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Öğe Are sleep and life quality of family caregivers affected as much as those of hemodialysis patients?(ELSEVIER SCIENCE INC, 2012) Celik, Gulperi; Annagur, Bilge Burcak; Yilmaz, Mumtaz; Demir, Tarik; Kara, FatihObjective: The purpose of this study was to determine and compare the quality of sleep, quality of life, and anxiety and depression symptoms reported by hemodialysis (HD) patients and family caregivers of HD patients. Methods: The study included 142 pairs of HD patients and their caregivers. To assess quality of sleep, quality of life, and anxiety and depressive symptoms, the 36-item Short Form, Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale, respectively, were used. Results: For the patients, 73.9% were poor sleepers. Low Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were found in 89.1% and 76.3% of HD patients, respectively. For the caregivers, 88% were poor sleepers. Low PCS and MCS scores were found in 62% and 70.4% of the caregivers, respectively. Mean PSQI scores, subjective sleep quality scores, sleep latency, sleep efficiency, sleep disturbance, use of sleep medications, and daytime dysfunction scores of the caregivers were significantly higher than the scores of the HD patients (P<.001). Conclusions: Caregivers of dialysis patients experience adverse effects on their quality of sleep and quality of life. Educational, social, and psychological support interventions should be considered to improve their ability to cope. (C) 2012 Elsevier Inc. All rights reserved.Öğe Assessment of Inhomogeneities of Repolarization in Patients with Systemic Lupus Erythematosus(WILEY, 2014) Avci, Ahmet; Demir, Kenan; Altunkeser, Bulent Behlul; Yilmaz, Sema; Yilmaz, Ahmet; Ersecgin, Ahmet; Demir, TarikObjectives: Systemic lupus erythematosus (SLE) is a chronic disease that affects many organ systems and manifests a broad spectrum of laboratory and clinical features. SLE patients have an increased risk of developing cardiovascular disease. The aim of this study was to evaluate inhomogeneities of repolarization by using T-peak-T-end (Tp-e) interval and Tp-e/QT ratio were measured from the 12-lead surface electrocardiogram (ECG) in patients with SLE. Material and method: This study included 69 SLE patients (69 females; mean age 35.8 +/- 10.2) and 57 control subjects (57 females; mean age 34.5 +/- 8.9). Transthoracic echocardiographic examination was done in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead ECG. These parameters were compared between groups. Results: No statistically significant difference was found between two groups in terms of basic characteristics. Diastolic function parameters were similar between the two groups (P > 0.05). In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QT dispersion (cQTd) were significantly increased in SLE patients compared the control group (49.5 +/- 16.4 ms vs. 32.8 +/- 11.7 ms and 56.7 +/- 19.5 ms vs. 36.4 +/- 13.1 ms, all P value < 0.001). Tp-e interval and Tp-e/QT ratio were also significantly higher in SLE patients (82.8 +/- 18.9 vs. 72.4 +/- 17.6 and 0.22 +/- 0.05 vs. 0.19 +/- 0.05, P = 0.002 and P = 0.001, respectively). Tp-e interval and Tp-e/QT were positively correlated with disease duration (r = 0.29, P = 0.01 and r = 0.24, P = 0.04, respectively). Conclusion: Our study revealed that QTd, cQTd, Tp-e interval and Tp-e/QT ratio increased in patients with SLE. Also, Tp-e interval and Tp-e/QT were positively correlated with disease duration.Öğe Fragmented QRS in patients with systemic lupus erythematosus(TAYLOR & FRANCIS LTD, 2014) Demir, Kenan; Avci, Ahmet; Yilmaz, Sema; Demir, Tarik; Ersecgin, Ahmet; Altunkeser, Bulent BehlulIntroduction. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with a variety of clinical features. Cardiac involvement is present in more than half of the patients with SLE. Fragmentation of QRS (fQRS) is presumed marker of cardiovascular risk and has not been previously evaluated in SLE. Methods. A total of 56 women previously diagnosed with SLE were recruited. In addition, a control group consisting of 51 healthy people was formed. QRS complexes were also evaluated in terms of fragmentations. All patients with SLE and control subjects underwent transthoracic echocardiographic examination. Erythrocyte sedimentation rate and C-reactive protein levels were also obtained. Results. Frequency of fQRS was higher in patients with SLE (41% vs. 21%, p = 0.03). Left ventricular posterior wall thickness and mass index were higher in the patients with SLE. CRP levels and age were significantly higher, and disease duration was significantly longer in the fQRS(+) group (p = 0.02, 0.01, and 0.006, respectively). Conclusion. A careful cardiovascular evaluation and follow-up is essential to continuously improve survival in SLE. For this purpose, fQRS may be used for the early detection in patients with SLE.