Karahan, Mehmet Zülkif
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| Journal | Count |
|---|---|
| Cureus | 4 |
| Artuklu International Journal of Health Sciences | 2 |
| International Journal of Cardiovascular Sciences | 2 |
| Journal of Electrocardiology | 2 |
| Dicle Tıp Dergisi | 2 |
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Book Part Kardiyovasküler Hastalıklarda Beslenme(2023) Kayan, Fethullah; Karahan, Mehmet ZülkifBölüm 20 - Kardiyovasküler Hastalıklarda Beslenme ............................................................ 399 Fethullah Kayan - M. Zülkif Karahan 1. Genel Bakış ........................................................................................................................ 400 2. Besinler .............................................................................................................................. 403 3. Gıdalar ............................................................................................................................... 405 xv 4. Hipertansiyon ve Beslenme................................................................................................ 408 5. Obezite-Diyabetüs Mellitüs ve Beslenme ........................................................................... 409 6. Kalp Yetmezliği ve Beslenme.............................................................................................. 410 7. Koroner Arter Hastalığı ve Beslenme .................................................................................. 411 Kaynaklar................................................................................................................................... 413Article Evaluation of Frontal QRS-T Angle in Patients with Coronary Artery Ectasia(Sociedade Brasileira de Cardiologia – SBC, 2023) Karahan, Mehmet Zülkif; Aktan, Adem; Güzel, Tuncay; Kayan, Fethullah; Günlü, SerhatBackground: Coronary artery ectasia (CAE) is defined by focal enlargement of the coronary artery exceeding 1.5 times the adjacent normal segment. CAE can often cause arrhythmias, heart failure, sudden death, and myocardial ischemia. Ischemia due to microvascular dysfunction may be responsible for the ventricular heterogeneity in CAE. Objectives: The aim of our study was to evaluate the frontal QRS-T angle in patients with CAE. Methods: Our study included 55 patients with CAE and 50 individuals in the control group. Demographic characteristics and electrocardiographic parameters were compared between the two groups. Categorical variables were compared using the chi-square test. Continuous variables were compared using unpaired Student’s t-test. P values < 0.05 were considered statistically significant. The frontal QRS-T angle was calculated from 12-lead electrocardiograms (ECGs) using the automatic report from the electrocardiography machine. Results: The average age of patients with CAE was 63.2 ± 3.4 years, with 18 women among them. The control group had an average age of 61.1 ± 3.2 years, with 28 women included. There was no significant difference in demographic parameters between the two groups. Compared to the control group, patients with CAE had significantly wider frontal QRS-T angle (p < 0.001), as well as longer QTmax duration, p = 0.002; Tp-Te interval, p = 0.02; and QT dispersion (QTd), p = 0.04. Conclusion: The frontal QRS-T angle can be calculated easily and time-efficiently using surface electrocardiography. In this study, we showed for the first time that the frontal QRS-T angle was significantly increased in patients with CAE.Article Local Against General Anesthesia For Transcatheter Aortic Valve Replacement(Bandırma Onyedi Eylül Üniversitesi Tıp Fakültesi, 2023) Günlü, Serhat; Kayan, Fethullah; Güzel, Tuncay; Aktan, Adem; Tanırcan, Muhammed Raşid; Karahan, Mehmet ZülkifBackground/Aims: Transcatheter aortic valve replacement (TAVR) poses significant challenges concerning anesthesia management. There is no consensus on the type of safer anesthesia for TAVR procedures. We aimed to evaluate the effectiveness and safety of TAVR performed with trans-femoral approach under local anesthesia with sedation (LAS) against general anesthesia (GA). Methods: This observational and retrospective analysis included individuals who were admitted on a planned basis from 2016 to 2022 and underwent Transfemoral TAVR. Effectiveness and safety outcomes were evaluated at 30 days. İndividuals were separated into two groups: GA and LAS. Demographic characteristics and procedural data were recorded during hospitalization. Results: 115 patients were included, of whom 62 (53.9%) received LAS and 53 received GA (46.1%). 