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Citation - WoS: 3
Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(ELSEVIER, 2023) Güzel, Tuncay; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed
Background In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥75 years) than in younger (<75 years) patients. Methods This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically signifcant hematoma (CSH), pericardial efusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results The overall sample included 1923 patients (1419<75 years and 504 aged≥75 years). There was no diference between the groups in terms of cumulative events defned as primary outcome (3.5% vs. 4.4%, p=0.393). Infection related to device system was signifcantly higher in the≥75 age group (1.8% vs. 3.4%, p=0.034). There was no signifcant diference between the groups in terms of clinically signifcant hematoma and pneumothorax (0.7% vs. 0.4%, p=0.451, 1.4% vs. 1.0%, p=0.477, respectively). In multivariate model analysis, no association was found between age≥75 years and infection related to the device system. Conclusion Infection rates were relatively higher in the patient group aged≥75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
Citation - WoS: 3
Citation - Scopus: 3
Aging and cardiac implantable electronic device complications: is the procedure safe in older patients?
(Springer, 2023) Güzel, Tuncay; Aktan, Adem; Kılıç, Raif; Günlü, Serhat; Arslan, Bayram; Arpa, Abdulkadir; Güzel, Hamdullah; Tatlı, İsmail; Aydın, Saadet; Suzan, Veysel; Demir, Muhammed
Background: In this study, we investigated whether there is a higher incidence of cardiac implantable electronic devices (CIED) procedures related complications in older (≥ 75 years) than in younger (< 75 years) patients. Methods: This retrospective cohort study enrolled patients who had undergone CIED procedures (de novo implantation, system upgrade, generator substitution, pocket revision or lead replacement) at two heart centers in Turkey between January 2011 and May 2023. The primary composite endpoint included clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to the device system. Secondary outcomes included each component of the composite end point. Results: The overall sample included 1923 patients (1419 < 75 years and 504 aged ≥ 75 years). There was no difference between the groups in terms of cumulative events defined as primary outcome (3.5% vs. 4.4%, p = 0.393). Infection related to device system was significantly higher in the ≥ 75 age group (1.8% vs. 3.4%, p = 0.034). There was no significant difference between the groups in terms of clinically significant hematoma and pneumothorax (0.7% vs. 0.4%, p = 0.451, 1.4% vs. 1.0%, p = 0.477, respectively). In multivariate model analysis, no association was found between age ≥ 75 years and infection related to the device system. Conclusion: Infection rates were relatively higher in the patient group aged ≥ 75 years. This patient group should be evaluated more carefully in terms of infection development before and after the procedure.
Citation - WoS: 1
Citation - Scopus: 1
The distribution and the antimicrobial susceptibility features of microorganisms isolated from the burn wounds; a ten-year retrospective analysis
(Oxford University Press, 2023) Özkaçmaz, Ayşe; Dicle, Yalçın; Bayram, Yasemin; Parlak, Mehmet; Akış, Feride; Çallı, İskan
In this study we aimed to evaluate the distribution features and antimicrobial susceptibility test results of the microorganisms isolated from the wounds of pediatric and adult burn patients. The culture and susceptibility test results of the microorganisms isolated from the wound swabs of the patients hospitalised in a tertiary burn care center in 10-years period, were retrospectively screened on the microbiology department databases. Their distribution of isolated microorganisms regarding species and susceptibility test results were compared with previous studies. A total of 367 microorganisms isolated from the burn wounds of 293 patients (13± 18.9 years, F/M: 0.93) (73 adult and 220 pediatric patients), were included in this study. A solitary agent was isolated in 239 (81.6%) patients, while two were isolated in 43 (14.7%) and three or more agents in 11 (3.8%). From these, 33% of the isolated microorganisms were gram positive cocci, 61% were gram negative bacteria and 6% were Candida spp. The most common isolated microorganisms were Staphylococcus aureus (18.5%), Pseudomonas spp. (16.9) and Escherichia coli (%11.2), while the least common was Streptococcus spp. (2.5%). Methicillin resistance was 15% among the S. aureus strains. No resistance was observed against levofloxacin, vancomycin, teicoplanin, linezolid, daptomycin, fusidic acid and tigecycline in S. aureus strains. The highest resistance rates were observed against levofloxacin (64%), tobramycin (64%), pip/tazobactam (63%), imipenem (63%), and the lowest against colistin (5%) and ceftazidime (29%), among Pseudomonas spp. The most common causative agents in burn wound infections and their current antimicrobial susceptibility features should be well identified, in order for prevention of serious complications and optimal management the condition to occur.
