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    Acoustic, perceptual and aerodynamic voice evaluation in an obese population
    (CAMBRIDGE UNIV PRESS, 2013) Celebi, S.; Yelken, K.; Develioglu, O. N.; Topak, M.; Celik, O.; Ipek, H. D.; Kulekci, M.
    Objective: To investigate perceptual, acoustic and aerodynamic voice parameters in obese individuals. Methods: Twenty obese and 20 normal-weight volunteers underwent voice evaluation by laryngoscopy, acoustic analysis, aerodynamic measurement and perceptual analysis (using the grade-roughness-breathiness-asthenia-strain ('GRBAS') scale and the Voice Handicap Index 10 scale). Data from both subject groups were compared. Results: No difference was found in acoustic analysis parameters between the two groups (p > 0.05). Maximum phonation time in the obese group (mean +/- standard deviation, 19.6 +/- 4.9 seconds) was significantly shorter than in controls (26.4 +/- 4.1 seconds) (p < 0.001), although the s/z ratio was very similar between the two groups. In the obese and control groups, the mean +/- standard deviation grade-roughness-breathiness-asthenia-strain scores were 1 +/- 1.3 and 0.2 +/- 0.6 (p = 0.002) and the mean +/- standard deviation Voice Handicap Index 10 scores were 0.5 +/- 1.2 and 1.2 +/- 1.7 (p = 0.27), respectively. Conclusion: Obese individuals had poorer vocal quality as judged by the grade-roughness-breathiness-asthenia-strain scale, and reduced maximum phonation time. However, there was no change in voice quality as assessed by acoustic analysis and Vocal Handicap Index 10 score, compared with controls.
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    Single dose ivabradine versus intravenous metoprolol for heart rate reduction before coronary computed tomography angiography (CCTA) in patients receiving long-term calcium channel-blocker therapy
    (SAGE PUBLICATIONS LTD, 2014) Celik, O.; Atasoy, M. M.; Erturk, M.; Yalcin, A. A.; Aksu, H. U.; Diker, M.; Akturk, I. F.; Atasoy, I.
    Background: In patients with contraindication for beta-blockers who are also under long-term calcium channel-blocker therapy for any reason, ivabradine may be used as an alternative treatment to achieve the target heart rate. Purpose: To assess whether single dose oral ivabradine in patients referred for coronary computed tomography angiography (CCTA) is safe and can significantly decrease heart rate compared to intravenous (i.v.) metoprolol in patients receiving long-term calcium channel-blocker therapy. Material and Methods: One-hundred and twenty patients who were under calcium channel-blocker therapy referred for CCTA were randomized to premedication with single dose (15 mg) ivabradine (n 63) or i. v. metoprolol (5-10 mg) (n = 62). Hearth rate (HR) was assessed at admission (HR1), prescan (HR2), and during CCTA scan (HR3) for all patients. Blood pressure (BP) was measured before medication (BP1) and immediately before CCTA scan (BP2). Results: Although the HR averages of two groups were not significantly different before medication (HRIv1 = 80 +/- 7 bpm vs. HR beta 1 = 81 +/- 7 bpm; P 0.42), significant HR reduction was observed in the ivabradine group (HRIv3 = 62 +/- 7 bpm) when compared to the metoprolol group (HR beta 3 = 66 +/- 6 bpm; P = 0.001). Decreases in HR forivabradine (18 +/- 6 bpm) was significantly higher than for metoprolol (15 +/- 4 bpm; P = 0.003) without relevant sideeffects. Ivabradine showed no significant effect on either systolic BP or diastolic BP (siBPIv1, 139 +/- 10; siBPIv2, 138 +/- 10; P = 0.260; diBPIv1, 81 +/- 7; diBPIv2, 81 +/- 6; P = 0.59). Nevertheless, metoprolol group demonstrated significant reduction in both SiBP and DiBP (siBP beta 1, 136 +/- 11; siBP beta 2 130 +/- 11; P < 0.001; diBP beta 1, 81 +/- 6; diBP beta 2, 78 +/- 6; P < 0.001). Conclusion: Single dose ivabradine is safe and significantly more effective than i. v. metoprolol in decreasing HR in patients under calcium channel-blocker therapy.