59 female (48.8%) patients with a mean age of 83.2±5.7 participated in the study. Successful TAVR procedure was performed in 100 (86.9%) of 115 patients with the transfemoral approach. The mean procedure time was 136.7±46.7 minutes, and the procedure time was shorter in patients who underwent LAS against GA (p=0.001). There were no differences among the groups including fluoroscopy time, contrast, and radiation dose (p>0.05). In 2 patients (3.2%), significant vascular complications necessitated immediate surgical intervention, necessitating a change in the anesthesia technique. Overall 30-day mortality was 5.2%, with no significant differences among the groups (GA 7.5% vs. LAS 3.2%, p =0.28). GA had substantially longer ICU and total hospitalization stays than LAS (p=0.009 and p =0.004, respectively). Conclusions: In our study, TAVR via the transfemoral route using LAS was an alternative for GA.Article Citation - WoS: 2The Significance of Frontal Plane QRS-T Angle for Estimating Non-Dipper Hypertension(Cureus, 2022) Evsen, Ali; Karahan, Mehmet ZülkifObjective: 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.Article Citation - Scopus: 1The predictive effect of shock index on mortality in patients with acute heart failure(AME Publishing, 2023) Günlü, Serhat; Kayan, Fethullah; Karahan, Mehmet ZülkifBackground: The predictive usefulness of the shock index (SI), which is determined as a proportion of heart rate (HR) to systolic blood pressure (SBP), and age-adjusted SI (SI × age) for clinical outcomes other than mortality in acute heart failure (AHF) is not well established. This research aimed to examine whether SI and SI × age measured non-invasively at a patient’s bedside can identify mortality risk in patients admitted to the coronary care unit (CCU) with AHF. Methods: This research was carried out as a retrospective case-control study. Indices were calculated. The receiving operating characteristic (ROC) and Youden index were applied to calculate the optimal SI and SI × age cut-off for estimating mortality. Using multivariate analysis to determine independent indicators of mortality in patients with AHF. Results: A total of 1,468 patients who were hospitalized at the CCU with AHF were included. The population’s median age was 81 (73–91) years and 53.7% were male. In the survivor group, the median SI was 0.6 (0.5–0.75), and the median SI × age was 46 (38–58). In the non-survivor group, the median SI was 0.62 (0.55–0.81) and the median SI × age was 53 (44–66). According to the Youden index, the best value of SI was 0.56 with a specificity of 46% and a sensitivity of 70%, and the best value of SI × age was 44.8 with a specificity of 48% and a sensitivity of 76%. In the multivariate analysis, the power of SI × age to predict mortality was 2.39 times greater than other independent predictors. Conclusions: SI and SI × age calculated in the CCU may be valuable prognostic markers for identifying AHF patients at high risk for adverse outcomes.Article Citation - WoS: 3Citation - Scopus: 3The 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 ZülkifBackground: 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.Book Part KRONİK HASTALIĞI OLAN BİREY VE AİLE İLE İLETİŞİM(2023) Aktan, Adem; Karahan, Mehmet ZülkifKronik hastalık, uzun süreli tedavi gerektiren ve hayatı boyunca sürebilecek bir sağlık durumunu ifade eder. Bunlar, diyabet, hipertansiyon, kalp hastalığı, kanser, multipl skleroz gibi bir dizi farklı hastalığı içerebilir. Kronik hastalık tanısı alan bireylerin ve ailelerin yaşamlarında büyük bir etkiye sahip olabilir ve duygusal, sosyal ve fiziksel zorluklara neden olabilir. Bu nedenle, kronik hastalık tanısı almış bireylerle ve aileleriyle iletişim kurarken dikkatli ve duyarlı olmak önemlidir (1). İletişim, bireylerin duygularını ifade etmelerine, endişelerini paylaşmalarına ve birbirleriyle destek sağlamalarına yardımcı olabilir. Kronik hastalıkla ilgili iletişim becerileri, bireylerin sağlıklı bir şekilde başa çıkmalarına ve daha iyi sonuçlar elde etmelerine yardımcı olabilir. Kronik hastalık tanısı almış bireyler ve aileleri arasındaki iletişim, aşağıdaki bazı temel prensiplere dikkat ederek etkili bir şekilde gerçekleştirilebilir: Açık iletişim kurma: Kronik hastalık tanısı almış bir bireyin ve ailesinin duygularını ve deneyimlerini anlamak için empati kurmak önemlidir. Açık iletişim, dürüst, saygılı ve etkili bir iletişim tarzını içerir. Kronik hastalık tanısı almış bir birey ve ailesiyle iletişim kurarken açık ve net olmak önemlidir. VII. Sonuç Kronik hastalık tanısı almış bireyler ve aileleriyle etkili iletişim kurmak önemlidir. Etkili iletişim, hastaların sağlık sonuçlarını, yaşam kalitesini ve