Aim: Galectin-3 affects inflammation, cell adhesion, proliferation, differentiation and angiogene... more Aim: Galectin-3 affects inflammation, cell adhesion, proliferation, differentiation and angiogenesis. Upon examining the pathogenesis of obesity and functions of galectin-3, we thought that galectin-3 may play a significant role in obese patients. This study aims to evaluate the relationship between obesity, insulin resistance and galectin-3 levels. Methods: Eighty five patients aged between 18-50 years were included in this cross-sectional study. BMI>30 were considered obese, those between 25-30 and 18-25 were considered overweight and normal weight, respectively. Patients with HOMA-IR>2.5 were considered insulin-resistant, and those with <2.5 were evaluated as insulin non-resistant.Galectin-3 levels were measured by Enzyme-linked immunosorbent assay. Results: Serum galectin-3 levels were significantly higher in obese patients, but not statistically significantly different between those with and without insulin resistance. Galectin-3 levels were also significantly correlated with BMI and total cholesterol levels, but not correlated with HOMA-IR. Conclusion: In obesity, serum galectin-3 levels may increase to compensate for the inflammation. Our results make it difficult to establish a relationship between insulin resistance and galectin-3.
Aim: In this study, we aimed to investigate the possible role of endotrophin, a profibrotic bypro... more Aim: In this study, we aimed to investigate the possible role of endotrophin, a profibrotic byproduct of collagen VI, in the complex process of fibrosis development in the disease group with pulmonary fibrosis among interstitial lung diseases. Material and method: When the patients' participation in the study were completed, smoking or alcohol drinking conditions, and family history were recorded. Their weights and heights were recorded and body mass index (BMI) was calculated. In every patient, Spirometry with bronchodilator testing, determination of single-breath DLCO, and plethysmographic measurement of thoracic gas volume and airway resistance were performed. Blood samples were obtained for the inflammation markers such as sedimentation rate, C-reactive protein (CRP), complete blood count, liver and renal function tests, and lactate dehydrogenase levels. Serum endotrophin levels were measured in all patients. Results: Thirty-five patients with interstitial lung disease who were having pulmonary fibrosis, 35 patients with interstitial lung disease without pulmonary fibrosis, and 20 control patients without any signs or symptoms of interstitial lung disease were included in the study. Age distribution was similar between groups. The fibrotic ILD group was more commonly smoker or ex-smoker compared with the non-fibrotic ILD patients or control cases. Fibrotic ILD patients were leaner, having significantly decreased total lung capacity, diffusion capacity, and higher LDH levels. In the comparison of the 3 study groups regarding the endotrophin levels, there was a significant difference between groups. The fibrotic and non-fibrotic patient groups were compared for the Endotrophin levels and the difference was also significant. However, there was not any significant difference regarding the endotrophin levels between control cases and non-fibrotic ILD patients. Smoked cigarette pocket x year showed a significant positive correlation and DLCO % and KCO % showed a significant negative correlation with the endotrophin levels. Conclusion: Serum endotrophin levels significantly increase in fibrotic ILD patients compared with the non-fibrotic ILD patients and control cases. Endotrophin may be suggested as a diagnostic marker in fibrotic interstitial lung diseases.
Endothelial-specific molecule 1 (endocan) is expressed in endothelial cells. We investigated the ... more Endothelial-specific molecule 1 (endocan) is expressed in endothelial cells. We investigated the relationship between acute coronary syndrome (ACS) and serum endocan levels. We included 30 individuals as a control group and 53 patients diagnosed with ACS. The severity of coronary artery disease was assessed by a modified Gensini stenosis and SYNTAX scoring system. There was a significant difference in serum endocan levels between the control group and the ACS group (0.75 + 0.13 vs 0.86 + 0.25 ng/mL, P ¼ .014). There was also a significant difference in serum endocan levels between diabetic patients with ACS and nondiabetic patients with ACS (1.02 + 0.33 vs 0.81 + 0.21 ng/mL, P ¼ .016). There was no significant correlation between serum endocan level, Gensini, and SYNTAX score (r ¼ .11, P ¼ .53 and r ¼ .16, P ¼ .37). Endocan, a new biomarker of endothelial pathology, is significantly increased in patients with ACS.
IB, Yilmaz U, et al. How do we follow the guidelines in the treatment of patients with type 2 dia... more IB, Yilmaz U, et al. How do we follow the guidelines in the treatment of patients with type 2 diabetes?. J Ist Faculty Med.
