bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophil-to-lymphocyte ratio independently predicts the epicardial fat thickness in diabetic patients
Authors: TURAN Yaşar , TURAN Elif 
Published: September 2019

Purpose: The aim of this study was to investigate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and epicardial fat thickness (EFT) in diabetic and non-diabetic patients, and to determine the factors affecting EFT in diabetic patients.Materials and Methods: In this cross-sectional study, 92 diabetic patients and 40 healthy volunteers without diabetes, admitted to our outpatient clinic, were included. Demographic data, anthropometric measurements, biochemical and hematological results, echocardiography findings and EFT were recorded. NLR and PLR were calculated. These values were compared statistically between the two groups.Results: The two groups were similar in terms of age, gender, smoking status, diastolic blood pressure, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and PLR. Body mass index (BMI), frequency of hypertension, systolic blood pressure, serum glucose, HbA1C, serum creatinine, triglyceride, total cholesterol/HDL, NLR and EFT were significantly higher in the diabetic group than the control group. Ejection fraction was significantly lower in diabetic group than the controls. NLR and BMI were independent predictors of EFT in diabetic patients.Conclusion: We suggest that echocardiographic EFT measurement, NLR and BMI might be useful in the evaluation of cardiovascular risk in diabetic patients.
Relationship between platelet distribution width and hospital stay in incarcerated inguinal hernia treated by open surgery
Authors: ULUTAŞ Kemal Türker , DAL Mehmet Burak 
Published: September 2019

Purpose: The study aimed to investigate the value of platelet distribution width (PDW) in incarcerated inguinal hernia which was treated with graft to illuminate its inflammatory role in surgery-related disorders.Materials and Methods: We perormed a case-control study by retrospective screening data of the 88 patients with inguinal hernia and 75 healthy. Patients data included demographics, hernia location, hospital stay, and hemogram parameters. Platelet-related parameters were anayzled with automated devices from EDTA samples.Results: The mean defect size was 25.3±17 mm for inguinal hernia, which ranged 6 to 75 mm. The PDW value was higher in group A as compared with that of group B. Also, the platelets were statistically higher in group A than group B. In the Pearson correlation analysis, PDW showed a strong and positive relationship with a hospital stay. Conclusion: We suggest that a strong positive correlation of platelet distribution width with hospital stay can be useful in incarcerated inguinal hernia which we treated with grafted by open surgery.
Hepatosellüler karsinomada bridging veya downstaging sonrası karaciğer transplantasyonu ile direkt transplantasyon stratejilerinin sağkalım üzerine etkilerinin karşılaştırılması
Authors: BALLI Tuğsan , ÜLKÜ Abdullah 
Published: September 2019

Amaç: Bu çalışmanın amacı kadaverik karaciğer transplantasyonu yapılmış hepatosellüler karsinomalı hastalarda downstaging ve bridging tedavilerinin transplantasyon sonrası sağ kalım süreleri üzerine etkilerini araştırmaktır.Gereç ve Yöntem: Çalışmamıza hepatosellüler karsinoma tanısı almış ve kadaverik karaciğer transplantasyonu yapılmış 33 hasta dahil edilmiştir. Bu hastalar downstaging, bridging ve kontrol olmak üzere 3 gruba ayrılmıştır. Bridging ve downstaging gruplarına transplantasyon öncesi transarteriyal kemo-embolizasyon, transarteriyal radyo-embolizasyon, radyofrekans ablasyon veya mikrodalga ablasyon tedavileri uygulanırken kontrol grubuna herhangi bir tedavi uygulanmadı. Transplantasyon sonrası sağ kalım süreleri hesaplanırken Kaplan-Meier yaşam analizi kullanıldı.Bulgular: Ortalama takip süresi 37,5±32,1 ay olarak hesaplandı. Genel sağ kalım oranı %48,5 idi. En yüksek sağ kalım oranı bridging grubunda (%54,5), daha sonra kontrol grubunda (%50,0) ve en düşük olarak (%41,7) downstaging grubunda olduğu tespit edildi. Her ne kadar gruplar arasında farklılıklar olsa da istatistiksel olarak anlamlı sonuçlar elde edilemedi.Sonuç: Bu çalışma ile bridging ve downstaging yöntemlerinin transplantasyon yapılacak hepatosellüler karsinomalı hastaları Milan Kriterleri içinde tutmaya yarayan etkili staratejiler olduğu, downstaging yöntemi uygulanan bazı hastalarda sağ kalım sürelerinin ortalamanın üstüne çıktığı sonucu elde edilmiştir.
Determination of clonal relationships and virulence genes of vancomycin-resistant enterococcus spp. isolated from colonized and infected patients
Authors: GÜVEN GÖKMEN Tülin , NAGİYEV Togrul , AKÇİMEN Beril , KAYAR Begüm , MERAL Melda , KÖKSAL Fatih 
Published: September 2019

