Tuba Taslamacioglu Duman

The effects of a single dialysis session on atrial electromechanical conduction times and functions.

Background/Aims: Abnormalities in atrial electromechanical delay (EMD) times and mechanical functions are considered as independent predictors of atrial fibrillation. However, to date, effects of a single hemodialysis (HD) session and acute volume-preload changes on atrial-EMD functions have not been investigated by Tissue Doppler Echocardiography (TDE). The aim of the present study was to evaluate atrial-EMD times and mechanical functions in HD patients. Methods: Thirty-five non-diabetic, normotensive HD patients and 35 healthy control subjects were enrolled in the study. Standard and TDE performed before mid-week dialysis session for hemodialysis group and on admission for control group. Results: Interatrial and left-right intraatrial-EMD intervals and left atrial mechanical volumes were significantly longer in hemodialysis group compared to controls (all p<0.01) and were reduced after HD session. Furthermore, removed ultrafiltration volume was associated with reduction in atrial-EMD intervals and functional volumes. LA-passive emptying volume, ultrafiltration volume, LV-E/E ratio, and Vp were independent predictors of interatrial-EMD. Conclusions: The present study confirms negative effects in HD patients of structural remodeling and reveals negative effects of electrical remodeling. Prolonged inter and intraatrial-EMD intervals should be the underlying pathophysiological factors of increased rate of atrial fibrillation in the HD population.

ANALYSIS OF THE TYPE 2 DIABETIC PATIENTS FOLLOWED IN A UNIVERSITY CLINIC

Amac: Bu calismanin amaci klinigimizde izlenen tip 2 diyabetik hastalarda hastaligin farkinda olma, tedaviye uyum, hedef Hb A1c duzeyini bilme gibi kan sekeri regulasyonunu etkileyebilecek faktorleri belirlemektir . Gerec ve Yontem: Klinigimizde izlenen tip 2 diyabetik hastalar calismaya alindi. Hasta verileri hastane veri tabani ve dosyalardan el de edildi. Antropometrik olcumler, kan basinci, fizik muayene bulgulari ve laboratuvar sonuclari kaydedildi. HbA1c seviyesine gore (%8’in alti ve ustu) hastalar iyi kontrollu ve kotu kontrollu diyabetikler olarak 2 gruba ayrildi . Bulgular: Toplamda 150 hasta (72’si erkek ve 78’i bayan)xa0 calismaya alindi. Bel cevresi, beden kitle indeksi, diyabet suresi, LDL- kolesterol, total kolesterol, trigliserid ve serum kreatinini iyi kontrollu diyabetiklerde kotu kontrollu olanlara kiyasla anlamli derecede dusuktu (hepsi icin p<0.05). Kentsel alanda yasan hastalarda iyi kontrol orani kirsalda yasayanlardan belirgin olarak daha fazlaydi (p=0.01). Ilaclarini taniyanlarda, kan sekerini evde kendi olcenlerde, hedef HbA1c duzeyinin farkinda olanlarda ve diyabetik nefropa ti, noropati ve diyabetik ayak bulunmayanlarda diyabetik regulasyon anlamli derecede daha iyiydi (hepsi icin p<0.05). Sonuc: Bu calisma daha iyi diyabetik kontrol icin, en onemli faktorlerin kendi kendine olcumlerle kan sekerini takip etmek, tedavi hedef d egerlerinin farkinda olmak ve kullandigi ilaclari bilmek oldugunu gostermistir. Bu faktorlerin hepsine iyi bir hasta egitimi ve hastalarin tedavi surecine katilimlari ile elde edilebilecegini dusunmekteyiz .