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  • Küçük Resim Yok
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    Early effects of low versus high dose atorvastatin treatment on coagulation and inflammation parameters in patients with acute coronary syndromes
    (Elsevier Ireland Ltd, 2008) Ordulu, Emine; Erdogan, Okan
    Aim: To demonstrate the efficacy of low or high dose statin treatment on C-reactive protein (CRP), von Willebrand Factor (vWF) and Factor VII (FVII) during the first two weeks of acute coronary syndromes. Patients and methods: Patients with acute coronary syndromes (n=60) were randomly and prospectively allocated in three different groups. They received 10 mg (low dose), 80 mg (high dose) of atorvastatin and placebo for two weeks. Plasma levels of CRP, vWF and FVII were compared at baseline, first and second weeks of treatment. Results: Low dose therapy resulted in non-significant elevation of CRP at first week, although high dose therapy significantly lowered its level (7.75 +/- 3.57 vs 7.13 +/- 2.95; p=.04). Both low and high dose therapies effectively suppressed the production and elevation of vWF in contrast to placebo (121.15 +/- 31.99 vs 139.7 +/- 28.53; p=.04). Conclusions: High dose atorvastatin significantly decreased CRP during the early days of acute coronary syndromes. Although vWF significantly increased in placebo group, both low and high dose atorvastatin treatments effectively suppressed its increased production. (c) 2007 Elsevier Ireland Ltd. All rights reserved.
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    Perikardiyal tamponad kliniği ile gelen tip A aort diseksiyon olgusuna acil yaklaşım
    (2007) Ordulu, Emine; Erdoğan, Okan
    Altmış sekiz yaşındaki erkek hasta ani başlayan göğüs ve sırt ağrısını takiben gelişen, geçici bilinç kaybı ile acil polikliniğimize başvurdu. Fizik bakıda baş ve boyun bölgesinde belirgin siyanoz, boyun ven distansiyonu bulunan hastanın ekokardiyografisinde kalp boşlukları çevresinde yoğun içerikli sıvı görüldü. Kontrastlı torakoabdominal bilgisayarlı tomografide diseksiyon lehine bulgu saptanamadı. Perikardiyal tüp drenajı ile 650 cc sıvı boşaltılan hastanın klinik durumu belirgin olarak düzeldi. Tekrarlanan ekokardiyografide çıkan aortta, kapak seviyesinden 2 cm proksimalde başlayan hipodens alanın ayırdığı çift kontur görünümü saptandı. Hasta ameliyata alındı, çıkan aorta kapak seviyesinden 2 cm proksimalden itibaren 6 cm'lik segment boyunca Dacron greft yerleştirildi ve şifa ile taburcu edildi.
  • Küçük Resim Yok
    Öğe
    Urgent approach to a patient presenting with type A aortic dissection associated with cardiac tamponade
    (Aves Yayincilik, Ibrahim Kara, 2007) Ordulu, Emine; Erdogan, Okan
    male patient aged 68 years, arrived to the emergen-cyoutpatient clinic with a transient loss of conscience, following acute onset chest and back pain. Physical examination of the. patient revealed cyanosis in the head and neck region and distension of neck veins. A dense effusion around the cardiac spaces was observed during the echocardiographic examination. Thoracoabdominal computed tomography with contrast did not reveal findings supporting dissection. The clinical condition of the patient improved significantly after the drainage of 650 ml of fluid. On repeat echocardiography, a double contour in the ascending aorta, 2 cm proximal to -the valvular level and separated by a hypodense area was observed. The patient was operated and a Dacron graft was inserted to the ascending aorta along the 6 cm segment starting from 2 cm proximal to the valvular level. The patient was discharged upon full recovery.