Akut faz yanitinin olcumu, hastaliklarin tani ve takibinde bize yardimci olmaktadir. Bu olcumler ... more Akut faz yanitinin olcumu, hastaliklarin tani ve takibinde bize yardimci olmaktadir. Bu olcumler icinde de Eritrosit Sedimentasyon Hizi (ESH) yaygin olarak kullanilan bir tetkikdir. ESH’yi eritrositlerdeki rulo olusumu ya da kume olusumu belirler ve bu olusumlari etkileyen baslica faktorler fibrinojen, α2, β ve γ globundir. Ayrica; eritrositlerle plazma arasindaki oran, plazma vizkozitesi, sedimantasyon tupu ile ilgili durumlar, kullanilan antikoagulan ve oda isisi da ESH’yi etkiler. ESH; gebelik, menstruasyon ve yaslilik gibi fizyolojik durumlarda yukselebilecegi gibi, patolojik bircok durumda da yukselebilir. ESH tipki nabiz ve vucut isisi gibi genel bilgi verir; ciddi hastaliklarin cogunda yukselir, ancak normalde kalabilir. Bu derlemede ESH’nin tanimi, olcum metodlari, etkileyen faktorleri ve klinikte kullanimi hakkinda pratik basvuru kaynagi sunmak amaclanmistir
Although paracetamol and diclofenac sodium are most commonly used drugs and considered as safe, t... more Although paracetamol and diclofenac sodium are most commonly used drugs and considered as safe, they are also frequently become a current issue with complications in therapeutic doses or overdose situations. Both drugs can cause bleeding disorders as a result of platelet dysfunction and can be presented as an atypical clinical situation such as subconjunctival hemorrhage. In these presented cases, the subconjunctival hemorrhage seen after ingestion of paracetamol and diclofenac sodium in toxic doses for the purpose of suicide, is considered as related with the bleeding disorder that is associated with drug side effect. For these patients who do not have any known co-morbidities, the reasons that can cause subconjunctival hemorrhage other than drugs such as trauma, infections, thrombocytopenia, malignant blood disorders, septicemia, hypertension, severe cough are excluded. Although hepatic and renal toxicities are commonly known side effects that are related with high doses of these ...
Woodhouse-Sakati Syndrome (WSS) is a rare autosomal recessive syndrome characterized by sensorine... more Woodhouse-Sakati Syndrome (WSS) is a rare autosomal recessive syndrome characterized by sensorineural hearing loss, ECG ST-T changes, partial alopecia, hypogonadism, diabetes, and moderate mental retardation. A 23-year-old male patient was admitted to our hospital with complaints of purpura and petechial rashes. His platelet count was 3.04 x 109/L and the peripheral blood smear was compatible with this count. No atypical cell was observed. He had mild mental retardation. He had hearing loss since childhood. Physical examination showed widespread petechiae and purpura on bilateral lower extremities. Significant growth retardation was detected and male pattern hair growth was less. In genital examination, bilateral testicles were small; penis length was 1 cm and it was 4 cm when elongated. T negativity was present in precordial derivations of ECG. He was diagnosed Immune thrombocytopenic purpura (ITP) and WSS according to these findings. In addition to ITP treatment with steroids, the...
Measuring acute phase response helps us diagnose and follow up diseases. Erythrocytes Sedimentati... more Measuring acute phase response helps us diagnose and follow up diseases. Erythrocytes Sedimentation Rate (ESR) among those measurements is a biochemical method which is commonly used. Roll formation or clustering of erythrocytes determines of sedimentation rate, and main factors affecting those events are fibrinogen, α2, β and γ globins. Moreover, some conditions such as ratio between plasma and erythrocytes, plasma viscosity, tube used for measuring in sedimentation rate, room temperature and anti-coagulant agent used affect Erythrocyte sedimentation rate measurement. It can be elevated in several pathological conditions as well as in pregnancy, senility and menstruation. ESH gives general idea or information as pulse and body temperature do; it is elevated in several severe diseases, it can be course in normal levels. In this review, it was aimed to present its use of clinical practice, definition, measurement methods, and factors affecting ESH.
Kaya, Ertugrul/0000-0003-0081-682XWOS: 000330151200043Aims: To determine the effects of diabetes ... more Kaya, Ertugrul/0000-0003-0081-682XWOS: 000330151200043Aims: To determine the effects of diabetes mellitus (DM) treatment regimens on malignancy. Methods: Six hundred fifty-five DM patients were enrolled. Patients receiving diabetes therapies for at least one year were retrospectively assessed with physical examination, detailed medical, habits, demographic characteristics and laboratory tests, and divided into two groups according to the diabetes treatment type (using oral agent or insulin and using metformin or not). Insulin users were grouped according to insulin regimens (intensive, basal and mixed) and to the insulin type (glargine, detemir, human insulin, biphasic analogue). Cancer cases were identified at the first visit. Results: Among 655 DM patients 13 (2%) were Type 1 DM, 642 (98%) were Type 2 DM; 379 (58%) were female, 276 (42%) were male. Thirty-sir cancers and 76 benign tumors were observed. Patients with and without a cancer were compared for diabetes treatment regimen...
Kaya, Ertugrul/0000-0003-0081-682XWOS: 000330151200043Aims: To determine the effects of diabetes ... more Kaya, Ertugrul/0000-0003-0081-682XWOS: 000330151200043Aims: To determine the effects of diabetes mellitus (DM) treatment regimens on malignancy. Methods: Six hundred fifty-five DM patients were enrolled. Patients receiving diabetes therapies for at least one year were retrospectively assessed with physical examination, detailed medical, habits, demographic characteristics and laboratory tests, and divided into two groups according to the diabetes treatment type (using oral agent or insulin and using metformin or not). Insulin users were grouped according to insulin regimens (intensive, basal and mixed) and to the insulin type (glargine, detemir, human insulin, biphasic analogue). Cancer cases were identified at the first visit. Results: Among 655 DM patients 13 (2%) were Type 1 DM, 642 (98%) were Type 2 DM; 379 (58%) were female, 276 (42%) were male. Thirty-sir cancers and 76 benign tumors were observed. Patients with and without a cancer were compared for diabetes treatment regimen...
