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    Brucella-mediated prosthetic valve endocarditis with brachial artery mycotic aneurysm
    (1999) Cakalagaoglu C.; Keser N.; Alhan C.
    A 39-year-old female with a Hall-Kaster mitral prosthesis developed fever, general malaise and arthralgia 15 years after valve replacement for rheumatic mitral valve disease. Prosthetic valve endocarditis was identified after serial laboratory, clinical and echocardiographic examinations. Penicillin G (40 x 106 units/day, i.v.) + gentamicin (240 mg/day, i.v.) was started as initial therapy. The patient showed no signs of recovery, and penicillin G was replaced with vancomycin (1,000 mg/day, i.v.). There was a gradual reduction in spiking fever, and prominent reductions in erythrocyte sedimentation rate and white cell count. Meanwhile, a tender and pulsatile mass developed in the anterior surface of the left arm; peripheral angiography yielded a diagnosis of brachial artery aneurysm. A successful aneurysmectomy with saphenous vein interposition was performed. Histopathology of the lesion revealed mycotic aneurysm. An initial control SAT for Brucella of 1/80(+) was found to increase. A detailed history showed the patient to have consumed unpasteurized dairy products. Doxycyline (200 mg/day, oral) + co-trimoxazole (2,700 mg/day, oral) + rifampicin (600 mg/day, oral) was administered to treat brucellosis. Later, doxycyline caused intolerable gastrointestinal side effects and was replaced by ciprofloxacin (1,000 mg/day, oral). Subsequently, the patient made an uneventful recovery within one week. Antibiotic treatment was continued for 12 months, with complete resolution of vegetation and paravalvular leakage. During a four- year follow up, the patient showed no signs of relapse.
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    The prevalence of microalbuminuria and relevant cardiovascular risk factors in Turkish hypertensive patients
    (2011) Kozan Ö.; Özcan E.E.; Sancaktar O.; Kabakci G.; Sözcüer A.H.; Kerpeten A.; Delice A.; Içli A.; Sökmen A.; Gürlek A.; Abaci A.; Bayram A.; Köşüş A.; Çamsari A.; Sakalli A.; Sert A.; Temizhan A.; Yilmaz A.; Daver A.; Aydinlar A.; Ergin A.; Kiliçoglu A.E.; Birdane A.; Aribaş A.; Lazoglu A.; Özdemir A.; Fiskeci A.; Çelik A.; Bitigen A.; Keskin A.; Yavuz A.; Akyüz A.; Karanfil A.; Ünsal A.; Sinci A.; Gülmez A.U.; Irmak A.; Vural A.; Güven A.; Ilerigelen B.; Erol B.; Polat B.; Tosun B.; Agçal C.; Genç C.; Kirdar C.; Rezzagil C.; Köz C.; Nazli C.; Ceyhan C.; Örem C.; Uyan C.; Türkoglu C.; Gaffari D.; Aytekin D.; Ural D.; Yeşilbursa D.; Aras D.; Semiz E.; Koçak E.; Atalar E.; Varol E.; Onrat E.; Şensoy E.; Acartürk E.; Akarca E.; Aygün E.; Ertaş F.S.; Koca F.; Özmen F.; Ulusoy F.V.; Özerkan F.; Inceer F.K.; Dönmez G.; Topkara G.; Daş G.; Bozkurt H.; Kültürsay H.; Tikiz H.; Akgöz H.; Kaymak H.; Öney H.; Yegin H.; Boga H.; Gök H.; Vural H.; Atasever H.; Arinç H.; Bozdemir H.; Gündüz H.; Tunar H.; Atmaca H.; Dogru I.; Özdogru I.; Susal I.; Kurt I.T.; Dinçer I.; Biyik I.; Tandogan I.; Jordan J.; Kulan K.; Şahna K.; Öztaş K.; Dönmez K.; Övünç K.; Kaya K.; Aytemir K.; Özdemir K.; Tigen K.; Saraç L.; Sirkeci M.T.; Çakmak M.; Şahin M.; Kutlu M.; Bilge M.; Bostan M.; Melek M.; Sunay M.Ö.; Şeker M.; Güçel M.