Coşkun, Reşit; Bezgin, Tahir; Karaaslan, Muhammet Buğra; Çağdaş, Metin; Karakoyun, Süleyman; Celik, Aziz Inan

Introduction: Rheumatic mitral valve disease (RMVD) is associated with autoimmune heart valve injury. Para- thyroid hormone (PTH) and vitamin D are two essential molecules that have effects on the immune system. In this study, we aimed to evaluate the relationship between PTH and vitamin D in patients with RMVD. Patients and Methods: We investigated 81 patients with RMVD and 75 healthy subjects. According to Wilkins score, baseline clinical, laboratory, and echocardiographic parameters were recorded, and all RMVD patients were analyzed. Multivariate logistic regression analysis was performed between the groups. Results: Vitamin D levels were significantly low in the RMVD group. Patients were stratified according to Wilkins score [Wilkins score <7 (n= 50) vs. Wilkins score ≥7 (n= 31)]. Age, BMI, and PTH were significantly higher, and mitral valve area was significantly lower in Wilkins score ≥7 patients. In multivariate analysis, age (OR= 1.052; 95% CI 1.005-1.100, p= 0.028) and PTH (OR= 1.017; 95% CI 1.000-1.033, p= 0.047) were found to be independent predictors of high Wilkins score. Conclusion: This study showed that vitamin D levels were low in patients with RMVD. According to the Wilkins score, PTH levels were significantly high in patients with a high Wilkins score. Changes in PTH and vitamin D levels may trigger inflammation and be responsible for valve damage.

Buyuklu, Mutlu; Yaşar, Hasan

Introduction: Essential tremor is a neurological disorder that causes involuntary shaking. The aim of this study was to examine cardiac autonomic functions in patients diagnosed with essential tremor, as previous studies have differed in their findings regarding whether cardiac autonomic functions are affected in essential tremor patients. Patients and Methods: The study included 32 patients diagnosed with essential tremor and 26 individuals without any diseases as the control group. Consensus criteria were used for the diagnosis of essential tremor. A clinical rating scale was utilized to measure the characteristics and degree of essential tremor. Based on this scale, patients were classified as having a mild, moderate, marked, or severe disability. An exercise treadmill test was performed in both the tremor and control groups. Chronotropic index values were used to evaluate the sympathetic system, and resting heart rate index values were calculated to evaluate the parasympathetic system. Heart rate recovery values were calculated at one, two, three, four, and five minutes after the exercise treadmill test. Results: The descriptive characteristics of the tremor and control groups were similar. The Chronotropic index values were statistically different between the tremor and control groups, as they were significantly decreased in the tremor group. This was evaluated as sympathetic incompetence. The resting heart rate index values did not differ significantly between the tremor and control groups at minutes one or two, but they were significantly higher in the tremor group at minutes three, four, and five. The parasympathetic activity was found to be insufficient in the later period. Conclusion: The findings suggest that cardiac autonomic functions may be affected in patients with essential tremor.

Coşgun, Muharrem Said; Suleyman, Halis; Celik, Aziz Inan; Çoşkun, Reşit; Dündar, Cihad

Introduction: Phoenix Dactylifera L (PDL) is a fruit containing a rich source of nutrients and bioactive mol- ecules. Doxorubicin is a widely used agent, especially in the treatment of solid cancers. However, cardiotoxicity is one of its most challenging side effects. The present study aimed to investigate the preventive effect of PDL extract against doxorubicin-induced cardiotoxicity. Patients and Methods: A total of 24 albino Wistar rats were divided into four equal groups. Phoenix Dactylifera L (PDLG) and Phoenix Dactylifera L + doxorubicin (PDXG) groups were strictly fed PDL for two weeks. The control group (CG) and the doxorubicin group (DOXG) were fed a standard diet. During this time, 5 mg/kg of doxorubicin was injected intraperitoneally to DOXG and PDXG once a day. Results: Administration of doxorubicin to the DOXG significantly increased tissue oxidative stress parameters and caused the cardiac biomarker troponin-I (TP-I) to be released into the circulation; on the contrary, the levels of potent antioxidants such as total glutathione, superoxide dismutase, and catalase significantly decreased in DOXG compared to the other three groups. However, feeding purely with PDL decreased oxidative stress pa- rameters and TP-I levels in PDXG animals, despite exposure to doxorubicin. Additionally, an excessive decrease of tissue antioxidants was prevented when compared to the DOXG. Histopathological damage signs, such as ne- crosis and hemorrhage, were severe in the DOXG. However, in the PDXG animals, feeding with PDL provided the integrity of the heart tissue structure. Conclusion: PDL was able to improve the cardiotoxic consequences of doxorubicin biochemically and histo- pathologically, possibly due to its antioxidant properties.

Topal, Ergün; Ceyhun, Gökhan; Buyuklu, Mutlu; Değirmenci, Hüsnü; Bakirci, Eftal Murat

At present, the number of imaging and interventional procedures using contrast agents is gradually increasing. Oxidative stress plays a significant role in its pathophysiology. Despite the use of various prophylactic therapies and low-osmolar contrast agents with lesser adverse effects, intravenous isotonic fluid infusion is the only method that has been proven to be effective in preventing contrast-induced nephropathy in clinic practice. Therefore, a novel kidney-protecting treatment model is required for contrast-induced nephropathy.