Archives of Physiology and Biochemistry, Sep 13, 2019
Abstract Aim We aimed to investigate the metabolic effects of HIIT exercise on PCOS patients and ... more Abstract Aim We aimed to investigate the metabolic effects of HIIT exercise on PCOS patients and how it affects adiponectin, vaspin and leptin. Material and methods Twenty women with PCOS were included in the study and were divided into two groups. HIIT program was applied for 10 PCOS and Medium Intensity Continuous Training (MICT) program was applied for other 10 PCOS. At the beginning and at the end of the study, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride(TG), insulin, Adiponectin, Leptin, Vaspin levels of both PCOS groups were evaluated. Results When PCOS patients by performed HIIT exercise for 12 weeks, we found that the levels of leptin and vaspin did not change while adiponectin levels increased. Moreover serum levels of insulin, TG, total cholesterol, LDL-C decreased but levels of HDL-C increased. Conclusion HIIT increased in the adiponectin levels in women with PCOS and provided more weight loss.
Bu çalışmanın amacı portal tipte asidi olan hastalarda sTREM-1 molekülünün spontan bakteriyel per... more Bu çalışmanın amacı portal tipte asidi olan hastalarda sTREM-1 molekülünün spontan bakteriyel peritonit tanısındaki rolünü araştırmaktır. Gereç ve Yöntem: Çalışmaya portal tipte asiti olan 122 hasta dahil edildi, 58 hastada enfekte asit (K/E:27/31, ortalama yaş 61,6±15,0 yıl), 64 hastada enfekte olmayan asit (K/A:23/41, ortalama yaş 63,4±9,4) vardı. Hastalardan başvuru sırasında alınan kan örneklerinde tam kan sayımı, albümin ve C-reaktif protein (CRP) değerleri; eşzamanlı alınan periton sıvısı örneklerinde ise albümin, total protein, laktat dehidrojenaz, (LDH) ve sTREM-1 seviyeleri ölçüldü. Bulgular: Enfekte asitli ve enfekte olmayan asitli hastalar karşılaştırıldığında asit nötrofil, serum nötrofil, CRP, asit LDH ve asit sTREM-1 düzeylerinde anlamlı farklılıklar görüldü. Asit nötrofil, serum nötrofil, CRP ve sTREM-1 için eğrinin altında kalan alanlar (EAA) sırasıyla 1,0 (%95 CI 1,0-1,0), 0,676 (%95 CI 0,580-0,771), 0,721 (%95 CI 0,632-0,811) ve 0,644 (%95 CI 0,546-0,74) idi. Ayrıca kadın hastalarda sTREM-1 değerleri; asit nötrofil, asit LDH, asit albümin, asit total protein değerleri ve trombosit sayısı ile pozitif korelasyon gösterdi.
Aim: There are many problems with insulin initiation though required in diabetes mellitus patient... more Aim: There are many problems with insulin initiation though required in diabetes mellitus patients. This study aims to determine why patients are unable to receive insulin treatments on time. Methods: Approval from the ethics committee and consent from the volunteers was obtained for this cross sectional, single center study, in which patients with type 2 diabetes mellitus over the age of 18 years were included. Pregnant women, patients with cirrhosis, and psychiatric disorders were excluded. A questionnaire was used for data collection. Statistical analysis was performed with SPSS 18.0. Results: A total of 1062 patients were included in this study. Diabetes mellitus was regulated in 34% of the patients. The number of patients who did not use insulin even though they should was 105. While physicians did not recommend any insulin treatment to 34 patients, 33 patients did not want insulin treatment due to fear of injection and 32 patients did not start insulin treatment because they had incorrect information regarding insulin. When 36 patients who stopped insulin treatment while they were using were questioned for the reason, it was learnt that 8 patients' insulin treatment was stopped by their physicians. The remaining 28 patients, on the other hand, stopped their insulin treatments most frequently because of the difficulty of injection and incorrect information they heard about insulin. Conclusions: Providing outpatient conditions that increase patient-physician dialogue, ensuring that the injection pen and needle are seen and tested by the patient in person, and conferences for the patients and medical doctors to prevent getting the incorrect information would be the solution of the delay in starting insulin in diabetes mellitus.
Nesfatin-1 is an anorectic protein, and we expect it to decrease during sepsis and septic shock. ... more Nesfatin-1 is an anorectic protein, and we expect it to decrease during sepsis and septic shock. We aimed to analyze it and determine the relationship between Nesfatin-1 levels and quick Sequential Organ Failure Assessment(qSOFA) score, renal Sequential Organ Failure Assessment (SOFA) score, and mortality in patients with sepsis and septic shock. Sixty-nine hospitalized adult patients diagnosed with sepsis and septic shock in the internal medicine department, were included in the study after approval of the Clinical Research Ethics Committee. Sepsis diagnosis was based on the detected focus of infection, positive blood cultures, and response to antibiotics. Twenty-one healthy controls matched for age and sex with these patients were also included in the study. Sixty-nine septic patients and twenty-one healthy volunteers were included in the study. Nesfatin-1 levels were compared with covariates. Nesfatin-1 levels in septic patients were lower than that of healthy controls. There was...