Citation - WoS: 1
Evaluation of Clinical, Biochemical, and Demographic Characteristics of Paediatric COVID-19 Patients Admitted to Dicle University Hospital
(Cureus, 2023) Orhan, Özhan; Akay, Cihan; Şen, Velat
Introduction and aim: In this study, we aim to determine how laboratory parameters were related to the clinical courses of patients admitted to the Dicle University Faculty of Medicine Department of Paediatrics and Paediatric Intensive Care Unit with COVID-19 diagnoses from March 2020 to November 2021. Materials and method: Clinical, biochemical and demographic characteristics of 220 patients between 0 and 16 years old with COVID-19 diagnoses at admission were analysed retrospectively. Results: We found that 57.3% of patients were male and 42.7% female, with a mean age of 107.8 ± 65.5 (range 1-192) months. Of the cases, 48.6% (n = 107) were asymptomatic, 35.5% (n = 78) were mild, 11.8% (n = 26) were moderately severe and 3.6% (n = 8) were severe. The patients’ site of admission, mortality rates, C reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and fibrinogen levels differed significantly (p < 0.001). Conclusion: It is important to learn about the clinical course of the disease by accurately interpreting the results of blood parameters and appropriate imaging studies.
Citation - WoS: 2
Citation - Scopus: 2
Evaluation of patients diagnosed with congenital hypothyroidism by newborn screening between 2011-2019 in Diyarbakir, Turkey
(LWW, 2023) Toktaş, İzzettin; Erdem, Özgür; Sarıbaş, Seyfettin; Özbek, Mehmet Nuri
This study aimed to determine the incidence of congenital hypothyroidism in Turkey’s Diyarbakir Province and assess the development and growth conditions of people with congenital hypothyroidism. Patients born between 2011-2019 and diagnosed with congenital hypothyroidism within the scope of the newborn screening program were included. The medical records of these patients were retrospectively reviewed. The length and weight for age, weight for length, and body mass index standard deviation scores were calculated. We investigated the treatment status of the patients, whether their relatives had a similar disorder, and the presence of consanguinity between parents. Blood samples were collected from 380,592 newborns. As a result of further tests, 498 newborns were diagnosed with congenital hypothyroidism (incidence: 1/764). Demographic and anthropometric data of 241 patients were analyzed. The patients comprised 46.9% (n = 113) females and 53.1% (n = 128) males. It was determined that 44.4% of the individuals had transient congenital hypothyroidism and 53.6% had permanent congenital hypothyroidism. The parents of 29.8% of the individuals diagnosed with transient congenital hypothyroidism and 44.2% of the individuals diagnosed with permanent congenital hypothyroidism were consanguineous (P = .02). According to the latest anthropometric assessment, 6.8% of individuals diagnosed with congenital hypothyroidism had a weight z-score below −2 SD and 16.9% had a length z-score below −2 SD. The incidence of congenital hypothyroidism was higher in our region. The ratio of consanguinity between parents was higher in patients diagnosed with permanent congenital hypothyroidism than in those diagnosed with transient congenital hypothyroidism. According to the most recent follow-up, weight and age were found to be similar in patients with transient and permanent congenital hypothyroidism.
