Van Yuksek Ihtisas Hospital

Van, Turkey

Van Yuksek Ihtisas Hospital

Van, Turkey
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PubMed | Van Lokman Hekim Hospital, Kafkas University, Sakarya University, Van Yuksek Ihtisas Hospital and Van Maternal and Child Health Hospital
Type: Journal Article | Journal: Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir | Year: 2013

We aimed to evaluate the short- and mid-term results of patients with atrial septal defect (ASD) who were treated with percutaneous closure.Seventy-nine patients with secundum ASD (54 female and 25 male; mean age 26.217.2; range 3 to 71] years) were included in this study. Patients were evaluated by transthoracic (TTE) and/or transesophageal echocardiography (TEE). Amplatzer septal occluder (ASO) was used in all patients. In 76 patients, the procedure was performed under local anesthesia with TTE, while in the other 3 patients, it was performed with general anesthesia with TEE. Patients were followed up at the 1st, 3rd, 6th and 12th months and annually thereafter. Mean follow-up time was 13.66.6 months.Mean diameter of ASDs was 18.27.5 mm and 20.78.04 mm during balloon dilatation, and mean diameter of implanted devices was 22.78.5 mm. Procedural time was 40.212.6 minutes and fluoroscopy time was 10.94.1 minutes. The procedure was successfully performed in all patients (100%). One patient with cardiac tamponade died seven days after cardiac surgery. In two patients, the implanted devices embolized to the pulmonary circulation. Residual flow was found in three patients immediately after the procedure, without residual shunts one month after closure. Mild pericardial effusion in one patient and significant residual shunt due to device malposition in another were discovered during the follow-up at 1 and 6 months, respectively, after the procedure.Our findings showed that percutaneous closure of ASDs is successful in most patients with a low complication rate, and demonstrated that residual shunts do not develop in the majority of patients in the short- and mid-term.


Kaya Y.,Van Yuksek Ihtisas Hospital | Ari E.,Van Yuksek Ihtisas Hospital | Demir H.,Yuzuncu Yil University | Gecit I.,Yuzuncu Yil University | And 2 more authors.
International Urology and Nephrology | Year: 2012

Objective Hemodialysis (HD) patients are at risk of deficiency of essential trace elements and excess of toxic trace elements. The aim of the study was to evaluate the relation between the serum levels of some trace elements and heavy metals (iron, zinc, manganese, copper, magnesium, cobalt, cadmium, and lead) and endothelial function in HD patients. Methods: Forty-eight chronic HD patients without known atherosclerotic disease and 42 age- and sexmatched healthy individuals were included in the study. The serum levels of trace elements (iron, zinc, manganese, copper, and magnesium) and heavy metals (cobalt, cadmium, and lead) were measured by Atomic Adsorption Spectrophotometer (UNICAM- 929). Results: The serum levels of iron, zinc, and manganese were lower, and levels of copper, magnesium, cobalt, cadmium, and lead were higher in HD patients compared to controls. Flow-mediated dilatation (FMD %) in HD patients was lower than that in the control group (7.27 ± 0.76 vs. 11.29 ± 0.82, P<0.001). There was a significant negative correlation between FMD % and serum levels of cobalt (r = -0.313, P = 0.03) and cadmium (r = -0.524, P<0.01). A linear regression analysis showed that serum cadmium levels were still significantly and negatively correlated with FMD % (regression coefficient = -0.526, P<0.001). Conclusion: We first demonstrated that serum cadmium levels independently predict endothelial function in HD patients without known atherosclerotic disease. © Springer Science+Business Media, B.V. 2011.


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.


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.


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.


Canbay E.,Basaksehir State Hospital | Akman E.,Van Yuksek Ihtisas Hospital
Journal of Medical Case Reports | Year: 2011

Introduction. Although appendix duplication is diagnosed as a rare congenital anomaly of the alimentary tract in childhood, a few adult cases have also been reported. Here we report a case of appendix duplication with perforated appendicitis co-existing with acute appendicitis in an adult patient. Case presentation. A 33-year-old Caucasian man was admitted to our Emergency Department with right-sided lower-quadrant pain that we explored for presumed complicated appendicitis. On exploration, a perforated inflamed appendix was found coexisting with a second inflamed appendix which was subserosal and retrocecal. Appendectomies were performed, and the pathological examination confirmed the signs of acute inflammation in both appendixes. Conclusion: Surgeons in emergency services should be aware of anatomical anomalies such as duplication and malposition of the appendix, even in patients with a history of previous appendectomy, because misdiagnosis of appendix duplication may lead to a poor clinical outcome and medicolegal issues. © 2011 Canbay and Akman; licensee BioMed Central Ltd.