Purpose: In this study, we investigated the possible relationship between virulence factors and clonal relationship between Vancomycin-resistant colonization and infection isolates. Materials and Methods: A total of 156 Vancomycin-resistant Enterococcus spp. (VRE) were collected and grouped as infection and colonization isolates. A multiplex polymerase chain reaction analysis was performed to screen specific virulence genes (esp, hyl, asa1, cylA and gelE) and vancomycin resistance genes (vanA, vanB). The clonal relationship among isolates was investigated by the Pulsed Field Gel Electrophoresis (PFGE) method. Results: The vanA gene was determined in 86 infection and 64 colonization isolates. esp was the most common virulence gene for both groups (55.8% and 56.25%), followed by hyl (51.1% and 35.9%) that statistically differed between the two groups. The 150 E. faecium isolates carrying the vanA resistance gene were divided into 24 main clusters (A-Y) in PFGE analysis. Conclusion: When the distribution of virulence genes or genes combinations of the infection and colonization groups was examined, there was no statistical significance of cluster distribution in the two groups. However, hyl gene was found to be more common in infection isolates.
Assessment of myocardial function by tissue Doppler imaging myocardial performance index in patients with acute ischemic stroke
Authors: ÖZTÜRK Ünal , ÖZTÜRK Önder , TAMAM Yusuf 
Published: September 2019

Purpose: The aim of this study is to investigate the relationship between myocardial function assessed by tissue Doppler imaging myocardial performance index (TDI-MPI) and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke. Materials and Methods: The study comprised 128 patients (males, 55; females, 73; 68 ± 19 years) with acute ischemic stroke. 20 patients were excluded. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score &lt; 16; Group 2, NIHSS score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac function was evaluated by transthorasic echocardiography within 48 hours of admission to the neurology care unit.Results: There were no significant differences among demographic parameters of patients. Tissue Doppler myocardial performance index was significantly higher in Group 2 patients than in Group 1 patients (0.62±0.28 vs 0.46±0.16).Conclusion: Our results suggest that TDI-MPI is associated with stroke severity on admission in patients with acute ischemic stroke. TDI-MPI is an indicator of global myocardial dysfunction with a different from LVEF. TDI-MPI, which includes both systolic and diastolic time intervals to assess the global cardiac dysfunction.
Acute angle closure glaucoma induced by selective serotonin reuptake inhibitor, and reversed by agomelatine
Authors: KARAYTUĞ Mahmut Onur , DEMİRKOL Mehmet Emin , TAMAM Lut 
Published: September 2019

Agomelatine, a MT1 (Melatonin) and MT2 receptor agonist and 5-HT2C (5-Hidroksitriptamin) antagonist, is an antidepressant agent used in the treatment of major depressive disorders. Intraocular pressure lowering effect of melatonin and its analogues have been demonstrated in a few experimental studies. In the present case report, we have documented the reversal of angle closure glaucoma by oral agomelatine in a patient with major depressive disorder under selective serotonine reuptake inhibitor treatment. The patient, who had previously been diagnosed with glaucoma, was also receiving antiglaucomatous treatment.
Üniversite yaşamının cinsel mit ve tutumlara etkisi
Authors: ERİŞ Özge , ERTEKİN YAZICI Aylin 
Published: September 2019