Ceyhun, Gökhan; Buyuklu, Mutlu; Değirmenci, Hüsnü; Bakirci, Eftal Murat; Hamur, Hikmet

Takayasu arteritis is a chronic, idiopathic, inflammatory, systemic disease that primarily affects large vessels such as the aorta and its main branches. A 37-year-old woman who had 98% left coronary ostial stenosis and right coronary ostial stenosis due to Takayasu arteritis was recommended transaortic patch enlargement of the stenosed left coronary ostium and right coronary ostium. We believe that this technique is more suitable and recommendable than conventional coronary bypass for coronary ostial stenosis in cases with Takayasu arteritis.

Topal, Ergün; Ceyhun, Gökhan; Buyuklu, Mutlu; Değirmenci, Hüsnü; Bakirci, Eftal Murat

A 50-year-old woman presented with fever and weakness. A large mobile mural mass was observed in the lateral side of the left ventricle using transthoracic and transesophageal echocardiography. We speculated this to be a case of culture negative infective endocarditis with left ventricular mural vegetation; to the best of our knowledge, this is the fi rst reported case in the literature.

Onk, Oruç Alper; Erol, Huseyin Serkan; Onk, Didem; Özçelik, Fatih; Yiğiner, Ömer; Aksüt, Mehmet; Kahraman, Ümit; Sertoglu, Erdim; Tuncer, Osman Nuri; Erkut, Bilgehan

The use of topical haemostatic agents has been popularised in recent years in many areas of surgery. We aimed to determine whether Ankaferd blood stopper&reg; (ABS) can shorten the bleeding time and decrease the amount of bleeding in a rat abdominal aortic bleeding modelPatients and Methods: A total of 40 rats were randomly divided into four groups (n= 10 in each group). Saline- and ABS-soaked gauzes were applied to rats that had not received any pre-treatment in Groups 1 and 2, while saline- and ABS-soaked gauzes were applied to rats that had received acetylsalicylic acid plus oral clopidrogel for 5 days in Groups 3 and 4. An incision of about 1 mm was made over the aorta just proximal to the iliac bifurcation. Mean bleeding time (MBT) and mean bleeding amount (MBA) were determined and compared. Results: There were no signifi cant differences in the age, weight and blood sample laboratory results of rats. Shorter MBT and less MBA were determined in ABS-soaked groups and the differences were statistically signifi cant. Conclusion: Ankaferd blood stopper&reg; has the potential to reduce the bleeding time and post-operative blood loss after a major aortic surgery.

Duman, Handan; İnci, Sinan; Kalkan, Kamuran; Hamur, Hikmet; Yildirim, Erkan; Durakoglugil, Murtaza Emre; Kucuksu, Zafer

Introduction: Coronary artery ectasia (CAE) is characterised by an abnormal dilatation of the coronary arteries. Platelet volume indices, including the mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT) and platelet count, are indicators of platelet activation. In this study, we investigated platelet volume indices in patients with CAE. Patients and Methods: The study group included 51 patients (38 men; mean age: 52 &plusmn; 9.9 years) with isolated CAE and 50 individuals with normal coronary arteries (39 men; mean age: 54 &plusmn; 11.3 years). Admission platelet volume indices were measured as part of the automated complete blood count. Results: Platelet count, MPV, PCT and PDW were higher in CAE than in the control group (p&lt; 0.05). Multivariate analysis revealed PDW (odds ratio: 0.22, 95% confidence interval: 0.06-0.73, p= 0.013) and PCT (odds ratio: 3.41, 95% confidence interval: 1.66-6.98, p&lt;= 0.001) as independent predictors of CAE. Conclusion: This study demonstrates that PCT and PDW are independent predictors of CAE.

Bayer Erdoğan, Sevinç; Farsak, Mustafa Bora; Sönmez, Serkan; Erentuğ, Vedat; Kayalar, Nihan; Mert, Bülent; Özkaynak, Berk; Kuplay, Hüseyin

Introduction: Venous leg ulcer is a major health problem in terms of high prevalence and high cost for treatment. Multi-layer compression bandage systems for venous leg ulcers are supposed to be the gold standard for the treatment of venous ulcers. The aim of the current study is to investigate the effectiveness of multi-layer compression bandage systems for the treatment of venous leg ulcers.Patients and Methods: Nineteen consecutive patients diagnosed to have leg ulcers were evaluated and four patients were excluded from the study due to the peripheral arterial disease. Fifteen patients, enrolled in the study, were classified according to CEAP classification and belonged to the same class. Betaven® multi-layer compression bandage was applied to patients. Patients were followed-up in terms of wound healing and reduction in wound diameter.Results: Twelve male and three female patients underwent multi-layer bandage system. Mean age of patients was 38.2 ± 4.2 years. Ulcer size was measured planimetrically and baseline ulcer size was 4-10 cm². The location of ulcer was on medial malloelus in seven patients, lateral malleolus in three patients, anterior surface of the leg in four patients and lateral side of the leg in one patient. Patients had chronic venous insuuficiency for a mean of 5.1 ± 2.1 years. CEAP classifications were C6, Ep, As2,3-p18, Pr2,3, 18. Each bandage was changed five days after application along with wound care. Mean duration of treatment was 6 ± 2 weeks. Complete healing of the venous ulcers occurred in all patients except for one. This patient was referred to plastic surgery clinic for reconstruction.Conclusion: Multi-layer compression bandage system is an effective method of treatment for venous leg ulcers associated with chronic venous insufficiency by reducing venous return and increasing intertitial tissue pressure. This effect occurred in the shortrun as well as with a low cost and prevented loss of labor