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    Alterations of serum parathormone, calcium, and Vitamin D levels in end-stage heart failure cases performed with left ventricular assist device implantation [Sol ventrikül destek cihazi implantasyonu uygulanan son dönem kalp yetmezlikli olgularda serum parathormon, kalsiyum ve Vitamin D seviyelerindeki de?işim]
    (Galenos Yayincilik,, 2018) Öztürk P.; Kirazli Y.
    Objective: Determination of the osteoporosis susceptibility in end-stage heart failure (ESHF) cases who underwent left ventricular assist device (LVAD) implantation by examining the alterations of serum parathormone (PTH), calcium, and Vitamin D levels. Materials and Methods: Records of 375 patients who underwent continuous-flow LVAD implantation with diagnosis of ESHF in our clinic were retrospectively scanned. Thirty three patients with a minimum three months of follow-up, who had complete data about serum PTH, calcium, 25-hydroxyvitamin-D (25-OH-D), and pro-brain natriuretic peptide (pro-BNP) levels for pre and postoperative periods, as well as those with a bone mineral density (BMD) measurement were included in the study. In cases whose bone mineral density measurements made for lomber and hip region, for parameters that were worked with demographic data, initial and last follow-up serum values were recorded and statistical changes were examined. Furthermore, the effects of implanted LVAD type on the studied parameters were evaluated comparatively. Results: Totally 33 cases, four of female (12.1%), mean age and body mass index were found 52.7±12.0 years and 27.3±4.3 kg/m2. Postoperative BMD examinations revealed that 50% of cases osteoporosis and 35.7% of osteopenia. Preoperative serum PTH, calcium, 25-OH-D, osteocalcin, urea, creatinine, glomerular filtration rate, and pro-BNP concentrations were 100.9±39.5 pg/mL, 8.9±0.8 mg/dL, 26.7±17.4 ng/mL, 6.98±5.46 ng/mL, 80.2±57.9 mg/dL, 1.48±0.89 mg/dL, 52.99±13.32 mL/minute/1.73 m2, and 9348.7±8176.7 pg/mL; whereas, at the end of the mean follow-up period of 14.2±7.7 months, these values were determined as 78.3±26.3 pg/mL, 9.2±0.5 mg/ dL, 29.8±13.8 ng/mL, 7.55±3.14 ng/mL, 36.2±17.2 mg/dL, 0.98±0.26 mg/dL, 59.72±1.21 mL/minute/1.73 m2, and 1838.9±1853.2 pg/ mL, respectively (p<0.001, p=0.033, p=0.038, p=0.841, p<0.001, p=0.003, p=0.006, and p<0.001, respectively). There was no statistically significant difference when the cases of two different LVAD type implanted were compared in terms of changes in study parameters. Conclusion: Close control of calcium, 25-OH-D, and PTH serum levels is necessary in patients with ESHF underwent with left ventricular assist device; regarding those who have osteoporosis or osteopenia according to BMD measurements except the daily calcium-rich dietary advice, the regulation of medical treatment should be planned. © Telif Hakki 2018 Türkiye Osteoporoz Derne?i.
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    Alterations of serum parathormone, calcium, and Vitamin D levels in end-stage heart failure cases performed with left ventricular assist device implantation [Sol ventrikül destek cihazi implantasyonu uygulanan son dönem kalp yetmezlikli olgularda serum parathormon, kalsiyum ve Vitamin D seviyelerindeki degişim]
    (Galenos Yayincilik,, 2018) Öztürk P.; Kirazli Y.
    Objective: Determination of the osteoporosis susceptibility in end-stage heart failure (ESHF) cases who underwent left ventricular assist device (LVAD) implantation by examining the alterations of serum parathormone (PTH), calcium, and Vitamin D levels. Materials and Methods: Records of 375 patients who underwent continuous-flow LVAD implantation with diagnosis of ESHF in our clinic were retrospectively scanned. Thirty three patients with a minimum three months of follow-up, who had complete data about serum PTH, calcium, 25-hydroxyvitamin-D (25-OH-D), and pro-brain natriuretic peptide (pro-BNP) levels for pre and postoperative periods, as well as those with a bone mineral density (BMD) measurement were included in the study. In cases whose bone mineral density measurements made for lomber and hip region, for parameters that were worked with demographic data, initial and last follow-up serum values were recorded and statistical changes were examined. Furthermore, the effects of implanted LVAD type on the studied parameters were evaluated comparatively. Results: Totally 33 cases, four of female (12.1%), mean age and body mass index were found 52.7±12.0 years and 27.3±4.3 kg/m2. Postoperative BMD examinations revealed that 50% of cases osteoporosis and 35.7% of osteopenia. Preoperative serum PTH, calcium, 25-OH-D, osteocalcin, urea, creatinine, glomerular filtration rate, and pro-BNP concentrations were 100.9±39.5 pg/mL, 8.9±0.8 mg/dL, 26.7±17.4 ng/mL, 6.98±5.46 ng/mL, 80.2±57.9 mg/dL, 1.48±0.89 mg/dL, 52.99±13.32 mL/minute/1.73 m2, and 9348.7±8176.7 pg/mL; whereas, at the end of the mean follow-up period of 14.2±7.7 months, these values were determined as 78.3±26.3 pg/mL, 9.2±0.5 mg/ dL, 29.8±13.8 ng/mL, 7.55±3.14 ng/mL, 36.2±17.2 mg/dL, 0.98±0.26 mg/dL, 59.72±1.21 mL/minute/1.73 m2, and 1838.9±1853.2 pg/ mL, respectively (p<0.001, p=0.033, p=0.038, p=0.841, p<0.001, p=0.003, p=0.006, and p<0.001, respectively). There was no statistically significant difference when the cases of two different LVAD type implanted were compared in terms of changes in study parameters. Conclusion: Close control of calcium, 25-OH-D, and PTH serum levels is necessary in patients with ESHF underwent with left ventricular assist device; regarding those who have osteoporosis or osteopenia according to BMD measurements except the daily calcium-rich dietary advice, the regulation of medical treatment should be planned. © Telif Hakki 2018 Türkiye Osteoporoz Dernegi.
