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Diagnostic accuracy and effective radiation dose of high pitch dual source multidetector computed tomography in evaluation of coronary artery bypass graft patency

Koplay M. | Guneyli S. | Akbayrak H. | Demir K. | Sivri M. | Avci A. | Erdogan H.

Article | 2016 | Wiener Klinische Wochenschrift128 ( 13-14 ) , pp.488 - 494

Objective: The aim of the study was to evaluate the diagnostic accuracy and effective radiation dose (ERD) of high pitch dual source multidetector computed tomography (MDCT) for coronary artery bypass graft (CABG) patency. Materials and methods: Fourty-five patients who underwent 128 × 2-slice MDCT angiography with a prospective electrocardiogram-triggering, low-dose, high pitch, dual source, flash spiral acquisition mode after CABG surgery were included in the study. The interobserver agreement of the image quality was evaluated with Cohen ? value. The image quality was compared to the heart rates (HRs) using Mann–Whitney U test an . . .d to the graft segments using ? 2 test. The findings for the CABG patency on MDCT were compared to those determined on catheter coronary angiography. Dose-length product (DLP) and ERD were compared to the gender, HRs, and body mass index (BMI) of the patients using Kruskall Wallis and Mann–Whitney U tests. Results: A total of 110 grafts and 330 vessel segments were evaluated with a good interobserver agreement (? = 0.80). The image quality was better in proximal and middle graft segments (p < 0.05), as well as in the patients with low HRs (p < 0.05). High pitch MDCT had the following sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for evaluation of graft patency: 92.8, 99.3, 92.8, 99.3 and 98.8 %, respectively. ERD was correlated to the HRs and BMI. Conclusions: High pitch 128 × 2-slice dual source CT angiography is a noninvasive imaging modality, and it can be safely and effectively used in evaluation of CABG patency with lower radiation dose. © 2016, Springer-Verlag Wien Daha fazlası Daha az

Imaging findings of pulmonary granulomatosis with polyangiitis (Wegener’s granulomatosis): lesions invading the pulmonary fissure, pleura or diaphragm mimicking malignancy

Guneyli S. | Ceylan N. | Bayraktaroglu S. | Gucenmez S. | Aksu K. | Kocacelebi K. | Acar T.

Article | 2016 | Wiener Klinische Wochenschrift128 ( 21-22 ) , pp.809 - 815

Background: Granulomatosis with polyangiitis (GPA, formerly Wegener’s granulomatosis), in which pulmonary involvement often predominates, is a multisystem granulomatous, necrotizing vasculitis that affects small and medium-sized vessels. In this study we evaluated various radiological findings of pulmonary GPA and focused on spiculated pulmonary lesions invading the pulmonary fissure, pleura or diaphragm mimicking malignancy. Methods: This retrospective study included 48 patients, aged 28–73 (mean, 47.3) years, who showed either histopathological diagnosis of GPA (n = 39) or elevated levels of the cytoplasmic anti-neutrophilic cytop . . .lasmic antibody serum marker (n = 9) between January 2003 and December 2013. All patients received a chest computed tomography (CT), and the types of pulmonary lesions were defined and evaluated. Results: Among the 48 patients, 33 had abnormal pulmonary findings on CT. The most commonly detected pulmonary lesion types were nodules and masses (n = 126) observed in 24 patients. Cavitation, necrosis, spiculation and invasion of the fissure, pleura or diaphragm were observed in 14, 9, 10 and 6 patients, respectively. Consolidation was found in 14 patients and thickening of bronchial wall in 8 patients. Conclusions: Pulmonary lesion types of GPA have a wide spectrum, potentially mimicking a high number of diseases including malignancy, infection and noninfectious inflammatory diseases. A spiculated lung lesion invading the fissure, pleura or diaphragm is mostly present in malignancy, but it can be also seen in GPA. © 2015, Springer-Verlag Wien Daha fazlası Daha az

Pneumonia in patients with novel influenza a (H1N1) virus in southeastern turkey

Örnek T. | Yalçın F.D. | Ekin S. | YalçIn S. | Yemişen M.

