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Öğe Arterial Stiffness and Carotid Intima-Media Thickness in Diabetic Peripheral Neuropathy(INT SCIENTIFIC LITERATURE, INC, 2014) Avci, Ahmet; Demir, Kenan; Kaya, Zeynettin; Marakoglu, Kamile; Ceylan, Esra; Ekmekci, Ahmet Hakan; Yilmaz, AhmetBackground: We investigated the relationship between peripheral neuropathy and parameters of arterial stiffness and carotid intima media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM). Material/Methods: The study included 161 patients (80 females and 81 males), 69 of whom had peripheral neuropathy. All patients underwent 24-h blood pressure monitoring, and arterial stiffness parameters were measured. The CIMT was measured using B- mode ultrasonography and patients also underwent transthoracic echocardiographic examination. Results: Patients with peripheral neuropathy, compared with those without it, were older (54.68 +/- 8.35 years vs. 51.04 +/- 7.89 years; p= 0.005) and had T2DM for longer periods (60 vs. 36 months; p= 0.004). Glycated hemoglobin (HbA1c) values (8.55 +/- 1.85 mg/dL vs. 7.30 +/- 1.51 mg/dL; p<0.001), pulse wave velocity (PWV) (7.74 +/- 1.14 m/s vs. 7.15 +/- 1.10 m/s; p= 0.001), CIMT (anterior 0.74 +/- 0.15 mm vs. 0.67 +/- 0.13 mm; p= 0.01), and left ventricular mass (LVM) index (98.68 +/- 26.28 g/m(2) vs. 89.71 +/- 19.70 g/m(2); p= 0.02) were all significantly increased in the group with peripheral neuropathy compared to the group without peripheral neuropathy. We determined that duration of diabetes, HbA1c, and LVM index were predictors of peripheral neuropathy. Conclusions: A significant relationship was found between diabetic neuropathy and increased PWV, a parameter of arterial stiffness, as well as CIMT, a marker of systemic atherosclerosis. Diabetic peripheral neuropathy may be a determinant of subclinical atherosclerosis in T2DM.Öğe Assessment of atrial electromechanical delay and P-wave dispersion in patients with type 2 diabetes mellitus(ELSEVIER, 2016) Demir, Kenan; Avci, Ahmet; Kaya, Zeynettin; Marakoglu, Kamile; Ceylan, Esra; Yilmaz, Ahmet; Ersecgin, AhmetObjectives: Diabetes mellitus is an independent and strong risk factor for development of atrial fibrillation (AF). Electrophysiologic and electromechanical abnormalities are associated with a higher risk of AF. In this study we aimed to determine the correlation of atrial conduction abnormalities between the surface electrocardiographic and tissue Doppler echocardiographic measurements in type 2 diabetes mellitus (T2DM) patients. Methods: A total of 88 consecutive T2DM patients and 49 age-, gender-, and body mass index-matched healthy volunteers were included in the present study. Baseline characteristics were recorded and 24 hour ambulatory blood pressure monitoring, transthoracic echocardiography, and 12-lead surface electrocardiography were performed for all study participants. Atrial electromechanical delay (EMD) intervals were measured. Results: Maximum P-wave duration and P-wave dispersion (Pd) were significantly higher in patients with T2DM (105.7 +/- 10.2 ms vs. 102.2 +/- 7.5 ms, p = 0.02; 40.6 +/- 7.6 ms vs. 33.6 +/- 5.9 ms, p < 0.001, respectively). Interatrial, intraatrial, and intraleft atrial EMD were significantly higher in the T2DM patients when compared with the controls (16.5 +/- 7.8 ms vs.11.2 +/- 4.4 ms, p < 0.001; 9.0 +/- 7.3 ms vs. 6.0 +/- 3.8 ms, p = 0.002, and 7.4 +/- 5.2 ms vs. 5.1 +/- 3.2 ms, p = 0.002 respectively). Correlation analysis showed a positive correlation between interatrial EMD and Pd (r = 0.429, p < 0.001) and left atrial volume (r = 0.428,p < 0.001). Conclusions: In this study, there was significant EMD and Pd in patients with T2DM as compared with healthy volunteers. Additionally, interatrial EMD was correlated with Pd and left atrial volume index. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.