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  • Küçük Resim Yok
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    The alteration of NTproCNP plasma levels following anaerobic exercise in physically active young men
    (Turkish Soc Cardiology, 2015) Temur, Hilal Akseki; Vardar, Selma Arzu; Demir, Muzaffer; Palabiyik, Orkide; Karaca, Aziz; Guksu, Zuhal; Ortanca, Arif
    Objective: Amino-terminal propeptide of C-type natriuretic peptide (NTproCNP) is a synthesis product of C-type natriuretic peptide (CNP). In this study, plasma levels of NTproCNP were compared before and after exercise in healthy young subjects who are physically active (PA) or not physically active (NPA). Methods: The study was carried on PA group (n=10) who defined the exercise duration more than 2.5 hours per week for at least one year and NPA group (n=10) whose exercise duration was lower than 1.5 hours per week. The level of maximal oxygen consumption was determined. Wingate exercise test was applied on the following day. Plasma NTproCNP levels were measured before the exercise and at the 1st, 5th and 30th minute after the exercise. Results: Exercise duration of physically active group was reported as 11.3 +/- 5.0 hours per week. Basal NTproCNP levels of the groups were found to be comparable. NTproCNP levels in the 5th minute (0.93 +/- 0.23 pmol/L; p<0.05) and in the 30th minute (0.77 +/- 0.21 pmol/L p<0.05) after exercise were higher than the levels before exercise (0.64 +/- 0.29 pmol/L) in PA group. Additionally, the plasma levels of NTproCNP after 5th minute of exercise were higher in PA group (0.93 +/- 0.23 pmol/L) than NPA group (0.74 +/- 0.16 pmol/L, p<0.05). Conclusion: Being physically active may be a fact affecting the secretion of CNP, which plays a protective role in endothelium, following exercise.
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    Atriyal natriüretik peptid infüzyonunun izole sıçan kalbinde iskemi sonrası oluşturduğu hemodinamik değişikliklerde egzersizin rolü
    (2015) Vardar, Selma Arzu; Palabıyık, Orkide; Yalta, Tülin; Özen, Serap Topçu; Guksu, Zuhal; Topuz, Ruhan Deniz; Karadağ, Çetin Hakan
    Bu çalışmada düşük akımlı iskemi sonrası reperfüzyon döneminde atriyal natriüretik peptid (ANP) uygulamasının sol ventrikül hemodinamik yanıtlarına etkisi ve bu etkide egzersizin rolü araştırıldı. Gereç ve yöntem: Çalışmada yer alan tüm sıçanlara 60 dakika düşük akımlı iskemi ve takiben 120 dk reperfüzyon uygulandı. Egzersiz (E) gruplarına ardışık olarak beş gün süreyle yürüyüş egzersizini takiben iskemi ve reperfüzyon uygulandı. Reperfüzyonun ilk 15 dakikasında 0.1 ?M/L ANP infüzyonu yapılan iki grup; ANP (n=6) ve Egzersiz-ANP (n=6) gruplarını oluşturdu. Tüm gruplarda sol ventrikül gelişim basıncı (SVGB), maksimum ve minimum sol ventrikül basınç değişim oranları (+dP/dt and -dP/dt) kaydedildi. Bulgular: Kontrol (K), E, ANP ve E-ANP gruplarının SVGB, +dp/dt, -dp/dt ve kalp hızı değerleri iskemi öncesinde ve iskemi sonrası reperfüzyonun 1, 60 ve 120. dakikalarında karşılaştırıldığında gruplar arasında istatistiksel olarak anlamlı bir farklılık göstermedi. Benzer şekilde infarkt alanlarının yüzde değerleri karşılaştırıldığında dört grup arasında istatistiksel olarak anlamlı farklılık bulunmadı. Sonuç: Kısa süreli yoğun egzersiz, reperfüzyon döneminde ANP uygulamasına bağlı kardiyak kontraktilitede oluşan değişimleri etkilememektedir
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    The effect of high-fructose feeding on hemodynamic behavior and infarct size of isolated rat hearts subjected to low-flow ischemia.
    (2022) Özen, Serap Topçu; Palabıyık, Orkide; Guksu, Zuhal; Aslan, Enver; Tosunoğlu, Esra Akbaş; Süt, Necdet; Vardar, Selma Arzu
    Objective: This study aimed to investigate the potentially deleterious effect of in vivo high-fructose feeding of rats on ex vivo hemodynamic recovery and infarct size of isolated rat hearts subjected to low-flow ischemia and reperfusion. Methods: After feeding Sprague-Dawley male rats with a high-fructose (n=9), high-glucose (n=9), or a standard diet (n=9) for four weeks, the hearts were extirpated and perfused ex vivo with a Krebs-Henseleit solution for 15 minutes; after that, the hearts were subjected to low-flow (0.3 ml/ minute) ischemia during 30 minutes followed by 60 minutes reperfusion. Left developed ventricular pressure, maximum and minimum rate changes of left ventricular pressure, and heart rate were recorded before ischemia and after reperfusion. The Infarct area was measured at the end of the reperfusion period. Results: The relative myocardial infarct size did not differ between the three groups in isolated hearts subjected to ex vivo low-flow ischemia followed by 60 minutes of reperfusion. Post-ischemic cardiac contractile recovery appeared complete in the high-fructose and high-glucose groups at 60 minutes of reperfusion. In contrast, the left developed ventricular pressure and minimum rate change of left ventricular pressure were still depressed at the end of 60 minutes of reperfusion in the control group. Conclusion: High-fructose diet in rats appears to positively affect the recovery of left ventricular contractile function after low-flow ischemia, compared to a standard diet, without a difference in relative myocardial infarct size. Similar results were obtained in the high-glucose-fed rats.
