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    Adropin Levels in Polycystic Ovary Syndrome Patients
    (Derman Medical Publ, 2017) Sen, Hacer; Erbag, Gokhan; Binnetoglu, Emine; Eroglu, Mustafa; Turkon, Hakan; Tekin, Sati Zeynep; Asik, Mehmet
    Aim: Polycystic ovary syndrome (PCOS) is one of the most commonly observed endocrinopathies in women of reproductive age. Women with PCOS are said to have increased classic risk factors for cardiovascular disease, hypertension, dyslipidemia, diabetes, and obesity, in addition to non-classic risk factors such as an increase in C-reactive protein (CRP), homocysteine, and tumor necrosis factor-a. Adropin is a protein thought to play a role in maintaining energy homeostasis and insulin response. The aim of our study is to investigate the relationship between levels of adropin and insulin resistance in PCOS patients with insulin resistance and an increased risk of diabetes. Material and Method: Fifty-seven female patients (30 patients with PCOS and 27 healthy control subjects) were enrolled in this study. All patient's body mass index and insulin resistance were calculated. The adropin levels were measured using commercial kits based on a competitive plasma EIA (enzyme immunoassay) method. Results: The adropin levels in the patient group were 10.79 ng/L, while the value was 13.02 ng/L in the control group, and the difference was statistically significant (p= 0.04). There was a significant negative correlation between the adropin levels and the insulin, aspartate aminotransferase (AST), triglyseride (TG), and homeostasis model assessment of insulin resistance (HOMA-IR) levels (p= 0.03, p= 0.03, p= 0.04, and p= 0.02, respectively). Discussion: In our study, the adropin level which is associated with insulin resistance, was found to be decreased in patients with PCOS. We think that it would be valuable to conduct new studies for the evaluation of adropin related clinical conditions leading to insulin resistance in patients with PCOS.
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    An unusual gastric ulcer cause: celiac crisis
    (Springer Wien, 2014) Akbal, Erdem; Erbag, Gokhan; Binnetoglu, Emine; Gunes, Fahri; Bilen, Yildiz Garip
    [Anstract Not Available]
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    Aromatase inhibitor treatment for breast cancer: short-term effect on bone health
    (Termedia Publishing House Ltd, 2015) Erbag, Gokhan; Uygun, Kazim; Binnetoglu, Emine; Korkmaz, Ayse Nurdan; Asik, Mehmet; Sen, Hacer; Gunes, Fahri
    Aim of this study was to examine the effects of aromatase inhibitors (AIs), which are used in every phase of breast cancer treatment, on the bone mineral density (BMD) of patients with early-stage breast cancer. Material and methods: Menopausal female patients who were diagnosed with stages 1-3 breast cancer and who were planned for anastrazole or letrozole as adjuvant therapy were examined. After the patients' BMD was measured, 45 patients without osteoporosis were included in the study. Six months after AI therapy started, the patients' BMD was measured again. Results: In this study, we tried to show that there was a statistical difference in the BMD of 45 patients before and 6 months after treatment. Among all measurements (femur and lumbar T-scores), the femur Z-score (p = 0.52) was the only score that was not statistically significant. Statistical significance (p < 0.01) was detected in comparative analysis of the other measurements. According to this analysis, a significant loss of BMD was seen even in the first six months after AI treatment was introduced. Conclusions: Female patients with breast cancer are at higher risk for bone loss and fractures than healthy women. In this study, we showed the negative effects on BMD of aromatase inhibitor therapy, one of the main contributions to osteoporosis in women with breast cancer. This study is the first to quantify the short-term effect of AI treatment on BMD in postmenopausal women with breast cancer.