Aim: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation and pe... more Aim: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation and permanent airflow limitations due to stenosis of the small airways. The role of the extracellular matrix (ECM) structure and its reshaping is gaining importance. Endotrophin is a division product formed during construction of type VI collagen. The aim of this study was to research the correlation between endotrophin and the stable COPD pathophysiology. Materials and Methods: The study included 90 clinically-stable COPD patients and 38 participants without COPD. The demographic data, respiratory function tests and endotrophin levels of patients were recorded and statistically evaluated. Results: Endotrophin levels were significantly high in COPD patients compared to healthy controls (p<0.001). Though there was a positive correlation between endotrophin and CRP (r=0.229, p=0.031), there was no correlation with FEV-1, FVC, mMRC dyspnea score, 6-minute walking test distance and GOLD degree. Conclusion: Endotrophin was identified to be high in clinically stable COPD cases. This elevation appears to be associated with continuing inflammation in COPD. This correlation may guide prognosis studies for COPD and ensure the opportunity to develop new treatment strategies targeting endotrophin.
The International Journal of Cardiovascular Imaging, 2020
Myocardial tissue is sensitive to insulin resistance (IR) due to its interactions with insulin le... more Myocardial tissue is sensitive to insulin resistance (IR) due to its interactions with insulin levels. Previous studies demonstrated that heart failure prevalence was higher in IR patients. Evaluation of myocardial deformation by multilayer global longitudinal strain (MGLS) might provide more information about IR related left ventricular dysfunction. In this study, we aimed to investigate subclinical LV dysfunction with MGLS in patients with IR. The study was designed as a prospective cross-sectional study. The present study included 64 patients with IR (+), and 54 subjects without IR (−) prospectively. The homeostasis model of insulin resistance (HOMA-IR) was used to quantify insulin resistance. Specific analysis for endocardial, mid-myocardial and epicardial layers were performed by two-dimensional (2D) speckle tracking echocardiography (STE) for multilayer global longitudinal strain. MGLS (Endocard-Mid-myocard-Epicard) values were significantly lower in the IR (+) group compared to IR (−) group ((GLS-endocard; − 15.1 ± 1.5 vs. − 18.7 ± 1.3, p < 0.001), (GLS-mid-myocard; − 16.0 ± 2.0 vs. − 18.0 ± 2.0, p < 0.001), (GLS-epicard; − 17.0 ± 1.7 vs. − 18.01 ± 1.94, p = 0.004)). GLS-endocard levels were significantly and positively correlated with HOMA-IR levels (r = 0.643, p < 0.001). HOMA-IR and age were found to be independent factors in detecting a decrease in GLS-endocard level in regression analysis. In conclusion, our data reveal that IR (+) patients had significantly lower strain values compared to IR (−) group. Besides, we presented that the HOMA-IR value was an independent predictor of subclinical left ventricular dysfunction.
Background: This study aimed to determine the number of antihypertensive agents required to achie... more Background: This study aimed to determine the number of antihypertensive agents required to achieve optimal blood pressure (BP) in Turkish hypertensive patients. Material and Methods: Totally 400 hypertensive patients (114 males and 286 females) were enrolled. BP was measured by patients at home twice a day. The patients were called for controlling in every four weeks, and those who had BP < 140/90 were not followed-up. In patients with BP > 140/90 drug, doses were increased or another antihypertensive drug added and the patients were continued to be followed-up. Results: In the first follow-up (on the 4 th week), 152 (38%) patients, including 35 (31%) men and 117 (41%) women, attained the goal BP. The mean duration of hypertension in single, double, triple, and quadruple treatment groups was 6.2 ± 5.0, 6.8 ± 5.9, 8.8 ± 5.4, and 10.4 ± 6.6 years, respectively. In the beginning, the median number of agents used for each patient was 2.17. When the follow-up was concluded, the median of agents used for each patient was 2.72. Conclusion: Thirty-eight percent of participants had controlled hypertension in the first follow-up. Women had better BP control. The median number of agents required for attaining and maintaining BP goal was 2.72. More drugs are needed when hypertension gets longer.