Article | 2011 | Wiener Klinische Wochenschrift123 ( 03.Apr ) , pp.106 - 111

Summary: The objective of this study was to describe the clinical characteristics and the radiological and laboratory findings of the hospitalised patients who had novel, laboratory-confirmed, swine-origin influenza A virus (S-OIV) infection with pneumonia. Between October and December 2009, 56 patients hospitalised for pneumonia who were tested for S-OIV infection were retrospectively evaluated. Thirty-three patients had positive S-OIV infections. In addition, 23 of the 56 patients who had negative test results for S-OIV infection were compared with the positive group. The mortality rate amongst the patients with S-OIV infection wa . . .s 24.2%. Of the 33 patients, 42.4% had at least one underlying medical condition and 4 (12%) patients were pregnant or postpartum. Fourteen patients (42.4%) with S-OIV infection were followed up in an intensive care unit. The most common symptom was dyspnea. The mean peak body temperature during hospital stay (39.42 ± 0.70) was higher in this group than in the negative group (38.51 ± 1.05) (p = 0.001). Thrombocytopenia, increased creatine kinase and elevated lactate dehydrogenase levels were statistically significant. Bilateral infiltration was more common in the patients with S-OIV infection. Although some laboratory, radiological and clinical data show a significant difference between the patients with S-OIV pneumonia and the negative group, each patient presenting with signs of pneumonia during pandemia should be tested for Influenza A. © 2011 Springer-Verlag Daha fazlası Daha az

The results of computed tomography guided tru-cut transthoracic biopsy: Complications and related risk factors

Beşir F.H. | Altın R. | Kart L. | Akkoyunlu M. | Özdemir H. | Örnek T. | Gündoğdu S.

Article | 2011 | Wiener Klinische Wochenschrift123 ( 03.Apr ) , pp.79 - 82

Summary: INTRODUCTION: Transthoracic biopsy (TTB) is a well-defined and effective method used for pathologic sampling in the diagnosis of the pulmonary lesions. It is less invasive in comparison to surgical procedures. In addition, diagnostic rate of tru-cut biopsy is higher than that of fine needle aspiration biopsy (FNAB) especially for benign lesions. In this study, we presented tru-cut transthoracic biopsy (TTB) procedure results and the frequency of TTB complications with related risk factors. MATERIAL AND METHODS: A total of 102 patients were evaluated by CT scan guided tru-cut TTB in the diagnosis of lung lesions between Janu . . .ary 2003 and December 2007. The complications due to tru-cut TTB were recorded. The factors such as the lesion depth, the lesion size, and the emphysematous changes that accompany the lesion were evaluated through ? 2 test. RESULTS: Among the samples, 51% malignancy and 49% benign pathology were observed. Pneumothorax developed in 15.7% of the 102 procedures. It was found that the lesions distance from the pleura, the size of the lesion, and emphysematous changes around the lesion significantly increased the risk of pneumothorax. DISCUSSION: The tru-cut biopsy complications are similar to those of FNAB. In the centers where cytologic examination is insufficient in the diagnosis of lung lesions, tru-cut biopsy should be routinely performed as it is a reliable biopsy technique compared to FNAB. © 2011 Springer-Verlag Daha fazlası Daha az

Transient ST segment elevation and left bundle branch block caused by mad-honey poisoning

Sayin M.R. | Karabag T. | Dogan S.M. | Akpinar I. | Aydin M.

Article | 2012 | Wiener Klinische Wochenschrift124 ( 07.Aug ) , pp.278 - 281

We herein present a case of a 76-year-old male patient presented with transient ST segment elevation and left bundle branch block caused by mad-honey poisoning. © Springer-Verlag Wien 2012.

A case of acute myocardial infarction due to the use of cayenne pepper pills

Sayin M.R. | Karabag T. | Dogan S.M. | Akpinar I. | Aydin M.

