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Article Citation - Scopus: 19Laboratory and Imaging Evaluation of Cardiac Involvement in Patients With Post-Acute Covid-19(Dove Medical Press Ltd, 2021) Sarıçam,E.; Dursun,A.D.; Sarıyıldız,G.T.; Can,N.; Bozkurt,E.; Gönüllü,U.; Ünlü,M.Background: In the post-acute COVID-19 syndrome, many patients suffer from palpitations, effort-associated fatigue, and even sudden death. The mechanism of heart involvement in this syndrome is uncertain. The main purpose of the study was to identify possible cardiac involvement causes in patients with post-acute COVID-19 by using biomarkers such as NT-proBNP and nitric oxide (NO) and cardiac imaging modalities. Methods: In this cross-sectional study, a total of 105 participants were included according to the existence of symptoms, and 40 of these participants were asymptomatic patients. The ages of the participants ranged from 20 to 50 years. All patients were healthy before COVID-19. The symptoms were defined as palpitations and/or fatigue association with exercise in post-acute COVID-19 term. The comparison of the two groups was made by using biochemical parameters (NT-proBNP, Troponin I, NO) and imaging techniques (echocardiography, cardiovascular magnetic resonance (CMR) and cardiac positron emission tomography (PET)). Results: The symptomatic patients had higher NT-proBNP levels compared with asymptomatic patients (132.30±35.15; 76.86±16.79, respectively; p < 0.001). Interestingly, the symptomatic patients had lower NO levels than asymptomatic patients (9.20±3.08; 16.15 ±6.02, respectively; p < 0.001). Echocardiography and CMR were normal. However, we found regional increased 18F-FDG uptake on cardiac PET to be compatible with myocardial fatigue. Conclusion: We found elevated NT-proNBP levels, low serum NO levels, and increased 18F-FDG uptake on cardiac PET in post-acute COVID syndrome. Cardiac PET could replace or be added to CMR for detecting subtle subacute/chronic myocarditis. The follow-up of patients with post-acute COVID-19 could target the possibility of risk of heart failure. © 2021 Sarıçam et al. This work is published and licensed by Dove Medical Press Limited.Article Citation - Scopus: 2Conservative Management of Unilateral and Unilocolor Ovarian Cysts ≥ 10 Cm in Diameter in Postmenopausal Women(IMR Press Limited, 2021) Oguz,M.S.; Ecemiş,T.; Sarıyıldız,G.T.Objective: To evaluate and follow up the native behaviour of large ovarian cysts in postmenopausal women and establish the best approach based on advanced imaging technology. Study Design: The number of patients that were evaluated from January 2015 to September 2019 were 417. At the end of this study period, 375 patients were considered for this prospective evaluation. The patients with an ultrasound diagnosis of unilateral and unilocular ovarian cysts with regular septa ≥ 10 cm in diameter at menopause were enrolled in this study. During the follow-ups, the patients who developed irregular or thick septa, papillary formation or solid areas, exhibited any suspicious sign of malignancy in magnetic resonance imaging (MRI) results or displayed an augmentation in CA-125 levels were excluded from the study. In this study cancer antigen-125 (CA-125) values > 65 IU/mL were considered abnormal. The patients who met these criteria were followed with periodical ultrasounds and yearly MRI. Results: The 42 patients who were excluded from the study had significant morphological changes. These patients were showing an increase in CA-125 levels along with abnormal MRI findings during the follow-ups and in addition, they had surgical removal of cysts. All the significant morphological changes were detected by transvaginal ultrasounds. Postoperative histopathological diagnosis of these ovarian cysts revealed no abnormality. From 375 patient's cysts samples one hundred and twenty-five (33.3%) cysts had significantly decrease in size, one hundred and eleven (29.6%) of the cysts had spontaneous resolution and one hundred thirty-nine (37%) cysts persistently remained unchanged during the follow up period. The diameter of the cysts ranged from 10.4 to 18.4 cm. The cysts were categorized into three groups corresponding to a range of diameters i.e., 10-12.9 cm (62%), 13-15.9 cm (24.1%) and ≥ 16 cm (13.8%) respectively. The patients who showed spontaneous resolution were discontinued with the follow-ups while the rest of the patients were continued with their regular follow up examinations. Conclusion: The cysts should be monitored conservatively as long as possible before proceeding to a surgical treatment regardless of the size of the unilateral and unilocular ovarian cysts at postmenopausal period with limited oncogenic potential and without significant morphological changes. © 2021 The Authors.