Amaç: Behçet hastalığı (BH)’nın doğal seyri sırasında ya da kullanılan ilaçlara bağlı olarak oste... more Amaç: Behçet hastalığı (BH)’nın doğal seyri sırasında ya da kullanılan ilaçlara bağlı olarak osteoporoz gelişebilir. Çalışmanın amacı BH’nda osteoprotegerin ve tümor nekroz faktör (TNF-?) düzeyleri ve bunlar arasındaki korelasyonu araştırmaktır. Gereç ve yöntem: Çalışmaya, hasta grubu ve kontrol grubu olarak iki grup alındı. TNF-?, osteoprotegerin, osteokalsin, sedimantasyon, CRP, idrar kreatin ve deoksipridinolin düzeyleri ile beraber kemik mineral dansitometrisi (KMD) ölçüldü ve iki grup karşılaştırıldı. Bulgular: Çalışma grubuna 41 hasta, kontrol grubuna 36 hasta alındı. Çalışma ve kontrol grubunun yaş ortalaması sırasıyla 42.2611.64 ve 41.6670.99 bulundu. Vücut kitle indeksi yönünden iki grup arasında fark bulunmadı. TNF-? (p0.001), deokspiridinolin (p0.001) ve osteokalsin (p0.041) düzeyleri kontrol grubundan önemli oranda yüksek bulundu. Osteoprotogerin düzeyi hasta grubunda düşüktü ancak anlamlı düzeyde değildi (p0.05). İdrar deoxypyridinoline/ idrar kreatinin oranı hasta grub...
Amaç: Behçet hastalığı (BH)’nın doğal seyri sırasında ya da kullanılan ilaçlara bağlı olarak oste... more Amaç: Behçet hastalığı (BH)’nın doğal seyri sırasında ya da kullanılan ilaçlara bağlı olarak osteoporoz gelişebilir. Çalışmanın amacı BH’nda osteoprotegerin ve tümor nekroz faktör (TNF-?) düzeyleri ve bunlar arasındaki korelasyonu araştırmaktır. Gereç ve yöntem: Çalışmaya, hasta grubu ve kontrol grubu olarak iki grup alındı. TNF-?, osteoprotegerin, osteokalsin, sedimantasyon, CRP, idrar kreatin ve deoksipridinolin düzeyleri ile beraber kemik mineral dansitometrisi (KMD) ölçüldü ve iki grup karşılaştırıldı. Bulgular: Çalışma grubuna 41 hasta, kontrol grubuna 36 hasta alındı. Çalışma ve kontrol grubunun yaş ortalaması sırasıyla 42.2611.64 ve 41.6670.99 bulundu. Vücut kitle indeksi yönünden iki grup arasında fark bulunmadı. TNF-? (p0.001), deokspiridinolin (p0.001) ve osteokalsin (p0.041) düzeyleri kontrol grubundan önemli oranda yüksek bulundu. Osteoprotogerin düzeyi hasta grubunda düşüktü ancak anlamlı düzeyde değildi (p0.05). İdrar deoxypyridinoline/ idrar kreatinin oranı hasta grub...
Although paracetamol and diclofenac sodium are most commonly used drugs and considered as safe, t... more Although paracetamol and diclofenac sodium are most commonly used drugs and considered as safe, they are also frequently become a current issue with complications in therapeutic doses or overdose situations. Both drugs can cause bleeding disorders as a result of platelet dysfunction and can be presented as an atypical clinical situation such as subconjunctival hemorrhage. In these presented cases, the subconjunctival hemorrhage seen after ingestion of paracetamol and diclofenac sodium in toxic doses for the purpose of suicide, is considered as related with the bleeding disorder that is associated with drug side effect. For these patients who do not have any known co-morbidities, the reasons that can cause subconjunctival hemorrhage other than drugs such as trauma, infections, thrombocytopenia, malignant blood disorders, septicemia, hypertension, severe cough are excluded. Although hepatic and renal toxicities are commonly known side effects that are related with high doses of these drugs, in our cases there were not any impairment of hepatic or renal function tests other than compensated metabolic acidosis. In this report, the relationship of parasetamol and diclofenac sodium with bleeding disorders is discussed over two cases which presented as subconjunctival hemorrhage.
Herediter anjioödem hepatositler tarafından üretilen C1 esteraz inhibitör eksikliği veya disfonks... more Herediter anjioödem hepatositler tarafından üretilen C1 esteraz inhibitör eksikliği veya disfonksiyonundan kaynaklanan, nadir rastlanılan, potansiyel olarak yaşamı tehdit edici bir hastalıktır. Subkutan veya submukozal bölgede tekrarlayan anjioödem ataklarıyla karakterizedir. Herediter anjioödemde nadir olarak görülen larenks ödemi ani hava yolu obstruksiyonuna neden olup ölümle sonuçlanabilir. Burada trakeostomi açılmasını gerektirecek kadar şiddetli larenks ödemi gelişen herediter anjioödemli bir erkek olgu sunulmaktadır.Hereditary angioedema is a rare and potentially life-threatening disease resulting from deficiency or disfunction of C1 esterase inhibitor which is produced by hepatocytes. It is characterized by recurrent angioedema attacks at subcutaneous or submucosal region. Larynx edema could be seen rarely in hereditary angioedema and may result in death by causing sudden air way obstruction. Herein, we present a male hereditary angioedema case with laryngeal edema which is severe enough to require tracheostomy
sarcoma is chemosensitive, 80% of patients relaps after chemotherapy and some receive further tre... more sarcoma is chemosensitive, 80% of patients relaps after chemotherapy and some receive further treatments like High-dose chemotherapy (HDC) with autologous stem cell transplantation (ASCT). According to 2011-Transplant Review Guidelines, minimum patient evaluation requirements for ASCT are echocardiogram with LVEF >40% and pulmonary function testing (PFT) with FVC ≥50%, FEV1 ≥50% and DLCO 40% for adults. Case report: The patient was a 23-year-old man who had been suffering from non-productive cough since January 2011. Radiologic examinations revealed a mass of 13×15 cm in the left lower lung zone and presence of pleural involvement. The patient underwent biopsy and histopathologic diagnosis revealed a Ewing's sarcoma. Combination VAC-alternating IE chemotherapy for 5 cycles, 31 fractions of radiotherapy and following two cycles of VAC/IE chemotherapy were administered. PET-CT after therapy showed intense metabolic activity highly suspicious for residual disease and left pneumonectomy with partial pericardiectomy was performed in February 2012. Pathologic diagnosis revealed a high-risk Ewing sarcoma. Patient was candidate for HDCT with ASCT. LVEF was 55%. PFT results were within normal limits (FVC: 45%, FEV1: 50%, DLCO: 52%). High-dose ICE (ifosfamide 10g/m 2 , carboplatin 1 g/m 2 , and etoposide 1g/m 2) was administered. The 3.2×10 6 CD34+ cells/kg were harvested and reinfused. Candida albicans isolated from hemocultures and caspofungin treatment was given in follow-up periods. No other complication was recorded and engraftment was obtained 17 days after reinfusion. Patient is still in remission and under follow-up. Conclusion: Ewing's sarcoma is a chemosensitive tumor. With supporting therapy and close follow-up, HDCT with ASCT is a strongly recommended combination therapy in high-risk Ewing's sarcoma even for patients with borderline organ functions, especially in physically young patients.