Amaç: Çalışmamızın amacı kişisel gelişimin ve örgün eğitimin en üst basamağı olan üniversite eğitiminin genç yetişkinlerin kendileri ile ilgili cinsellik konularına, başkalarının seçimlerine, toplumsal bir konu olan imam nikâhına bakış açılarını, cinselliğe dair tutumları ve cinsellikle ilgili mitler üzerine etkilerini değerlendirmektir. Gereç ve Yöntem: BU çalışma için hazırlanmış olan anketin yanısıra standardize bir ölçek olan Cinsel Mitler Ölçeği, Mersin Üniversitesi 1. ve 4. sınıf öğrencilerine uygulanmış, sonuçları karşılaştırılmıştır. Bulgular: Çalışmamıza 337 1. Sınıf ve 329 4. Sınıf öğrencisi toplam 666 öğrenci katılmıştır. Katılımcıların %54.1’i kadın, %45.6’sı erkektir. Üniversite eğitiminde geçen sürecin cinsel mit ve tutumlara pozitif yönde bir etkisi olduğu belirlenmiştir. İlerleyen yaş, olgunlaşan ilişkiler, bireysel gelişim, araştırma, bilgiye daha kolay erişme gibi faktörler de etkili olmuştur.Sonuç: Üniversite yaşamının cinsel tutumları değiştirici ve cinsel mitleri azaltıcı etkisi olduğu sonucuna varılmıştır. Sonuçların toplumsal önlemler almak, yeni politikalar üretilirken yol gösterici olmak açısından fayda sağlayacağı düşünülmektedir.
Surgical Treatment of Ischemic Cardiomyopathy: Current State of the Problem
Authors: Shipulin V. M. , Pryakhin A. S. , Andreev S. L. , Shipulin V. V. , Kozlov B. N. 
Published: September 2019

In this article we present discussion of the current state of the problem of surgical treatment of ischemic cardiomyopathy (ICM). The pathophysiological aspects of left ventricular remodeling in patients with ICM are also covered. A detailed characterization of methods for assessing the myocardial viability is given and their role in patients with ICM is shown. The problem of right ventricular dysfunction in ICM is discussed. Main attention is focused on the methods of surgical treatment of ICM. Limitations of the Surgical Treatment for Ischemic Heart Failure (STICH) study are analyzed. The article is intended for cardiologists, general practitioners and cardiac surgeons.
Spontaneous Coronary Artery Dissection
Authors: Zhukova N. S. , Shakhnovich R. M. , Merkulova I. N. , Sukhinina T. S. , Pevzner D. V. , Staroverov I. I. 
Published: September 2019

During several recent decades spontaneous coronary artery dissection (SCAD) has been known as one of causes of development of acute coronary syndrome (ACS). It has been assumed that this condition is extremely rarely met and is associated with pregnancy and postpartum period. The use in clinical practice of high sensitivity troponin, coronary angiography (CAG) in early period of ACS, in conjunction with the growing awareness of doctors about this pathology led to a revision of the viewse on prevalence of the disease. At present SCAD is considered as one of the causes of ACS in young and middle-aged women. In this review we present results of studies of pathogenesis, diagnostics, and treatment of SCAD, describe various angiographic types of this disease, and discuss problems of choice of optimal strategy of management of patients with SCAD.
Features of Cardiovascular Risk Factors, Target Organ Damage in Patients with Diabetes Mellitus Type 2 and Arterial Hypertension
Authors: Mehdiyev S. Kh. , Mustafaev I. I. , Mamedov M. N. 
Published: September 2019