Journal of the American College of Cardiology, Oct 1, 2013
Background: Abnormal left ventricular (LV) geometric patterns, particularly concentric LV hypertr... more Background: Abnormal left ventricular (LV) geometric patterns, particularly concentric LV hypertrophy, are associated with a greater risk of hypertensive complications. The aim of this study was to investigate the association between LV myocardial performance index (LVMPI) and aortic distensibility (AD) with different LV geometric patterns in patients with newly diagnosed hypertension (HT). Methods: We studied 181 patients with newly diagnosed HT (mean age; 51.7AE5.4 years) and 39 healthy control subjects (mean age; 51.2AE5.1 years). Echocardiographic examination was performed in all subjects. Four different geometric patterns were determined in hypertensive patients according to LV mass index (LVMI) and relative wall thickness (RWT). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements. LVMPI was calculated from the tissue Doppler derived ejection time, isovolumic contraction, and relaxation times. Results: The highest LVMPI and the lowest AD values were observed in concentric hypertrophy group compared with control, normal geometry, concentric remodelling and eccentric hypertrophy groups (p<0.05, for all)(Table). LVMPI was associated with LVMI (r¼0.497, p<0.001), RWT (r¼0.270, p<0.001), AD (r¼-0.316, p<0.001) and E deceleration time (r¼0.171, p¼0.02) in bivariate analysis. In multiple linear regression analysis, LVMPI was independently related to LVMI (b¼0.381, p<0.001) and AD (b¼-0.263, p¼0.001). Conclusıons: The LVMPI was highest and AD was lowest in patients with concentric hypertrophy. The LVMPI was independently associated with LVMI and AD in hypertensive patients.
March and May 2013. Cognitive function was evaluated via Standardized Mini-Mental State Examinati... more March and May 2013. Cognitive function was evaluated via Standardized Mini-Mental State Examination)SMMSE) scores. Logistic regression analysis was performed to determine factors predicting poor cognitive function. Results: Mild-to-moderate cognitive impairment was noted in 39.2% of the patients. Median)interquartile range) total SMMSE scores were significantly higher in patients aged ≤60 than >60 years)27.0)2.0) vs. 25.0)5.0), p=0.000). Multivariate linear regression analyses revealed female gender)B, −1.27; 95% CI, −2.36 to −0.18; p=0.023) and aging)B, −0.20; 95% CI, −0.26 to −0.14; p<0.001) to result in a significant decrease in the total SMMSE scores. Conclusions: Mild-to-moderate cognitive impairment was observed in 39.2% of internal medicine outpatients. Old age and female gender were significant predictors of lower total SMMSE scores. Furthermore, besides for high language scores in hypertensive patients on combined therapy, no significant impact of hypertension or obesity was observed on the SMMSE scores.
Yersiniae enterocolitica, a gram negative rod-like organism, causes terminal ileitis and mesenter... more Yersiniae enterocolitica, a gram negative rod-like organism, causes terminal ileitis and mesenteric adenitis in adolescents and adults. Some forms present with liver and spleen abscesses and have worse prognosis. We report a type 1 diabetic patient with a liver abscess mimicking metastatic liver disease who was successfully treated with percutaneous drainage and antibiotic administration; culture from blood was positive for Yersinia enterocolitica, but drainage material from the liver abscess did not yield a positive result for Yersinia enterocolitica. Although the prognosis is not good in such cases, with high mortality rates, our patient recovered from the disease with appropriate treatment.
Yersiniae enterocolitica, a gram negative rod-like organism, causes terminal ileitis and mesenter... more Yersiniae enterocolitica, a gram negative rod-like organism, causes terminal ileitis and mesenteric adenitis in adolescents and adults. Some forms present with liver and spleen abscesses and have worse prognosis. We report a type 1 diabetic patient with a liver abscess mimicking metastatic liver disease who was successfully treated with percutaneous drainage and antibiotic administration; culture from blood was positive for Yersinia enterocolitica, but drainage material from the liver abscess did not yield a positive result for Yersinia enterocolitica. Although the prognosis is not good in such cases, with high mortality rates, our patient recovered from the disease with appropriate treatment.
European review for medical and pharmacological sciences, 2018
OBJECTIVE Type 1 cardiorenal syndrome (CRS) is an acute renal failure in patients with acute deco... more OBJECTIVE Type 1 cardiorenal syndrome (CRS) is an acute renal failure in patients with acute decompensated heart failure with an incidence of 24% to 45%. The aim of our study was to investigate the significance of new renal biomarkers to predict type 1 CRS. PATIENTS AND METHODS The study included 111 patients with acute decompensated heart failure diagnosed at the Istanbul Medical Faculty Emergency Department between 2014 and 2016, and 24 healthy volunteers. All urine samples were stored at -80°C after centrifugation. Samples were run according to the instructions of TIMP-2, ILGF-7, KIM-1, and IGFBP-7 ELISA kits. Diuretic treatments were then administered with intravenous administration of at least 80 mg furosemide per day. Follow-up biochemical and spot urine specimens were taken after 72 hours. For statistical analysis, SPSS version 21.0 statistical software was used. Significance was evaluated at p<0.05. RESULTS The baseline creatinine level was measured as 1.33 ± 0.39 mg/dL i...