A pancreatic pseudocyst is a localized fluid collection wit-hin or adjacent to the pancreas, encl... more A pancreatic pseudocyst is a localized fluid collection wit-hin or adjacent to the pancreas, enclosed by a non-epit-helized wall. Pseudocysts account for about 75 % or mo-re of the cystic lesions of the pancreas (1). Pancreatitis, trauma and obstructive neoplasms are the common cau-ses. Pancreatic pseudocysts often arise as a complication of acute or chronic pancreatitis. The prevalence of pan-creatic pseudocysts in acute pancreatitis has been repor-ted to range from 6%-18.5%, while the prevalence of pancreatic pseudocysts in chronic pancreatitis ranges from 20%-40 % (2,3). A 52-year-old man with a diagnosis of acute pancreatitis was referred to our clinic with diffuse abdominal and back pain. His relatives recalled that he had suffered an acute pancreatitis attack three weeks before. He did not
OBJECTIVE The mean platelet volume (MPV) can be used as an indicator of platelet activation. Howe... more OBJECTIVE The mean platelet volume (MPV) can be used as an indicator of platelet activation. However, it has been shown that the platelet/lymphocyte ratio (PLR) can provide useful predictive information about inflammation and aggregation pathways. The neutrophil/lymphocyte ratio (NLR) may also be helpful as a marker of systemic or local inflammation. The main objective of this study evaluated to unselected critically ill patients the relationship of initial MPV, NLR, and PLR with mortality, length of hospitalization, and the risk of developing nosocomial infections in ICU patients. PATIENTS AND METHODS In this retrospective study, we evaluated consecutive patients at our tertiary nine-bed ICU. One hundred seventy-three patients who were followed up during a 1-year period were included. RESULTS MPV levels were found to be higher in patients who died in the hospital (p = 0.05). In addition, there was a significant positive correlation between expected mortality rate and MPV among non-...
Aim: The aim of the Melen Study was to investigate the cardiovascular risk profile of Turkish adu... more Aim: The aim of the Melen Study was to investigate the cardiovascular risk profile of Turkish adults by utilizing newest techniques. Besides prevalence and types of endemic goiter will be established which was an important health problem in the Black sea region Method: The study was conducted on 2230 participants (1427 women, 803 men with a mean age of 49). The participants underwent a Doppler Ultrasound examination of carotid intima media thickness, echocardiographic examination, ECG recording, bioempedance meter analysis of body composition, pulmonary function test and various biochemical analysis. Result: Twenty nine percent of the population had hypertension, 12% had diabetes mellitus and 17% were smokers. Thyroid ultrasonography revealed that 29% of the cohort had goiter. Echocardiographic measurements showed that 39% of the participants had diastolic dysfunction. Comparison of males with females showed that men had significantly higher visceral fat, triglyceride, hemoglobin and CIMT whereas women had higher mean diastolic blood pressure, HDL and total cholesterol. Conclusion: According to the histories of patients, hypertension, diabetes mellitus and smoking were very frequent among Turkish adults. Among the objectively measured variables, diastolic dysfunction, visceral adiposity and goiter were strikingly high.
International Journal of Advanced Research in Medicine, 2019
Background: Diabetes mellitus refers to a group of common metabolic disorders that share the phen... more Background: Diabetes mellitus refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The present study was conducted to determine carotid intima-media thickness in patients of controlled and uncontrolled type 2 diabetes mellitus. Materials and Methods: The present study was conducted on 150 type 2 diabetes mellitus patients (75 in controlled diabetes and 75 in uncontrolled diabetes group) of both genders. All patients underwent carotid doppler of common carotid artery determined by higher resolution B mode ultrasonography using Philips Affinity 70 machine. The total of 3 values was averaged to give mean common carotid intima-media thickness value for each patient. Results: Group I had 40 males and 35 females whereas group II had 45 males and 30 females. The mean diameter of right CCA in group I was 6.4 mm and in group II was 7.3 mm, in left CCA was 6.5 mm and in group II was 6.8 mm, right ICA was 4.5 mm in group I and 4.7 mm in group II and left ICA was 4.6 mm in group I and 4.5 mm in group II. The mean IMT of right CCA in group I was 0.72 mm and in group II was 0.84 mm, in left CCA was 0.74 mm and in group II was 0.87 mm, right ICA was 0.43 mm in group I and 0.48 mm in group II and left ICA was 0.45 mm in group I and 0.54 mm in group II. Conclusion: Authors found increase diameter and thickness of intima media in uncontrolled diabetics as compared to controlled diabetics.
