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    A comparative toxicity study between small and large size zinc oxide nanoparticles in tilapia (Oreochromis niloticus): Organ pathologies, osmoregulatory responses and immunological parameters
    (Pergamon-Elsevier Science Ltd, 2016) Kaya, Hasan; Aydin, Fatih; Gurkan, Mert; Yılmaz, Sevdan; Ates, Mehmet; Demir, Veysel; Arslan, Zikri
    Tilapia (Oreochromis niloticus) was exposed to different sizes of zinc oxide nanoparticles (ZnO-NPs) to evaluate their organ pathologies (kidney, liver, gill, and intestine), osmoregulatory responses and immunological parameters. Sub-chronic exposure was conducted in fresh water with 1 and 10 mg/L concentrations of the small (10-30 nm) and large-size ZnO (100 nm) particles for 7 and 14 days. In this study, it is found that small and large forms of ZnO-NPs cause various pathologic findings in the target organs at all concentrations. These findings are increased of melanomacrophage aggregates, tubular deformations, necrosis and cytoplasmic vacuolations in the kidney, oedema, mononuclear cell infiltrations, fatty changes, pyknotic nuclei and hepatocellular vacuolations in the liver, hyperplasia, aneurysms, and epithelial liftings in the gills, and hyperplasia, swelled of goblet cells, villus deformations in the intestine. Results showed that respiratory burst and potential killing activity at the small-size ZnO concentration significantly increased compared to the control group (p < 0.05) but significant reductions of these parameters at the large-size ZnO concentrations compared to control (p < 0.05) were measured. These findings demonstrate the potential of each particle size to cause significant damage to the immune system. Moreover, because ZnO NPs inhibit the Na, K-F-ATPase activity at all concentrations and increase serum Ca2+ and Cl- levels especially in gill, these particles are osmoregulatory and toxicant for tilapia fish. As a summary, both sizes of the particles have led to organ damage, osmoregulatory changes and immune disorder in tilapia fish. (C) 2015 Elsevier Ltd. All rights reserved.
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    Chest pain score: a novel and practical approach to angina pectoris. A diagnostic accuracy study
    (Associacao Paulista Medicina, 2019) Aydin, Fatih; Aksit, Ercan; Yildirim, Ozge Turgay; Aydin, Ayse Huseyinoglu; Dagtekin, Evrin; Samsa, Murat
    BACKGROUND: The chest pain classifications that are currently in use are based on studies that are several decades old. Various studies have indicated that these classifications are not sufficient for determining the origin of chest pain without additional diagnostic tests or tools. We describe a new chest pain scoring system that examines the relationship between chest pain and ischemic heart disease (IHD). DESIGN AND SETTING: Cross-sectional study conducted in a tertiary-level university hospital and two public hospitals. METHODS: Chest pain scores were assigned to 484 patients. These patients then underwent a treadmill stress test, followed by myocardial perfusion scintigraphy if necessary. Coronary angiography was then carried out on the patients whose tests had been interpreted as positive for ischemia. Afterwards, the relationship between myocardial ischemia and the test score results was investigated. RESULTS: The median chest pain score was 2 (range: 0-7) among the patients without IHD and 6 (1-8) among those with IHD. The median score of patients with IHD was significantly higher than that of patients without IHD (P = 0.001). Receiver operating characteristic analysis showed that the score had sensitivity of 97% and specificity of 87.5% for detecting IHD. CONCLUSION: We developed a pre-test chest pain score that uses a digital scoring system to assess whether or not the pain was caused by IHD. This scoring system can be applied easily and swiftly by healthcare professionals and can prevent the confusion that is caused by other classification and scoring systems.