Aim: to investigate relationship between arterial hypertension (AH) and risk factors / subclinical damage of target organs in patients with type 2 diabetes mellitus (DM2). Methods. We included into this clinical epidemiological study 528 patients with DM2 (30.5 % men, 69.5 % women; mean age 54.1±0.3 years; 80.3 % with AH, 19.7 % without AH), who answered questions of the ARIC study questionnaire related to risk factors. Also, we studied features of target organ damage and laboratory indicators. Results. In comparison with normotensives patients with AH more frequently had ischemic heart disease (12.7±1.6 % vs. 5.8±2.3 %, p<0.05), chronic heart failure (CHF) (30.9±2.2 % vs. 9.6±2.9 %, p<0.001), atherosclerosis of vessels of lower extremities (69.8±2.2 % vs. 53.8±4.9 %, p<0.01) and cerebral vessels (50.9±2.4 % vs. 28.8±4.4 %, p<0.001), history of stroke (5.0±1.1 % vs. 0 %, p<0.05), hypertonic angiopathy (14.5±1.8 % vs. 6.5±2.5 %, p<0.05), low level of high density lipoprotein (87.3±2.2 % vs. 74.5±6.4 %, p<0.05), electro- and echocardiographic signs of left ventricular hypertrophy (75.6±2.1 % vs. 45.4±5.1 %, p<0.001; 61.1±2.6 % vs. 24.4±4.7 %, p<0.001, respectively), lowering of left ventricular ejection fraction (12.5±1.7 % vs. 7.8±2.8 %, p<0.001), diastolic disfunction of the left ventricle (52.6±2.7 % vs. 23.2±4.7 %, p<0.001), atherosclerosis of the aorta (38.0±2.6 % vs. 20.7±4.5 %, p<0.01), lowering of the ankle-brachial index (left – 29.8±2.3 % vs. 14.9±3.5 %, p<0.01; right – 31.5±2.3 % vs. 9.9±3.0 %, p<0.001, respectively), increased intima-media thickness of the right carotid artery (84.6±5.0 % vs. 60.0±11.0 %, p<0.05). Conclusion. In patients with type 2 diabetes and AH, in order to develop strategy of macro- and microvascular complications prevention, it is necessary to conduct early screening of risk factors and subclinical damage of target organs.
Long-Term Survival of Patients with Ischemic Heart Disease After Surgical Correction of Moderate Ischemic Mitral Regurgitation
Authors: Karevа Yu. E. , Efendiev V. U. , Rakhmonov S. S. , Chernyavsky A. M. , Lukinov V. L. 
Published: September 2019

Aim: to assess effect of correction of moderate ischemic mitral regurgitation (IMR) in patients with ischemic cardiomyopathy (IMC) in immediate and remote period. Materials and methods. We included in a single center prospective study 76 patients with IMC, left ventricular ejection fraction ≤35 %, and moderate IMR. Patients with indications to postinfarction aneurism repair were not included. For randomization we used the method of envelopes. Thirty-eight patients were randomized in the group where coronary artery bypass grafting (CABG) was combined with of mitral valve repair (MVR), and 38 patients in the control group of isolated CABG. Mean age of patients was 57±8 (from 30 to 75 лет) years. For IMR correction we used rigid MEDENG ring. Results. Inhospital mortality was 5.4 % (n=2) after isolated CABG and 10.81 % (n=4) after CABG + MVR. Main cause of death was acute heart failure. One- and 2‑year survival was 84 and 78 %, respectively, after CABG+MVR, and 84 and 71 % after isolated CABG. There was significant difference in three-year survival between groups (hazard ratio [HR] of death 0.457, p=0.04). Five-year survival was 45 and 74 % after isolated CABG and CABG+MVR, respectively (р=0.037). Factors associated with inhospital mortality were pulmonary hypertension (HR 2.177, 95 % confidence interval [CI] 2.299 to 9.831; p=0.043), NYHA class IV chronic heart failure (HR 3.027, 95 % CI 1.605 to 5.707; р=0.001), negative result of stress test echocardiography (HR 0.087, 95 %CI 0.041 to 0.186; р<0.001), atrial fibrillation (HR 4.754, 95 %CI 2.299 to 9.831; р<0.001). Conclusion. Correction of moderate IMR in patients with IMC leads to improvement of parameters of survival in remote period. Five-year survival after isolated CABG was 45 %, while after CABG+MVR – 74 % (р=0.037).
The Strategy of Management Patients with non-ST Elevation Acute Coronary Syndrome
Authors: Prilutskaya Yu. A. , Dvoretski L. I. 
Published: September 2019