Journal of the College of Physicians and Surgeons Pakistan, 2019
Thiamine-responsive megaloblastic anemia (TRMA) syndrome is a rare disease comprising a classic t... more Thiamine-responsive megaloblastic anemia (TRMA) syndrome is a rare disease comprising a classic triad of megaloblastic anemia, diabetes mellitus, and early-onset sensorineural deafness. TRMA can generally be diagnosed in early childhood. Early diagnosis is important to prevent complications that may develop soon. As it is a rare disease, diagnosis may sometimes be difficult. We present a rare case of an adult patient with TRMA who had been mistakenly diagnosed with myelodysplastic syndrome (MDS), whose anemia was corrected only after thiamine treatment was started.
To investigate the correlation between vitamin B12 and body mass index (BMI) along with insulin r... more To investigate the correlation between vitamin B12 and body mass index (BMI) along with insulin resistance (IR) in middle-aged obese women. Materials and methods: Th e study was designed as a case-control study. Th e study group included middle-aged obese women and the control group included aged-matched lean women. Weight, height, and hip and waist circumferences were measured. Biochemical parameters such as fasting and postprandial glucose, vitamin B12 and folic acid levels, and lipid profi les were assayed. Results: Enrolled in the study were 116 middle-aged obese and 103 aged-matched healthy lean women. Th e vitamin B12 level of the obese women was signifi cantly lower than that of the lean women (244.1 ± 131.5 pg/mL vs. 336.2 ± 163.1 pg/mL, P = 0.002). However, there was no signifi cant diff erence in folic acid levels between the groups (P > 0.05). Th e vitamin B12 level was similar in the obese women with metabolic syndrome and those without (245.1 ± 145.3 pg/mL vs. 241.2 ± 96.5 pg/mL, P > 0.05), but the level in the control group was signifi cantly higher than that of patients with obesity and metabolic syndrome (P = 0.010 and P = 0.020, respectively). Vitamin B12 levels correlated with BMI (r =-0.259, P = 0.003) but not with IR (r =-0.053, P > 0.05). Conclusion: Th e vitamin B12 concentration was low in obese patients and this level negatively correlated with BMI, but not with homeostasis model assessment-estimated IR (HOMA-IR).
Nutritional support plays a vital role in patients admitted to the intensive care unit (ICU) due ... more Nutritional support plays a vital role in patients admitted to the intensive care unit (ICU) due to various reasons. Losing body mass leads delayed functional recovery after discharge, and reduces the survival rate [1]. Therefore, nutritional status should be carefully assessed with proper tools. A consensus issued by the Academy of Nutrition and Dietetics (AND) and American Society for Parenteral and Enteral Nutrition (ASPEN) underscores the importance of inflammation in malnourished adults [2]. In this consensus, malnutrition was defined as the presence of 2 or more of the six (insufficient energy intake, weight loss, loss of muscle mass, loss of subcutaneous fat, localized or generalized fluid accumulation that may sometimes mask weight loss and diminished functional status as measured by hand grip strength) predetermined components [2]. There is no special consensus recommendation for the ICU patients or the elderly patient group. Several indexes have been used to determine the nutritional status of ICU patients [3]. One of them is the ''NUTrition Risk in Critically ill (NUTRIC) Score'', which includes age, number of comorbidities, days from hospital to ICU admission, acute physiology and chronic health evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) Scores. NUTRİC score can be calculated with or without interleukin (IL)-6 values [4]. Subjective Global Assessment (SGA) comprises evaluation of the following: current weight, weight before illness and weight
Knowledge about the inhibition of centrally located angiotensin-I (AT-I) receptors by highly lipo... more Knowledge about the inhibition of centrally located angiotensin-I (AT-I) receptors by highly lipophilic AT-I receptor blockers and its' effect are limited with experimental studies. Thus, we aimed to investigate the effect of Telmisartan on Inter-dialytic weight gain (IDWG) % and echocardiographic measurements in anuric hemodialysis (HD) patients. A total of forty-one anuric HD patients with ≥ 6 months maintenance on HD were included in this prospective, randomized and self-controlled study. Four weeks prior the study, angiotensin converting enzyme blockers and AT-I receptor blocker drugs were stopped. Patients were assessed three times during the study protocol. These are baseline, three months later (without Telmisartan period) and three months after Telmisartan therapy. IDWG % was significantly decreased in the period of with Telmisartan compared to period without Telmisartan (5.6 ± 1.0% vs 5.3 ± 1.0%, p = 0.03). After the administration of Telmisartan left ventricule end-dia...
Turkish Journal of Endocrinology and Metabolism, 2012
Anah tar ke li me ler: Obezite, abdominal obezite, vücut kitle indeksi, diabetes mellitus Abs tra... more Anah tar ke li me ler: Obezite, abdominal obezite, vücut kitle indeksi, diabetes mellitus Abs tract Purpose: The aim of our study was to determine the prevalence of obesity and abdominal obesity in the West Black Sea region of Turkey and to display the associated chronic diseases, especially Diabetes Mellitus (DM) in this population. Material and Method: We evaluated 2222 (1418 female, 804 male, mean age: 50) participants in Yigilca. The medical histories were recorded and physical examinations were done in all participants. Body weight categories were defined according to the body mass index (BMI) as follows: BMI <18.5 lean, 18.5-24.9 normal, 25-29.9 overweight, ≥30 obese and ≥40 morbidly obese. According to waist circumference measurements, >94 cm in males and >90 cm in females were accepted as the cutoff points for abdominal obesity. Results: The mean BMI of the participants was 30.6 in females and 27.5 in males. According to BMI, obesity prevalence was 53.1% in females and 26.9% in males. The mean obesity prevalence was 43.5% in general. Abdominal obesity prevalence was 63% in females, 46% in males and 57% in all participants. Obesity prevalence increased with age in both sexes. Especially 3/4 (75%) of females and 1/3 (33%) of males aged 50-59 years were obese. Postmenopausal females had very high (64%) obesity prevalence but the rate was %43 in premenopausal women. While DM prevalence was 12.6% according to patient history, DM prevalence increased to 18.8% by adding patients with fasting glucose >126 mg/dl. Discussion: Obesity, especially abdominal obesity and DM prevalence was found to be at exaggerated rates in both sexes being highest in postmenopausal females.
