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Öğe Evaluation of carotid-femoral pulse wave velocity, aortic stiffness index, and aortic distensibility in patients with fibromyalgia(Springer London, 2019) Gunturk E.E.; Ekiz T.; Akkaya H.Objective: The aim of this study was to compare the carotid-femoral pulse wave velocity (CFPWV), aortic stiffness index (ASI), and aortic distensibility values of fibromyalgia patients with those of healthy subjects. Methods: This study was conducted as a case-control study between September 2017 and March 2018. Echocardiographic evaluations were administered by the same cardiologist. ASI, aortic distensibility, CFPWV, and other echocardiographic parameters of fibromyalgia patients and healthy subjects were compared. In addition, all patients were assessed using the Fibromyalgia Impact Questionnaire (FIQ), number of tender points, and Visual Analogue Scale (VAS) pain score. Results: The fibromyalgia group consisted of 67 female patients with a mean age of 48.54 ± 3.1 years (range, 42–55 years) and the control group consisted of 50 healthy subjects with a mean age of 49.76 ± 3.1 years (range, 42–55 years). No significant difference was observed between the groups in respect of age and body mass index (p > 0.05). CFPWV and ASI values were significantly higher in the fibromyalgia group than in the control group. Aortic distensibility values were significantly lower in the fibromyalgia group compared to the control group (p < 0.05 for all). There was a very strong, positive correlation between the CFPWV values and number of tender points (r = 0.936, p < 0.001), VAS (r = 0.927, p < 0.001), FIQ (r = 0.941, p < 0.001), and ASI (r = 0.957, p < 0.001). Conclusion: CFPWV and aortic stiffness seem to be increased and aortic distensibility seems to be decreased in patients with fibromyalgia. Alleviating pain and improving the disease severity may be helpful in preventing cardiovascular risk factors in patients with fibromyalgia. © 2019, International League of Associations for Rheumatology (ILAR).Öğe Prediction of neonatal respiratory distress syndrome via pulmonary artery Doppler examination(Taylor and Francis Ltd, 2019) Büke B.; Destegül E.; Akkaya H.; Şimşek D.; Kazandi M.Objective: We aimed with this study to evaluate the role of pulmonary artery acceleration time to ejection time ratio (PATET) in the prediction of respiratory distress syndrome (RDS) in preterm neonates. Materials and methods: In this prospective cohort study, 105 singleton pregnant women with no congenital abnormalities and pregnancy complications who delivered before 37 weeks of gestational age were included. All the patients underwent ultrasound examination to obtain fetal pulmonary artery Doppler. 15 patients were excluded from the study as they did not give birth within 3 days subsequent to ultrasound examination, or inadequate Doppler measurements. After delivery the neonates were grouped according to diagnosis of RDS as RDS + and RDS-. Results: One hundred five women met the inclusion criteria. Regarding the Doppler findings; only the PATET ratio was significantly different between the groups (0.2965 ± 0.042 versus 0.386 ± 0.068 p <.001, Z = -5.206). There was an inverse correlation between the diagnosis of RDS in the neonates and the PATET values, even after adjusted for gestational age estimated fetal weight and fetal gender (r = -0.52 and p =.0017). A cut-off value of 0.327 provided optimal specificity of 77.1%, a sensitivity of 90.9%, a negative predictive value of 95.4%, and a positive predictive value 52.7%. Conclusions: In consideration of these results fetal PATET ratio is a promising noninvasive tool to predict RDS in cases of preterm deliveries. © 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group.Öğe The effect of increased amnion volume severity on fetal Doppler indices and perinatal outcomes in idiopathic polyhydramnios(Taylor and Francis Ltd, 2018) Akkaya H.; Büke B.; Destegül E.Aim: To evaluate the relationship between polyhydramnios severity and alterations in Doppler indices and perinatal outcomes in idiopathic polyhydramnios. Methods: This prospective case control study was conducted in a tertiary hospital with 173 singleton pregnancies between 29 and 41 weeks gestational age between May 2015 and December 2016. Polyhydroamnios is classified as mild (amniotic fluid index 25–30 cm), moderate (30.1–35 cm), and severe (>35 cm) and the number of the patients in mild, moderate, and severe groups were 55, 39, and 26, respectively. The results were compared with 53 healthy controls. Fetal echocardiography and Doppler measurements of the groups were made and the perinatal outcomes from each group were noted. The relationship between the results and the severity of polyhydramnios was analyzed statistically. Results: The myocardial performance index was significantly higher in the fetuses of women with severe polyhydramnios compared to the other groups (p =.006). There were statistically significant differences among the groups in terms of first and fifth minutes according to the Apgar scores (p =.011, p =.016 respectively). In the severe polyhydramnios group compared with other groups, the middle cerebral artery pulstatility index was significantly lower (p =.002), while middle cerebral artery peak systolic velocity and umbilical artery pulstatility index values were significantly higher (p =.0001, p =.045). Conclusions: Our study showed an increase in myocardial performance index and middle cerebral artery peak systolic velocity values and a decrease in middle cerebral artery pulstatility index values, especially in the severe idiopathic polyhydramnios group. Idiopathic polyhydramnios were associated with low first and fifth minute Apgar score. Additionally, the increase in umbilical artery pulstatility index value and the decrease in middle cerebral artery pulstatility index value became more apparent with the increase in amniotic fluid volume. It should be taken into consideration that brain sparing effect may develop especially in cases with severe polyhydramnios. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.Öğe The effect of nebivolol on P wave duration and dispersion in patients with Behçet's disease; a prospective single-arm controlled study [Behçet hastali{dotless}gi{dotless}nda nebivololün P dalga süresi ve P dalga dispersiyonuna etkisi; prospektif, tek grup kontrollü çali{dotless}şma](AVES Ibrahim Kara, 2013) Akkaya H.; Karakaş M.S.; Şahin Ö.; Borlu M.; Oguzhan A.Objective: Behçet's disease (BD) is a chronic multi-system disease presenting with recurrent oral and genital ulceration, and relapsing uveitis. Left ventricular diastolic dysfunction, ventricular arrhythmia and sudden cardiac death have been documented in BD. P wave dispersion (PD) has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. PD has been reported to be longer in patients with BD. Nebivolol, besides its selective beta1-blocking activity, causes an endothelium dependent vasodilatation through nitric oxide release. In this study, we searched for the effects of nebivolol on P wave duration and dispersion in patients with BD. Methods: This study was designed as prospective single-arm controlled study. We prospectively studied 35 Behçet's patients who were diagnosed according to the International Study Group criteria. Patients received 5 mg nebivolol per day for 3 months. The patients were evaluated with 12-leads electrocardiography at baseline and after for 3-month therapy. The difference between maximum and minimum P wave durations was defined as PD. The paired samples t test, Wilcoxon test were used for statistical analysis. Results: A significant decrease was observed in PD after therapy period (62.85±21.62 vs. 44.28±18.03 msec, p=0.001). No adverse effects were observed in treatment period. Conclusion: BD is associated with prolonged P wave duration and dispersion. We have shown for the first time that nebivolol causes a significant decrease in maximum P wave duration and PD in patients with BD. However, further comprehensive studies are needed to determine the long-term effects of nebivolol. © 2013 by AVES Yayi{dotless}nci{dotless}li{dotless}k Ltd.