The review covers issues of epidemiology, diagnostics, management strategy, and treatment outcomes in patients with non-ST elevation acute coronary syndrome. Numerous factors affecting the choice of an invasive strategy are analyzed as well as its correspondence to existing recommendations of patient’s management. The stratification of risk of development of adverse coronary events, which is a part of the formation of a treatment strategy, is discussed.
The Case of Fulminant Myocarditis
Authors: Titov V. A. , Shishkova A. A. , Mitrofanova L. B. , Ivanova S. V. , Zverev D. A. , Marichev A. O. , Moiseeva O. M. 
Published: September 2019

Fulminant myocarditis (FM) is a severe form of inflammatory myocardial injury rapidly developing as acute heart failure, cardiogenic shock, or life-threatening disturbances of cardiac rhythm. FM requires intensive treatment including drug therapy, mechanical circulatory support, and in some cases – heart transplantation. Echocardiography can be used as a screening method of diagnostics. Magnetic resonance imaging of the heart often cannot be performed because of hemodynamic instability of a patient, therefore endomyocardial biopsy with histological and immunohistochemical studies as well as molecular-genetic analysis of obtained samples is required for final diagnosis. Prognosis of the disease is determined by histological picture. In most cases, after cessation of acute stage of the inflammatory process, FM has a favorable long-term prognosis. In this article we present a clinical case of FM and review of current literature on diagnosis and treatment of this disease.
The Possibility of Correcting Anxiety Symptoms in Cardiac Patients in Primary Care Settings: Results of the Therapeutic Part of a Russian Multicenter Study COMETA
Authors: Pogosova N. V. , Yufereva Y. M. , Ausheva A. K. , Kursakov A. A. , Arutyunov A. A. , Boytsov S. A. 
Published: September 2019

Purpose: to assess efficacy of correction of anxiety states by anxiolytic drug fabomotizole in ambulatory patients with arterial hypertension (AH) and / or ischemic heart disease (IHD).Materials and methods. In the framework of multicenter cross-sectional study with participation of patients aged ≥55 years with verified AH / IHD we conducted the therapeutic part of the COMETA program in which we included patients with comorbid anxiety state (≥11 points on the Hospital Anxiety and Depression Scale Anxiety [HADS-A] and clinically expressed anxiety state) without clinically expressed depressive symptoms (<11 points on the HADS-Depression). Participants were randomized into main and control groups. Patients in the main group in addition to therapy prescribed because of AH / IHD were given a recommendation to take fabomotizole (10 mg thrice a day), patients of control group received standard therapy. Efficacy of therapy was evaluated by HADS and visual analog scale after 6 and 12 weeks of observation.Results. We included 182 and 104 in the main and control groups, respectively. Most patients in main and control groups had AH (97.3 and 95.2 %, respectively, about one third had IHD (36.8 and 30.8 %, respectively). Social-demographic, clinical characteristics, and recommended for AH / IHD treatment of participants of both groups were similar. Portion of patients with complete reduction of anxiety symptoms (<8 points on HADS-A) was significantly higher already after 6 weeks of fabomotizole therapy (37.9 and 19.2 %, respectively, p<0.001). Analogous picture was noted by the end of observation (66.9 and 32 %, respectively; p<0.001). Mean estimate of chronic psychoemotional stress in the main group decreased by 25 % after 6 weeks (from 6.45±2.20 to 5.05±1.96 points; р<0.001) and by 40 % after 12 weeks (from 6.45±2.20 to 3.98±1.99 points; р<0.001). In the control group it also decreased but degree of lowering was 2 times less than in the main group (11.1 % vs. 25 % after 6 weeks, р=0.016; and 20 % vs. 40 % after 12 weeks, р<0.001, respectively).Conclusion. The use of fabomotizole by patients with AH / IHD provided improvement of psychological status (reduction of anxiety symptoms and lowering of the level of chronic psychoemotional stress).
Approaches to the Diagnosis and Treatment of Arterial Hypertension in the Light of European Recommendations
Authors: Larina V. N. , Bart B. Ya. , Vartanian E. A. , Fedorova E. V. , Mikhailusova M. P. , Lunev V. I. 
Published: September 2019

