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Atakan A.,Fatih Sultan Mehmet State Hospital | Macunluoglu B.,Uskudar State Hospital | Kaya Y.,Van Yuksek Ihtisas Hospital | Ari E.,Van Yuksek Ihtisas Hospital | And 3 more authors.
Hemodialysis International | Year: 2014

Cardiovascular disease (CVD) is the main cause of mortality in hemodialysis (HD) patients. Epicardial fat tissue (EFT) is a new risk factor in CVD. The aim of this study was to evaluate the association between EFT and coronary artery flow reserve (CFR), which is an early indicator of endothelial dysfunction in coronary vessels of HD patients. We performed a cross-sectional study including 71 chronic HD patients and 65 age- and sex-matched healthy controls. Epicardial fat tissue was significantly higher in HD patients when compared to healthy controls (6.53±1.01mm vs. 5.79±1.06mm, respectively, P<0.001). On transthoracic Doppler echocardiography, CFR values were significantly lower in HD patients when compared to healthy controls (1.73±0.11 vs. 2.32±0.28, P<0.001). Correlation analysis showed CFR values to be inversely correlated with EFT (r=-0.287, P<0.05). Multiple linear regression analysis was used to define independent determinants of EFT in HD patients. Artery flow reserve, age, body mass index and total cholesterol levels were independently correlated with EFT thickness. This study demonstrated that EFT was significantly higher among HD patients compared to healthy controls. In addition, this study was the first to demonstrate an inverse correlation between EFT and CFR in this patient population. © 2013 International Society for Hemodialysis.


Ari E.,Van Yuksek Ihtisas Hospital | Kedrah A.E.,Marmara University | Alahdab Y.,Marmara University | Bulut G.,Van Yuksek Ihtisas Hospital | And 3 more authors.
British Journal of Radiology | Year: 2012

Objectives: The aim of the study was to assess the effect of paricalcitol on the experimental contrast-induced nephropathy (CIN) model. We hypothesised that paricalcitol may prevent CIN. Methods: 32 Wistar albino rats were divided into four groups (n=8 each): control group, paricalcitol group, CIN group and paricalcitol plus CIN group. Paricalcitol (0.4 μg kg -1 day -1) was given intraperitoneally for 5 consecutive days prior to induction of CIN. CIN was induced at day 4 by intravenous injection of indometacin (10 mg kg -1), Nω-nitro-L-arginine methyl ester (L-NAME, 10 mg kg -1) and meglumine amidotrizoate (6 ml kg -1). Renal function parameters, oxidative stress biomarkers, histopathological findings and vascular endothelial growth factor (VEGF) immunoexpression were evaluated. Results: The paricalcitol plus CIN group had lower mean serum creatinine levels (p=0.034) as well as higher creatinine clearance (p=0.042) than the CIN group. Serum malondialdehyde and kidney thiobarbituric acid-reacting substances levels were significantly lower in the paricalcitol plus CIN group than in the CIN group (p=0.024 and p=0.042, respectively). The mean scores of tubular necrosis (p=0.024), proteinaceous casts (p=0.038), medullary congestion (p=0.035) and VEGF immunoexpression (p=0.018) in the paricalcitol plus CIN group were also significantly lower. Conclusion: This study demonstrates the protective effect of paricalcitol in the prevention of CIN in an experimental model. © 2012 The British Institute of Radiology.


Macunluoglu B.,Uskudar State Hospital | Kaya Y.,Van Yuksek Ihtisas Hospital | Atakan A.,Fatih Sultan Mehmet State Hospital | Ari E.,Van Yuksek Ihtisas Hospital | And 5 more authors.
Hemodialysis International | Year: 2013