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    EOSINOPHILIC COLITIS: A RARE CAUSE OF LOWER GASTROINTESTINAL BLEEDING IN AN ELDERLY ADULT
    (Wiley, 2014) Kocak, Gulay; Kocak, Erdem; Akbal, Erdem; Sen, Hacer; Erbag, Gokhan; Erdogan, Ceren
    [Anstract Not Available]
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    Evaluation of affective temperament and anxiety-depression levels of patients with polycystic ovary syndrome
    (Elsevier Science Bv, 2015) Asik, Mehmet; Altinbas, Kursat; Eroglu, Mustafa; Karaahmet, Elif; Erbag, Gokhan; Ertekin, Hulya; Sen, Hacer
    Background: Women with polycystic ovary syndrome (PCOS) are reported to experience depressive episodes at a higher rate than healthy controls (HC). Affective temperament features are psychiatric markers that may help to predict and identify vulnerability to depression in women with PCOS. Our aim was to evaluate the affective temperaments of women with PCOS and to investigate the association with depression and anxiety levels and laboratory variables in comparison with HC. Methods: The study included 71 women with PCOS and 50 HC. Hormonal evaluations were performed for women with PCOS. Physical examination, clinical history, Hospital Anxiety and Depression Scale (DADS) and TEMPS -A were performed for all subjecLs. Differences between groups were evaluated using Student's [-tests and Mann Whitney U tests. Correlations and logistic regression tests were performed. Results: All temperament subtype scores, except hyperthyrnic, and DADS anxiety, depression, and total scores were significantly higher in patients with PCOS compared to HC. A statistically significant positive correlation was found between EMI and irritable temperament, and insulin and DADS depression scores in patients with PCOS. Additionally, hirsutism score and menstrual irregularity were correlated with DADS depression, anxiety and total scores in PCOS patients. In logistic regression analysis, depression was not affected by PCOS, hirsutism score or menstrual irregularity. However, DADS anxiety score was associated with hirsutism score. Conclusions: Our study is the first to evaluate the affective temperament features of women with PCOS. Consequently, establishing affective temperament properties for women with PCOS may help clinicians predict those patients with PCOS who are at risk for depressive and anxiety disorders. (C) 2015 Elsevier B.V. All rights reserved.
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    EVALUATION OF EPICARDIAL FAT TISSUE THICKNESS AND CAROTID INTIMA MEDIA THICKNESS IN PATIENTS WITH PRIMARY HYPERPARATHYROIDISM AFTER PARATHYROIDECTOMY
    (Carbone Editore, 2017) Eroglu, Mustafa; Ozkul, Faruk; Erbag, Gokhan; Temiz, Ahmet; Altun, Burak; Arik, Kasim; Sen, Hacer
    Introduction: It has been shown that epicardial fat tissue (EFT) thickness in primary hyperparathyroidism (PHPT) is increased and that this is closely associated with cardiovascular disease and atherosclerosis. However, EFT thickness in patients with hyperparathyroidism who were treated with parathyroidectomy has not yet been studied. In this study we aimed to examine whether carotid intima-media thickness (CIMT) and EFT thickness would be affected after treatment of PHPT by parathyroidectomy. Materials and methods: 27 patients with PHPT who were diagnosed with a parathyroidectomy indication and 39 healthy volunteers were included in the study. For all patients with PHPT, anthropometric measurements were made before and 12 months after parathyroidectomy, and EFT thickness, CIMT, serum parathormone (PTH), calcium and lipid levels were measured. Results: It was observed that preoperative CIMT and EFT thickness in patients with PHPT were significantly higher than the control group (for both p<0.001). Although hyperparathyroidism and hypercalcemia of the patients improved after parathyroidectomy, no significant change in the thickness of CIMT or EFT was determined. Conclusions: CIMT and EFT thickness seem to be good cardiovascular indicators for diagnosis of patients with PHPT. Nevertheless, this study raises the question of the reliability of a decrease in these parameters in patient follow-up. It is therefore necessary to be more careful in evaluating these parameters after treatment of patients with PHPT.
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    Evaluation of epicardial fat tissue thickness in patients with hyperthyroidism
    (Springer Wien, 2014) Binnetoglu, Emine; Asik, Mehmet; Altun, Burak; Sen, Hacer; Gazi, Emine; Erbag, Gokhan; Gunes, Fahri
    Thyroid hormones have several effects on the cardiovascular system, and recent studies have found that thyroid disorders affect coronary intima-media thickness (CIMT) in particular. Despite increased CIMT in patients with hyperthyroidism, the extent of the relationship between CIMT and epicardial fat thickness (EFT) in those patients is unknown. Furthermore, there is no report evaluating the relationship between EFT and overt hyperthyroidism (OH) in the literature. In this study, we aim to evaluate the effectiveness of EFT in predicting atherosclerosis as well as CIMT in patients with OH. A total of 30 newly diagnosed, untreated overt hyperthyroid patients and 44 control subjects were included in the study. EFT was measured using a commercially available echocardiography machine (VIVID 7; General Electric Medical Systems, Norway) with a 2.5-MHz probe. The echo-free space between the visceral and parietal pericardium on the anterior wall of the right ventricle was diagnosed as EFT. A linear-array imaging probe of the same echocardiography probe was used to evaluate the CIMT of the right common carotid artery. The hyperthyroid patients had a significantly greater EFT (mean: 4.31 +/- A 1.12 mm) than the healthy subjects (mean: 3.11 +/- A 0.84 mm; p < 0.001). CIMT was also significantly greater in the hyperthyroid patients (mean: 0.62 +/- A 0.17 mm) than in the healthy subjects (mean: 0.50 +/- A 0.11 mm; p < 0.01). In conclusion, the present study shows that mean EFT and CIMT were significantly higher in OH patients, irrespective of confounding factors such as hypertension.