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    Comment on: Direct oral anticoagulants in adults with congenital heart disease - A single centre study
    (Elsevier Ireland Ltd, 2020) Yildirim, Ozge Turgay; Aydin, Fatih; Aydin, Ayse Huseyinoglu; Aksit, Ercan
    [Anstract Not Available]
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    Effects of zinc oxide nanoparticles on bioaccumulation and oxidative stress in different organs of tilapia (Oreochromis niloticus)
    (Elsevier Science Bv, 2015) Kaya, Hasan; Aydin, Fatih; Gurkan, Mert; Yılmaz, Sevdan; Ates, Mehmet; Demir, Veysel; Arslan, Zikri
    Nano-size zinc oxide particles (ZnO NPs) are used in diverse industrial and commercial fields. However, the information from existing studies is not sufficient in evaluating the potential toxic effects of ZnO NPs. In this study, tilapia fish (Oreochromis niloticus) were exposed to different concentrations of small and large ZnO NPs in vivo. Accumulation in various organs/tissues (liver, gill, intestine, kidney, brain and muscle) and possible oxidative stress mechanisms were investigated comparatively. Fish were exposed to 1 and 10 mg/L concentrations of small (10-30 nm) and large (100 nm) ZnO NPs semi-statically for 14 days. Both small and large ZnO NPs accumulated substantially in the tissues. Accumulation for the small ZnO NPs was significantly higher compared to larger NPs under same exposure regimes. Significant fluctuations were observed in antioxidant defense system biomarkers, including Superoxide dismutase (SOD), Catalase (CAT) and Glutathione (GSH) levels depending on particle size, exposure time and concentration. Lipid peroxidation measured with TBARS levels were higher in groups exposed to the suspensions of small ZnO NPs than that of large ZnO NPs and controls. These results imply that colloidal suspensions of small ZnO NPs induce elevated oxidative stress and toxic effects on tilapia compared to the larger NPs. (C) 2015 Elsevier B.V. All rights reserved.
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    Efficacy of direct oral anticoagulants on left ventricular thrombus
    (Lippincott Williams & Wilkins, 2019) Yildirim, Ozge Turgay; Aksit, Ercan; Aydin, Fatih; Aydin, Ayse Huseyinoglu
    Left ventricular thrombus (LVT) is a commonly seen complication of myocardial infarction and it also can be seen because of hypertrophic cardiomyopathies, nonischemic dilated cardiomyopathies, malignancies, and so on. Guidelines suggest the use of warfarin for left ventricular thrombi, but recent case reports show that direct oral anticoagulants (DOACs) are beginning to be used for this complication. DOACs are strong alternatives for warfarin because of their efficacy and safety even though there is no randomized controlled trial that proves the effect of DOACs against LVT. In this article, we gather the case reports of DOACs against left ventricular thrombi in various conditions. Copyright (C) 2019 Wolters Kluwer Health, Inc. All rights reserved.
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    Is Rivaroxaban a Safe Choice for Apical Thrombus in Atrial Fibrillation Patients? A Case Report
    (Elsevier Science Bv, 2018) Aydin, Fatih; Yildirim, Ozge Turgay; Aydin, Ayse Huseyinoglu; Dagtekin, Evrin; Aksit, Ercan
    Left ventricular thrombi are mostly seen in the akinetic segments of left ventricle and warfarin is the golden standard treatment. In our case, a 67-year-old male patient with ischemic dilated cardiomyopathy and atrial fibrillation was under warfarin treatment, but due to fluctuations in international normalized ratio, warfarin was discontinued and changed to rivaroxaban (20 mg once a day). He had a fixed thrombus measuring 1.80 x 1.12 cm(2) in the left ventricle under warfarin treatment before rivaroxaban use. After 6 months of rivaroxaban treatment, the thrombus regressed to 1.54 x 1.06 cm(2) without any embolic episode or bleeding. This case supports the finding that rivaroxaban can be a safe alternative to warfarin when warfarin cannot be used.
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    Red cell distribution width and its prediction value of mortality
    (Mosby-Elsevier, 2020) Yildirim, Ozge Turgay; Aydin, Fatih; Aydin, Ayse Huseyinoglu; Aksit, Ercan
    [Anstract Not Available]
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    Short term follow-up of a patient with uncomplicated type B aortic dissection under dabigatran treatment
    (Turkish Soc Cardiology, 2019) Yildirim, Ozge Turgay; Canakci, Mustafa Emin; Aydin, Fatih; Aydin, Ayse Huseyinoglu; Aksit, Ercan
    This case report illustrates the follow-up of a 57-year-old female with a type B aortic dissection (AD) under dabigatran treatment. The patient had been operated on 8 years earlier due to type A AD. The aortic valve was repaired and a 26-mm polyester fiber graft was applied to the ascending aorta and the aortic arch. In computerized tomography scans taken after the procedure, a dissection flap extending from the descending aorta to the iliac arteries was seen, but the patient was asymptomatic and no further surgery was performed. The patient was subsequently diagnosed with atrial fibrillation. A CHA(2)DS(2)VASc score of 3 was recorded and dabigatran treatment was initiated. The aortic aneurysm and dissection were followed up via computed tomography and echocardiography at regular intervals, and at 6 months no progression was seen. No thromboembolic or hemorrhagic events were observed. To our knowledge, this is the first case report of dabigatran treatment for a patient with a type B AD. Based on this case, the use of dabigatran would appear to be safe in a patient with an uncomplicated type B AD, but the results of this case need to be confirmed with extended follow-up and additional patients.