Article | 2012 | Wiener Klinische Wochenschrift124 ( 07.Aug ) , pp.285 - 287

The use of weight loss pills containing cayenne pepper has ever been increasing. The main component of cayenne pepper pills is capsaicin. There are conficting data about the effects of capsaicin on the cardiovascular system. In this paper, we present the case of a 41 year old male patient with no cardiovascular risk factors who took cayenne pepper pills to lose weight and developed acute myocardial infarction. © Springer-Verlag Wien 2012.

Evaluation of atrial electromechanical delay and left atrial mechanical function in patients with obstructive sleep apnea Cardiac involvement in patients with OSA

Karabag T. | Aydin M. | Altin R. | Dogan S.M. | Cil C. | Buyukuysal C. | Sayin M.R.

Article | 2012 | Wiener Klinische Wochenschrift124 ( 13-14 ) , pp.444 - 452

Objective The aim of this study was to evaluate atrial electromechanical delay measured by tissue Doppler imaging and left atrial mechanical function in patients with obstructive sleep apnea (OSA). Materials and methods Fourty-seven moderate-tosevere OSA patients who were newly diagnosed by poly-somnography (Apnea-hypopnea index ≥15 events/h, 32 males, mean age 49.4±11.5) and 30 patients who had no OSA in polysomnography (Apnea-hypopnea index<5 events/h, 21 males, mean age 45.4±9.1) were included in the study. Using tissue Doppler, diastolic functions, atrial electromechanical coupling were measured from the lateral mitral, se . . .ptal, and tricuspid annulus. Inter, intra, and left atrial electromechanical delay were calculated (lateral-tricuspid, septum-tricuspid, lateralseptal). Left atrial volumes (maximal, minimal, and presystolic) were measured by the method of discs in the apical four-chamber view and were indexed to body surface area. Mechanical function parameters of the left atrium were also calculated. Results Interatrial, intraatrial, and left atrial electromechanical delays were significantly higher in the OSA group compared to the control group. Passive emptying fraction was significantly decreased, volume at the beginning of atrial systole and active emptying volume were significantly increased in OSA patients compared to the controls. The apnea-hypopnea index was significantly associated with interatrial and intraatrial electromechanical delay, passive emptying fraction, and conduit volume. Conclusions Electromechanical delay was markedly prolonged and left atrial electromechanical function was impaired in untreated OSA patients. These impairments worsen with increasing severity of OSA. © Springer-Verlag Wien 2012 Daha fazlası Daha az

Evaluation of biochemical, hematological, and thyroid function parameters in nondipper and dipper hypertensive patients

Akpinar I. | Basar N. | Sen N. | Kisacik H.L.

Article | 2012 | Wiener Klinische Wochenschrift124 ( 13-14 ) , pp.439 - 443

Aim of the study In this study we investigated the effects of biochemical, hematologic, and thyroid function parameters on the circadian rhythm of hypertensive patients whose 24-h ambulatory blood pressure was being followed. Methods We studied the fasting glucose, urea, creatinine, uric acid, aspartate transaminase, alanine aminotransferase, gamma-glutamyl transferase, total protein, albumin, lipid profiles, sodium, potassium, hemoglobin, white blood cell count, platelet count, mean platelet volume, thyroid stimulating hormone, free thyroid hormone values obtained simultaneously with 24-h ambulatory blood pressure results, as docum . . .ented in the case records of 470 patients. Patients Of the patients, 398 were in the nondipper hypertensive group and 72 in the dipper hypertensive group. Differences in serum biochemical, hematologic, and thyroid function parameters were compared between the groups. Results No statistically meaningful difference was detected between the age, gender, biochemical and hematologic parameters of the two groups. When the two were compared with respect to thyroid function tests, thyroid stimulating hormone levels in the nondipper hypertensive group were significantly higher, while free triiodothyronine and thyroxine levels were significantly lower. Conclusions Thyroid function disorders are associated with hypertension. However, there are not enough data on the effects of thyroid hormones particularly on the nighttime blood pressure decrease in hypertensive patients. Although the exact mechanism between low thyroid hormone levels and nondipping hypertension development is not known, relatively low thyroid hormone levels in the nondipper group may be related to the decrease in vein wall compliance, considering the vascular effect of overt hypothyroidism. © Springer-Verlag Wien 2012 Daha fazlası Daha az

Liver abscess following radioembolization with yttrium-90 microspheres [Leberabszess nach Radioembolisation mit Yttrium-90 Mikrosphären]

Korkmaz M. | Bozkaya H. | Çinar C. | Sanal B. | Güneyli S. | Parildar M. | Oran I.