Ari E.,Van Yuksek Ihtisas Hospital | Kaya Y.,Van Yuksek Ihtisas Hospital | Demir H.,Yuzuncu Yil University | Asicioglu E.,Marmara University | Keskin S.,Yuzuncu Yil University
Biological Trace Element Research | Year: 2011

Changes in essential trace elements and heavy metals may affect the atherosclerotic state of patients on maintenance hemodialysis (HD). The aim of the study was to evaluate the relation between the serum levels of some trace elements and heavy metals (iron, zinc, manganese, copper, magnesium, cobalt, cadmium, lead, and copper/zinc ratio) and carotid artery intima-media thickness (CIMT) in HD patients. Fifty chronic HD patients without known atherosclerotic disease and 48 age- and sex-matched healthy individuals were included in the study. The serum levels of trace elements (iron, zinc, manganese, copper, and magnesium) and heavy metals (cobalt, cadmium, and lead) were measured by Atomic Adsorption Spectrophotometer (UNICAM-929). CIMT was assessed by carotid artery ultrasonography. The serum levels of iron, zinc, and manganese were lower; levels of copper, magnesium, cobalt, cadmium, lead, and copper/zinc ratio were higher in HD patients compared to controls. CIMT in HD patients were higher than the control group (0.64±0.11 vs 0.42±0.05, p<0.001). There was a significant negative correlation between CIMT and serum levels of zinc (r=-0.70, p<0.01), iron (r=-0.71, p< 0.01), and manganese (r=-0.47, p<0.01), while there was a significant positive correlation between CIMT and serum levels of copper (r=0.63, p<0.01), magnesium (r=0.77, p<0.01), cobalt (r=0.63, p<0.01), cadmium (r=0.48, p<0.01), lead (r=0.38, p<0.01), and copper/zinc ratio (r=0.68, p<0.01). A linear regression analysis showed that serum levels of magnesium, cadmium, lead, and copper/zinc ratio were still significantly and positively correlated with CIMT. We propose that copper/zinc ratio, magnesium and toxic metals cadmium and lead are independent determinants of CIMT in maintenance HD patients without known atherosclerotic disease. © Springer Science+Business Media, LLC 2011.


Ari E.,Van Yuksek Ihtisas Hospital | Kaya Y.,Van Yuksek Ihtisas Hospital | Demir H.,Yuzuncu Yil University | Cebi A.,Giresun University | And 4 more authors.
Hemodialysis International | Year: 2011

Oxidative stress is accepted as a nonclassical cardiovascular risk factor in chronic renal failure patients. The aim of this study was to evaluate the relation between oxidative DNA damage (8-hydroxy-2'-deoxyguanosine/deoxyguanosine [8-OHdG/dG] ratio), oxidative stress biomarkers, antioxidant enzymes, and carotid artery intima-media thickness (CIMT) in hemodialysis (HD) patients. Forty chronic HD patients without known atherosclerotic disease and 48 age- and sex-matched healthy individuals were included in the study. Plasma malondialdehyde (MDA) levels and 8-OHdG/dG ratio were determined as oxidative stress markers. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were measured as antioxidants. CIMT was assessed by carotid artery ultrasonography. 8-OHdG/dG ratios and MDA levels were higher; SOD and GPx activities were lower in HD patients compared to controls. HD patients had significantly higher CIMT compared to controls (0.61±0.08 vs. 0.42±0.05, p<0.001). There was a significant positive correlation between CIMT and 8-OHdG/dG ratio (r=0.57, p<0.01) and MDA levels (r=0.41, p<0.01), while there was a significant negative correlation between CIMT and SOD (r=-0.47, p<0.01) and GPx levels (r=-0.62, p<0.01). It is firstly demonstrated that CIMT is positively correlated with oxidative DNA damage in HD patients without known atherosclerotic disease. © 2011 The Authors; Hemodialysis International © 2011 International Society for Hemodialysis.


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

Objectives: Accelerated atherosclerosis is the major cause of mortality in patients on chronic maintenance hemodialysis (HD). Epicardial fat tissue (EFT) is a new risk factor in cardiovascular disease (CVD). The aim of this study was to evaluate the relation between plasma coenzyme Q10 levels (Co-Q10) which is a potent physiologic antioxidant and EFT thickness in HD patients. Design and methods: Seventy one chronic HD patients and 65 age and sex matched healthy individuals were included in the study. Plasma Co-Q10 levels were performed by high-performance liquid chromatography (HPLC) measurements. EFT was measured by transthoracic echocardiograpy (TTE) performed with a VIVID 7 instrument. Results: Plasma Co-Q10 levels (1.36±0.43 vs 2.53±0.55, p<0.001) were significantly lower in HD patients compared to controls. EFT was significantly increased in HD patients compared to healthy controls (6.53±1.01 vs. 5.79±1.06mm respectively, p<0.001). Correlation analysis showed that plasma Co-Q10 levels were inversely correlated with EFT (r=-0.263, p<0.05). Multiple linear regression analysis was used to define independent determinants of EFT in HD patients. According to linear regression analysis, age, BMI, total cholesterol and Co-Q10 levels were found to be independent predictors of EFT (adjusted r2=0.38, p<0.001). Conclusion: This study demonstrated that EFT thickness was significantly higher among HD patients compared to healthy controls. In addition; this study was the first to demonstrate an inverse correlation between EFT thickness and Co-Q10 levels in this patient population. © 2014 The Canadian Society of Clinical Chemists.


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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