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    The Crucial Importance of Optimal Primary and Secondary Prevention of Cardiovascular Disease during COVID-19 Pandemic
    (Taiwan Soc Cardiology, 2020) Aksit, Ercan; Gazi, Emine; Kinlmaz, Bahadir; Yildirim, Ozge Turgay; Aydin, Fatih
    [Anstract Not Available]
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    The Effect of Direct Oral Anticoagulant Drugs on Platelet Indiceses and Their Relationship with Bleeding Events
    (2020) Aksit, Ercan; Aydin, Fatih; Yildirim, Ozge Turgay; Dagtekin, Evrin; Aydin, Ayse Huseyinoglu
    Aim: Atrial fibrillation is a common disorder and is an important cause of thromboembolic events. Recently, direct oral anticoagulant drugs (DOACs) are being used to reduce the frequency of thromboembolic events among these patients. DOACs have several advantages over oral vitamin K antagonists, such as fixed dosage and fewer side effects. However, since the drugs and their affects cannot be monitored directly, difficulties are encountered in assessing drug efficacy and side effects. For this purpose, platelet indices and their relationship with DOACs may be utilized for the prediction of thromboembolic and hemorrhagic events. Patients and Methods: 301 patients with atrial fibrillation who were using DOACs were included in the study. Platelet indices such as platelet count, platelet distribution volume, plateletcrit, platelet-large cell ratio were evaluated at the first and sixth months. The effect of DOACs on these indices and relationships with bleeding events were investigated.Results: All groups were similar in regard to baseline platelet indices, except for lower P-LCR value among recipients of rivaroxaban. When post-treatment results were compared, all groups were found to have similar values in all parameters. However, time-bound comparisons revealed that apixaban and dabigatran significantly reduced P-LCR value after 6 months of use. Conclusion: This study showed that apixaban, rivoraxaban and dabigatran had no effect on platelet count, MPV, PDW, PCT values in whole blood count of patients with non-valvular AF. All characteristics of those with and without hemorrhagic events were also similar of patients with non-valvular AF.
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    The timing for percutaneous coronary intervention for patients with Chapman's sign
    (W B Saunders Co-Elsevier Inc, 2020) Yildirim, Ozge Turgay; Aydin, Fatih; Aksit, Ercan; Aydin, Aye Huseyinoglu
    [Anstract Not Available]
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    Ticagrelor Can Be an Important Agent in the Treatment of Severe COVID-19 Patients with Myocardial Infarction
    (Galenos Publ House, 2020) Aksit, Ercan; Kirilmaz, Bahadir; Gazi, Emine; Aydin, Fatih
    [Anstract Not Available]
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    Transient ST Segment Elevation Caused by Intracoronary Thrombus after Acute Carbon Monoxide Poisoning
    (Cambridge Univ Press, 2019) Aksit, Ercan; Yildirim, Ozge Turgay; Aydin, Fatih; Bardakci, Okan; Aydin, Ayse Huseyinoglu
    Carbon monoxide (CO) poisoning is the most common cause of death and injury among all poisonings. Myocardial injury is detected in one-third of CO poisonings. In this Case Report, a previously healthy 41-year-old man was referred for CO poisoning. The initial electrocardiogram (ECG) showed 1 mm ST segment elevation in leads DII, DIII, and aVF. As the patient did not describe chest pain and had no cardiac symptoms, ECG was repeated 10 minutes later and it was seen that ST segment elevation disappeared. As the patient had a transient ST segment elevation and elevated high-sensitive Tn-T (HsTn-T), the patient was transferred to the coronary angiography laboratory. The patient's left coronary system was normal, but a thrombus image narrowing the lumen by approximately 60% was observed in the right coronary artery. Intravenous tirofiban was administered for 48 hours. Control coronary angiography showed continuing thrombus formation and a bare metal stent was successfully implanted. This is the first reported case with transient ST segment elevation associated with acute coronary thrombus caused by CO poisoning. It may be recommended that patients with CO poisoning should be followed-up with a 12-lead ECG monitor or 24-hour ECG Holter monitoring, even if they show no cardiac symptoms and echocardiography shows no wall motion abnormality. Early coronary angiography upon detection of such dynamic ECG changes in these recordings as ST segment elevation can reduce the risk of myocardial infarction (MI) and mortality in these patients.