Traditional and nontraditional lipid parameters in Helicobacter pylori infection.

Aims: This study sought to evaluate the relationship between Helicobacter pylori infection and traditional and nontraditional lipid parameters, including atherogenic index of plasma, cardiogenic risk ratio, atherogenic coefficient and remnant cholesterol. Methods: After the application of exclusion criteria, 309 patients were allocated according to the absence (n = 52) or presence (n = 257) of H. pylori infection. Results: Total cholesterol, low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels were nonsignificantly higher, and HDL-C levels were nonsignificantly lower, in the H. pylori-infected patient group. Triglyceride-to-HDL-C ratio, LDL-C-to-HDL-C ratio, atherogenic index of plasma, cardiogenic risk ratio, atherogenic coefficient and remnant cholesterol were comparable among groups. Conclusion: There was no significant association between H. pylori infection and traditional and nontraditional novel lipid parameters and indices.

The relationship between perception of COVID-19, fear of COVID-19 and self-care management in individuals with chronic diseases during the pandemic process in Turkey.

AIMS: To determine the relationship between perception of COVID-19, fear of COVID-19 and self-care management in individuals with chronic diseases during the pandemic process. BACKGROUND: Individuals with chronic diseases are a sensitive group during the COVID-19 pandemic process; it is thought that self-care management may be adversely affected as a result of their more intense exposure to the psychological, physiological and economic effects of the pandemic. In the literature, there is no study examining the effect of perception of COVID-19 and fear of COVID-19 on self-care management in individuals with chronic diseases. DESIGN: Descriptive study. METHODS: The study was conducted with 322 individuals who applied to the internal medicine outpatient clinics of a university's Health Practice and Research Center, met the inclusion criteria, agreed to participate in the study and had a chronic disease. Questionnaire form, Perception of COVID-19 Scale (P-COVID-19), The Fear of COVID-19 Scale (FCV-19S) and Self-Care Management Process in Chronic Illness Scale (SCMP-G) were used to collect data. STROBE checklist was used to report the present study. RESULTS: In the study, it can be stated that individuals with chronic diseases had a moderate to the high perception of contagiousness and dangerousness of COVID-19, they had a moderate-high level of fear of COVID-19 and their self-care care management was above moderate level. There was a significant positive correlation between P-COVID-19, FCV-19S and SCMP-G in the study. CONCLUSIONS: It was found that the perception of COVID-19 contagiousness and the fear of COVID-19 had a positive effect on the self-care management of individuals with chronic diseases. RELEVANCE TO CLINICAL PRACTICE: Determining the level of COVID-19 perception and fear of COVID-19 and their effects on the life of the individual, and evaluating self-care management during the difficult pandemic process will increase the success in the holistic nursing care and management of chronic diseases.

The increase of neuropathic symptoms in diabetic patients is related with osteopenia.

PURPOSE: To investigate the relationship between the intensity of neuropathic pain and the severity of osteopenia in type 2 diabetic patients with painful diabetic peripheral neuropathy (painful DPN). METHODS: In 220 patients with type 2 diabetes included in the screening, the presence of neuropathic pain was evaluated using the Douleur Neuropathique 4 Questions (DN4) scoring system. One hundred forty-five patients with painful DPN were identified and included in the study. Socio-demographic and laboratory evaluations were made and bone mineral density (BMD) of these patients was evaluated by the dual-energy x-ray absorptiometry (DEXA) method. RESULTS: There was a significant correlation between the neuropathic pain score and the total T scores of the lumbar spine and femur in patients with painful DPN. According to the regression analysis (standard coefficients), the DN4 score (0.498); the level of vitamin D (- 0.246) and the female sex (0.236) for the lumbar spine region; age (0.387); DN4 score (0.261); and vitamin D level (- 0.155) for the femur region were independently influencing factors on the development of osteoporosis. When osteoporosis (T score ≤ - 2.5) of the lumbar spine was analyzed by binary logistic regression, the risk of osteoporosis in women was 4.4 times higher, and the risk increased with increasing DN4 score. CONCLUSION: The increase of neuropathic symptoms in patients with DPN is an effective and important factor in the development of diabetic osteopenia.