Aim: Galectin-3 affects inflammation, cell adhesion, proliferation, differentiation and angiogene... more Aim: Galectin-3 affects inflammation, cell adhesion, proliferation, differentiation and angiogenesis. Upon examining the pathogenesis of obesity and functions of galectin-3, we thought that galectin-3 may play a significant role in obese patients. This study aims to evaluate the relationship between obesity, insulin resistance and galectin-3 levels. Methods: Eighty five patients aged between 18-50 years were included in this cross-sectional study. BMI>30 were considered obese, those between 25-30 and 18-25 were considered overweight and normal weight, respectively. Patients with HOMA-IR>2.5 were considered insulin-resistant, and those with <2.5 were evaluated as insulin non-resistant.Galectin-3 levels were measured by Enzyme-linked immunosorbent assay. Results: Serum galectin-3 levels were significantly higher in obese patients, but not statistically significantly different between those with and without insulin resistance. Galectin-3 levels were also significantly correlated with BMI and total cholesterol levels, but not correlated with HOMA-IR. Conclusion: In obesity, serum galectin-3 levels may increase to compensate for the inflammation. Our results make it difficult to establish a relationship between insulin resistance and galectin-3.
Aim: In this study, we aimed to investigate the possible role of endotrophin, a profibrotic bypro... more Aim: In this study, we aimed to investigate the possible role of endotrophin, a profibrotic byproduct of collagen VI, in the complex process of fibrosis development in the disease group with pulmonary fibrosis among interstitial lung diseases. Material and method: When the patients' participation in the study were completed, smoking or alcohol drinking conditions, and family history were recorded. Their weights and heights were recorded and body mass index (BMI) was calculated. In every patient, Spirometry with bronchodilator testing, determination of single-breath DLCO, and plethysmographic measurement of thoracic gas volume and airway resistance were performed. Blood samples were obtained for the inflammation markers such as sedimentation rate, C-reactive protein (CRP), complete blood count, liver and renal function tests, and lactate dehydrogenase levels. Serum endotrophin levels were measured in all patients. Results: Thirty-five patients with interstitial lung disease who were having pulmonary fibrosis, 35 patients with interstitial lung disease without pulmonary fibrosis, and 20 control patients without any signs or symptoms of interstitial lung disease were included in the study. Age distribution was similar between groups. The fibrotic ILD group was more commonly smoker or ex-smoker compared with the non-fibrotic ILD patients or control cases. Fibrotic ILD patients were leaner, having significantly decreased total lung capacity, diffusion capacity, and higher LDH levels. In the comparison of the 3 study groups regarding the endotrophin levels, there was a significant difference between groups. The fibrotic and non-fibrotic patient groups were compared for the Endotrophin levels and the difference was also significant. However, there was not any significant difference regarding the endotrophin levels between control cases and non-fibrotic ILD patients. Smoked cigarette pocket x year showed a significant positive correlation and DLCO % and KCO % showed a significant negative correlation with the endotrophin levels. Conclusion: Serum endotrophin levels significantly increase in fibrotic ILD patients compared with the non-fibrotic ILD patients and control cases. Endotrophin may be suggested as a diagnostic marker in fibrotic interstitial lung diseases.
Endothelial-specific molecule 1 (endocan) is expressed in endothelial cells. We investigated the ... more Endothelial-specific molecule 1 (endocan) is expressed in endothelial cells. We investigated the relationship between acute coronary syndrome (ACS) and serum endocan levels. We included 30 individuals as a control group and 53 patients diagnosed with ACS. The severity of coronary artery disease was assessed by a modified Gensini stenosis and SYNTAX scoring system. There was a significant difference in serum endocan levels between the control group and the ACS group (0.75 + 0.13 vs 0.86 + 0.25 ng/mL, P ¼ .014). There was also a significant difference in serum endocan levels between diabetic patients with ACS and nondiabetic patients with ACS (1.02 + 0.33 vs 0.81 + 0.21 ng/mL, P ¼ .016). There was no significant correlation between serum endocan level, Gensini, and SYNTAX score (r ¼ .11, P ¼ .53 and r ¼ .16, P ¼ .37). Endocan, a new biomarker of endothelial pathology, is significantly increased in patients with ACS.
IB, Yilmaz U, et al. How do we follow the guidelines in the treatment of patients with type 2 dia... more IB, Yilmaz U, et al. How do we follow the guidelines in the treatment of patients with type 2 diabetes?. J Ist Faculty Med.
