Yasemin Kaya

Relationship Between Red Cell Distribution Width and Stroke in Patients With Stable Chronic Heart Failure: A Propensity Score Matching Analysis

Aim: We aimed to investigate the association between baseline red cell distribution width (RDW) level and the risk of stroke in patients with heart failure (HF). Methods: A total of 153 consecutive patients with HF (New York Heart Association [NYHA] I-III and left ventricular ejection fraction of <40%) were included in this prospective study. All the patients were followed up for 1 year, and during this period the cerebrovascular disease was questioned. Results: In matched population, using propensity score matching comparing patients with HF having stroke with patients without stroke, we found significantly increased basal RDW and serum uric acid. The receiver-operating characteristic curves of RDW for predicting stroke are performed. An RDW ≥15.2% measured on admission had 87% sensitivity and 74% specificity in predicting stroke in patients with HF (area under the curve: 0.923, 95% confidence interval: 0.852-0.994, P < .001). Conclusion: In conclusion, this study demonstrated that RDW may be important hematological indices for stroke in patients with HF using propensity score analysis.

The relation of sexual dysfunction to depression and anxiety in patients with Parkinson's disease.

Objective In this study, we aimed to find out whether sexual dysfunction in patients with Parkinson’s Disease (PD) was associated to PD-related disability and whether this relationship was modulated by depressive and anxiety symptoms. Methods Eighty-nine consecutive patients with idiopathic PD who attended to our movement disorders outpatient clinics between January 2011 and June 2014 were included in this study. The diagnosis of PD was confirmed by a movement disorders specialists in Neurology, according to UK Parkinson’s Disease Society Brain Bank Criteria. The Unified PD Rating Scale (UPDRS) motor was used to assess motor disability and Hoehn and Yahr stage (H&Y) was used to establish disease severity. Cognitive function was assessed by the Mini-Mental State Examination. Patients were also administered the Hamilton depression (HAMD) and anxiety (HAMA) rating scales. The sexual functions of the patients were rated by applying the Turkish version of the Arizona Sexual Experiences Scale (ASEX). Results The mean age at the time of the study visit was 67.74±9.05. Male/female ratio was 1.87. Mean UPDRS total was 29.06±13.96 and mean UPDRS motor was 17.62±9.07. Mean HAMD score was 13.92±10.86, 58.4% of the patients had minor or major depression; and mean HAMA score was 7.94±6.49, 56.2% of the patients had minor or major anxiety. The mean ASEX score was 18.54±7.27 out of a maximum of 30. ASEX total scores were correlated with age, H&Y stage and HAMA scores. Age and also age at onset were correlated with ASEX subdomains except sexual desire. There was no correlation between disease duration and ASEX subdomains. UPDRS motor score was correlated with erection/lubrication. HAMD was only correlated with orgasm satisfaction. HAMA score was correlated with stimulation and orgasm. Conclusion In patients with PD, there may be a common factor that modulates both depression, anxiety and sexual function. Further studies are needed to clarify the exact relationship.

The association between symptoms of sexual dysfunction and age at onset in Parkinson’s disease

ObjectiveAge at onset in Parkinson’s disease (PD) seems to be related nonmotor symptoms. In this study we investigated the effect of the age at onset on symptoms of sexual dysfunction (SSD) in patients with PD.MethodsThis prospective study comprised 22 consecutive outpatients with early onset PD (EOPD—onset of the disease before 55xa0years), and 66 outpatients with late onset PD (LOPD—onset of PD over 55xa0years). They were all recruited from the Department of Movement Disorders, Clinic of Neurology. The diagnosis was established according to the UK PD Brain Bank Criteria by a movement disorders specialist. The Unified PD Rating Scale (UPDRS) motor was used to assess motor disability and Hoehn and Yahr (H&Y) stage was used to establish disease severity. The sexual functions of the patients were rated by applying the Arizona Sexual Experiences Scale (ASEX).ResultsThirteen EOPD patients (59.09xa0%) and 53 of the LOPD patients (80.3xa0%) (p 0.047) reported dissatisfaction with at least one item of ASEX. There were no differences between H&Y stages (p 0.205) UPDRS total (p 0.267) and motor scores (p 0.100) between groups. LOPD patients had significantly higher ASEX scores than EOPD patients (p 0.001).InterpretationSexual dysfunciton occurs more frequently and more severely in LOPD than EOPD patients. PD patients with different ages at onset clinically present differently in terms of SSD.