Citation - WoS: 2
Citation - Scopus: 2
Examining the effect of COVID-19 vaccines on the menstrual cycle: A study from Turkey
(LWW, 2023) Toktaş, İzzettin; Akelma, Hakan; Araç, Eşref
Concerns about a possible relationship between vaccination against Coronavirus Disease 2019 (COVID-19) and menstrual disorders have been raised in the media. In addition, different studies have shown that the COVID-19 vaccine may be associated with menstrual changes. This study was conducted to investigate the effects of COVID-19 vaccines on the menstrual cycle in women. This cross-sectional descriptive study was conducted between August 16 and September 17, 2021. Data were collected through a self-administered questionnaire via an online form sent to the participants through social media. Data of 586 women were included in this study. A total of 82.4% (n = 483) of the participants were aged between 31 and 50 years. The BioNTech vaccine (2 doses) was administered to 75.8% (n = 444), Sinovac (3 doses) to 9.0% (n = 53) of the participants. 53.1% (n = 311) of the women experienced changes in their menstrual cycles. The most common menstrual changes after vaccination were delayed menstruation (n = 176; 30.0%) and prolonged menstrual duration (n = 132; 22.5%). Menstrual delay, prolonged menstrual duration, heavy bleeding, and early menstruation were more common in women than prior to receiving the vaccine (P < .05). More than half of the women experienced menstrual cycle changes after receiving the COVID-19 vaccine. Women experienced significantly higher rates of menstruation delay, prolonged menstrual duration, heavy bleeding, and early bleeding compared to before vaccination.
The Importance of Frontal QRS-T Angle in Predicting the Effectiveness and Success of Thrombolytic Therapy in Patients With Acute Pulmonary Embolism
(Cureus, 2023) Durgun, Mehmet; Karahan, Mehmet Zülkif
Objective: The frontal QRS-T angle (fQRS-T) is associated with myocardial ischemia and ventricular arrhythmias. On the other hand, acute pulmonary embolism (APE) is a major risk factor for cardiac adverse events. This research aimed to determine whether the fQRS-T, a marker of ventricular heterogeneity, can be used to predict successful thrombolytic therapy in patients with APE. Methods: This was a retrospective observational study. Patients diagnosed with APE and hospitalized in the intensive care unit between 2020 and 2022 were included in the research. A total of 136 individuals with APEs were enrolled in this research. The patients were divided into two groups: thrombolytic-treated (n=64) and non-treated (moderate to severe risk, n=72). An ECG was conducted for each patient, and echocardiography was performed. Results: The mean age of the thrombolytic group was 58.2±17.6 years, with 35 females (55.1% of the group) and 29 males (44.9%). The non-thrombolytic group had a mean age of 63.1±16.2, with 41 females (56.5%) and 31 males (43.5%). Respiratory rate, heart rate, and fQRS-T were higher in the thrombolytic group, and oxygen saturation ratio and systolic and diastolic blood pressure were higher in the non-thrombolytic group (p=0.006, p<0.001, p=0.021; p<0.001, p=0.015, p<0.001, respectively). In the thrombolytic therapy group, comparing pre- and post-treatment ECG data revealed a statistically significant change in the fQRS-T value (p=0.019). Conclusion: The fQRS-T may provide important clues for the successful treatment of APEs
Is There a Relationship Between First-Trimester Aneuploidy Screening Serum Biomarker Values and Nuchal Translucency Measurements and the Development of Retinopathy of Prematurity (ROP) in Premature Infants?
(Springer, 2023) Küçük, Mehmet Fatih; Savaş Hasan Basri; Süren, Elçin; Erol, Muhammet; Yaprak, Lütfiye; Sabancı, Şenol
Purpose The purpose of this study is the evaluation of serum biomarker and nuchal translucency (NT) values measured during first-trimester aneuploidy screening in terms of the development of retinopathy of prematurity (ROP) in premature infants and investigation of whether the development of ROP is associated with these parameters. Methods In this retrospective cohort study, 3,750 premature infants who underwent ROP screening from 2016 to 2021 were identified from the hospital medical record system. Among 2,130 premature babies screened for first-trimester aneuploidy, 166 babies whose mothers had single pregnancies were screened by the same method and showed the same clinical course in both eyes were included in the study. The infants were divided into two groups according to the presence of ROP, and those with ROP were further evaluated in two groups according to the presence of proliferation. The groups were compared in terms of the serum values of human chorionic gonadotropin and pregnancy-associated plasma protein A, among aneuploidy screening biomarkers, and NT measurements. Results There was no significant difference in the evaluated serum biomarker values and NT measurements between the ROP and non-ROP groups or between the proliferative ROP, non-proliferative ROP, and non-ROP groups. Conclusion Our results showed that first-trimester aneuploidy screening serum biomarker values and NT measurements were not associated with the development of ROP in premature infants.