Archives of Physiology and Biochemistry, Sep 13, 2019
Abstract Aim We aimed to investigate the metabolic effects of HIIT exercise on PCOS patients and ... more Abstract Aim We aimed to investigate the metabolic effects of HIIT exercise on PCOS patients and how it affects adiponectin, vaspin and leptin. Material and methods Twenty women with PCOS were included in the study and were divided into two groups. HIIT program was applied for 10 PCOS and Medium Intensity Continuous Training (MICT) program was applied for other 10 PCOS. At the beginning and at the end of the study, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceride(TG), insulin, Adiponectin, Leptin, Vaspin levels of both PCOS groups were evaluated. Results When PCOS patients by performed HIIT exercise for 12 weeks, we found that the levels of leptin and vaspin did not change while adiponectin levels increased. Moreover serum levels of insulin, TG, total cholesterol, LDL-C decreased but levels of HDL-C increased. Conclusion HIIT increased in the adiponectin levels in women with PCOS and provided more weight loss.
Bu çalışmanın amacı portal tipte asidi olan hastalarda sTREM-1 molekülünün spontan bakteriyel per... more Bu çalışmanın amacı portal tipte asidi olan hastalarda sTREM-1 molekülünün spontan bakteriyel peritonit tanısındaki rolünü araştırmaktır. Gereç ve Yöntem: Çalışmaya portal tipte asiti olan 122 hasta dahil edildi, 58 hastada enfekte asit (K/E:27/31, ortalama yaş 61,6±15,0 yıl), 64 hastada enfekte olmayan asit (K/A:23/41, ortalama yaş 63,4±9,4) vardı. Hastalardan başvuru sırasında alınan kan örneklerinde tam kan sayımı, albümin ve C-reaktif protein (CRP) değerleri; eşzamanlı alınan periton sıvısı örneklerinde ise albümin, total protein, laktat dehidrojenaz, (LDH) ve sTREM-1 seviyeleri ölçüldü. Bulgular: Enfekte asitli ve enfekte olmayan asitli hastalar karşılaştırıldığında asit nötrofil, serum nötrofil, CRP, asit LDH ve asit sTREM-1 düzeylerinde anlamlı farklılıklar görüldü. Asit nötrofil, serum nötrofil, CRP ve sTREM-1 için eğrinin altında kalan alanlar (EAA) sırasıyla 1,0 (%95 CI 1,0-1,0), 0,676 (%95 CI 0,580-0,771), 0,721 (%95 CI 0,632-0,811) ve 0,644 (%95 CI 0,546-0,74) idi. Ayrıca kadın hastalarda sTREM-1 değerleri; asit nötrofil, asit LDH, asit albümin, asit total protein değerleri ve trombosit sayısı ile pozitif korelasyon gösterdi.
Aim: There are many problems with insulin initiation though required in diabetes mellitus patient... more Aim: There are many problems with insulin initiation though required in diabetes mellitus patients. This study aims to determine why patients are unable to receive insulin treatments on time. Methods: Approval from the ethics committee and consent from the volunteers was obtained for this cross sectional, single center study, in which patients with type 2 diabetes mellitus over the age of 18 years were included. Pregnant women, patients with cirrhosis, and psychiatric disorders were excluded. A questionnaire was used for data collection. Statistical analysis was performed with SPSS 18.0. Results: A total of 1062 patients were included in this study. Diabetes mellitus was regulated in 34% of the patients. The number of patients who did not use insulin even though they should was 105. While physicians did not recommend any insulin treatment to 34 patients, 33 patients did not want insulin treatment due to fear of injection and 32 patients did not start insulin treatment because they had incorrect information regarding insulin. When 36 patients who stopped insulin treatment while they were using were questioned for the reason, it was learnt that 8 patients' insulin treatment was stopped by their physicians. The remaining 28 patients, on the other hand, stopped their insulin treatments most frequently because of the difficulty of injection and incorrect information they heard about insulin. Conclusions: Providing outpatient conditions that increase patient-physician dialogue, ensuring that the injection pen and needle are seen and tested by the patient in person, and conferences for the patients and medical doctors to prevent getting the incorrect information would be the solution of the delay in starting insulin in diabetes mellitus.
Nesfatin-1 is an anorectic protein, and we expect it to decrease during sepsis and septic shock. ... more Nesfatin-1 is an anorectic protein, and we expect it to decrease during sepsis and septic shock. We aimed to analyze it and determine the relationship between Nesfatin-1 levels and quick Sequential Organ Failure Assessment(qSOFA) score, renal Sequential Organ Failure Assessment (SOFA) score, and mortality in patients with sepsis and septic shock. Sixty-nine hospitalized adult patients diagnosed with sepsis and septic shock in the internal medicine department, were included in the study after approval of the Clinical Research Ethics Committee. Sepsis diagnosis was based on the detected focus of infection, positive blood cultures, and response to antibiotics. Twenty-one healthy controls matched for age and sex with these patients were also included in the study. Sixty-nine septic patients and twenty-one healthy volunteers were included in the study. Nesfatin-1 levels were compared with covariates. Nesfatin-1 levels in septic patients were lower than that of healthy controls. There was...