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    Evaluation of liver perfusion in diabetic patients using 99mTc-sestamibi
    (Springer Wien, 2015) Sen, Hacer; Tan, Yusuf Ziya; Binnetoglu, Emine; Asik, Mehmet; Gunes, Fahri; Erbag, Gokhan; Gazi, Emine
    Objective The liver is an important organ for various aspects of glucose metabolism, including glucose uptake, storage, and synthesis. It is a major organ in the metabolic process with perfusion provided by both the portal vein and hepatic artery. In diabetic patients organ perfusion is reduced and this is linked to atherosclerosis, and as a result complications occur. In this study, we aimed to evaluate liver perfusion by scintigraphic methods in diabetic patients. Design and patients We retrospectively investigated 1,100 myocardial perfusion scintigraphies taken between January 2011 and December 2012 at Canakkale Onsekiz Mart University Medical Faculty Nuclear Medicine Department. A total of 66 patients who were diagnosed with diabetes mellitus and had myocardial perfusion scintigraphies were included in the study. The control subjects included 127 patients without diabetes mellitus who were chosen at random. Patients with chronic liver disease were not included in the study. The values from liver regions of interest (liver-ROI) rates and heart regions of interest (heart-ROI) rates were compared between the patients and controls. Results Patients were grouped according to the presence of diabetes. In the diabetes mellitus group, the liver-ROI average was lower (p = 0.66) than in the controls. In the control group, the average liver-ROI/heart-ROI ratios were higher than the ratio in the diabetes mellitus group (p = 0.019). Multivariate variance analysis showed that the diabetes mellitus liver-ROI/heart-ROI ratio was independent of other risk factors (p = 0.003; F: 9.6). Powered by Editorial Manager. and ProduXion Manager. from Aries Systems Corporation. Conclusions This study shows that liver perfusion in diabetic patients is reduced compared with those without diabetes. Prospective studies with larger patient groups are required.
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    EVALUATION OF THE RISK OF ATHEROSCLEROSIS IN PATIENTS WITH ADRENAL INCIDENTALOMA USING THE ULTRASOUND BIOMARKERS EFT AND CIMT
    (Carbone Editore, 2015) Sen, Hacer; Uysal, Fatma; Binnetoglu, Emine; Asik, Mehmet; Erbag, Gokhan; Gunes, Fahri; Eroglu, Mustafa
    Introduction: Adrenal incidentalomas (AIs) are masses frequently observed on radiological examination that have attracted attention due to their coincidence with metabolic disorders. Recently, the relationship between atherosclerosis and adrenal incidentalomas has been noted. Epicardial fat tissue (EFT) and carotid artery intima-media thickness (CIMT) measurements show the development of atherosclerosis (AS). The aim of this study is to evaluate the risk of cardiovascular disease in AI patients using EFT and CIMT readings. Materials and methods: Our study included 63 Al patients and 48 healthy controls. All patients were evaluated for blood pressure, Body Mass index(BMI), EFT, CIMT, and lipid parameters. Al patients were also investigated for hormonal secretion. The relationship between risk of atherosclerosis and EFT, CIMT was analyzed. Results: Control subjects (mean EFT, 3.92 +/- 1.14 mm) had lower EFT than patients with subclinical Cushing's syndrome (SCS) and non-functional adenoma (NFA) (mean EFT, 6.22 +/- 1.97 mm and 5.44 +/- 1.61 mm, respectively) (both P < 0.001). There was no difference in EFT between SCS and NFA patients. CIMT was significantly lower in control subjects (mean CIMT, 0.65 +/- 0.11 mm) than in NFA patients (mean CIMT, 0.75 +/- 0.18 mm) (P < 0.01). The EFT of SCS patients was not significantly different from the EFT of either NFA patients or controls. Conclusion: EFT thickness measurements may be helpful as an early atherosclerosis marker in AI patients.
