47 research outputs found
The relationship between mindfulness and resilience: The mediating role of self compassion and emotion regulation in a sample of underprivileged Turkish adolescents
No full textWOS: 000456764200049The purpose of this study was to examine a mindfulness model of resilience through the mediating effects of self compassion and difficulties in emotion regulation among underprivileged Turkish adolescents. The sample of the study consisted of 752 students (426 female, 326 male) who aged 14-19 (M = 15.82, SD = 0.88). A path analysis was conducted in order to examine the proposed model. The results showed mindfulness to be a positive and significant predictor of self-compassion while negatively and significantly predicting difficulties in emotion regulation. Furthermore, self-compassion and difficulties in emotion regulation were found to be significant predictors of resilience. Indirect paths from mindfulness to resilience (via self-compassion and via difficulties in emotion regulation) were also significant in the model. The hypothesized model explained 21% of the variance in resilience scores.Scientific and Technological Research Council of Turkey (TUBITAK)This study was financially supported by The Scientific and Technological Research Council of Turkey (TUBITAK) under my PhD Thesis process. Prof. Oya Yerin Guneri, the second author of this article, was also the supervisor of my PhD Thesis
Influence of carvedilol on serum digoxin levels in heart failure: is there any gender difference?
No full textObjective: The activity of the human cytochrome P450 and P-glycoprotein (P-gp) changes according to gender. The present study evaluated the effect of gender on the influence of carvedilol on serum digoxin levels in patients with heart failure. Methods: Twenty-four patients (12 female and 12 male) with New York Heart Association class II-III heart failure were included in the study. Patients were taking oral digoxin (0.0625-0.25 mg, once a day) and were administered oral carvedilol (6.25 mg, two times daily) for 7 days. Results: In the male group, carvedilol led to statistically significant increases in the area under the concentration time curve to 16 h (AUC(0-16h)) and the peak concentration (C-max) for digoxin, with no change in time to peak (t(max))(AUC(0-16h)= 24.1 +/- 9.2 ng.h/ml vs. 15.4 +/- 5.8 ng.h/ml, p 0.05). In the female group, carvedilol administration did not cause statistically significant change in the AUC(0-16h), C-max, or t(max) for digoxin (p > 0.05). In the male group, carvedilol resulted in a significant increase in the AUC(0-16h) and C-max for digoxin compared with the female group (AUC(0-16h)=24.1 +/- 9.2ng.h/ml vs. 17.0 +/- 6.8 ng.h/ml, C-max=2.2 +/- 1.0 ng/ml vs. 1.5 +/- 0.6 ng/ml, p < 0.05, respectively). Conclusion: Men seem to have a higher activity relative to women for the drug efflux transporter P-gp. Our results suggest that carvedilol will cause drug interaction with digoxin following the inhibition of P-gp-mediated transcellular transport of digoxin in males
The Relationship between Resistant Hypertension and Arterial Stiffness
No full textObjectives: With growing awareness of arterial stiffness (AS) in the past 10 years, it was realized that resistant hypertension (RH) and AS share the same associated conditions such as older age, isolated systolic hypertension (HT), obesity, chronic kidney disease (CKD), and so on. Until now, there is no study investigating the role of AS in RH. In our study we aimed to determine whether there is an association between RH and AS. Methods: Among 87 patients enrolled in this study, 30 were resistant hypertensives (Group 1), 29 were controlled hypertensives (Group 2), and 28 were normotensives (Group 3). Arterial stiffness was measured by both applanation tonometry and echocardiography; augmentation index, pulse wave velocity (PWV), aortic strain, and aortic distensibility were recorded in each patient. Diastolic function parameters were also assessed. Results: In resistant hypertensive group, augmentation index and PWV were significantly higher than Group 2 and Group 3 (P = .03 and P < .01). Aortic strain and aortic distensibility parameters were significantly lower in RH group (P < .01 and P < .01). Arterial stiffness parameters were similar among Group 2 and Group 3. Among diastolic function parameters, left atrial volume index and left ventricular mass index significantly differ between groups. These two parameters were significantly lower in control group (P < .01 and P = .02) whereas similar in Group 1 and Group 2. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels were significantly different between groups as expected. When the correlation between two methods of AS was analyzed, a significant strong inverse correlation was found between echocardiographic and tonometric parameters. Conclusion: Arterial stiffness was found to be associated with RH. The inconsistency of this association in controlled hypertensives suggests a possible role of AS in RH pathogenesis. This study also showed that aortic strain and distensibility correlate well with the PWV which is the gold standard in the assessment of AS. This finding is important for the evaluation of AS more commonly in daily practice as echocardiography is a more feasible device than applanation tonometry
Age-related digoxin-alprazolam interaction
No full textA case report of dramatic increases in serum digoxin levels after alprazolam administration prompted our investigation. Twelve inpatients receiving long-term digoxin (0.25 mg daily) randomly received oral administration of either 1.0 or 0.5 mg alprazolam per day for 7 days. In each dosage group, three patients were older than and three were younger than 65 years of age. The area under the concentration-time curve for serum digoxin increased significantly in patients receiving 1 mg alprazolam daily, and this increase was more pronounced in patients older than 65 years of age. Clinical digoxin toxicity developed in one elderly patient who was receiving 1 mg/day alprazolam
Clinical outcomes and mortality in patients with implantable cardioverter-defibrillator for primary prevention