Akut faz yanitinin olcumu, hastaliklarin tani ve takibinde bize yardimci olmaktadir. Bu olcumler ... more Akut faz yanitinin olcumu, hastaliklarin tani ve takibinde bize yardimci olmaktadir. Bu olcumler icinde de Eritrosit Sedimentasyon Hizi (ESH) yaygin olarak kullanilan bir tetkikdir. ESH’yi eritrositlerdeki rulo olusumu ya da kume olusumu belirler ve bu olusumlari etkileyen baslica faktorler fibrinojen, α2, β ve γ globundir. Ayrica; eritrositlerle plazma arasindaki oran, plazma vizkozitesi, sedimantasyon tupu ile ilgili durumlar, kullanilan antikoagulan ve oda isisi da ESH’yi etkiler. ESH; gebelik, menstruasyon ve yaslilik gibi fizyolojik durumlarda yukselebilecegi gibi, patolojik bircok durumda da yukselebilir. ESH tipki nabiz ve vucut isisi gibi genel bilgi verir; ciddi hastaliklarin cogunda yukselir, ancak normalde kalabilir. Bu derlemede ESH’nin tanimi, olcum metodlari, etkileyen faktorleri ve klinikte kullanimi hakkinda pratik basvuru kaynagi sunmak amaclanmistir
Although paracetamol and diclofenac sodium are most commonly used drugs and considered as safe, t... more Although paracetamol and diclofenac sodium are most commonly used drugs and considered as safe, they are also frequently become a current issue with complications in therapeutic doses or overdose situations. Both drugs can cause bleeding disorders as a result of platelet dysfunction and can be presented as an atypical clinical situation such as subconjunctival hemorrhage. In these presented cases, the subconjunctival hemorrhage seen after ingestion of paracetamol and diclofenac sodium in toxic doses for the purpose of suicide, is considered as related with the bleeding disorder that is associated with drug side effect. For these patients who do not have any known co-morbidities, the reasons that can cause subconjunctival hemorrhage other than drugs such as trauma, infections, thrombocytopenia, malignant blood disorders, septicemia, hypertension, severe cough are excluded. Although hepatic and renal toxicities are commonly known side effects that are related with high doses of these ...
Woodhouse-Sakati Syndrome (WSS) is a rare autosomal recessive syndrome characterized by sensorine... more Woodhouse-Sakati Syndrome (WSS) is a rare autosomal recessive syndrome characterized by sensorineural hearing loss, ECG ST-T changes, partial alopecia, hypogonadism, diabetes, and moderate mental retardation. A 23-year-old male patient was admitted to our hospital with complaints of purpura and petechial rashes. His platelet count was 3.04 x 109/L and the peripheral blood smear was compatible with this count. No atypical cell was observed. He had mild mental retardation. He had hearing loss since childhood. Physical examination showed widespread petechiae and purpura on bilateral lower extremities. Significant growth retardation was detected and male pattern hair growth was less. In genital examination, bilateral testicles were small; penis length was 1 cm and it was 4 cm when elongated. T negativity was present in precordial derivations of ECG. He was diagnosed Immune thrombocytopenic purpura (ITP) and WSS according to these findings. In addition to ITP treatment with steroids, the...
Measuring acute phase response helps us diagnose and follow up diseases. Erythrocytes Sedimentati... more Measuring acute phase response helps us diagnose and follow up diseases. Erythrocytes Sedimentation Rate (ESR) among those measurements is a biochemical method which is commonly used. Roll formation or clustering of erythrocytes determines of sedimentation rate, and main factors affecting those events are fibrinogen, α2, β and γ globins. Moreover, some conditions such as ratio between plasma and erythrocytes, plasma viscosity, tube used for measuring in sedimentation rate, room temperature and anti-coagulant agent used affect Erythrocyte sedimentation rate measurement. It can be elevated in several pathological conditions as well as in pregnancy, senility and menstruation. ESH gives general idea or information as pulse and body temperature do; it is elevated in several severe diseases, it can be course in normal levels. In this review, it was aimed to present its use of clinical practice, definition, measurement methods, and factors affecting ESH.
Kaya, Ertugrul/0000-0003-0081-682XWOS: 000330151200043Aims: To determine the effects of diabetes ... more Kaya, Ertugrul/0000-0003-0081-682XWOS: 000330151200043Aims: To determine the effects of diabetes mellitus (DM) treatment regimens on malignancy. Methods: Six hundred fifty-five DM patients were enrolled. Patients receiving diabetes therapies for at least one year were retrospectively assessed with physical examination, detailed medical, habits, demographic characteristics and laboratory tests, and divided into two groups according to the diabetes treatment type (using oral agent or insulin and using metformin or not). Insulin users were grouped according to insulin regimens (intensive, basal and mixed) and to the insulin type (glargine, detemir, human insulin, biphasic analogue). Cancer cases were identified at the first visit. Results: Among 655 DM patients 13 (2%) were Type 1 DM, 642 (98%) were Type 2 DM; 379 (58%) were female, 276 (42%) were male. Thirty-sir cancers and 76 benign tumors were observed. Patients with and without a cancer were compared for diabetes treatment regimen...
Kaya, Ertugrul/0000-0003-0081-682XWOS: 000330151200043Aims: To determine the effects of diabetes ... more Kaya, Ertugrul/0000-0003-0081-682XWOS: 000330151200043Aims: To determine the effects of diabetes mellitus (DM) treatment regimens on malignancy. Methods: Six hundred fifty-five DM patients were enrolled. Patients receiving diabetes therapies for at least one year were retrospectively assessed with physical examination, detailed medical, habits, demographic characteristics and laboratory tests, and divided into two groups according to the diabetes treatment type (using oral agent or insulin and using metformin or not). Insulin users were grouped according to insulin regimens (intensive, basal and mixed) and to the insulin type (glargine, detemir, human insulin, biphasic analogue). Cancer cases were identified at the first visit. Results: Among 655 DM patients 13 (2%) were Type 1 DM, 642 (98%) were Type 2 DM; 379 (58%) were female, 276 (42%) were male. Thirty-sir cancers and 76 benign tumors were observed. Patients with and without a cancer were compared for diabetes treatment regimen...
