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Öğe Assessment of venous leg symptoms in patients with hemorrhoidal disease (VEIN-HEMORRHOID study)(Sage Publications Inc, 2022) Cuglan, Bilal; Ozturk, Selcuk; Ozcan, Fulya; Atmaca, Hasan; Ensaroglu, Fatih; Sacikara, Alparslan; Yetkin, ErtanBackground Coexistence of dilating venous diseases in different vascular territories has raised the idea that they have similar vascular wall abnormality in their evolutionary process. Accordingly, we aimed to evaluate venous leg symptoms in patients with hemorrhoidal disease (HD) by means of VEINES-Sym questionnaire. Materials and methods The study involved 249 consecutive patients who underwent colonoscopy and met the inclusion criteria. Presence and grading of HD were made according to Goligher's classification. All patients were examined for the existing of varicose vein and classified in respect of CEAP classi?cation. All participants were requested to answer the VEINES-Sym questionnaire. Results There was not statistically significant differences between the patients without HD (grade 0 or I) and with HD (Grade II or III) in respect to clinical characteristics except female predominance in hemorrhoid group (p = 0.07). Scores of heavy legs, swelling, burning sensation, restless leg, throbbing, tingling, and total VEINES score were significantly lower (ie: worse) in hemorrhoid group. Logistic regression analysis revealed that female gender and total VEINES score were independently associated with HD (OR: 2.03, 95% CI: 1.17-3.52, p = 0.01; OR: 0.96, 95% CI: 0.92-0.99, p = 0.02, respectively). Among all venous leg symptoms, severity of heavy legs, night cramps, swelling and aching were significantly correlated with the grades of HD. Conclusion We have shown significant association between the HD and venous leg symptoms reflected by total VEINES score and significant correlation between the HD grade and venous leg symptoms severity including heavy legs, swelling, night cramps and aching legs.Öğe Atrial septal aneurysm and cryptogenic stroke: an arrhythmic approach to pathophysiology(Hygeia Press Corridori Marinella, 2023) Yetkin, Ertan; Atmaca, Hasan; Cuglan, Bilal; Yalta, KenanIn patients with cryptogenic strokes, more attention should be paid to the possible existence of paroxysmal atrial fibrillation, especially in those with atrial septal aneurysm with or without patent foramen ovale.Öğe Systolic Blood Pressure to Diastolic Blood Pressure Ratios in Diabetic and Non-diabetic Patients: Deviation from Golden Ratio(Adis Int Ltd, 2022) Atmaca, Hasan; Cuglan, Bilal; Yalta, Kenan; Yetkin, ErtanIntroduction Cardiovascular measures like, systolic to diastolic time intervals on ECG recordings, end-diastolic to end-systolic diameters of the left ventricle on echocardiography, pulmonary and systemic hemodynamic measures have gained an interest in terms of Golden ratio or Golden proportions. Ratio of SBP to DBP as a reflection of GR has been recently evaluated in patients who have undergone ABPM to assess the presence of hypertension. Aim To assess and compare the ratios of SBP to DBP as a reflection of GR in 24 h ABPM recordings in patients with and without DM who were not on medical treatment. Methods Six hundred and thirty two patients who underwent ABPM were retrospectively screened and enrolled in the study population in between October 2020 and March 2021. After exclusion of 378 who did not meet the inclusion criteria, 254 patients were enrolled in statistical analysis. Systolic blood pressure and diastolic blood pressure measurements were also averaged for the day and the night spans according to the patients' reported time of waking up and going to bed. The ABPM was programmed to measure blood pressure every 45 min during both the day time and night time periods Results Among those 254 patients included in statistical analysis, 212 patients were classified as non-diabetic and 42 patients as diabetic. SBP/DBP ratios were significantly higher in diabetics compared to those of non-diabetics in all time spans (1.698 vs 1.631, p = 0.041 for 24 h; 1.689 vs 1.618 p = 0.032 for day-time; 1.74 vs 1.66 p = 0.037 for night time). In non-diabetic patients interestingly day time SBP/DBP gave almost the same value of GR i.e 1.618, likewise the 24 h value of SBP/DBP gave the value of 1.631 which was so close to GR. On the other hand SBP/DBP ratios for all time spans were deviated far from the 1.618 in diabetic patients Conclusion We have shown that systolic to diastolic blood pressure ratios of patients with DM are significantly higher than those without DM. These differences are mainly to due to the lower DBP of diabetic patients compared to non-diabetic patients. Beyond these differences SBP/DBP ratio of non-diabetic patients has shown close proximity to 1.618 known as golden ratio.