memnuniyetini artırabilir. Ailelerin de katılımıyla birlikte, uygun tıbbi bakım sağlanabilir ve sağlıklı bir iyileşme süreci desteklenebilir. Bu nedenle, sağlık profesyonellerive diğer ilgili paydaşlar, hastalarla etkili iletişim kurma becerilerini geliştirmek için yönlendirilmelidir. Kronik hastalık yönetiminde etkili iletişim, hastaların ve ailelerinin gereksinimlerini anlamak ve onları desteklemek için vazgeçilmez bir araçtır.Article Relationship Between Atrial Fibrillation Recurrence and Frontal QRS-T Angle After Effective Cardioversion(Cureus, 2023) Özen, Kaya; Karahan, Mehmet ZülkifObjective: 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.Article Serum Ürik Asit, Kronik Total Oklüzyon'a PCI Yapıldığında, Kontrast Maddeye Bağlı Nefropatiyi Öngörür(2025) Kayan, Fethullah; Karahan, Mehmet ZülkifAmaç : CIN (kontrast kaynaklı nefropati), CTO (kronik total oklüzyon) için yapılan PCI (perkütan koroner girişim) sonrasında görülen önemli bir komplikasyondur. Yükselmiş serum ürik asit (SUA) düzeylerinin böbrek hasarında rol oynadığı bildirilmiştir, ancak CTO-PCI hastalarında CIN için öngörücü değerleri net değildir. Bu çalışma, SUA düzeyleri ile CIN riski arasındaki ilişkiyi bu hasta grubunda incelemeyi amaçlamıştır. Yöntemler: Bu retrospektif gözlemsel çalışmaya, Nisan 2017 – Mart 2023 tarihleri arasında Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi’nde CTO nedeniyle PCI uygulanan 225 hasta dahil edilmiştir. Hastalar, başlangıçtaki SUA düzeylerine göre üç gruba ayrılmıştır: ≤5.2 mg/dL (n=75), 5.3–6.6 mg/dL (n=75) ve ≥6.7 mg/dL (n=75). CIN, PCI sonrası 48–72 saat içinde serum kreatinin düzeyinde %25’ten fazla artış olarak tanımlanmıştır. Klinik, demografik ve laboratuvar parametreleri ki-kare, ANOVA veya Kruskal-Wallis testleriyle karşılaştırılmıştır. SUA’nın CIN için öngörücü değerini belirlemek amacıyla lojistik regresyon ve ROC analizleri uygulanmıştır. Bulgular: CIN, 44 hastada (%19,6) gelişmiştir. Yüksek SUA düzeyleri; artmış CIN insidansı (p<0.001), daha yüksek kronik böbrek hastalığı prevalansı (p<0.001), düşük ejeksiyon fraksiyonu (EF) (p=0.027) ve artmış mortalite (p=0.023) ile ilişkili bulunmuştur. ROC analizi, 5.95 mg/dL SUA kesim değerini belirlemiştir (AUC=0.643, %95 GA: 0.561–0.725, p=0.003) — bu değer için duyarlılık %72.7 ve özgüllük %56.4 olarak saptanmıştır. Tek değişkenli analizde yaş, EF, C- reaktif protein ve SUA CIN’in anlamlı belirteçleri olarak saptanmış, ancak çok değişkenli analizde anlamlılıklarını korumamışlardır. Sonuç: Yüksek SUA düzeyleri, CTO-PCI hastalarında artmış CIN riski ile ilişkilidir. Rutin SUA değerlendirmesi, yüksek riskli hastaların erken tanımlanmasına yardımcı olabilir ve önleyici stratejilerin güçlendirilmesini destekleyebilir.Article Vatanından Uzakta Ölmek” Palyatif Bakım Kliniğinde Ölen 7 Suriye Uyruklu Hasta ve Ülkemizin Sığınmacıların Sağlık İhtiyaçlarını Karşılamadaki Rolü(2022) Akelma, Hakan; Karahan, Mehmet ZülkifSavaşlar, iç çatışmalar telafisi mümkün olmayan yıkımlara neden olup, en çok da sivilleri etkilemektedir. Yıkımın etkisi başta ikincil şahıslara ihtiyaç duyan çocuk, yaşlı ve kadınlar için daha belirgindir. Şu anda dünyadaki sığınmacıların yarısından fazlası Suriye’de hayatlarını kurtarmak için ülkelerinden ayrılmak zorunda kalan sığınmacılardan oluşmaktadır. Siyasal, sosyal, kültürel ve ekonomik açıdan toplumu ve bireyleri etkileyen yurdundan edilme durumu sağlık sorunlarını da beraberinde getirmektedir. Sığınmacılar zor yaşam koşulları, barınma, beslenme, şiddet ve psikolojik travmalar gibi birçok neden ile sağlık bakım sisteminde en kırılgan ve savunmasız gruplardandır. Kendi yaşam alanlarından zorunlu olarak ayrılan bireylerin yaşam konforlarının azalması ve yaşadıkları psikolojik yıkım, beraberinde bulaşıcı hastalıklar, kardiyovasküler hastalıklar, diyabet, kanser ve akciğer hastalıkları gibi kronik hastalıkların riskini artırmaktadır. Bu hastalıklara bağlı palyatif bakım ünitelerine yatışlar artmakta ve bu kliniklerde yaşam koşullarından daha iyi şartlarda sağlık hizmeti almakta ancak hastalıklarının şiddetine göre ölümler gerçekleşmektedir. Türkiye, sığınmacılara mümkün olan en iyi yaşam koşullarını ve kapsamlı insani yardımı sağlamaktadır. Sığınmacılar hem kamplarda hem de barındıkları iskânlarda tüm sağlık hizmetlerini sürdürmektedir. Bu sığınmacılar aynı şekilde gerekli durumlarda palyatif bakım hizmetlerinden faydalanmaktadır. Bu çalışmanın amacı palyatif bakım kliniklerde özellikle kanser, diyabet ve diğer kronik hastalıklar sonucu hayatını kaybeden sığınmacı hastaların değerlendirilmesi ve bunun yanında ülkemiz sağlık bakımındaki desteğini vurgulamaktır.
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