Amaç: Behçet hastalığı (BH)’nın doğal seyri sırasında ya da kullanılan ilaçlara bağlı olarak oste... more Amaç: Behçet hastalığı (BH)’nın doğal seyri sırasında ya da kullanılan ilaçlara bağlı olarak osteoporoz gelişebilir. Çalışmanın amacı BH’nda osteoprotegerin ve tümor nekroz faktör (TNF-?) düzeyleri ve bunlar arasındaki korelasyonu araştırmaktır. Gereç ve yöntem: Çalışmaya, hasta grubu ve kontrol grubu olarak iki grup alındı. TNF-?, osteoprotegerin, osteokalsin, sedimantasyon, CRP, idrar kreatin ve deoksipridinolin düzeyleri ile beraber kemik mineral dansitometrisi (KMD) ölçüldü ve iki grup karşılaştırıldı. Bulgular: Çalışma grubuna 41 hasta, kontrol grubuna 36 hasta alındı. Çalışma ve kontrol grubunun yaş ortalaması sırasıyla 42.2611.64 ve 41.6670.99 bulundu. Vücut kitle indeksi yönünden iki grup arasında fark bulunmadı. TNF-? (p0.001), deokspiridinolin (p0.001) ve osteokalsin (p0.041) düzeyleri kontrol grubundan önemli oranda yüksek bulundu. Osteoprotogerin düzeyi hasta grubunda düşüktü ancak anlamlı düzeyde değildi (p0.05). İdrar deoxypyridinoline/ idrar kreatinin oranı hasta grub...
Amaç: Behçet hastalığı (BH)’nın doğal seyri sırasında ya da kullanılan ilaçlara bağlı olarak oste... more Amaç: Behçet hastalığı (BH)’nın doğal seyri sırasında ya da kullanılan ilaçlara bağlı olarak osteoporoz gelişebilir. Çalışmanın amacı BH’nda osteoprotegerin ve tümor nekroz faktör (TNF-?) düzeyleri ve bunlar arasındaki korelasyonu araştırmaktır. Gereç ve yöntem: Çalışmaya, hasta grubu ve kontrol grubu olarak iki grup alındı. TNF-?, osteoprotegerin, osteokalsin, sedimantasyon, CRP, idrar kreatin ve deoksipridinolin düzeyleri ile beraber kemik mineral dansitometrisi (KMD) ölçüldü ve iki grup karşılaştırıldı. Bulgular: Çalışma grubuna 41 hasta, kontrol grubuna 36 hasta alındı. Çalışma ve kontrol grubunun yaş ortalaması sırasıyla 42.2611.64 ve 41.6670.99 bulundu. Vücut kitle indeksi yönünden iki grup arasında fark bulunmadı. TNF-? (p0.001), deokspiridinolin (p0.001) ve osteokalsin (p0.041) düzeyleri kontrol grubundan önemli oranda yüksek bulundu. Osteoprotogerin düzeyi hasta grubunda düşüktü ancak anlamlı düzeyde değildi (p0.05). İdrar deoxypyridinoline/ idrar kreatinin oranı hasta grub...
Although paracetamol and diclofenac sodium are most commonly used drugs and considered as safe, t... more Although paracetamol and diclofenac sodium are most commonly used drugs and considered as safe, they are also frequently become a current issue with complications in therapeutic doses or overdose situations. Both drugs can cause bleeding disorders as a result of platelet dysfunction and can be presented as an atypical clinical situation such as subconjunctival hemorrhage. In these presented cases, the subconjunctival hemorrhage seen after ingestion of paracetamol and diclofenac sodium in toxic doses for the purpose of suicide, is considered as related with the bleeding disorder that is associated with drug side effect. For these patients who do not have any known co-morbidities, the reasons that can cause subconjunctival hemorrhage other than drugs such as trauma, infections, thrombocytopenia, malignant blood disorders, septicemia, hypertension, severe cough are excluded. Although hepatic and renal toxicities are commonly known side effects that are related with high doses of these drugs, in our cases there were not any impairment of hepatic or renal function tests other than compensated metabolic acidosis. In this report, the relationship of parasetamol and diclofenac sodium with bleeding disorders is discussed over two cases which presented as subconjunctival hemorrhage.
Herediter anjioödem hepatositler tarafından üretilen C1 esteraz inhibitör eksikliği veya disfonks... more Herediter anjioödem hepatositler tarafından üretilen C1 esteraz inhibitör eksikliği veya disfonksiyonundan kaynaklanan, nadir rastlanılan, potansiyel olarak yaşamı tehdit edici bir hastalıktır. Subkutan veya submukozal bölgede tekrarlayan anjioödem ataklarıyla karakterizedir. Herediter anjioödemde nadir olarak görülen larenks ödemi ani hava yolu obstruksiyonuna neden olup ölümle sonuçlanabilir. Burada trakeostomi açılmasını gerektirecek kadar şiddetli larenks ödemi gelişen herediter anjioödemli bir erkek olgu sunulmaktadır.Hereditary angioedema is a rare and potentially life-threatening disease resulting from deficiency or disfunction of C1 esterase inhibitor which is produced by hepatocytes. It is characterized by recurrent angioedema attacks at subcutaneous or submucosal region. Larynx edema could be seen rarely in hereditary angioedema and may result in death by causing sudden air way obstruction. Herein, we present a male hereditary angioedema case with laryngeal edema which is severe enough to require tracheostomy
sarcoma is chemosensitive, 80% of patients relaps after chemotherapy and some receive further tre... more sarcoma is chemosensitive, 80% of patients relaps after chemotherapy and some receive further treatments like High-dose chemotherapy (HDC) with autologous stem cell transplantation (ASCT). According to 2011-Transplant Review Guidelines, minimum patient evaluation requirements for ASCT are echocardiogram with LVEF >40% and pulmonary function testing (PFT) with FVC ≥50%, FEV1 ≥50% and DLCO 40% for adults. Case report: The patient was a 23-year-old man who had been suffering from non-productive cough since January 2011. Radiologic examinations revealed a mass of 13×15 cm in the left lower lung zone and presence of pleural involvement. The patient underwent biopsy and histopathologic diagnosis revealed a Ewing's sarcoma. Combination VAC-alternating IE chemotherapy for 5 cycles, 31 fractions of radiotherapy and following two cycles of VAC/IE chemotherapy were administered. PET-CT after therapy showed intense metabolic activity highly suspicious for residual disease and left pneumonectomy with partial pericardiectomy was performed in February 2012. Pathologic diagnosis revealed a high-risk Ewing sarcoma. Patient was candidate for HDCT with ASCT. LVEF was 55%. PFT results were within normal limits (FVC: 45%, FEV1: 50%, DLCO: 52%). High-dose ICE (ifosfamide 10g/m 2 , carboplatin 1 g/m 2 , and etoposide 1g/m 2) was administered. The 3.2×10 6 CD34+ cells/kg were harvested and reinfused. Candida albicans isolated from hemocultures and caspofungin treatment was given in follow-up periods. No other complication was recorded and engraftment was obtained 17 days after reinfusion. Patient is still in remission and under follow-up. Conclusion: Ewing's sarcoma is a chemosensitive tumor. With supporting therapy and close follow-up, HDCT with ASCT is a strongly recommended combination therapy in high-risk Ewing's sarcoma even for patients with borderline organ functions, especially in physically young patients.