Aim: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation and pe... more Aim: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation and permanent airflow limitations due to stenosis of the small airways. The role of the extracellular matrix (ECM) structure and its reshaping is gaining importance. Endotrophin is a division product formed during construction of type VI collagen. The aim of this study was to research the correlation between endotrophin and the stable COPD pathophysiology. Materials and Methods: The study included 90 clinically-stable COPD patients and 38 participants without COPD. The demographic data, respiratory function tests and endotrophin levels of patients were recorded and statistically evaluated. Results: Endotrophin levels were significantly high in COPD patients compared to healthy controls (p<0.001). Though there was a positive correlation between endotrophin and CRP (r=0.229, p=0.031), there was no correlation with FEV-1, FVC, mMRC dyspnea score, 6-minute walking test distance and GOLD degree. Conclusion: Endotrophin was identified to be high in clinically stable COPD cases. This elevation appears to be associated with continuing inflammation in COPD. This correlation may guide prognosis studies for COPD and ensure the opportunity to develop new treatment strategies targeting endotrophin.
The International Journal of Cardiovascular Imaging, 2020
Myocardial tissue is sensitive to insulin resistance (IR) due to its interactions with insulin le... more Myocardial tissue is sensitive to insulin resistance (IR) due to its interactions with insulin levels. Previous studies demonstrated that heart failure prevalence was higher in IR patients. Evaluation of myocardial deformation by multilayer global longitudinal strain (MGLS) might provide more information about IR related left ventricular dysfunction. In this study, we aimed to investigate subclinical LV dysfunction with MGLS in patients with IR. The study was designed as a prospective cross-sectional study. The present study included 64 patients with IR (+), and 54 subjects without IR (−) prospectively. The homeostasis model of insulin resistance (HOMA-IR) was used to quantify insulin resistance. Specific analysis for endocardial, mid-myocardial and epicardial layers were performed by two-dimensional (2D) speckle tracking echocardiography (STE) for multilayer global longitudinal strain. MGLS (Endocard-Mid-myocard-Epicard) values were significantly lower in the IR (+) group compared to IR (−) group ((GLS-endocard; − 15.1 ± 1.5 vs. − 18.7 ± 1.3, p < 0.001), (GLS-mid-myocard; − 16.0 ± 2.0 vs. − 18.0 ± 2.0, p < 0.001), (GLS-epicard; − 17.0 ± 1.7 vs. − 18.01 ± 1.94, p = 0.004)). GLS-endocard levels were significantly and positively correlated with HOMA-IR levels (r = 0.643, p < 0.001). HOMA-IR and age were found to be independent factors in detecting a decrease in GLS-endocard level in regression analysis. In conclusion, our data reveal that IR (+) patients had significantly lower strain values compared to IR (−) group. Besides, we presented that the HOMA-IR value was an independent predictor of subclinical left ventricular dysfunction.
Background: This study aimed to determine the number of antihypertensive agents required to achie... more Background: This study aimed to determine the number of antihypertensive agents required to achieve optimal blood pressure (BP) in Turkish hypertensive patients. Material and Methods: Totally 400 hypertensive patients (114 males and 286 females) were enrolled. BP was measured by patients at home twice a day. The patients were called for controlling in every four weeks, and those who had BP < 140/90 were not followed-up. In patients with BP > 140/90 drug, doses were increased or another antihypertensive drug added and the patients were continued to be followed-up. Results: In the first follow-up (on the 4 th week), 152 (38%) patients, including 35 (31%) men and 117 (41%) women, attained the goal BP. The mean duration of hypertension in single, double, triple, and quadruple treatment groups was 6.2 ± 5.0, 6.8 ± 5.9, 8.8 ± 5.4, and 10.4 ± 6.6 years, respectively. In the beginning, the median number of agents used for each patient was 2.17. When the follow-up was concluded, the median of agents used for each patient was 2.72. Conclusion: Thirty-eight percent of participants had controlled hypertension in the first follow-up. Women had better BP control. The median number of agents required for attaining and maintaining BP goal was 2.72. More drugs are needed when hypertension gets longer.