Is there a difference between Parkinson disease patients and a control group in terms of urinary symptoms and quality of life

BACKGROUND/AIMnThe aim of this study is to research whether urinary symptoms and disruption of quality of life observed in Parkinson disease patients are different than those of their healthy peers. Additionally, whether these complaints were affected by characteristics such as age at onset of Parkinson disease, sex, disease duration, and severity was investigated.nnnMATERIALS AND METHODSnThis study comprised a total of 79 individuals, 39 Parkinson patients and a control group of 40 individuals. Parkinson diagnosis was provided by a neurology expert according to the UK Parkinsons Disease Society Brain Bank Criteria. All patients were evaluated by a urologist with the International Prostate Symptom Score (IPSS) and an overactive bladder (OAB) questionnaire.nnnRESULTSnCompared with the control group, the Parkinson patient group had statistically significantly higher rates of urological complaints (P < 0.001), irritative symptoms (P < 0.001), voiding symptoms (P < 0.001), OAB score (P < 0.001), IPSS total score (P = 0.007), and treatment requirements (P < 0.001).nnnCONCLUSIONnUrologic complaints were observed more frequently in the Parkinson patient group compared to the control group. Another important result of this study is that in the Parkinson patient group there was no difference found between urologic complaints in terms of sex.

A New and Simple Risk Predictor of Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention: TIMI Risk Index

Background The thrombolysis in myocardial infarction risk index (TRI) was developed to estimate prognosis at the initial contact of the healthcare provider in coronary artery disease patients without laboratory parameters. In this study, we aimed to investigate the relationship of the baseline TRI and contrast-induced nephropathy (CIN) in patients with ST-elevation myocardial infarction (STEMI). Methods A total of 963 consecutive STEMI diagnosed patients who underwent primary percutaneous intervention were included in the study. TRI was calculated using the formula “heart rateu2009×u2009(age/10) 2/SBP” on admission. CIN was defined as an increase in serum creatinine concentration ≥25%, 48 hours later over the baseline. Results Of the total of 963 patients, CIN was observed in 13% (n=128). TRI was significantly higher in the CIN (+) group compared with the CIN (−) group (32.9u2009±u200918.8 vs 19.9u2009±u20099.9, P < 0.001). There was a stronger correlation between CIN and age, diastolic blood pressure, heart rate, Killip class, left ventricular ejection fraction, amount of contrast media, and diabetes mellitus. The amount of contrast media (OR 1.010, 95% CI 1.007–1.012, P < 0.001) and TRI (OR 1.047, 95% CI 1.020–1.075, P=001) were independent predictors of CIN. The best threshold TRI for predicting CIN was ≥25.8, with a 67.1% sensitivity and 80.4% specificity (area under the curve (AUC): 0.740, 95% CI: 0.711–0.768, P < 0.001). Conclusion TRI is an independent predictor of CIN, and it may be used as a simple and reliable risk assessment of CIN in STEMI patients without the need for laboratory parameters.

Monocyte to high-density lipoprotein cholesterol ratio in patients with diabetes mellitus and diabetic nephropathy

AIMnWe investigated the relationship of monocyte to high-density lipoprotein cholesterol ratio (MHR) with diabetes mellitus and diabetic nephropathy.nnnMETHODS & RESULTSnA total of 220 diabetes mellitus patients and 70 healthy controls were enrolled. There was no difference in an MHR between normoalbuminuric diabetic patients and the healthy controls. The MHR in patients with diabetic nephropathy was significantly higher than that of both the normoalbuminuric diabetic patients and the healthy controls. There was a significant positive correlation between urine albumin to creatinine ratio and the MHR. In multivariate linear regression analysis, the MHR was independently correlated with urine albumin to creatinine ratio.xa0 Conclusion: An increased MHR may be a biomarker for diabetic nephropathy.

Association between metabolic syndrome and fragmented QRS complexes: Speckle tracking echocardiography study

BACKGROUNDnMetabolic syndrome (MetS) is an endocrinological disease with both metabolic and physiological components. Previous studies have shown a relationship between MetS and left ventricular (LV) dysfunction. A fragmented QRS (fQRS) is a reliable electrocardiogram (ECG) finding with the importance of an indicator of myocardial fibrosis and scarring. In this study, we examined the utility of speckle tracking echocardiography (STE) in assessing LV function in MetS patients with fQRS.nnnMETHODSnThe 164 consecutive MetS patients included in the study. They were separated into two groups; those with (n=33) and those without (n=131) fQRS. The two groups were compared by obtaining LV strain values with STE.nnnRESULTSnStatistically significant differences between the fQRS (-) and fQRS (+) groups were identified for LV global longitudinal strain (LV-GLS) (p<0.001), maximum left atrial volume index (maxLAVI) (p≤0.001), strain rate during isovolumic relaxation period (SRivr) (p<0.001), and the E/SRivr ratio (p<0.001). In the multiple linear regression analysis, fQRS (β=-1.456, p=0.003), diabetes mellitus (β=-0.973, p=0.015), hypertension (β=-0.820, p=0.015) and MaxLAVI (β=-0.142, p=0.018) were independent predictors of LV-GLS. However, fQRS (β=21.995, p<0.001), MaxLAVI (β=3.090, p<0.001), and E/Em ratio (β=3.326, p<0.001) were also independent predictors of E/SRivr.nnnCONCLUSIONSnThe results of this study showed that LV dysfunction was more common in MetS patients with fQRS. MetS patients, and especially those who are fQRS (+), should thus be closely monitored for subclinical LV systolic and diastolic dysfunction.

