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Biomedical subjects

Ahmet Yilmaz

Publications and source records attributed to Ahmet Yilmaz.

25 records · Page 2Linked to original sources

Diagnostic value of tumoural markers in pleural effusions.

The aim was to reassess the diagnostic value of tumour markers such as carcinoembryonic antigen (CEA), cancer antigen (CA) 15-3, CA 19-9 and CA 72-4 in the pleural fluid of various diseases, both in benign and malignant. Eighty-one patients (41 malignant and 40 benign pleural effusion) were included in this study. The effusion levels of CEA, CA 15-3, CA 19-9 and CA 72-4 were assayed with commercial enzyme immunoassays. CEA, CA 15-3, CA 19-9 and CA 72-4 mean pleural effusion fluid levels in malignant group were found to be significantly higher than that in benign group, but CA 19-9 mean pleural effusion fluid levels of malignant and benign group were similar. It was of interest to evaluate the prediction of the origin by pleural tumour markers. In pleurisies with a negative cytology, these assays are particularly useful when the clinical presentation cannot clearly exclude an underlying malignancy.

Adult↗

Prognostic importance of predischarged troponin T levels in acute anterior myocardial infarction.

The baseline cardiac troponin T (cTnT) level strongly predicts short-term mortality in acute coronary syndromes, but the added value of predischarged (7th day) measures to predict short-term outcome and left ventricular (LV) remodeling in patients with ST elevation myocardial infarction (MI) is controversial. Baseline, peak and predischarged cTnT results were evaluated in 52 patients (15 females, 37 males, mean age, 54.4 +/- 8.8 years) with first acute anterior MI. There were 4 deaths (all cardiac origin) during the 30 day follow up period. Kaplan-Meier analysis revealed patients with a predischarged serum cTnT level higher than the median level (1.2 ng/mL) had a higher mortality rate than those with submedian levels (P < 0.05). Additionally, the highest correlation rate was found between predischarged cTnT values and LV ejection fraction (LV-EF, r = -0.58, P < 0.002). There were no differences between the groups in the 7th day left ventricular diastolic parameters, but the 30th day isovolumetric relaxation time and mitral E wave deceleration time were shorter (146.9 +/- 30.1 vs 129 +/- 23.4 msec, P = 0.025 and, 185.8 +/- 51.8 vs 144.6 +/- 58.1 msec, P = 0.012) in patients with higher predischarged cTnT level. High levels of predischarged cTnT levels in patients admitted with first acute anterior MI defines a subgroup. These patients have poor systolic and diastolic functions and are at increased risk of short term mortality. This group of patients may have benefit from early intensive treatment strategies before discharge.

Adult↗

Calciphylaxis involving both the upper and lower extremities.

Calciphylaxis is an uncommon complication of end stage renal disease (ESRD) and secondary hyperparathyroidism. It characterized by cutaneous necrosis with mural calcifications and thrombosis in the small vessels of dermis. It is important to diagnose and treat, because of mortality rate from calciphylaxis is very high. We present the case of a patient with ESRD and type II diabetes mellitus developing calciphylaxis of the both upper and lower extremities had normal corrected calcium-phosphate product level. After amputation, necrosis was showed rapid progression resulting in death in one month.

Calciphylaxis↗

Clinical assessment of 324 breast cancer cases in two centers between the years of 1992 and 2002.

The records of the 324 patients with breast cancer; diagnosed and followed in two different University Hospital between years of January 1992 and January 2002 were reviewed retrospectively. The median age of the patients was 49.0+/-12.5 years, with the range of 18 and 90 years. The most frequently seen age interval of the patients was 40 and 49 years. The most frequently seen symptom and physical examination finding of the patients were breast mass. Breast cancer was diagnosed in 324 women, 173 in the left breast and 151 in the right breast. At the hospital admission percentages of the patients' disease stages were as follows: I (2.8%), IIA (30.0%), IIB (24.0%), IIIA (19.8%), IIIB (11.4) and IV (12.0%). The most frequently seen histopathological diagnosis was infiltrative ductal carcinoma (84.4%). Axillary lymph node metastasis was found in 61.7% of the patients. Primary therapeutic options and percentages were surgical therapy (78.5%), systemic chemotherapy (17.5%) and radiotherapy (4%). Systemic chemotherapy was given to 81.2% of the patients. From the files, estrogen receptor status was known in 311 and positive in 128 (41.2%) of them. Tamoxifen was given patients who had positive estrogen receptor. The five-year survival rate of the patients was calculated as 75.9%.

Adolescent↗

Prevalence and predictors of significant coronary artery disease in Turkish patients who undergo heart valve surgery.

BACKGROUND AND AIMS OF THE STUDY: The presence of significant atherosclerotic coronary artery disease (CAD) in patients with valvular heart disease is an important predictor of perioperative mortality. The prevalence of CAD in patients undergoing valvular heart surgery is 20-40% in industrialized countries. The study aim was to determine CAD prevalence in Turkish patients undergoing valvular heart surgery, and to identify predictors of its presence. METHODS: A total of 760 patients (357 males, 403 females; mean age 54.4+/-18.1 years) who underwent coronary angiography before valvular surgery between 1995 and 2000 was enrolled retrospectively. Single- and multi-valve involvement was present in 46% and 54% of patients, respectively. Patients with ischemic mitral regurgitation were excluded from the study. Significant CAD was defined as the presence of > or =50% diameter stenosis anyone of the coronary arteries. The presence of angina pectoris, and of risk factors (e.g. hypertension, smoking, diabetes mellitus (DM), hyperlipidemia, family history of CAD) were sought in all patients. Predictors of CAD were identified by logistic regression analysis. RESULTS: Significant CAD was present in 15.8% of patients (24% males, 9% females) (p <0.001); the highest prevalence was in those with aortic stenosis (p <0.05). CAD was not seen in young patients (aged <45 years) with none of the above-mentioned risk factors. The highest correlation between CAD and risk factors was family history of CAD, followed by DM, hyperlipidemia, hypertension and smoking, in decreasing order. CONCLUSION: The study results showed that CAD in patients with valvular heart disease was less prevalent in Turkey than in industrialized countries. The incidence of coronary lesions rises notably from the age of 50 years in both males and females. Coronary angiography before valvular heart surgery could be omitted in young patients (age <45 years) with none of the coronary risk factors, or without angina.

Adult↗