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    Association between the low percentage of forced vital capacity and increased mortality after left ventricular assist device implantation
    (Baycinar Medical Publishing, 2020) Ekren P.K.; Öztürk P.; Ertugay S.; Özdil A.; Nalbantgil S.; Engin Ç.; Özbaran M.
    Background: This study aims to investigate the effect of low percentage of forced vital capacity measured in the preoperative period on the 28-day mortality in patients undergoing left ventricular assist device implantation. Methods: A total of 131 patients (111 males, 20 females; median age 54 years; range, 47 to 59 years) who underwent left ventricular assist device implantation with HeartWare™ between December 2010 and January 2016 were retrospectively analyzed. The patients were divided into two groups according to the results of pulmonary function test as a forced vital capacity percentage of ?60% (n=113) and <60% (n=18). Both groups were compared in terms of laboratory and clinical characteristics, and postoperative complications. Risk factors for postoperative 28-day mortality were analyzed. Results: Pre- and intraoperative characteristics were similar in both groups, except for left ventricular end-diastolic diameter. The ventilator-free days up to 28 days was shorter (p=0.046) and the length of intensive care unit stay was longer (p=0.011) in the low percentage of forced vital capacity group. The 28-day mortality rate was also higher (22.2% vs. 9.7%, respectively; p=0.12) in this group. The history of prior cardiac operation (odds ratio: 4.40; 95% confidence interval 1.19-16.20, p=0.026) and tricuspid valve repair at the time of device implantation (odds ratio: 5.30; 95% confidence interval 1.33-21.00, p=0.018) were found to be independent risk factors for mortality. Multivariate analysis showed that a forced vital capacity of <60% was not associated with mortality (odds ratio: 3.96; 95% confidence interval 0.95-16.43, p=0.058). Conclusion: The length of intensive care unit stay and duration of mechanical ventilation may be longer in patients with a low percentage of forced vital capacity. Although the association between 28-day mortality and low percentage of forced vital capacity is not significant, the risk of 28-day mortality is higher in this group. Therefore, the patients should be assessed carefully before the left ventricular assist device operation. © 2020 © 2020 All right reserved by the Turkish Society of Cardiovascular Surgery. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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    Medicolegal aspects of blood-urine toluene and urinary ortho-cresol concentrations in toluene exposure
    (2001) Akgür S.A.; Öztürk P.; Kurtulmuş Y.; Karali H.; Ertürk S.
    Toluene is a widely used solvent in different industrial areas and has a depressant effect on the central nervous system. In medicolegal cases, for the possible influence of toluene on actions or conditions prior to death, a reliable indicator of exposure must be precisely investigated. We developed an appropriate method for toluene analysis and investigate the blood-urine toluene levels and urinary ortho-cresol levels in toluene-exposed workers. Blood and urine toluene levels from 50 male subjects were detected by Gas Chromatography-FID (GC-FID) using the head-space method, and urinary o-cresol levels, a metabolite of toluene, were analyzed by GC. The significance of difference of ocresol/creatinine levels was evaluated by the nonparametric statistics Kruskal-Wallis One Way Anova, and correlation and regression statistics were determined by Pearson Correlation of bivariant analysis. The toluene concentrations in blood ranged from 0.07 to 2.12 mg/g. Urinary o-cresol levels were not correlated significantly with blood or urine toluene levels. There was no significant difference for ortho-cresol/creatinine levels between the control and worker groups. It is concluded that for medicolegal purposes, urine toluene and urinary o-cresol levels are not reliable markers, and direct toluene analysis in blood must be preferrred in toluene exposure.