Is There a Relationship Between First-Trimester Aneuploidy Screening Serum Biomarker Values and Nuchal Translucency Measurements and the Development of Retinopathy of Prematurity (ROP) in Premature Infants?
(Nature, 2023)
Abstract Purpose The purpose of this study is the evaluation of serum biomarker and nuchal translucency (NT) values measured during first-trimester aneuploidy screening in terms of the development of retinopathy of prematurity (ROP) in premature infants and investigation of whether the development of ROP is associated with these parameters. Methods In this retrospective cohort study, 3,750 premature infants who underwent ROP screening from 2016 to 2021 were identified from the hospital medical record system. Among 2,130 premature babies screened for firsttrimester aneuploidy, 166 babies whose mothers had single pregnancies were screened by the same method and showed the same clinical course in both eyes were included in the study. The infants were divided into two groups according to the presence of ROP, and those with ROP were further evaluated in two groups according to the presence of proliferation. The groups were compared in terms of the serum values of human chorionic gonadotropin and pregnancy-associated plasma protein A, among aneuploidy screening biomarkers, and NT measurements. Results There was no significant difference in the evaluated serum biomarker values and NT measurements between the ROP and non-ROP groups or between the proliferative ROP, non-proliferative ROP, and non-ROP groups. Conclusion Our results showed that first-trimester aneuploidy screening serum biomarker values and NT measurements were not associated with the development of ROP in premature infants.
Citation - WoS: 9
Citation - Scopus: 10
Laparoscopic versus open portoenterostomy for treatment of biliary atresia: a meta-analysis
(SpringerLink, 2023) Bilici, Salim; Mehmet Hanif Okur, Bahattin Aydoğdu, Mustafa Azizoğlu, Salim Bilici, Salih Bayram, Fikret Salik
Abstract Objective Our goal was to compare laparoscopic portoenterostomy versus open portoenterostomy for the treatment of biliary atresia. Materials and methods Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing laparoscopic and open surgery for the treatment of biliary atresia were included. Results Twenty-three studies comparing laparoscopic portoenterostomy (LPE) (n=689) and open portoenterostomy (OPE) (n=818) were considered appropriate for meta-analysis. Age at surgery time was lower in the LPE group than OPE group (I 2=84%), (WMD − 4.70, 95% CI − 9.14 to − 0.26; P=0.04). Signifcantly decreased blood loss (I 2=94%), (WMD − 17.85, 95% CI − 23.67 to − 12.02; P<0.00001) and time to feed were found in the laparoscopic group (I 2=97%), (WMD − 2.88, 95% CI − 4.71 to − 1.04; P=0.002). Signifcantly decreased operative time was found in the open group (I 2=85%), (WMD 32.52, 95% CI 15.65–49.39; P=0.0002). Weight, transfusion rate, overall complication rate, cholangitis, time to drain removal, length of stay, jaundice clearance, and two-year transplant-free survival were not signifcantly diferent across the groups. Conclusions Laparoscopic portoenterostomy provides advantages regarding operative bleeding and the time to begin feeding. No diferences in remain characteristics. Based on the data presented to us by this meta-analysis, LPE is not superior to OPE in terms of overall results.