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    Letter to the Editor: Treatment of Paget's Disease in Patients With Renal Impairment
    (Endocrine Soc, 2015) Asik, Mehmet; Kadioglu, Gulay Kocak; Eroglu, Mustafa; Sen, Hacer; Erbag, Gokhan; Ukinc, Kubilay
    [Anstract Not Available]
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    Neutrophil-Lymphocyte Ratio Connected to Treatment Options and Inflammation Markers of Ankylosing Spondylitis
    (Wiley, 2015) Gokmen, Ferhat; Akbal, Ayla; Resorlu, Hatice; Gokmen, Esra; Guven, Mustafa; Aras, Adem Bozkurt; Erbag, Gokhan
    BackgroundIn recent years, white blood cells (WBCs) and their subtypes have been studied in relation to inflammation. The aim of our study was to assess the relationship between neutrophil-lymphocyte ratio (NLR) and ankylosing spondylitis (AS). Materials and methodsWe enrolled a total of 177 patients, 96 AS and 81 healthy controls. Complete blood count, WBC, neutrophil and lymphocyte levels were measured, and the NLR was calculated. In the assessment of AS, we used the erythrocyte sedimentation rate, C-reactive protein (CRP), the Bath Ankylosing Spondylitis Disease Activity Index, and the Bath Ankylosing Spondylitis Functional Index. ResultsIn the present study, 96 AS and 81 healthy individuals were enrolled. The mean age was 43.8 12.9 and 46.5 +/- 11.2 years, respectively. Mean disease duration of AS patients was 6.9 +/- 5.6 years (median = 5, min-max = 1-25). The patients with AS had a higher NLR than the control individuals (mean NLR, 2.24 +/- 1.23 and 1.73 +/- 0.70, respectively, P < 0.001). A statistically significant positive correlation was observed between NLR and CRP (r = 0.322, P = 0.01). The patients receiving antitumor necrosis factor therapy had a lower NLR than the patients receiving nonsteroidal anti-inflammatory drug therapy (mean NLR, 1.71 +/- 0.62 and 2.41 +/- 1.33, respectively, P = 0.02). ConclusionNLR may be seen as a useful marker for demonstrating inflammation together with acute phase reactants such as CRP and in evaluating the effectiveness of anti-TNF- therapy.
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    Pantoprazole-induced thrombocytopenia in patients with upper gastrointestinal bleeding
    (Taylor & Francis Inc, 2015) Binnetogolu, Emine; Akbal, Erdem; Sen, Hacer; Gunes, Fahri; Erbag, Gokhan; Asik, Mehmet; Bozkurt, Neslihan
    Proton pump inhibitors (PPIs) are highly effective drugs for patients suffering from peptic ulcer and gastro-esophageal reflux diseases, but recent studies have indicated possible risks with the long-term use of PPIs, such as osteoporosis, fractures, increased risk of pneumonia, diarrhea, iron and vitamin B12 deficiencies. There are publications written as a case study that indicate thrombocytopenia as side effects of PPIs, but there is no study on this subject. This study aimed to investigate the development of thrombocytopenia in patients with short-term use of PPI-infusion therapy. In this study, the records of the patients were evaluated retrospectively, for the period between January 2012 and January 2013. Thirty-five patients with upper gastrointestinal bleeding were enrolled. Platelet counts were analyzed before treatment, and on the first, second and third day of treatment, respectively. All patients were treated with intravenous pantoprazole. Hemogram values of patients were analyzed before and after PPI infusion treatment. Platelet counts were found to decrease from the first day to the third day of treatment (249 714.29/mu l, 197 314.29/mu l, 193 941.18/mu l, 183 500/mu l, respectively). The platelet count decrease was statistically significant (p<0.001). After cessation of infusion therapy, platelet counts began to rise on the fourth day. Three patients had severe thrombocytopenia on the third day of the treatment. (69 000/mu l, 97 000/mu l and 49 000/mu l respectively). Platelet counts recovered after discontinuation of treatment. In conclusion, this study demonstrates that PPIs may cause thrombocytopenia, and this result should not be ignored. In particular, patients with PPI infusion therapy should be monitored more closely.