A pancreatic pseudocyst is a localized fluid collection wit-hin or adjacent to the pancreas, encl... more A pancreatic pseudocyst is a localized fluid collection wit-hin or adjacent to the pancreas, enclosed by a non-epit-helized wall. Pseudocysts account for about 75 % or mo-re of the cystic lesions of the pancreas (1). Pancreatitis, trauma and obstructive neoplasms are the common cau-ses. Pancreatic pseudocysts often arise as a complication of acute or chronic pancreatitis. The prevalence of pan-creatic pseudocysts in acute pancreatitis has been repor-ted to range from 6%-18.5%, while the prevalence of pancreatic pseudocysts in chronic pancreatitis ranges from 20%-40 % (2,3). A 52-year-old man with a diagnosis of acute pancreatitis was referred to our clinic with diffuse abdominal and back pain. His relatives recalled that he had suffered an acute pancreatitis attack three weeks before. He did not
OBJECTIVE The mean platelet volume (MPV) can be used as an indicator of platelet activation. Howe... more OBJECTIVE The mean platelet volume (MPV) can be used as an indicator of platelet activation. However, it has been shown that the platelet/lymphocyte ratio (PLR) can provide useful predictive information about inflammation and aggregation pathways. The neutrophil/lymphocyte ratio (NLR) may also be helpful as a marker of systemic or local inflammation. The main objective of this study evaluated to unselected critically ill patients the relationship of initial MPV, NLR, and PLR with mortality, length of hospitalization, and the risk of developing nosocomial infections in ICU patients. PATIENTS AND METHODS In this retrospective study, we evaluated consecutive patients at our tertiary nine-bed ICU. One hundred seventy-three patients who were followed up during a 1-year period were included. RESULTS MPV levels were found to be higher in patients who died in the hospital (p = 0.05). In addition, there was a significant positive correlation between expected mortality rate and MPV among non-...
Aim: The aim of the Melen Study was to investigate the cardiovascular risk profile of Turkish adu... more Aim: The aim of the Melen Study was to investigate the cardiovascular risk profile of Turkish adults by utilizing newest techniques. Besides prevalence and types of endemic goiter will be established which was an important health problem in the Black sea region Method: The study was conducted on 2230 participants (1427 women, 803 men with a mean age of 49). The participants underwent a Doppler Ultrasound examination of carotid intima media thickness, echocardiographic examination, ECG recording, bioempedance meter analysis of body composition, pulmonary function test and various biochemical analysis. Result: Twenty nine percent of the population had hypertension, 12% had diabetes mellitus and 17% were smokers. Thyroid ultrasonography revealed that 29% of the cohort had goiter. Echocardiographic measurements showed that 39% of the participants had diastolic dysfunction. Comparison of males with females showed that men had significantly higher visceral fat, triglyceride, hemoglobin and CIMT whereas women had higher mean diastolic blood pressure, HDL and total cholesterol. Conclusion: According to the histories of patients, hypertension, diabetes mellitus and smoking were very frequent among Turkish adults. Among the objectively measured variables, diastolic dysfunction, visceral adiposity and goiter were strikingly high.
International Journal of Advanced Research in Medicine, 2019
Background: Diabetes mellitus refers to a group of common metabolic disorders that share the phen... more Background: Diabetes mellitus refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The present study was conducted to determine carotid intima-media thickness in patients of controlled and uncontrolled type 2 diabetes mellitus. Materials and Methods: The present study was conducted on 150 type 2 diabetes mellitus patients (75 in controlled diabetes and 75 in uncontrolled diabetes group) of both genders. All patients underwent carotid doppler of common carotid artery determined by higher resolution B mode ultrasonography using Philips Affinity 70 machine. The total of 3 values was averaged to give mean common carotid intima-media thickness value for each patient. Results: Group I had 40 males and 35 females whereas group II had 45 males and 30 females. The mean diameter of right CCA in group I was 6.4 mm and in group II was 7.3 mm, in left CCA was 6.5 mm and in group II was 6.8 mm, right ICA was 4.5 mm in group I and 4.7 mm in group II and left ICA was 4.6 mm in group I and 4.5 mm in group II. The mean IMT of right CCA in group I was 0.72 mm and in group II was 0.84 mm, in left CCA was 0.74 mm and in group II was 0.87 mm, right ICA was 0.43 mm in group I and 0.48 mm in group II and left ICA was 0.45 mm in group I and 0.54 mm in group II. Conclusion: Authors found increase diameter and thickness of intima media in uncontrolled diabetics as compared to controlled diabetics.