Citation - WoS: 7
Citation - Scopus: 10
Metabolic Syndrome in School Children in Mardin, South-Eastern of Turkey
(AVES Ibrahim Kara, 2014) Battaloğlu İnanç, Betül
Amaç: Okul çocukları popülasyonunda, metabolik sendrom (MES) prevelansının tespit edilmesi amaçlandı.Gereç ve Yöntem: Türkiye'nin güneydoğusundaki, Mardin şehir merkezinde, üç ilköğretim okulundaki, 7-15 yaşları arası, üç bin dört yüz altmış çocuk, Nisan-Mayıs 2011'de çalışmaya dahil edildi. Yaş, cins, boy, ağırlık, bel çevresi, kalça çevresi, bel/kalça oranı, sistolik ve diyas tolik kan basınçları ölçüldü ve kan testleri kaydedildi. MES tanısı için Uluslararası Diyabet Federasyonu (IDF) kriterleri kullanıldı.Bulgular: Çocukların %9,42'si fazla kilolu ve %8'i obezdi. Obezite kızlarda %9,1, erkekler de %6,9'du. Obezite prevelansı, kızlar arasında erkeklerden daha yüksek ve anlamlıydı (p<0.001). Vücut kitle indeksi (VKI) ve bel ve kalça çevresi, bel/kalça oranı, sistolik ve diyasto lik kan basıncı, trigliserid arasında pozitif korelasyon bulundu (p=0.0001). Total kolesterol, trigliserid, VKI, sistolik ve diyastolik kan basıncı obez MES'lu grupta, obez olmayanlardan anlamlı farklı idi (p<0.05). Kızların bel/kalça oranı referans değerleri, erkeklerinkinden anlamlı olarak daha yüksekti (p>0.05). MES prevelansı %6,3'tü. MES, kızlarda ve obezlerde daha yüksekti. Obez çocuklarda MES oranı %30,3'tü.Sonuç: Çocukluk döneminde obezite, hipertansiyon ve MES sıklığı her geçen gün artmakta dır. Santral obezite ve yüksek vücut kitle indeksine sahip olan çocuklar, MES için daha dikkat li değerlendirilmelidir. Ve toplumun yaşam kalitesi, yaşam tarzı değişiklikleri ile risklerin azaltılması yoluna gidilerek, gerekli tedavi ve takiplerle sağlanmalıdır.
Citation - WoS: 2
Non-Dipper Blood Pressure Impact on Coronary Slow Flow in Hypertensive Patients With Normal Coronary Arteries
(Cureus, 2023) Özen, Kaya; Karahan, Mehmet Zülkif
Objective: Coronary slow flow (CSF) is linked to myocardial ischemia, malignant arrhythmias, and cardiovascular mortality. On the other hand, hypertension (HTN) is an important risk factor for vascular disorders. There is limited research on the relationship between CSF and HTN. This study aimed to investigate TIMI frame count (TFC), which is an indicator of CSF, in dipper and non-dipper hypertensive individuals with normal coronary arteries. Methods: The study was conducted as a retrospective observational study. Patients diagnosed with CSF and dipper or non-dipper hypertension were included in this study. Blood tests were routinely conducted for all patients. ECG was conducted for each patient, and echocardiography was performed. Coronary artery images were obtained in the CAG laboratory. Blood pressure (BP) measurements were obtained from the ambulatory Holter records. The patients were separated into two groups based on ambulatory Holter monitoring. The relationship between CSF and HTN was also examined. Results: A total of 71 patients, comprising 25 women (37.2%) and 46 men (62.8%) with an average age of 52.75±9.42 years, were enrolled in the research. Based on ambulatory BP, the individuals were separated into two groups: non-dipper (n=36) and dipper (n=35). The pulse rate was significantly higher in the non-dipper group (p<0.001). In terms of mean systolic and diastolic blood pressure, there were no substantial differences across the groups (p = 0.326 and p = 0.654, respectively). The daytime mean systolic and diastolic BP did not significantly differ across the groups (p = 0.842 and p = 0.421). The dipper group had substantially lower nighttime systolic and diastolic BP values (p <0.001). The LAD, Cx, and RCA TIMI frame scores were significantly lower in the dipper group (p<0.001). Conclusion: In this study, non-dipper patients had a greater CSF rate than dipper.
