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    Ecchymosis and coldness in peripheral varicose vein patients: observations from Vein-Turkey study
    (Sage Publications Inc, 2020) Öztürk, Selçuk; Akbaba, Kağan Türker; Kılıç, Süleyman Sırrı; Çiçek, Tufan; Peşkircioğlu, Levent; Tandoğan, İzzet; Gürlek, Ahmet; Aydemir, Özbay; İleri, Mehmet; Yetkin, Ertan
    The purpose of this subgroup analysis is to investigate and analyze the venous leg symptoms including sense of coldness and sign of ecchymosis in patients with or without peripheral varicose veins (PVVs) from VEIN-TURKEY study population. A total of 600 patients, who were enrolled to VEIN-TURKEY study recently, were included in this subgroup analysis. Patients were examined clinically for the presence and severity of PVV and varicocele. Patients were asked to answer the VEINES-Sym questionnaire consisting of 10 parts and questions about ecchymosis and coldness in their legs. Frequency of symptoms present in the VEINES-Sym instrument, coldness (16.6%, 6.5%, P = .002, respectively), and ecchymosis (16.6%, 2.7%, P < .001, respectively) were significantly higher in patients with PVV compared to patients without PVV. Mean score of each symptom was significantly lower in PVV (+) patients including scores of ecchymosis and coldness. Total VEINES-Sym score was also correlated with the scores of ecchymosis (r = 0.18, P < .001) and coldness (r = 0.35, P < .001). Logistic regression analysis revealed that heavy legs, aching legs, night cramps, and ecchymosis are significantly and independently associated with PVV. In conclusion, sign of ecchymosis and coldness are significantly higher in patients with PVV compared to patients without PVV in a population recruited from the urology clinics. In clinical evaluation, presence or sign of ecchymosis and coldness in legs should be considered to be compatible with PVV in the absence of trauma, hematologic pathologies including antiplatelet treatment, and arterial stenosis or obstruction.
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    Echocardiographic findings in patients with atrial septal aneurysm: a prospective case-control study
    (Hindawi Ltd, 2019) Atak, Ramazan; İleri, Mehmet; Öztürk, Selçuk; Korkmaz, Ahmet; Yetkin, Ertan
    Background. Atrial septal aneurysm (ASA) is a congenital deformity of the interatrial septum with a prevalence of 1-2% in the adult population. Although ASA has been supposed to be an incidental finding in echocardiographic examination, its structural and clinical associations have gained an increasing interest. Aim. To investigate and compare the clinical features and echocardiographic parameters between ASA patients and age- and gender-matched control group patients. Methods. 410 patients with ASA were enrolled in the study, prospectively. After the exclusion of 33 patients, the remaining 377 patients comprised the study group. The control group consisted of 377 age- and gender-matched patients without ASA. Results. Aortic valve regurgitation and mitral valve regurgitation were more often observed in patients with ASA, and percentages of patients with ascending aortic aneurysm (AAA), patent foramen ovale (PFO), and atrial septal defect (ASD) were higher in ASA patients compared to control group patients. Aortic root diameter was larger in ASA patients compared to control group patients (29.2 +/- 3.9, 28.6 +/- 3.1, p = 0.05, respectively). Ascending aorta diameter was higher in ASA patients compared to patients without ASA (44 +/- 0.3, 41.5 +/- 0.2, p = 0.02). Logistic regression analysis revealed that mitral valve regurgitation (OR: 2.05, 95% CI:1.44-2.92, p < 0.001) and PFO (OR: 11.62, 95% CI:2.64-51.02, p = 0.001) were positively and independently associated with the presence of ASA. AAA tended to be statistically and independently associated with ASA (OR: 2.69, 95% CI:0.97-7.47, p = 0.05). Conclusions. We have demonstrated a higher incidence of mitral/aortic valvular regurgitations, AAA, PFO, and ASD in ASA patients compared to age- and gender-matched control group patients. In addition, we have shown that ASA is significantly and positively associated with mild mitral regurgitation and PFO.
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    Venous leg symptoms in patients with varicocele: a multicenter assessment study (VEIN-TURKEY study)
    (Sage Publications Inc, 2019) Öztürk, Selçuk; Akbaba, Kaan Türker; Kılıç, Süleyman Sırrı; Çiçek, Tufan; Peşkircioğlu, Levent; Tandoğan, İzzet; Gürlek, Ahmet; Aydemir, Özbay; İleri, Mehmet; Yetkin, Ertan
    Objective The aim of this study is to evaluate chronic venous disease symptoms by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in varicocele patients. Material and methods The study was designed as a prospective, case controlled study and conducted in four hospitals from Turkey. A total of 600 patients who admitted to urology outpatient clinic were enrolled to the study. After the exclusion of 44 patients who do not match the inclusion criteria, the remaining 556 patients were examined for the presence and grade of varicocele and subsequently examined clinically for the presence of chronic venous disease findings. Finally, patients were asked to answer the VEINES-Sym questionnaire consisting of 10 items. All patients' demographic parameters, cardiovascular risk factors, other co-morbid diseases and drug usage were noted. Results Patients were classified into two groups: varicocele (+) group (n=269) and varicocele (-) group (n=287). VEINES-Sym scores of varicocele patients were lower compared to patients without varicocele (41.415.21, 43.19 +/- 3.22, respectively, p<0.001). Grades of varicocele significantly but inversely correlated with VEINES-Sym score (r=0, -206, p=0.001). Logistic regression analysis revealed that presence of varicocele irrespective of grading significantly and independently associated with the presence of aching (odds ratio: 2.054, 95% confidence interval: 1.265-3.338, p=0.004) and throbbing (odds ratio: 2.586, 95% confidence interval: 1.353-4.943, p=0.004). Conclusion Varicocele patients have lower VEINES-Sym scores compared to patients without varicocele and this finding is inversely correlated with the degree of the varicocele. This association supports the hypothesis that there may be a systemic vessel wall abnormality in venous disease patients. Patients with symptoms related to vascular dilatation in any territory may deserve to be assessed systematically with the support of further clinical studies.