The effect of hyperglycemic peak induced by oral glucose tolerance test on the oxidant and antioxidant levels

Background/aim: The possibility of adverse effects of the oral glucose tolerance test (OGTT) carried out for the screening of gestational diabetes among pregnant women and fetuses is a frequently discussed topic. The purpose of this study was to investigate the effects of the hyperglycemia peak during OGTT on the levels of oxidants and antioxidants in the body. Materials and methods: Eighty individuals who applied to the Outpatient Clinic with suspected diabetes and OGTT indication were included in the study. Glucose, total oxidant capacity status (TOS), total antioxidant capacity (TAS), superoxide dismutase (SOD), and lipid hydroperoxide (LOOH) levels were tested on blood samples collected from these individuals at 0, 60, and 120 min during the OGTT carried out with 75 g of glucose. Oxidative stress index (OSI) was calculated as the ratio of TOS to TAS. Results: While the oxidative parameters TOS and LOOH were significantly increased at 60. min of OGTT, only LOOH was significantly increased at 120. min of OGTT. Significant decreases in antioxidative parameters (TAS, SOD) were observed at 60. and 120. min of the OGTT and OSI was significantly increased at 60. and 120. min of the OGTT. Conclusion: Oxidative stress parameters were increased and antioxidative parameters were decreased during the OGTT. However, more extended studies are required to determine the effects of the increased oxidative stress on pregnant women and fetuses.

The relationship between benign paroxysmal positional vertigo and thyroid autoimmunity.

CONCLUSION: Although there have been few studies concerning BPPV and thyroid autoimmunity and a positive relation was found between them, this study didn't find any relation between BPPV and thyroid autoimmunity. IT is thought that further large-scale studies must be done to clarify the relation. OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) consists of ∼ 20% of vestibular disorders. Self-limited rotatory nystagmus with positional vertigo are the main findings of BPPV. Although canalolithiasis theory was confirmed by demonstrating freely floating debris in the endolymph of the posterior semicircular channel in following studies, currently, the etiology hasn't been explained totally. This study investigated the relation of BPPV and thyroid autoimmunity evaluated via measurement of serum thyroid autoantibodies. METHOD: Fifty patients (37 female, 13 male) with BPPV (BPPV group), 52 patients (40 female, 12 male) with non-BPPV vertigo (non-BPPV group) and 60 otherwise normal control (38 female, 22 male) samples were enrolled in the study. All samples of BPPV, non-BPPV groups and controls had undergone a cochleovestibular test following thorough ENT examination. After blood samples were drawn from each subject, thyroid-stimulating hormone (TSH), anti-thyroid peroxidase antibody (TPO-Ab) and anti-thyroglobulin antibody (TG-Ab) levels were measured accordingly. RESULTS: In the study, eight patients of the BPPV group (16%) had a high thyroid antibody level. In the non-BPPV group, six patients (11.5%) had elevated thyroid antibodies. In the control group, 15 patients (25%) had elevated thyroid antibodies. TSH values of all subjects were detected to be within normal range. No statistical difference was found between the groups with respect to TG-Ab and TPO-Ab values (p-values = 0.729 and 0.812, respectively).

The prevalence of anemia, iron, vitamin B12, and folic acid deficiencies in community dwelling elderly in Ankara, Turkey.

OBJECTIVE: Anemia is a common problem among older people. Deficiency of essential erythropoiesis elements (iron, vitamin B12, and folic acid) is one of the major causes of anemia in older people. Studies evaluated prevalence of anemia in our country generally consisted of older people admitted to hospital. Studies conducted on community dwelling older people were much more less. The aim of this study is to evaluate prevalence of anemia and nutritional deficiencies in community dwelling elderly in our country. Totally 827 elderly individuals living in community participated in this study. MATERIALS AND METHODS: Anemia was defined according to the World Health Organization (Hb<13 g/dl for men and Hb<12 g/dl for women). Iron, vitamin B12, and folic acid deficiencies were evaluated. Iron deficiency anemia was diagnosed when anemia with iron level<60 µg/dl and ferritin level<12 ng/ml. Vitamin B12 deficiency anemia was diagnosed when anemia with vitamin B12 level<200 pg/ml. Folic acid deficiency anemia was diagnosed when anemia with folic acid level<2.6 ng/ml. RESULTS: Prevalence of anemia was found 7.3%. Prevalence of iron deficiency, vitamin B12, and folic acid deficiency were found 7.1%, 64.2% and 10.9%, and 10.9%, respectively. Prevalence of iron deficiency anemia was found 2.8%. Prevalence of vitamin B12 deficiency anemia was found 4.4% and folic acid deficiency anemia was found 1%. CONCLUSIONS: Prevalence of anemia was seen 7.3% in our study, but more studies are needed on anemia in community dwelling elderly in our country. Deficiency of iron, vitamin B12, and folic acid is also high in Turkey.