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    PLASMA LEVELS OF NESFATIN-1 IN PATIENTS WITH POLYCYSTIC OVARY SYDROME
    (Carbone Editore, 2014) Binnetoglu, Emine; Erbag, Gokhan; Gencer, Meryem; Turkon, Hakan; Asik, Mehmet; Gunes, Fahri; Sen, Hacer
    Introduction. Polycycstic ovary syndrome (PCOS) is an important disorder in women of reproductive age which is characterised with menstrual dysfunction, anovulation and hyperandrogenism. 5-10% of the female population affected by this syndrome. Nesfatin-1 is a new anorexigenic hormone which is expressed from several regions of hypothalamus and peripheral tissues. Nesfatin-1 is related with obesity, insulin resistance and appetite. We aimed to evaluated the nesfatin-1 levels in patients with PCOS. Material and methods: Sixty-five patients (37 patients with PCOS and 28 healthy control subjects) were enrolled in the study. We included newly diagnosed patients with PCOS in our study. Diagnosis of PCOS was based on the 2003 ESHREIASRM diagnostic criteria. Results: The patients with PCOS and controls were similar in terms of mean age body mass index (BMI), waist/hip (W/H) ratio and homeostasis model assessment-insulin resistance (HOMA-IR) index. Plasma Nesfatin-1 levels were similar between groups. There was no correlation between plasma Nesfatin-1 levels and other parameters. Conclusion: In conclusion nesfatin-1 may be play important role in glucose metabolism and insulin resistance. In this study due to the absence of insulin resistance in PCOS patients, levels of Nesfatin-1 were similar with control group. Nesfatin levels were associated with glucose metabolism, but further studies are needed in this regard.
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    Predictive value of elevated neutrophil-lymphocyte ratio for left ventricular systolic dysfunction in patients with non ST-elevated acute coronary syndrome
    (Professional Medical Publications, 2015) Bekler, Adem; Erbag, Gokhan; Sen, Hacer; Gazi, Emine; Ozcan, Sedat
    Objective: We aimed to study the predictive value of the neutrophil-lymphocyte ratio (NLR) for left ventricular systolic dysfunction (LVSD) in patients with non ST-elevated acute coronary syndrome (NST-ACS). Methods: A total of 405 patients (mean age 62 years and 75% male) with NST-ACS were included in the study. The study population was divided into tertiles based on admission NLR values. The low, medium and high tertiles defined as NLR <= 1.81 (n=135), 1.81<=.3.2 (n=135) and NLR>3.2 (n=135), respectively. Results: The patients in the high NLR group were older (p<0.001), have higher rate of diabetes mellitus (p=0.028) and non-ST elevated myocardial infarction (NSTEMI) (p<0.001) and have lower left ventricular ejection fraction (LVEF) (p<0.001). Baseline WBC (p=0.02) and neutrophil (p<0.001) levels and NLR (p<0.001) were significantly higher, baseline hemoglobin (p=0.044), hematocrit (p=0.019) and lymphocyte (p<0.001) levels were significantly lower in the high NLR group. NLR was negatively correlated with LVEF in correlation analysis. An NLR >3.2 and age >= 70 were found to be an independent predictor of systolic dysfunction in multivariate analyses. Conclusion: An NLR >3.2 is a useful predictor for LVSD in patients with NST-ACS. The practice of using an NLR count on admission may be useful for identifying high-risk patients and their associated treatment methods.
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    Relationship Between Bilirubin Level and Disease Activity in Crohn's Disease
    (Derman Medical Publ, 2016) Sen, Hacer; Akbal, Erdem; Erbag, Gokhan; Binnetoglu, Emine
    Aim: Crohn's disease (CD) is a chronic inflammatory disease of the gastrointestinal system. Regarding its pathogenesis, it is known that transmural inflammation develops in the bowel. In recent years, it has been considered that bowel damage occurs as a consequence of an imbalance between oxidative stress and ischaemia and antioxidant capacity. Bilirubin is the metabolic product that develops as a result of heme destruction. In oxidative stress, blood bilirubin levels increase in correlation with the intensity of ischaemia. The aim of our study was to evaluate the potential of bilirubin as a serum factor to be a marker of disease activity of CD. Material and Method: Thirty patients diagnosed with active CD and 66 healthy control subjects were involved in the study. Clinical activity was determined using the Crohn's Disease Activity Index (CDAI). Serum bilirubin levels of active disease and remission periods were compared with the control group. Results: When total bilirubin values were examined, the bilirubin level among Crohn's disease patients was significantly increased compared to the control group (p < 0.05). The total bilirubin value exhibited significant alteration during the remission period (p < 0.05). Discussion: Our study showed that serum bilirubin was increased in active CD patients compared to controls.