Accelerated atherosclerosis is the major cause of mortality in patients on chronic hemodialysis (HD). The aim of this study was to evaluate the relation between coenzyme Q10 (CoQ10) levels and coronary flow reserve (CFR) in HD patients as an indicator of atherosclerosis. Seventy-one chronic HD patients and 65 age- and sex-matched healthy individuals were included in the study. Plasma CoQ10 levels were performed by high-performance liquid chromatography measurements. CFR was assessed by transthoracic Doppler echocardiography. Serum CoQ10 levels (1.36±0.43 vs. 2.53±0.55, P<0.001) and CFR values (1.73±0.11 vs. 2.32±0.28, P<0.001) were significantly lower in HD patients compared with controls. There was a significant positive correlation between CFR and serum levels of CoQ10 (r = 0.669, P<0.001). A linear regression analysis showed that serum levels of CoQ10 were still significantly and positively correlated with CFR (regression coefficient = 0.235, P<0.001). Our data have demonstrated that HD patients exhibit decreased plasma CoQ10 levels and CFR values. The study also showed for the first time that serum CoQ10 levels independently predict CFR in HD patients. © 2013 The Authors. Hemodialysis International © 2013 International Society for Hemodialysis.


Gumrukcuoglu H.A.,Yuzuncu Yil University | Odabasi D.,Yuzuncu Yil University | Akdag S.,Van Yuksek Ihtisas Hospital | Ekim H.,Yuzuncu Yil University
Cardiology Research and Practice | Year: 2011

Background. Cardiac tamponade (CT) represents a life-threatening condition, and the optimal method of draining accumulated pericardial fluid remains controversial. We have reviewed 100 patients with CT at our institution over a five-year period and compared the results of echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis with regard to functional outcomes. Methods. The study group consisted of 100 patients with CT attending Yuzuncu Yil University from January 2005 to January 2010 who underwent one of the 3 treatment options (echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis). CT was defined by clinical and echocardiographic criteria. Data on medical history, characteristics of the pericardial fluid, treatment strategy, and follow-up data were collected. Results. Echo-guided pericardiocentesis was performed in 38 (38) patients (Group A), primary surgical treatment was preformed in 36 (36) patients (Group B), and surgical treatment following pericardiocentesis was performed in 26 (26) patients (Group C). Idiopathic and malignant diseases were primary cause of tamponade (28 and 28, resp.), followed by tuberculosis (14). Total complication rates, 30-day mortality, and total mortality rates were highest in Group C. Recurrence of tamponade before 90 days was highest in Group A. Conclusions. According to our results, minimal invasive procedure echo-guided pericardiocentesis should be the first choice because of lower complication and mortality rates especially in idiopathic cases and in patients with hemodynamic instability. Surgical approach might be performed for traumatic cases, purulent, recurrent, or malign effusions with higher complication and mortality rates. © 2011 Hasan Ali Gumrukcuoglu et al.


Asker S.,Yuzuncu Yil University | Asker M.,Van Yuksek Ihtisas Hospital | Yeltekin A.C.,Yuzuncu Yil University | Aslan M.,Yuzuncu Yil University | Demir H.,Yuzuncu Yil University
Sleep and Breathing | Year: 2015

Purpose: The aim of the present study was to evaluate the serum levels of trace minerals and heavy metals in obstructive sleep apnea (OSA) patients and to investigate whether there is a correlation between levels of trace minerals and demographic and biochemical variables.Methods: This clinical, case–control study was performed on 61 OSA patients and 36 healthy controls. Demographic, radiological, biochemical variables, as well as serum levels of trace minerals (magnesium, copper, iron, zinc, manganese, cobalt) and heavy metals (lead, cadmium) were compared in OSA and control groups. In addition, correlation of serum levels of these substances to demographic, biochemical, and radiological parameters was tested.Results: Not only serum levels of cholesterol, triglycerides, cadmium, cobalt, copper, iron, magnesium, manganese, lead, and zinc were found to be higher, but also carotid intima-media thickness (CIMT) was increased in OSA patients. Increase in CIMT was found to be correlated with levels of cobalt, copper, iron, magnesium, manganese, and zinc.Conclusion: Our results have shown that serum levels of trace minerals and heavy metals were higher in OSA. This difference may ensource from deterioration of the balance of these substances due to oxidative stress and inflammation. Significance of these findings with respect to the etiopathogenesis, diagnosis, and treatment of OSA warrants further trials. © 2014, Springer-Verlag Berlin Heidelberg.

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