Citation - WoS: 1
Citation - Scopus: 1
Prognostic Significance of the Chemerin Level in Coronavirus Disease 2019 Patients
(Lippincott Williams & Wilkins, 2024) Arac, Songul; Yokus, Beran; Gokdemir, Guel Sahika; Gokdemir, Mehmet Tahir
Increased serum chemerin levels have been reported in several inflammatory diseases. Few studies have investigated the relationship between chemerin and clinical features of COVID-19. Thus, chemerin may modulate the development and progression of COVID-19. We compared the serum chemerin concentration between patients with and without SARS-CoV-2 infection and its association with the severity and prognosis of COVID-19 pneumonia. This is a prospective, single-center, cross-sectional study. We enrolled COVID-19 patients who presented to our tertiary hospital and healthy controls. The COVID-19 patients were conducted and the dates of symptom onset were recorded. After admission to the hospital and stabilization, blood samples were obtained for routine hemogram, biochemistry, and chemerin. The chemerin level was 37.93 +/- 17.3 ng/mL in patients followed in the ICU, 29.41 +/- 12.79 ng/mL in inpatients, 30.48 +/- 10.86 ng/mL in outpatients, and 25.12 +/- 9.82 ng/mL in healthy controls. The difference between patients treated in the ICU and healthy controls was significant (P < .001). The high-sensitivity C-reactive protein (hs-CRP), ferritin, procalcitonin (PCT), and D-dimer levels were significantly higher in the intensive care unit (ICU) group (P < .001). Moreover, the chemerin level of patients who died was significantly higher than that of those who survived (P < .001). The chemerin level was increased in COVID-19 patients and also increased with increasing disease severity. The chemerin level was higher in the COVID-19 patients than healthy controls and was significantly higher in patients who died compared to those who did not.
Citation - WoS: 3
Citation - Scopus: 3
The prognostic value of ORBIT risk score in predicting major bleeding in patients with acute coronary syndrome
(ScienceDirect, 2023) Günlü, Serhat; Arpa, Abdulkadir; Kayan, Fethullah; Güzel, Tuncay; Kılıç, Raif; Aktan, Adem; Altintaş, Bernas; Karahan, Mehmet Zülkif
Background: The most significant adverse effect of antithrombotic medication in acute coronary syndrome (ACS) is major bleeding, which is related to increased mortality. Studies on ORBIT risk score in predicting major bleeding in ACS patients are limited. Objective: This research aimed to examine whether the ORBIT score calculated at the bedside can identify major bleeding risk in patients with ACS. Methods: This research was retrospective, observational, and conducted at a single center. Analyses of receiver operating characteristics (ROC) were utilized to define the diagnostic value of CRUSADE and ORBIT scores. The predictive performances of the two scores were compared using DeLong's method. Discrimination and reclassification performances were evaluated by the integrated discrimination improvement (IDI), and net reclassification improvement (NRI). Results: The study included 771 patients with ACS. The mean age was 68.7 ± 8.6 years, with 35.3 % females. 31 patients had major bleeding. Twenty-three of these patients were BARC 3 A, five were BARC 3 B, and three were BARC 3 C. Bleeding history [OR (95 % CI), 2.46 (1.02-5.94), p = 0.021], hemoglobin levels [OR (95 % CI), 0.54 (0.45-0.63), p < 0.001], and age > 74 years [OR (95 % CI), 1.03 (1.01-1.06), p = 0.039] were independent predictors of major bleeding. The ORBIT score was an independent predictor of major bleeding in the multivariate analysis: continuous variables [OR (95 % CI), 2.53 (2.61-3.95), p < 0.001] and risk categories [OR (95 % CI), 3.06 (1.69-5.52), p < 0.001]. Comparison of c-indexes for major bleeding events revealed a non-significant difference for the discriminative ability of the two tested scores (p = 0.07) with a continuous NRI of 6.6 % (p = 0.026) and an IDI of 4.2 % (p < 0.001). Conclusion: In ACS patients, the ORBIT score independently predicted major bleeding.