The quality of life after cardiac surgery in octogenarians and evaluation of its early and mid-term results.

OBJECTIVE: The aim of this study is to evaluate our early and mid- term results and the qualities of life of the patients aged eighty years or older who underwent heart surgery. METHODS: Eighty- eight patients aged 80 years and older who underwent open-heart surgery at Göztepe Safak Hospital between May 2004 and December 2010 have been included to the study. This study was designed as two-stage: in the first stage, determinants of survival were analyzed retrospectively. In the second stage, the quality of life of survived patients was evaluated by using Short- Form 36 (SF-36), Turkish version in the cross-sectional study. The statistical analysis was performed using Fischer's exact, Pearson Chi-square test, Student t-test, Mann-Whitney U test and logistic regression analysis. RESULTS: In the logistic regression analysis; the left ventricular ejection fraction as <50% (OR: 11.02, 95% CI: 2.6-46.6, p<0.05), application of redo surgery (OR: 8.3, 95% CI: 1.04-66.6, p<0.05), coronary bypass and mitral surgery procedures in the same session (OR: 9.2, 95% CI: 1.6-53.7, p<0.05), left main coronary lesion as >50% (OR: 4.3, 95% CI: 1.1-17.7, p<0.05), preoperative creatinine as >1.8 mg/dl (OR: 14.1, 95% CI: 2.6-76.1, p<0.01), New York Heart Association class III-IV (OR: 4.9, 95% CI: 1.2-20.1, p<0.05), chronic obstructive pulmonary disease (OR: 10.3, 95% CI: 2.5-41.7, p<0.01) were found to be risk factors of hospital mortality. Physical functions, social functions and all sub-scales other than the role limitation depending on the emotional situation were evaluated as general population mean or above. CONCLUSION: We think that with a successful heart surgery in patients aged 80 years and older under appropriate conditions, their life qualities and mean life expectations can return to normal and they can lead a symptomless life.

Does the surgical technique used in the orthotopic heart transplant affect the results regarding the rhythm?

OBJECTIVE: The aim of this study was to compare the requirement for temporary and permanent pacemaker insertion and the incidence of the problems regarding the rhythm following heart transplantation with the bicaval or biatrial technique in the early postoperative period. METHODS: Sixty-one patients underwent orthotopic heart transplantation between the dates of September 1989 and December 2008 in our clinics were included to the study. The study was designed as retrospective analysis, and all data were collected from hospital records. The transplantation was performed by using standard biatrial method in 28 of the patients, by using bicaval anastomosis method in 33 of the patients. Statistical analyses were performed using Chi-square, Fischer's exact and Mann-Whitney U tests. Predictors of temporary and permanent pacemaker insertion were analyzed using logistic regression analysis. RESULTS: In the biatrial group, the temporary pacemaker requirement (p<0.05), left bundle branch block (LBBB) (p<0.01) and atrioventricular block (AV block) (p<0.05) were observed statistically significantly more than in bicaval anastomosis group. In addition, in the biatrial group, one patient needed implantation of permanent pacemaker and one patient-implantable cardioverter defibrillator. On the postoperative echocardiographic evaluation, in the patients operated with the bicaval technique, the tricuspid (p<0.01) and mitral insufficiency (p<0.01) were observed significantly less. In the logistic regression analysis, hypertension (OR: 1.053, 95% CI: 1.019-1.176, p<0.05), donor age (OR: 1.016, 95% CI: 1.023-1.038, p<0.05) and application of the operation with the biatrial technique (OR: 10.287, 95% CI: 1.298-91.278, p<0.01) were determined as the risk factors requiring the temporary pacemaker usage. In the bicaval group, arrhythmia (ventricular and atrial premature beats) and atrioventricular valve insufficiency were observed less, the rhythm returned to normal in an earlier period. CONCLUSION: Biatrial surgical technique, donor age and hypertension were determined as significant predictors of temporary pacemaker insertion in the orthotopic heart transplantation. Atrioventricular block, left bundle branch block, and arrhythmia frequency was significantly less in the bicaval group. In terms of factors affecting morbidity, the bicaval technical results were found superior than biatrial technique.