No full textBackground: Implantable cardioverter-defibrillator (ICD) is indicated for primary prevention in patients with left ventricular ejection fraction (LVEF) <= 35% and New York Heart Association class II or III heart failure despite 3 months of optimal medical therapy. However, studies that support this recommendation are over 20 years old, and they may not reflect modern heart failure patients' characteristics. Objectives: Retrospectively evaluate patients who received an ICD for primary prevention. Methods: All-cause and sudden death rates were compared in patients who received ICD between January 1, 2015 and March 1, 2020 and those who did not accept ICD. Variables were analyzed at a 95% confidence interval, and p < 0.05 was considered as significant. Results: When comparing mortality rates between patients with and without ICD, 67 of 228 patients (29.4%) in the ICD group and 39 of 150 patients (26%) in the control group died from all causes (p = 0.473). Age, LVEF, BNP value, and hospitalization were found to be independent predictors of all-cause mortality. Patients with BNP above 508.5, LVEF below 24.5%, and age over 68.5 years had a 25-fold increased all-cause mortality. Coronary artery disease was not found to be an independent risk factor. Survival in the control group was statistically significantly better in the first months. Although there was no statistical difference in the long term, survival was numerically better in the ICD arm. This could be attributed to the fact that ICD implantations were performed on patients with worse clinical conditions. The higher survival rate observed in patients with ICD may be due to the fact that they came in for device control and remained in follow-up. Conclusions: With advances in the treatment of heart failure, ICD implantation should be performed in selected patients
The relationship between angiotensin converting enzyme gene polymorphism and hypertensive retinopathy
No full textIn this paper, we give a simple counter example to the famous Hodgeconjecture
An observational study to evaluate factors responsible and actions taken for hypertensive patients who are not at blood pressure goal: i-target Goal Study
No full textWOS: 000305001900010PubMed ID: 22318207To evaluate the percentage of hypertensive patients who could achieve target blood pressure (TBP) according to the guidelines in the context of recommended measures and the factors responsible for failure. A total of 589 hypertensive patients (59.0% female; mean age: 57.7+/-10.4 years) were assessed twice for TBP achievement based on 2007 ESH/ESC guidelines and the investigators' view, in addition to the recommended measures and possible causes of failure in hypertension management in this national multi-center (n = 99), non-interventional observational study. Only 29.5% of the patients at the first visit and 46.8% at the second visit achieved the TBP levels specified by the guidelines. However, the investigators' evaluation indicated a higher achievement rate at the first (43.5%) as well as the second (69.1%) visit when compared with the guideline-based assessments (P<0.001). The primary reasons identified by the investigators for the failure to reach TBP were non-compliance with dietary recommendations (61.6%) at the first visit and non-compliance with treatment (63.92%) at the second visit. Recommendations for lifestyle were the most commonly identified treatment plan by the investigators at both visits (62.9% and 66.1%, respectively). Although more patients achieved the TBP levels specified by the guidelines for the second visit compared with the first, effective blood pressure control was achieved only in 29.5% of our patients. Interestingly, the investigators had a more optimistic view about their patients' control of hypertension, which may have contributed to a poor achievement of TBP. Hypertension Research (2012) 35, 624-632; doi:10.1038/hr.2012.12; published online 9 February 2012Sanofi-Aventis TurkeyThe study was funded by Sanofi-Aventis Turkey. We thank Cagla Isman, M. D. and Professor Sule Oktay, M. D., Ph.D. from KAPPA Consultancy Traning Research Ltd., Istanbul, who provided editorial support; and Oguz Akbas, M. D., Ph.D., Esra Koruyucu and Arzu Calisgan M. Sc. from Monitor CRO, Istanbul, for their support of the statistical analysis, funded by Sanofi-Aventis Turkey
Are complex coronary lesions more frequent in patients with diabetes mellitus?
No full textBACKGROUND: Coronary atherosclerotic burden is excessive in diabetic patients. Diabetes mellitus (DM) is an independent predictor for both death and myocardial infarction. It is not known whether the prevalence of complex coronary lesions, such as bifurcation and ostial lesions, is different in diabetics from nondiabetics
Ventricular Diastolic Function of Ankylosing Spondylitis Patients by Using Conventional Pulsed Wave Doppler, Myocardial Performance Index and Tissue Doppler Imaging
No full textObjective: The aim of this study was to evaluate ventricular functions by using standard Doppler echocardiography (SDE), myocardial performance index (MPI), and pulsed wave tissue Doppler imaging (PW-TDI) in patients with ankylosing spondylitis (AS) and healthy controls. Methods: Forty-nine AS patients (38 +/- 11 years, 25 M/24 F) and 33 controls (36 +/- 9 years, 17 M/16 F) were studied. Two-dimensional, M-Mode, SDE, PW-TDI echocardiography examinations were performed. Spinal mobility was assessed by the Bath ankylosing spondylitis metrology index (BASMI) measurement. Patients were also evaluated using the Bath ankylosing spondylitis functional index (BASFI) and the Bath ankylosing spondylitis disease activity index (BASDAI). Results: Four control subjects and six AS patients met the left ventricular (LV) diastolic dysfunction (DD) criteria by using conventional Doppler echocardiography (p > 0.05). However, using PW-TDI method 22 patients in the AS group and six subjects in the control group were diagnosed to have LV DD (Em/Am < 1). Pseudonormalized pattern was present in 16 AS patients and two control subjects. Correlation analysis revealed significant moderate negative correlations between Em/Am and BASMI, age and body mass index (p < 0.05; r = -0.3, -0.6, and -0.4, respectively). No correlation was observed between Em/Am and disease duration, BASFI, BASDAI, CRP, and ESR. We could not detect any right ventricular function involvement either by conventional or by recently introduced echocardiography methods. The risk of developing LV DD was found to be 3.7 times higher in AS patients. Conclusion: When sensitive echocardiographic Doppler techniques such as MPI, TDI-derived MPI, and PW-TDI are utilized, DD can be detected in a significant proportion of patients with AS without cardiovascular (CV) disease which may contribute CV mortality in these patients