Citation - WoS: 3
The prognostic value of ORBIT risk score in predicting major bleeding in patients with acute coronary syndrome
(ELSEVIER, 2023) Günlü, Serhat; Arpa, Abdulkadir; Kayan, Fethullah; Güzel, Tuncay; Kılıç, Raif; Aktan, Adem; Bernas, Altıntaş; Karahan, Mehmet Zülkif
Background: The most significant adverse effect of antithrombotic medication in acute coronary syndrome (ACS) is major bleeding, which is related to increased mortality. Studies on ORBIT risk score in predicting major bleeding in ACS patients are limited. Objective: This research aimed to examine whether the ORBIT score calculated at the bedside can identify major bleeding risk in patients with ACS. Methods: This research was retrospective, observational, and conducted at a single center. Analyses of receiver operating characteristics (ROC) were utilized to define the diagnostic value of CRUSADE and ORBIT scores. The predictive performances of the two scores were compared using DeLong's method. Discrimination and reclassification performances were evaluated by the integrated discrimination improvement (IDI), and net reclassification improvement (NRI). Results: The study included 771 patients with ACS. The mean age was 68.7 ± 8.6 years, with 35.3 % females. 31 patients had major bleeding. Twenty-three of these patients were BARC 3 A, five were BARC 3 B, and three were BARC 3 C. Bleeding history [OR (95 % CI), 2.46 (1.02–5.94), p = 0.021], hemoglobin levels [OR (95 % CI), 0.54 (0.45–0.63), p < 0.001], and age > 74 years [OR (95 % CI), 1.03 (1.01–1.06), p = 0.039] were independent predictors of major bleeding. The ORBIT score was an independent predictor of major bleeding in the multivariate analysis: continuous variables [OR (95 % CI), 2.53 (2.61–3.95), p < 0.001] and risk categories [OR (95 % CI), 3.06 (1.69–5.52), p < 0.001]. Comparison of c-indexes for major bleeding events revealed a non-significant difference for the discriminative ability of the two tested scores (p = 0.07) with a continuous NRI of 6.6 % (p = 0.026) and an IDI of 4.2 % (p < 0.001). Conclusion: In ACS patients, the ORBIT score independently predicted major bleeding.
Relationship Between Atrial Fibrillation Recurrence and Frontal QRS-T Angle After Effective Cardioversion
(Cureus, 2023) Özen, Kaya; Karahan, Mehmet Zülkif
Objective: Maintaining sinus rhythm is important in the management of atrial fibrillation (AF). After cardioversion, there is a significant probability of AF recurrence. There is limited research on the relationship between AF recurrence and ECG parameters. This study aimed to evaluate whether the frontal plane QRS-T angle (fQRS-T), a predictor of ventricular heterogeneity, could be used to predict AF recurrence following cardioversion. Methods: The study was conducted as a retrospective observational study. Patients diagnosed with acuteonset AF for the first time were included in the study. All patients underwent an ECG after cardioversion, and ECG parameters were evaluated. The patients were separated into two groups based on the presence of AF recurrence during hospitalization after cardioversion. The relationship between the fQRS-T and AF recurrence was also examined. Results: A total of 162 patients, comprising 68 women (41.9%) and 94 men (58.1%) with an average age of 59.4±6.5 years, were enrolled in the research. Based on the patient monitoring device findings, patients were separated into two groups: non-recurrent AF (n=118) and recurrent AF (n=44). P-wave duration was significantly longer in the recurrence group (p=0.009). The recurrence group's mean fQRS-T was significantly higher (p<0.001). AF recurrence was substantially higher in patients with fQRS-T >90 ̊compared to those with fQRS-T ≤90 ̊(56.1% vs. 14.2%, p <0.001). Increased fQRS-T >93.7 ̊indicated AF recurrence with 78.3% sensitivity and 83.4% specificity (AUC {area under curve}:0.748, p < 0.001). In multivariate analysis, fQRS-T was revealed to be an early indicator of recurrent AF (OR: 1.882, 95%CI: 1.358-2.881, p<0.001). Conclusion: The fQRS-T, an easily determinable parameter from automatic identification ECG recordings, may be useful for predicting the early return of AF after successful cardioversion.