Evaluation of sexual dysfunction in Parkinson’s disease between two different regions of Turkey

OBJECTIVEnIn this study, we aimed to evaluate sexual dysfunction (SD) between two different regions of Turkey in patients with Parkinsons Disease (PD).nnnPATIENTS AND METHODSnForty-three PD patients in Ordu and 71 patients in Istanbul were included. The Unified PD Rating Scale and Hoehn and Yahr Stage (HYS) scale were used to assess disease severity. Cognitive function was assessed by the Mini-Mental State Examination (MMSE). The sexual functions of the patients were evaluated with applying the Turkish version of the Arizona Sexual Experiences Scale (ASEX).nnnRESULTSnMean age of patients in Istanbul was 67.25±8.34years and mean age of patients in Ordu was 67.98±8.93 (p=0.66). There was 87.33% SD in Istanbul group and 95.35% in Ordu group (p=0.20) respectively. In terms of ASEX score, no difference was found between the Istanbul and Ordu groups. ASEX scores were significantly higher in females in both groups.nnnCONCLUSIONnIn this study, we have found that living in the different regions of our country does not have an impact on sexual function in PD patients.

Assessment of Subclinical Atherosclerosis with Aortic Velocity Propagation in Patients with Type 2 Diabetes and Chronic Kidney Disease

Introduction: Diabetes mellitus (DM) and chronic kidney disease (CKD) accelerate the process of atherosclerosis. To improve clinical outcomes, non-invasive imaging modalities have been proposed to measure and monitor atherosclerosis. Recently, colour M-mode-derived propagation velocity of the descending thoracic aorta [aortic velocity propagation (AVP)] has been shown to be associated with coronary and carotid atherosclerosis. Patients and Methods: The study population included 90 patients with type 2 diabetes who had CKD (Group 1) and 40 ageand sex-matched patients with type 2 diabetes who had a normal renal function (Group 2). Carotid intima-media thickness (CIMT) and AVP were measured. Patients with known coronary heart disease or end-stage renal disease were excluded. Results: Compared with Group 1, patients in Group 2 had significantly lower AVP (Group 1= 29.85 ± 3.95 cm/s and Group 2= 41.05 ± 3.34 cm/s, p< 0.001) and higher CIMT (Group 1= 1.06 ± 0.11 mm and Group 2= 0.78 ± 0.10 mm, p< 0.001). There were significant correlations between AVP and CIMT (r= -0.669, p< 0.001). Conclusion: Patients with diabetes who have CKD exhibit more subclinical atherosclerosis, which is determined by more prominent AVP and CMIT, than patients with diabetes who have a normal renal function. These simple methods might improve patient selection for the prevention of primary atherosclerotic progression.

Are erectile functions affected by AB0 blood group

AIMnThe aim of this study was to investigate whether there is a relationship between erectile dysfunction (ED), thought to be a vascular disease, and AB0 blood group.nnnMATERIAL AND METHODnThe study included 350 people abiding by the study criteria who applied to our clinic from April 2012-April 2015. The patients were divided into two groups including those with ED (Group 1) and those without (Group 2). Age, blood group, IIEF-5 score and presence of additional diseases were recorded. Erectile functions were analyzed according to blood group.nnnRESULTSnThere was no difference between the mean age of 111 patients with ED and that of 239 patients without ED included in the study (p = 0.284). There was no difference between patients in the two groups in terms of smoking, alcohol use, hypertension and diabetes (p > 0.05). Among patients in the ED group, the mean IIEF-5 score according to blood group was 19.8 ± 5.04 in the 0 blood group, 16.5 ± 5.2 in the A blood group, 17.2 ± 5.3 in the B blood group and 13.3 ± 3.02 in the AB blood group. The IIEF-5 scores of individuals in the 0 blood group were significantly high compared to individuals in other blood groups (p = 0.004). Logistic regression analysis found that compared to the 0 blood group, the erectile dysfunction risk was 3.9 times greater for the A blood group, 3.5 times greater for the B blood group and 4.7 times greater for the AB blood group (p = 0.001) (Table 3).nnnCONCLUSIONnThe risk of erectile dysfunction was significantly increased for individuals in the A, B and AB blood groups compared to individuals in the 0 blood group.