Results of adjunctive coronary endarterectomy in 548 patients.

Coronary endarterectomy is a controversial procedure that plays a particular role in the treatment of coronary artery disease. We retrospectively investigated the results for 548 patients who underwent coronary endarterectomy as an adjunctive therapy for coronary artery bypass graft surgery during the period between 1996 and 2004. We assessed short-term outcomes and identified risk factors for adverse outcomes. Mean patient age was 67.9 + 9.3 years and mean angina class was 2.7 + 0.3. The mean number of distal anastomoses was 3.8 + 1.1 patients (73.4%) had single and 151 (27.6%) multiple coronary artery endarterectomies. Of the 151 patients who underwent multiple endarterectomies, 97 (17.7%) had endarterectomies in 2 coronary arteries, 40 (7.2%) in 3 coronary arteries, 11 (2%) in 4 coronary arteries, 2 (0.36%) in 5 coronary arteries, and 1 (0.18%) in 6 coronary arteries. Postoperative mortality was 6.2% (34 patients). The predictors for early mortality were recent myocardial infarction and left ventricular dysfunction. Our results suggest that adjunctive coronary endarterectomy can be accomplished with acceptable results but with higher mortality rates than ordinary coronary artery bypass grafting. Adjunctive coronary endarterectomy should be considered as a last option for the surgical treatment of diffuse coronary disease.

Long-term results of the left anterior descending coronary artery reconstruction with left internal thoracic artery.

BACKGROUND: Recent refinements in percutaneous techniques have resulted in an increase in the numbers of patients with diffuse coronary artery disease who are referred to cardiac surgeons. Long-segmental reconstruction of the diffusely diseased left anterior descending (LAD) coronary artery with the left internal thoracic artery (LITA) has been shown to be beneficial for patients with diffuse coronary artery disease. In this retrospective study, we analyzed the long-term outcomes obtained with this technique. METHODS: Between April 1997 and February 2006, 3736 coronary artery bypass grafting (CABG) operations were performed by our team. Of these cases, 524 patients (14%) with the diffusely diseased LAD underwent a long-segmental reconstruction procedure with a LITA graft. RESULTS: The cohort consisted of 372 men (71%) and 152 women (29%), and the mean age was 56.5 +/- 8.2 years. The mean length of the arteriotomy incision was 4.5 +/- 1.2 cm (range, 2 to 10 cm). Postoperative mortality was 1.9%, and the myocardial infarction rate was 6.9%. At 3, 5, and 7 years, overall survival was 93.8% +/- 0.5%, 89.6% +/- 1.5%, and 85.5% +/- 2.6%, and actuarial freedom from angina recurrence was 94.5% +/- 1%, 88.5% +/- 2%, and 82.9% +/- 3%, respectively. Among survivors, interim angiographic evaluation was performed in 128 patients at a mean follow-up of 52.4 +/- 13.5 months, and the patency rate of the LITA-LAD anastomosis was 91.4%. CONCLUSIONS: Patients with diffuse LAD disease present a major challenge for cardiovascular surgeons. The long-term results of long-segmental LAD reconstruction are very encouraging, and this approach may be used safely in this subgroup of patients.

Pericardial patch augmentation of both anterior and septal leaflets in Ebstein's anomaly.