Journal of the College of Physicians and Surgeons Pakistan, 2019
Thiamine-responsive megaloblastic anemia (TRMA) syndrome is a rare disease comprising a classic t... more Thiamine-responsive megaloblastic anemia (TRMA) syndrome is a rare disease comprising a classic triad of megaloblastic anemia, diabetes mellitus, and early-onset sensorineural deafness. TRMA can generally be diagnosed in early childhood. Early diagnosis is important to prevent complications that may develop soon. As it is a rare disease, diagnosis may sometimes be difficult. We present a rare case of an adult patient with TRMA who had been mistakenly diagnosed with myelodysplastic syndrome (MDS), whose anemia was corrected only after thiamine treatment was started.
To investigate the correlation between vitamin B12 and body mass index (BMI) along with insulin r... more To investigate the correlation between vitamin B12 and body mass index (BMI) along with insulin resistance (IR) in middle-aged obese women. Materials and methods: Th e study was designed as a case-control study. Th e study group included middle-aged obese women and the control group included aged-matched lean women. Weight, height, and hip and waist circumferences were measured. Biochemical parameters such as fasting and postprandial glucose, vitamin B12 and folic acid levels, and lipid profi les were assayed. Results: Enrolled in the study were 116 middle-aged obese and 103 aged-matched healthy lean women. Th e vitamin B12 level of the obese women was signifi cantly lower than that of the lean women (244.1 ± 131.5 pg/mL vs. 336.2 ± 163.1 pg/mL, P = 0.002). However, there was no signifi cant diff erence in folic acid levels between the groups (P > 0.05). Th e vitamin B12 level was similar in the obese women with metabolic syndrome and those without (245.1 ± 145.3 pg/mL vs. 241.2 ± 96.5 pg/mL, P > 0.05), but the level in the control group was signifi cantly higher than that of patients with obesity and metabolic syndrome (P = 0.010 and P = 0.020, respectively). Vitamin B12 levels correlated with BMI (r =-0.259, P = 0.003) but not with IR (r =-0.053, P > 0.05). Conclusion: Th e vitamin B12 concentration was low in obese patients and this level negatively correlated with BMI, but not with homeostasis model assessment-estimated IR (HOMA-IR).
Nutritional support plays a vital role in patients admitted to the intensive care unit (ICU) due ... more Nutritional support plays a vital role in patients admitted to the intensive care unit (ICU) due to various reasons. Losing body mass leads delayed functional recovery after discharge, and reduces the survival rate [1]. Therefore, nutritional status should be carefully assessed with proper tools. A consensus issued by the Academy of Nutrition and Dietetics (AND) and American Society for Parenteral and Enteral Nutrition (ASPEN) underscores the importance of inflammation in malnourished adults [2]. In this consensus, malnutrition was defined as the presence of 2 or more of the six (insufficient energy intake, weight loss, loss of muscle mass, loss of subcutaneous fat, localized or generalized fluid accumulation that may sometimes mask weight loss and diminished functional status as measured by hand grip strength) predetermined components [2]. There is no special consensus recommendation for the ICU patients or the elderly patient group. Several indexes have been used to determine the nutritional status of ICU patients [3]. One of them is the ''NUTrition Risk in Critically ill (NUTRIC) Score'', which includes age, number of comorbidities, days from hospital to ICU admission, acute physiology and chronic health evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) Scores. NUTRİC score can be calculated with or without interleukin (IL)-6 values [4]. Subjective Global Assessment (SGA) comprises evaluation of the following: current weight, weight before illness and weight
Knowledge about the inhibition of centrally located angiotensin-I (AT-I) receptors by highly lipo... more Knowledge about the inhibition of centrally located angiotensin-I (AT-I) receptors by highly lipophilic AT-I receptor blockers and its' effect are limited with experimental studies. Thus, we aimed to investigate the effect of Telmisartan on Inter-dialytic weight gain (IDWG) % and echocardiographic measurements in anuric hemodialysis (HD) patients. A total of forty-one anuric HD patients with ≥ 6 months maintenance on HD were included in this prospective, randomized and self-controlled study. Four weeks prior the study, angiotensin converting enzyme blockers and AT-I receptor blocker drugs were stopped. Patients were assessed three times during the study protocol. These are baseline, three months later (without Telmisartan period) and three months after Telmisartan therapy. IDWG % was significantly decreased in the period of with Telmisartan compared to period without Telmisartan (5.6 ± 1.0% vs 5.3 ± 1.0%, p = 0.03). After the administration of Telmisartan left ventricule end-dia...
Turkish Journal of Endocrinology and Metabolism, 2012
Anah tar ke li me ler: Obezite, abdominal obezite, vücut kitle indeksi, diabetes mellitus Abs tra... more Anah tar ke li me ler: Obezite, abdominal obezite, vücut kitle indeksi, diabetes mellitus Abs tract Purpose: The aim of our study was to determine the prevalence of obesity and abdominal obesity in the West Black Sea region of Turkey and to display the associated chronic diseases, especially Diabetes Mellitus (DM) in this population. Material and Method: We evaluated 2222 (1418 female, 804 male, mean age: 50) participants in Yigilca. The medical histories were recorded and physical examinations were done in all participants. Body weight categories were defined according to the body mass index (BMI) as follows: BMI <18.5 lean, 18.5-24.9 normal, 25-29.9 overweight, ≥30 obese and ≥40 morbidly obese. According to waist circumference measurements, >94 cm in males and >90 cm in females were accepted as the cutoff points for abdominal obesity. Results: The mean BMI of the participants was 30.6 in females and 27.5 in males. According to BMI, obesity prevalence was 53.1% in females and 26.9% in males. The mean obesity prevalence was 43.5% in general. Abdominal obesity prevalence was 63% in females, 46% in males and 57% in all participants. Obesity prevalence increased with age in both sexes. Especially 3/4 (75%) of females and 1/3 (33%) of males aged 50-59 years were obese. Postmenopausal females had very high (64%) obesity prevalence but the rate was %43 in premenopausal women. While DM prevalence was 12.6% according to patient history, DM prevalence increased to 18.8% by adding patients with fasting glucose >126 mg/dl. Discussion: Obesity, especially abdominal obesity and DM prevalence was found to be at exaggerated rates in both sexes being highest in postmenopausal females.
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