Journal of the American College of Cardiology, Oct 1, 2013
Background: Abnormal left ventricular (LV) geometric patterns, particularly concentric LV hypertr... more Background: Abnormal left ventricular (LV) geometric patterns, particularly concentric LV hypertrophy, are associated with a greater risk of hypertensive complications. The aim of this study was to investigate the association between LV myocardial performance index (LVMPI) and aortic distensibility (AD) with different LV geometric patterns in patients with newly diagnosed hypertension (HT). Methods: We studied 181 patients with newly diagnosed HT (mean age; 51.7AE5.4 years) and 39 healthy control subjects (mean age; 51.2AE5.1 years). Echocardiographic examination was performed in all subjects. Four different geometric patterns were determined in hypertensive patients according to LV mass index (LVMI) and relative wall thickness (RWT). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements. LVMPI was calculated from the tissue Doppler derived ejection time, isovolumic contraction, and relaxation times. Results: The highest LVMPI and the lowest AD values were observed in concentric hypertrophy group compared with control, normal geometry, concentric remodelling and eccentric hypertrophy groups (p<0.05, for all)(Table). LVMPI was associated with LVMI (r¼0.497, p<0.001), RWT (r¼0.270, p<0.001), AD (r¼-0.316, p<0.001) and E deceleration time (r¼0.171, p¼0.02) in bivariate analysis. In multiple linear regression analysis, LVMPI was independently related to LVMI (b¼0.381, p<0.001) and AD (b¼-0.263, p¼0.001). Conclusıons: The LVMPI was highest and AD was lowest in patients with concentric hypertrophy. The LVMPI was independently associated with LVMI and AD in hypertensive patients.
March and May 2013. Cognitive function was evaluated via Standardized Mini-Mental State Examinati... more March and May 2013. Cognitive function was evaluated via Standardized Mini-Mental State Examination)SMMSE) scores. Logistic regression analysis was performed to determine factors predicting poor cognitive function. Results: Mild-to-moderate cognitive impairment was noted in 39.2% of the patients. Median)interquartile range) total SMMSE scores were significantly higher in patients aged ≤60 than >60 years)27.0)2.0) vs. 25.0)5.0), p=0.000). Multivariate linear regression analyses revealed female gender)B, −1.27; 95% CI, −2.36 to −0.18; p=0.023) and aging)B, −0.20; 95% CI, −0.26 to −0.14; p<0.001) to result in a significant decrease in the total SMMSE scores. Conclusions: Mild-to-moderate cognitive impairment was observed in 39.2% of internal medicine outpatients. Old age and female gender were significant predictors of lower total SMMSE scores. Furthermore, besides for high language scores in hypertensive patients on combined therapy, no significant impact of hypertension or obesity was observed on the SMMSE scores.
Yersiniae enterocolitica, a gram negative rod-like organism, causes terminal ileitis and mesenter... more Yersiniae enterocolitica, a gram negative rod-like organism, causes terminal ileitis and mesenteric adenitis in adolescents and adults. Some forms present with liver and spleen abscesses and have worse prognosis. We report a type 1 diabetic patient with a liver abscess mimicking metastatic liver disease who was successfully treated with percutaneous drainage and antibiotic administration; culture from blood was positive for Yersinia enterocolitica, but drainage material from the liver abscess did not yield a positive result for Yersinia enterocolitica. Although the prognosis is not good in such cases, with high mortality rates, our patient recovered from the disease with appropriate treatment.
Yersiniae enterocolitica, a gram negative rod-like organism, causes terminal ileitis and mesenter... more Yersiniae enterocolitica, a gram negative rod-like organism, causes terminal ileitis and mesenteric adenitis in adolescents and adults. Some forms present with liver and spleen abscesses and have worse prognosis. We report a type 1 diabetic patient with a liver abscess mimicking metastatic liver disease who was successfully treated with percutaneous drainage and antibiotic administration; culture from blood was positive for Yersinia enterocolitica, but drainage material from the liver abscess did not yield a positive result for Yersinia enterocolitica. Although the prognosis is not good in such cases, with high mortality rates, our patient recovered from the disease with appropriate treatment.
European review for medical and pharmacological sciences, 2018
OBJECTIVE Type 1 cardiorenal syndrome (CRS) is an acute renal failure in patients with acute deco... more OBJECTIVE Type 1 cardiorenal syndrome (CRS) is an acute renal failure in patients with acute decompensated heart failure with an incidence of 24% to 45%. The aim of our study was to investigate the significance of new renal biomarkers to predict type 1 CRS. PATIENTS AND METHODS The study included 111 patients with acute decompensated heart failure diagnosed at the Istanbul Medical Faculty Emergency Department between 2014 and 2016, and 24 healthy volunteers. All urine samples were stored at -80°C after centrifugation. Samples were run according to the instructions of TIMP-2, ILGF-7, KIM-1, and IGFBP-7 ELISA kits. Diuretic treatments were then administered with intravenous administration of at least 80 mg furosemide per day. Follow-up biochemical and spot urine specimens were taken after 72 hours. For statistical analysis, SPSS version 21.0 statistical software was used. Significance was evaluated at p<0.05. RESULTS The baseline creatinine level was measured as 1.33 ± 0.39 mg/dL i...
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