In Ebstein's anomaly, the aim of surgical intervention is the restoration of tricuspid valve competence. In some circumstances, however, paucity of the leaflet tissue precludes successful repair and negatively influences the long-term durability of the valvuloplasty procedure. We report a modified technique that provides satisfactory results for right atrioventricular valve function.

An alternative technique of proximal anastomosis in patients with an atherosclerotic ascending aorta.

Coronary artery bypass grafting operations in patients with an atherosclerotic ascending aorta are still associated with an increased risk of cerebral embolism and mortality despite previously described techniques. Here we present an alternative technique for the construction of a proximal anastomosis avoiding aortic clamping and deep hypothermic circulatory arrest.

Simultaneous coronary artery bypass grafting and ascending aorta to bifemoral bypass for ischemic heart disease combined with critical leg ischemia: case reports.

Coronary artery disease may coexist with aortoiliac occlusive disease, and concomitant revascularization procedures may be required. The ascending aorta may be used as the source of inflow to both the femoral and coronary arteries in patients who present with coronary artery disease and critical leg ischemia. We present here 2 patients in whom coronary artery bypass grafting and ascending aorta-to-bifemoral bypass operations were performed simultaneously.

CABG without using heparin in a patient with heparin-induced thrombocytopenia.

BACKGROUND: Despite the low incidence of heparin-induced thrombocytopenia and thrombosis, these two syndromes are much disputed in life-threatening conditions especially in cardiovascular surgery where heparin is routinely used. Nowadays a pharmacological agent that can exactly replace heparin does not exist. Many of the drugs called "alternative drugs to heparin" are associated with a high risk of hemorrhagic complications and an increased need of blood transfusions. Neither the use of heparin nor "alternative drugs to heparin" may be the best way to revascularize a patient with heparin-induced thrombocytopenia. METHODS: Coronary artery bypass grafting without using heparin was performed in a 62-year-old male patient with heparin-induced thrombocytopenia. He received clopidogrel and acethyl salicylic acid for 2 days before operation. He was operated off-pump using special maneuvers. RESULTS: He was discharged on postoperative day 5 after an uneventful course and is doing well in the sixth month postoperatively. CONCLUSIONS: According to our investigations in English literature, this surgical technique and coronary artery bypass grafting without using heparin is firstly described in this article. Increasing the number of cases will show the reliability and safety of this method.

Use of Alfieri stitch technique in a patient with hypertrophic obstructive cardiomyopathy.

Systolic anterior motion of the anterior mitral leaflet plays an important role in the dynamic outflow tract obstruction encountered in patients with hypertrophic obstructive cardiomyopathy. Here we present a 58-year-old male patient who was successfully treated with a myectomy procedure applied along with the edge-to-edge Alfieri stitch technique. The use of the Alfieri technique provides satisfactory short-term results and can be considered as an alternative adjunct to abolish systolic anterior motion.

Isolation ratio and T- serotyping of group A streptococci from pediatric upper respiratory tract infections in Turkey.

OBJECTIVE: Acute rheumatic fever can follow throat infections with group A streptococci. Certain serotypes of group A streptococci such as M1, M3, M5, M6, M14, M18, M19, M24 are associated with this disorder. Immunity to streptococci and to rheumatic fever depends on antibodies to the M proteins. Due to current scarcity of M-typing sera, many laboratories use T typing and opacity factor production for serotype identification of group A streptococci. In order to, investigate the most common serotypes of group A streptococci in our country in recent years we studied T-agglutination typing and opacity factor of 120 group A streptococci strains isolated from throat cultures of 930 children. METHODS: Diffuse, stable suspensions of group A streptococci were tested with polyvalent antisera (T,U,W,X,Y) by slide agglutination. Microplate method was used for opacity factor detection. RESULTS: T-protein -agglutination patterns U (2,4,6,28) were the most common among typeable strains. The rate of T-protein -agglutination patterns T (1,3,13, B3264) and X (8,14,25,Imp.19) were 20 % and 18 % respectively. Opacity factor production rate of isolated group A streptococci strains was 65%. CONCLUSION: To profit global assessment of rheumatic fever and rheumatic heart disease, more epidemiological and serotyping research is required in our country.