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    Relationship between presence of fragmented QRS on 12-lead electrocardiogram on admission and long-term mortality in patients with non-ST elevated myocardial infarction
    (Turkish Soc Cardiology, 2014) Bekler, Adem; Gazi, Emine; Erbag, Gokhan; Peker, Tezcan; Barutcu, Ahmet; Altun, Burak; Temiz, Ahmet
    Objectives: Fragmented QRS (fQRS) as a predictor of cardiac events in coronary artery disease has previously been reported. In this study, we hypothesized that presence of fQRS on a 12-lead electrocardiogram (ECG) on admission would be predictive of adverse outcomes in non-ST elevated myocardial infarction (NSTEMI). Study design: A total of 149 NSTEMI patients (112 male, 37 female) were retrospectively analyzed. The fQRS pattern was defined as the presence of an additional R', notching in the nadir of the S wave, fragmentation of the RS or QS complexes in 2 contiguous leads corresponding to a major coronary artery territory. The relationship between presence of fQRS on admission on a 12-lead ECG, and primary end points [cardiovascular death (CVD)] and secondary end points (re-infarction, repeat target vessel revascularization [percutaneous/surgical]) were assessed. The median follow-up time was 18 (13-24) months. Results: Other than age, there were no significant differences in baseline characteristics and laboratory findings for patients in the fQRS and non-fQRS groups. The patients in the fQRS group were older [64 years vs 59 years, p=0.048]. CVD and re-infarction were significantly higher in the fQRS group in the median 18- month follow-up (26.1% vs 8.7%, p=0.005; 23.9% vs 10.7%, p=0.035, respectively). By a multivariate regression analysis in all 149 patients, age = 65 years and the presence of fQRS in a 12-lead ECG on admission were found to be powerful independent predictors of cardiovascular mortality (HR: 4.91, 95% CI: 1.60-15.03, p=0.005; HR: 2.77, 95% CI: 1.02-7.50, p=0.044, respectively). Conclusion: Presence of fQRS on a 12-lead ECG on admission is associated with increased long-term mortality in patients with NSTEMI.
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    Relationship between red cell distribution width and long-term mortality in patients with non-ST elevation acute coronary syndrome
    (Kare Publ, 2015) Bekler, Adem; Tenekecioglu, Erhan; Erbag, Gokhan; Temiz, Ahmet; Altun, Burak; Barutcu, Ahmet; Gazi, Emine
    Objective: Red cell distribution width (RDW) has been reported to be a predictor of cardiac events in coronary artery disease (CAD). Here, we hypothesized that RDW level on admission would be predictive of adverse outcomes in non-ST elevation acute coronary syndrome (NST-ACS). Methods: In total, 202 patients with NST-ACS (159 males and 43 females) were retrospectively analyzed. The patients were divided into two groups based on the 50th percentile of admission RDW levels. A high RDW group (n=100) was defined as those patients having RDW levels of >14.0. The relationship between RDW and primary endpoint (cardiovascular death), secondary endpoints [(reinfarction, repeat target vessel revascularization-percutaneous/surgical)], and major adverse cardiac events (MACE) were assessed. The median follow-up time was 18 (13-24) months. Results: The patients in the high RDW group were older (62.9 vs. 57.5, p=0.001). Multivessel disease, low-density lipoprotein, creatinine, platelet, CK-MB, troponin I, and RDW were higher (p=0.047, p=0.003, p=0.012, p=0.012, p=0.017, p<0.001, respectively), and gender (male/female), ejection fraction, and hemoglobin levels were lower (p=0.021, p=0.04, p=0.016, respectively) in the high RDW group. Cardiovascular death and MACE were higher in the high RDW group (16% vs. 4.9%, p=0.01, 52% vs. 31.4%, p=0.003, respectively). By multiple regression analysis in 202 patients, age >= 65 and RDW > 14.0% on admission were found to be powerful independent predictors of cardiovascular mortality (OR: 4.5, 95% CI: 1.5-13.1, p=0.005, OR: 3.0, 95% CI: 1.0-8.9, p=0.039, respectively). Conclusion: A high RDW level on admission is associated with increased long-term mortality in patients with NST-ACS.
