samples were screened by microagglutination test (MAT), and the positive samples were also confirmed by a commercial ELISA kit (Serazym, Germany). Four (6.3%) out of 64 were found to be seropositive for tularemia with titers of 1/160 in three cases, and 1/2560 in one case. All of the MAT positive samples yielded positive results with ELISA test and all seropositive cases had negative brucella agglutination result. No tularemia compatible clinical history were determined in two hunters with 1/160 antibody titer. However, one of the cases had defined symptoms consistent with oropharyngeal form. The hunter with 1/2560 antibody titer developed acute oropharyngeal tularemia and treated with 14 days of ciprofloxacin therapy. Evaluation of risk factors in seropositive cases revealed consumption of spring water as a risk factor. In conclusion, our results indicated a considerable exposure of hunters to F.tularensis in Yozgat province and reflected a high prevalence of the pathogen around Yozgat, which coincided with the high notification rate of tularemia in this region.

Guven S.,Yozgat Sorgun State Hospital | Sen T.,Dumlupinar University | Tufekcioglu O.,Turkiye Yuksek Ihtisas Hospital | Gucuk E.,Turkiye Yuksek Ihtisas Hospital | And 2 more authors.
Cardiology Journal | Year: 2014

Background: Mitral stenosis (MS) is still the most common complication of acute rheumatic fever in Turkey. Rheumatic carditis affects not only cardiac valves but also myocardium. In this study, we aimed to evaluate the subclinical left ventricular (LV) systolic dysfunction and contraction of short and long axial circumferential and longitudinal fibers by pulsed wave tissue Doppler in rheumatic MS patients who have preserved LV systolic function in 2D echo-cardiography. Methods: Fifteen severe, 20 moderate rheumatic MS patients hospitalized for mitral balloon valvuloplasty, and 15 patients who had normal echocardiographic findings were included in the study. After routine conventional transthoracic echocardiographic examination, LV myocardial systolic velocities were evaluated with pulsed wave tissue Doppler in the short and long axis with simultaneous electrocardiographic monitoring. Results: Long axis first systolic velocity (SW1) of mild-moderate and severe MS was much lower than normal group (10.7 ± 2.3 in normal group vs. 7.9 ± 1.3 in mild-moderate MS group vs. 6.2 ± 1.4 in severe MS group, p < 0.001). Long axis Q-SW1 duration was longer in mild-moderate MS group (145 ± 32 in normal group vs. 199 ± 43 in mild-moderate MS group, p = 0.001). Short axis Q-SW2 duration was longer in normal group compared to mild--moderate and severe MS groups (298 ± 41 in normal group vs. 245 ± 37 in mild-moderate MS group vs. 234 ± 26 in severe MS group, p < 0.001). Significant correlation between mitral valve area and SW1, Q-SW1 was determined (p = 0.01). Conclusions: Even if LV functions are normal with conventional 2D echocardiography, subclinical systolic dysfunction exists in MS. Also, there is a dyssynchrony between contraction of longitudinal and circumferential myofibrils. © 2014 Via Medica.

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