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    The effects of dietary folate and iron supplementation on restless legs and preeclampsia in pregnancy
    (Mattioli 1885, 2019) Aynaci, Gulden; Guksu, Zuhal
    Introduction: RLS in pregnant women at the beginning of the condition increases the risk of reduced sleep quality, systemic arterial pressure increase, iron and folate deficiency anemia. The most common causes are thought to be physical changes, decreased sleep quality, or organic factors (decreasing folate and iron level). Aim: The aim of this study was to evaluate the role of RLS and its interaction with preeclampsia, anemia, folate deficiency, and low sleep quality. Methods: Our study was conducted between July 2018 and February 2019 in Trakya University Medical Faculty Hospital, Obstetrics Department. Pregnant women with symptoms related to RLS were investigated in terms of sleep quality and preeclampsia. An interview form was completed with the pregnant women during face-to-face interviews. Sociodemographic characteristics were questioned in this form. The IRLSGG criteria were used for RLS evaluations. The sleep quality of the participants was assessed using the PSQI. The iron status of pregnant women was questioned. Pregnant women were asked whether they received prophylactic iron medication. Results: Three hundred twenty-four volunteer pregnant women who presented to the obstetrics clinic of Trakya University Medical Faculty Hospital were included in the study. The mean age of the pregnant women in the study was 29.18 +/- 6.19 years. There was no statistically significant difference when we compared pregnant women with and without RLS when asked about their BMI in pre-gestational periods. The average use of iron medication of the women with RLS was 3 days or less per week. There was a significant difference between women with and without RLS regarding iron prophylaxis. The evaluation of the relationship between RLS, sleep quality, and preeclampsia in the pregnant women showed that RLS and PSQI levels had statistically significant differences according to trimesters. Discussion: Our study evaluated the frequency of RLS, the relationship between RLS and preeclampsia, and the relationship between RLS and sleep quality in pregnant women. RLS is more common in pregnant women who do not receive iron support. Low iron levels contribute to the development of RLS. Clinical and laboratory (hemoglobin) analysis revealed some differences between the groups. As the hemoglobin levels and iron supplementation decreased, the incidence of RLS symptoms was found to increase. For the treatment of RLS, non-pharmacologic treatments in pregnant women should be considered first; however, the use of iron medication is usually recommended. After the iron requirement is met, additional treatment planning should be made by investigating whether the RLS symptoms have regressed. Therefore, it was concluded that RLS was related to BMI and hemoglobin level differences. During pregnancy, the recommended dietary allowance (RDA) for folate is 600 mu g/day of dietary folate equivalent. Natural folate with foods and folate supplementation since pregnancy may help to prevent fetal morbidity. The major sources of dietary folate are citrus fruits and juices, legumes, wholewheat bread, and green leafy vegetables. To prevent fetal morbidities, women planning childbirth or pregnant should consume 400 mu g per day of synthetic folic acid from natural foods (cereals and other grains), or supplement drugs. Pregnant women may need advice from a physician or a qualified dietetics professional to follow nutritional guidelines, especially for folate and iron. Pregnant women; must be provided a wide range of nutrition quality and evaluation. We suggest that more studies are needed to assess the relationship between low quality of sleep, iron and folate supports in nutrition, RLS symptoms, and/or preeclampsia. Conclusion: Our study demonstrates the need to establish quality care and interventions for the protection of both maternal and fetal health due to poor sleep quality and RLS symptoms during pregnancy. Pregnant women should be presented with a variety of evidence-based patient care interventions. In the presence of RLS, signs of systemic arterial hypertension and iron supplementation in pregnant women should be examined carefully and if necessary, pregnancy interventions should be added.