In this review we present analysis the European recommendations on hypertension – what’s new and what has changed in the tactics of managing patients with arterial hypertension (AH). We compared recommendations on hypertension of the European Society of Cardiology (ESC) and the European Society of hypertension (ESH) 2018 with European recommendations of previous years. In the updated version of guidelines, it is still recommended to determine AH as blood pressure (BP) ≥140 and / or ≥90 mm Hg; to subdivide BP levels into optimal, normal, and high normal, to classify severity of AH as 3 degrees, and to distinguish separately its isolated systolic form. Values for out-of-office BP remained unchanged, but recommendations emerged concerning wider use of ambulatory BP monitoring and self-measurement of BP. For initial therapy, it was recommended to use two drugs combinations preferably as single pill combinations. An increase of the role of nurses and pharmacists in teaching, supporting patients and controlling hypertension has been noted. This can improve the achievement of target BP and, as a result, reduce the cardiovascular risk. New European recommendations highlight the modern aspects of classification and diagnosis of AH, main stages of screening, and algorithm of drug treatment of AH.
Treatment of Patients with Stable Manifestations of Atherosclerotic Vascular Disease: New Possibilities (Conclusion of the Council of Experts from November 16, 2018, Rostov-on-Don)
Authors: Kanorskii S. G. , Vasuk Y. A. , Gridasova R. A. , Kastanayan A. A. , Pagaev F. P. , Sadovoy V. I. , Sidorov R. V. , Terent’ev V. P. , Tuaeva I. B. , Frolov D. V. , Khaisheva L. A. , Khripun A. V. , Chesnikova A. I. 
Published: September 2019

In the conclusion of the council of experts (list of participants see text) the following issues are discussed: regional specifics of diagnostics and therapy of patients with ischemic heart disease (IHD) and / or peripheral arterial disease (PAD), methods of risk assessment in patients with stable course of atherosclerotic disease, pathogenetic validity of simultaneous inhibition of coagulation and platelet thrombus formation, as well as clinical significance of a novel therapeutic approach – combined use of rivaroxaban and acetylsalicylic acid (ASA). Possible problems and ways to their solution at implementation in clinical practice of the novel scheme of antithrombotic therapy are presented. Importance of multidisciplinary approach to management of patients with IHD and concomitant diseases is stressed. Experts have noted that after registration of the corresponding indication therapy with rivaroxaban 2.5 mg twice daily and ASA 75–100 mg once daily might be recommended to majority of patients with atherosclerotic involvement of blood vessels. In real clinical practice prescription of this therapy is appropriate first of all in patients with IHD and high risk of complications – with multifocal atherosclerosis, with history of myocardial infarction after stoppage of dual antiplatelet therapy, – patients with concomitant diabetes, heart failure, and other prognosis worsening comorbid diseases. Experts express hope that in the nearest time combined antithrombotic therapy will be included into corresponding national clinical recommendations.