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    Right ventricular function and its relationship with grade of hepatosteatosis in non-alcoholic fatty liver disease
    (Clinics Cardive Publ Pty Ltd, 2015) Bekler, Adem; Gazi, Emine; Erbag, Gokhan; Binnetoglu, Emine; Barutcu, Ahmet; Sen, Hacer; Temiz, Ahmet
    Objective: This study was designed to assess right ventricular systolic and diastolic function and its relationship with grade of hepatosteatosis (HS) in non-alcoholic fatty liver disease (NAFLD) patients using conventional and tissue Doppler echocardiography. Methods: NAFLD was diagnosed in 32 individuals (15 males, 17 females; 59% were grade I HS, 41% grade II-III HS) by means of ultrasonography. Twenty-two individuals, whose ultrasonography data did not show HS, comprised the control group (11 males, 11 females) and were included in the study. Right ventricular systolic and diastolic function and their relationship with grade of HS were assessed by conventional and tissue Doppler echocardiography. Additionally, right ventricular global function was assessed by myocardial performance index (MPI). Results: When compared by conventional echocardiographic parameters, there were no significant differences between the two groups. With tissue Doppler parameters, the tricuspid annulus peak early diastolic velocity and ratio of early-to-late diastolic velocity were lower in the patients than in the controls (p = 0.03, p = 0.02, respectively). The isovolumetric relaxation time and MPI were significantly higher (p < 0.001, p < 0.001, respectively) in the patient group. HS grade was positively correlated with right ventricular isovolumetric relaxation time and MPI index (r = 0.295, p = 0.03, r = 0.641, p < 0.001, respectively). Conclusion: These results show that right ventricular diastolic dysfunction (RVDD) in patients with NAFLD and degree of HS was associated with RVDD.
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    The Prevalence of Incidental Adrenal Mass Found Using Diagnostic Imaging Techniques
    (Galenos Yayincilik, 2013) Sen, Hacer; Asik, Mehmet; Uysal, Fatma; Kizildag, Betul; Binnetoglu, Emine; Gunes, Fahri; Erbag, Gokhan
    Purpose: Incidentally-found adrenal masses detected by imaging studies performed for unrelated reasons have become more common in the clinical practice. Our study aims to assess the nature and prevalence of incidental adrenal masses discovered on CT or MRI in patients without malignancy. Material and Method: We analyzed the reports of 8378 abdomen or chest CT and 820 abdominal MRI examinations performed on 4973 patients in our hospital. We found 629 (12.6%) incidental adrenal masses. We excluded 194 (3.9%) patients with known cancer or high-risk adrenal metastasis. The remaining 435 (8.7%) adrenal masses constituted the study group. This group consisted of 274 (5.9%) patients [123 (44.9%) women and 151 (55.1%) men] with masses greater than 1 cm in diameter and 161 (2.8%) patients with masses less than 1 cm. Results: The mean age of the patients was 62.55 +/- 13.23 years. Unilateral adenoma was the most common type of adrenal masses (n= 112, 40.9%). Less commonly observed adrenal masses were: unilateral [n= 79 (28.8%)] and bilateral [n= 35 (12.8%)] macronodular hyperplasia, unilateral [n= 33 (12%)] and bilateral [n= 2 (0.7%)] diffuse adrenal thickness, bilateral adenoma [ n= 7 (2.6)], unilateral [n= 3 (1.1%)] and bilateral [ n= 3 ( 1.1%)] micronodular hyperplasia. The masses were most commonly found in the left adrenal gland (165, 60.2%). They were found at lower rates in the right adrenal gland (66, 24.1%) and bilateral adrenal glands (43, 15.7%). The mean sizes of left and right adrenal masses were 1.89 +/- 1.11 cm and 2.02 +/- 0.86 cm, respectively. Discussion: Patients harbouring adrenal incidentalomas should be evaluated for the possibility of malignancy and/ or hormone activity. The lack of controlled studies impedes specific management and recommendations for adrenal incidentalomas. Large prospective controlled studies on this topic are needed.