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    İsatinin izole sıçan kalbinde oluşturulan iskemi reperfüzyon hasarındaki etkileri
    (Trakya Üniversitesi Sağlık Bilimleri Enstitüsü, 2014) Guksu, Zuhal; Vardar, Selma Arzu
    İsatin vücut sıvılarında bulunan, natriüretik peptid antagonisti olduğu bilinen endojen bir indoldür. Bu çalışmada isatinin izole sıçan kalbindeki hemodinamik etkisi ve isatin uygulanmasına bağlı siklik guanozin monofosfat değerlerindeki değişim incelendi. Ayrıca isatinin miyokardiyal dokuda iskemi üzerine siklooksigenaz-2 ve nükleer faktör kappa B düzeylerine etkisinin incelenmesi amaçlanmıştır. Bu çalışmada 250-350 gr ağırlığında erkek Wistar sıçanlar kullanıldı. Düşük akımlı iskeminin 30 dakika öncesinde Kontrol grubuna (n=10) serum fizyolojik, isatin grubuna (n=10) isatin (50 mg/kg) intraperitoneal olarak uygulandı. İzole kalpler Langendorf aparatına yerleştirildi. Bu gruplardaki izole kalplere 15 dakika boyunca Krebb's Henseleit solüsyonu perfüze edildi. Atriyal natriüretik peptit grubunda (n=7) ve isatin + atriyal natriüretk peptit grubunda (n=7) perfüzyon solüsyonuna atriyal natriüretik peptit (0.1 µM/L) eklendi. Tüm gruplarda sol ventrikül gelişim basıncı maksimum ve minimum basınç değişim değerleri çalışma boyunca kaydedildi. Sol ventrikül dokusunda siklooksigenaz-2 mRNA and nükleer faktör kapa B mRNA düzeyleri isatin (n=10) ve serum fizyolojik (n=10) verilmesini takiben 30 dakika sonrasında belirlendi. İsatin grubunun reperfüzyonun 60. dakikasındaki sol ventrikül gelişim basıncı değerleri (18,9 ± 17,1 mmHg) atriyal natriüretik peptit grubundan (68,9± 55,5 mmHg; p<0.05) ve isatin + atriyal natriüretik peptit grubundan (80,8± 53,2 mmHg; p<0.05) daha düşüktü. İsatin grubunda reperfüzyonun 60. dakikasında isatin ve atriyal natriüretik peptit grubuna göre azalmış minimum basınç değişimi saptandı. Atraiyal natriüretik peptit (1,22±0.07 pmol/ml) ve isatin + atriyal natriüretik peptit (1,22±0.11 pmol/ml) gruplarının perfüzyon solüsyonunda isatin grubundan (0,67±0.39 pmol/ml) daha yüksek siklik guanozin monofosfat düzeyleri saptandı(sırasıyla, p<0.01 and p<0.01). İsatin grubunda infakt alanı (19,7±7,1 %) atriyal natriüretik peptit (8,8±6,0 %; p<0.01) ve isatin + atriyal natriüretik peptit (9,1±4,2 %; p<0.01) grubundan daha fazlaydı. Grupların siklooksigenaz-2 ve nükleer faktör kapa B mRNA değerleri isatin verilmesini takiben kontrol grubuna benzer bulundu. İzole sıçan kalbinde yüksek doz isatin verilmesi kontrol grubuna benzer kontraktil etki oluşturmuş bulunmaktadır. Bununla birlikte, atriyal natriüretik peptit sıçan kalbinde reperfüzyonun 60. dakikasında siklik guanozin monofosfat düzeyini artırarak pozitif inotropik ve lusiotropik etkiler oluşturmaktadır.
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    Nutritional screening and the impact of malnutrition on poor postoperative outcomes in gynecological oncology patients
    (Mattioli 1885, 2019) Aynaci, Gulden; Guksu, Zuhal
    Background: Sufficient nutrition effects the survival and life quality of gynecologic oncology patients. The prevalence of malnutrition among gynecological cancer patients at the time of their diagnosis is estimated to be 20%. The main aim of the study is to provide the care recommendations that can be applied to any gynecologic surgery clinic to reduce the incidence of malnutrition after surgery and to investigate the effects of malnutrition on the healing process of the patient. We aimed also to improve the nutritional status of inpatients and to increase the awareness of malnutrition in hospitals. Methods: Our study was a prospective study conducted with 403 patients, 334 of whom were oncologic, at the gynecology clinic of the University of Trakya between February 2017- January 2019. Nutritional characteristics were evaluated with NRS-2002 during the preoperative period. Results: The increase in the rate of complications was observed to increase with the risk of malnutrition. It was observed that oncology patients who were hospitalized and operated in gynecology services were at risk for malnutrition. Our study draws attention to the need for nutritional support and follow-up for those at risk of malnutrition. Discussion: To identify patients at risk for malnutrition and to intervene in their nutrition program can help to make significant progress in the patient's healing process. In our study, we observed that the increase in complication rate led to an increase in the tendency of malnutrition. The rate of gynecologic oncology patients who were at nutritional risk was not to be underestimated. Nutritional support plans of patients with preoperative malnutrition were required to reduce postoperative morbidity and improve long-term patient outcomes. It is therefore important that in gynecological cancer patients the nutritional risk is determined during their hospitalization and so that, trough treatment, malnutrition can be prevented.