The role of metabolic diseases in neonatal convulsions
(European Review for Medical and Pharmacological Sciences, 2023) Serhat Samancı, Muhittin Çelik, Osman Aldeniz, İbrahim Değer, Nezir Özgün, Berat Kanar, Heybet Tüzün
Objective: The neonatal period is the most vulnerable time for the development of seizures, particularly in the first weeks after birth. These seizures often signify serious malfunction or damage to the immature brain and constitute a neurological emergency, necessitating urgent diagnosis and management. This study was performed to identify the etiology of convulsions during the neonatal period and to determine the rate of congenital metabolic disease. Patients and methods: A total of 107 term and preterm infants 0-28 days old who were treated and followed-up in the neonatal intensive care unit of our hospital between January 2014 and December 2019 were analyzed retrospectively based on data obtained by scanning the hospital information system and patient files. Results: The study population included 54.2% male infants, and 35.5% of infants were born by caesarean section. Birth weight was 3,016 ± 560 (1,300-4,250) g, mean length of gestation was 38 (29-41) weeks, and mean maternal age was 27.4 ± 6.1 (16-42) years. Of the infants, 26 (24.3%) were preterm and 81 (75.7%) were term deliveries. Examination of family history revealed 21 (19.6%) cases with consanguineous parents and 14 (13.1%) cases with a family history of epilepsy. Hypoxic ischemic encephalopathy was the most common etiology of the seizures (34.5%). Burst suppression was detected on amplitude integrated electroencephalography in 21 (56.7%) monitored cases. Although subtle convulsions were most common, myoclonic, clonic, tonic and unclassified convulsions were also observed. The convulsions appeared during the first week of life in 66.3% of cases and during the second week or later in 33.7%. Fourteen (13.1%) patients examined by metabolic screening due to suspected congenital metabolic disease had a different congenital metabolic diagnosis. Conclusions: Although hypoxic ischemic encephalopathy was the most common cause of neonatal convulsions in our study, congenital metabolic diseases with autosomal recessive inheritance were detected at a high rate.
Citation - WoS: 2
The Significance of Frontal Plane QRS-T Angle for Estimating Non-Dipper Hypertension
(Cureus, 2022) Evsen, Ali; Karahan, Mehmet Zülkif
Objective: The frontal QRS-T angle (fQRS-T) is linked to myocardial ischemia and ventricular arrhythmias. On the other hand, non-dipper hypertension is a risk factor for cardiac adverse events. The objective of this research was to determine whether the fQRS-T, a marker of ventricular heterogeneity, could be used to predict non-dipper hypertensive individuals in the lack of left ventricular hypertrophy. Methods: The observational study was carried out retrospectively. Patients diagnosed with hypertension were included in this study. Blood tests were routinely conducted for all patients. Electrocardiography (ECG) was conducted for each patient and echocardiography was performed. Blood pressure (BP) values were collected from the ambulatory Holter records. According to ambulatory Holter monitoring, the individuals were separated into two groups. The association between fQRS-T and hypertension was investigated. Results: The research involved 123 patients, with an average age of 51.85±8.22 years, comprising 76 women (61.8%) and 47 males (38.2%). According to ambulatory Holter monitoring, patients were separated into dippers (n=65) and non-dippers (n=58). There were no statistically significant in the laboratory and echocardiographic variables (p>0.05). QT dispersion (QTd) and fQRS-T were substantially greater in the non-dipper group than in the dipper group (p=0.043 and p<0.001, respectively). Independent determinants of non-dipper status were determined by univariate and multivariate logistic regression analyses. fQRS-T was found to be the only independent indicator of non-dipper status (OR: 1.03, 95%CI: 1.02-1.06, p<0.001). Conclusion: The fQRS-T may be a useful marker for estimating non-dipper hypertensive individuals in the lack of left ventricular hypertrophy.

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