Ş.; Yazici M.; Kayikçioglu M.; Öç M.; Gürsürer M.; Dagalp M.; Bilaloglu M.; Yalçin M.; Şerifi M.; Gökçe M.; Kiliçkap M.; Polat M.; Şan M.; Tahtasiz M.; Yilmaz M.; Etemoglu M.; Coşkun N.; Aran N.S.; Ata N.; Sönmez N.; Çam N.; Koylan N.; Özer N.; Keser N.; Döven O.; Tartanoglu O.; Ergene O.; Elönü O.H.; Onbaşili O.A.; Özbek Ö.; Pinar P.; Akdemir R.; Kargin R.; Topsakal R.; Yoldaş R.; Uçar R.; Ateşal S.; Toktaş S.; Cinsoy S.; Güleç S.; Aytekin S.; Çolak S.; Mecit S.; Sakalli S.; Sevimli S.; Topaloglu S.; Aydogdu S.; Turan S.C.; Kahraman S.; Yorganci S.; Coşkun Ş.; Ünal Ş.; Durmaz T.; Ulusoy T.; Keleş T.; Kirat T.; Gündogdu T.T.; Peker T.; Sümerkan U.; Aytekin V.; Koca V.; Çam V.; Gökçe V.; Gürlertop Y.; Balbay Y.; Çavuşoglu Y.; Erzurum Y.; Selçoki Y.; Yakar Y.; Işilak Z.; Tosun Z.; Kaplan Z.; Tartan Z.
    Objectives: A growing body of data illustrates the importance of microalbuminuria (MAU) as a strong predictor of cardiovascular risk in the hypertensive population. The present study was designed to define the prevalence of MAU and associated cardiovascular risk factors among Turkish hypertensive outpatients. Study design: Representing the Turkish arm of the multinational i-SEARCH study involving 1,750 sites in 26 countries around the world, a total of 1,926 hypertensive patients from different centers were included in this observational and cross-sectional survey study. Patients with reasons for a false-positive MAU test were excluded. The prevalence of MAU was assessed using a dipstick test, and patients were inquired about comorbidities, comedication, and known cardiovascular risk factors. Results: The overall prevalence of MAU was 64.7% and there was no difference between genders. Most of the patients (82.5%) had uncontrolled hypertension, 35.6% had dyslipidemia, and 35.5% had diabetes, predominantly type 2. Almost one-third of the patients (26.4%) had at least one cardiovascular-related comorbidity, with 20.3% having documented coronary artery disease (CAD). Almost all patients (96.8%) had one or more risk factors for cardiovascular disease in addition to hypertension, including family history of myocardial infarction or CAD, diabetes, dyslipidemia, lack of physical exercise, and smoking. A trend towards higher MAU values in the presence of CAD was determined. Conclusion: Microalbuminuria tests should be routinely used as a screening and monitoring tool for the assessment of subsequent cardiovascular morbidity and mortality among hypertensive patients. © 2011 Turkish Society of Cardiology.
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    Primary prevention from coronary artery disease [Koroner arter hastaligindan korunma: Nasil yapalim?]
    (2007) Sekban A.; Keser N.
    Coronary artery disease is one of the most important causes of mortality and morbidity. Almost 95 % of coronary artery disease cases is due to atherosclerosis. Factors accelerating atherosclerosis have been well defined and being aware of these risk factors and managing the treatable ones will decrease both mortality and morbidity. When the treatment of coronary artery disease and treatment of risk factors is compared, managing the risk factors is found to be more cost effective. So primary prevention seems to be of utmost importance. Treatment of coronary artery disease either pharmacologically or nonpharmacologically also decreases mortality and increases life expectancy.