Article | 2014 | Wiener Klinische Wochenschrift126 ( 23 ) , pp.785 - 788

Radioembolization with yttrium-90 microspheres is an accepted and useful intervention model with minimal invasion in both primary and secondary liver malignancies. Radioembolization may lead to some complications. Liver abscess is a rare complication that can occur several weeks after radioembolization treatment of liver tumor with yttrium-90 microspheres. There are only a few case reports on hepatic liver abscess observed in early term of radioembolization treatment, and our case also constitutes a rare report that may contribute to the possible future improvements in radioembolization field to get more insight into the current und . . .erstanding of the formation of some deleterious insults such as hepatic abscess. © Springer-Verlag Wien 2014 Daha fazlası Daha az

Comparison of diagnostic values of procalcitonin, C-reactive protein and blood neutrophil/lymphocyte ratio levels in predicting bacterial infection in hospitalized patients with acute exacerbations of COPD [Vergleich der diagnostischen Wertigkeit von Procalcitonin, C-reaktivem Protein und vom Neutrophilen/Lymphozyten Quotienten bei der Vorhersage von bakteriellen Infekten bei hospitalisierten Patienten mit akuter Exazerbation einer chronisch obstruktiven Lungenerkrankung]

Tanrıverdi H. | Örnek T. | Erboy F. | Altınsoy B. | Uygur F. | Atalay F. | Tor M.M.

Article | 2015 | Wiener Klinische Wochenschrift127 ( 19-20 ) , pp.756 - 763

Background: Viral or bacterial upper respiratory infections are the most common cause of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Based on available data, no reliable parameter has been presented to distinguish between bacterial and nonbacterial exacerbations. Therefore, we compared the diagnostic value of procalcitonin (PCT) level, which is a newer marker for predicting bacterial infections in patients with AECOPD, to routine parameters such as C-reactive protein (CRP) levels and the neutrophil/lymphocyte (N/L) ratio. Methods: This study included all consecutive patients who were admitted for a diagnosi . . .s of AECOPD between January 1 and March 31, 2014. PCT, CRP, and the N/L ratio were assessed in addition to cultures from tracheal aspirates or sputum on the first day of admission. Patients with a pneumonic infiltration on chest radiographs, or an extrapulmonary infection focus, or whose blood samples were not obtained for PCT and/or CRP at the same time as sputum culture were excluded from the study. Results: A total of 77 patients were included with a mean age of 71.7 ± 9.5 years. Bacteria were isolated in 37.4 % of the patients. Mean PCT levels were significantly higher in patients with positive sputum cultures than in patients with negative sputum cultures. The cut-off values for PCT, CRP, and the N/L ratio for predicting a bacterial infection were 0.40 ng/mL, 91.50 mg/L, and 11.5, respectively; sensitivity was 61, 54, and 61 % respectively; specificity was 67, 52, and 58 %, respectively; and the area under the curve (AUC) values were 0.64, 0.52, and 0.58, respectively. The AUC value of PCT was significantly better for predicting bacterial infection compared with the CRP level or the N/L ratio (p = 0.042). Conclusion: PCT was better than CRP and the N/L ratio for predicting a bacterial infection in hospitalized patients with AECOPD. However, we find PCT not so reliable in predicting bacterial infection in AECOPD due to sensitivity and specificity of less than 80 % and a low AUC value. © 2014, Springer-Verlag Wien Daha fazlası Daha az

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