Öğe Carbon Monoxide Poisoning Presenting with Atrial Fibrillation(MODESTUM LTD, 2015) Avci, Ahmet; Yilmaz, Ahmet; Demir, Kenan; Celik, Mustafa; Karatas, RecepCarbon monoxide intoxication is one of the most common types of poisoning and it is the leading cause of death by poisoning in the world. We report a carbon monoxide intoxication case presenting with atrial fibrillation on 17 years old healthy boy. 17 years old boy admitted to emergency service after exposuring carbon monoxide gas approximately 3 hours. His first electrocardiography (ECG) showed atrial fibrillation with rapidly ventricular response. After oxygen supply sinus rhythm was achieved spontaneously. Emergency physicians should be aware of the clinical presentation of carbon monooxide intoxication. Every patient that arrived emergency service with acute or chronically carbon monoxide poisoning should undergo cardiovascular investigation, including ECG and measurement of cardiac enzymes.Öğe Determination of the Salt Tolerance of Some Barley Genotypes and the Characteristics Affecting Tolerance(TUBITAK, 2003) Bağci, Seydi Ahmet; Ekiz, Hasan; Yilmaz, AhmetThe Salt (NaCl) tolerance of 8 barley genotypes was investigated. Plants were grown hyroponically in Hoagland solution at 5 different NaCl concentrations. Germination percentage, shoot and root length, shoot and root dry weight, salt tolerance percentage, and K and Na concentrations in the shoots and roots were evaluated. Salt tolerance percentage, which is calculated from the germination percentage and dry weight production, was the most reliable criterion. On the other hand, with some exceptions, high K concentration and K/Na ratios were other potential criteria. Erginel-90 and WBELT-10 showed high levels of tolerance: and Obruk-86, Anadolu-86, Kiral-97 and Karatay-94 showed medium levels. Tokak-157/37 and Hamidiye-85 were the most susceptible genotypes to NaCl.Öğe A FUZZY EXPERT SYSTEM DESIGN FOR IRON DEFICIENCY ANEMIA(IEEE, 2013) Yilmaz, Ahmet; Dagli, Mehmet; Allahverdi, NovruzIn this study, an application of fuzzy expert system was introduced. This system was designed to determine the level of iron deficiency anemia and thus, expert physicians were provided with a system to assist them to determine an exact diagnosis prior to their treatment. While realizing the system design, the laboratory records obtained from real patients were examined, the appropriate parameters were specified, the input and output parameters were fuzzified and finally the rule base was built with the expert physician. This study used the centroid defuzzification method together with the Mamdani inference mechanism which is often used in the related literature. With the help of a visual programming language, the level of the disease was displayed in a perceptible way as the result of running the system.Öğe Long-term prognostic significance of terminal QRS distortion on patients with stemi and its correlation with the GRACE scoring system(CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 2019) Yilmaz, Ahmet; Demir, Kenan; Karatas, Recep; Celik, Mustafa; Avci, Ahmet; Keles, Fikret; Ersecgin, Ahmet; Aygül, Nazif; Altunkeser, Bülent Behlül[Abstract not Available]Öğe Successful Treatment of Suicide Attempt by Megadose of Propafenone and Captopril(HUMANA PRESS INC, 2013) Avci, Ahmet; Yilmaz, Ahmet; Celik, Mustafa; Demir, Kenan; Keles, FikretIntoxication caused by propafenone is very rare, and there is no case reported before propafenone and captopril intoxication together. There are few case reports in the literature about intoxication with more than 6 g of propafenone. We present the clinical manifestation and successfully treatment of 9 g of propafenone and 1 g captopril intoxication in an 18-year-old female. An 18-year-old female was brought to the emergency department approximately half an hour after she committed suicide with 30 propafenone tablets, 300 mg each, and 20 captopril tablets, 50 mg each. Her fist electrocardiography (ECG) shows a chaotic ventricular rhythm with a prolonged QRS complex. After fluid and sodium bicarbonate infusion and permanent pacemaker implantation, sinus rhythm was achieved. This case, to our knowledge, is the first in that it describes the successful recovery of a patient who ingested extensively large doses of propafenone (9 g) and captopril (1 g), both of which are known to have severe cardiac side effects.