Öğe An Unresolved İssue: Diagnosing Coronary Artery Disease İn Left Bundle Branch Block(Springer, 2021) Çuğlan, Bilal; Atmaca, Hasan; Yetkin, ErtanLetter To The EdıtorÖğe An unresolved issue: Diagnosing coronary artery disease in left bundle branch block(Springer, 2021) Atmaca, Hasan; Cuglan, Bilal; Yetkin, Ertan[Abstract Not Available]Öğe Uterine fibroids in hypertension and pregnancy(Lippincott Williams & Wilkins, 2021) Cuglan, Bilal; Atmaca, Hasan; Yalta, Kenan; Yetkin, Ertan[Abstract Not Available]Öğe Varicose vein and diastolic dysfunction: Is there an interaction?(Sage Publications Inc, 2021) Atmaca, Hasan; Cuglan, Bilal; Yetkin, Ertan[Abstract Not Available]Öğe Varicose Veins: Systemic Hemodynamic Disorder or Systemic Vascular Wall Pathology?(Sage Publications Inc, 2021) Atmaca, Hasan; Cuglan, Bilal; Aksoy, Alper; Yetkin, ErtanObjectives: A chest radiograph (CXR) is still the preferred diagnostic method when pneumonia is suspected, although the sensitivity is relatively low. The aim of this study was to compare the diagnostic sensitivity, specificity, and accuracy of ultrasonography (US) for the diagnosis of community-acquired pneumonia (CAP), compared with CXR. Materials and Methods: A principled search was conducted to identify original English articles using PubMed, EMBASE, Web of Science, Scopus, and the Cochrane library, with the end date of October 2020. A combination of keywords, such as ultrasound or ultrasonography, pneumonia, sensitivity, and specificity, was used. Methodologic quality was assessed using Quality Assessment of Diagnostic Accuracy Studies 2 criteria. Statistical analysis was completed on the resulting study data. Results: The search produced 16 eligible articles that reported on 2040 patients. The overall pooled sensitivity for US and CXR, to diagnose pneumonia, was 0.96 and 0.65, respectively. The overall pooled specificity for US and CXR was 0.85 and 0.81, respectively. The overall pooled positive likelihood ratio for US and CXR was 9.74 and 3.67, respectively. The negative likelihood ratio for US and CXR was 0.05 and 0.42, respectively. In addition, summary receiver operative characteristics areas under the curve were 0.98 for US and 0.77 for CXR. Conclusion: This review demonstrated that lung US is a useful technique for the diagnosis of pneumonia. This diagnostic method can be used by emergency physicians with high accuracy, sensitivity, and specificity. Among an elderly population, this diagnostic method may be a better choice than CXR. The rapid performance of lung US may facilitate a quick, cost-effective, and safe diagnosis of this potentially fatal disease.Öğe Venous leg symptoms in migraineurs: a potential clue on the pathophysiology of migraine(Edizioni Minerva Medica, 2022) Cuglan, Bilal; Onalan, Aysenur; Ozturk, Selcuk; Altuntas, Emine; Demiral, Ahmet B.; Atmaca, Hasan; Altintas, SaitBACKGROUND: Migraine is a neurovascular disorder which cerebral venous congestion might have role in pathogenesis. The objective was to assess the association between venous disease and migraine by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in migraineurs and non-migraineurs. METHODS: The study was designed as a non-randomized, prospective cohort study and consisted of patients diagnosed with migraine and age-, sex- matched healthy subjects without migraine. All participants were examined for the presence of chronic venous disease (CVD). VEINES-Sym questionnaire was applied to assess venous symptoms. The Migraine Disability Assessment (MIDAS) questionnaire was used to assess the severity of disease in migraineurs. RESULTS: Participants were classified into two groups as migraine-positive group (N.=130) and migraine-negative group (N.=130). Migraine patients and control group were comparable in terms of clinical status and demographic parameters. Total VEINES-Sym score was lower in patients with migraine compared to control group (34.4 +/- 8.7, 37.6 +/- 8.12, P=0.003, respectively). Additionally, there was a significant negative correlation between VEINES-Sym score and total MIDAS disability score (r=-0.33, P<0.001) and MIDAS severity levels (little or no, mild, moderate, severe) (r=-0.266, P=0.003) of the migraineurs. Logistic regression analysis revealed that VEINES-Sym score is an independent and statistically significant associate of migraine (OR=0.95, 95% CI:0.92-0.98, P=0.001). CONCLUSIONS: We have documented an independent association between migraine and VEINES-Sym score indicating possible pathophysiological link between migraine and CVD. Further studies are warranted to figure out the pathophysiological associations between migraine and venous vascular pathology and peripheral varicose vein.