Giriş: Mikroanjiopatik hemolitik anemiler (MAHA) oldukça nadir görülen ve tedavi edilmediğinde mo... more Giriş: Mikroanjiopatik hemolitik anemiler (MAHA) oldukça nadir görülen ve tedavi edilmediğinde mortal seyreden bir grup hastalığa verilen isimdir. Amaç: Bu çalışmadaki amacımız; trombositopeni saptanan ve özellikle de end-organ tutulumu olmayan hastalarda ayırıcı tanıda MAHA'nın hatırlanması gerekliliğini vurgulamaktır. Aynı zamanda erken tanı ve tedavide mortalite oranının düştüğünü gösterebilmektir. Gereç ve yöntem: Eylül 2017-mayıs 2019 tarihlerinde arasında iç hastalıkları servisinde tanısı koyularak takip ve tedavi edilen vakaları retrospektif olarak inceledik. Tanı kriterlerine uyan toplam 15 hasta çalışmaya alındı. Hastalardan, ilk başvuruda; tam kan sayımı, sedimentasyon, periferik yayma, direkt coombs, CRP, koagülasyon testleri ve biyokimyasal tetkikler çalışıldı. Ayrıca her plazmaferez işleminden önce ve sonra; tam kan sayımı, üre, kreatin, LDH, indirek bilirubin düzeyleri bakıldı. Bulgular: Hastaların E/K oranı 8 /7 (% 53.3/ 46.6) ve yaş ortalaması 46.8 (25-79) bulundu. Hastaların etyolojik sınıflandırılması sonucu; 8 hasta (%53.3) TTP(Trombotik trombositopenik purpura) olarak, 4 hasta (%26.6) vitamin B 12 eksikliğine bağlı, 1 hasta sistemik lupus eritamatozus (%6.6), 1 hasta (%6.6) atipik hemolitik üremik sendrom ve 1 hasta (%6.6) da ilaç ilişkili MAHA olarak değerlendirildi. Sonuç: Çalışmaya alınan 15 hastadan 11 hastanın (%73.3) iyileşme, 4 hastanın (%20) izlemi esnasında exitus, 1 hastanın (%6.6) taburculuktan sonra, toplamda 5 (%33.3) hastanın exitus olduğu tespit edildi.
Amaç: Trombosit-lenfosit oranı (PLR) ve nötrofil-lenfosit oranı (NLR) kanser hastalarında yaygın ... more Amaç: Trombosit-lenfosit oranı (PLR) ve nötrofil-lenfosit oranı (NLR) kanser hastalarında yaygın araştırılan non-invaziv enflamasyon belirteçleri olup; non-alkolik steatohepatit ve kronik hepatit B'li (KHB) hastalarda fibrozis ile ilişkisini gösteren bazı çalışmalar bulunmaktadır. Amacımız, KHB'li hastalarda karaciğer histopatolojisi ve viral yük parametrelerinin; NLR, PLR ve ortalama trombosit hacmi (MPV) ile olan ilişkisini incelemektir. Gereç ve Yöntemler: İç hastalıkları ve gastroenteroloji polikliniğine 2016-2019 yılları arasında başvuran karaciğer biyopsisi yapılan 224 KHB hastası geriye dönük incelendi. Çalışma verileri, hasta dosyaları ve elektronik kayıtlardan elde edildi.
Objective: Adenosine deaminase (ADA) and neopterin are increased in disorders that stimulate cell... more Objective: Adenosine deaminase (ADA) and neopterin are increased in disorders that stimulate cells involved in the immune system. We investigated the effect of therapy on serum ADA activity and neopterin levels in patients with pulmonary tuberculosis (TB) and with community-acquired pneumonia (CAP). Methods: Seventeen pulmonary TB, 24 CAP, and a control group of 20 healthy volunteers were included in this study. ADA and neopterin assay was performed colorimetrically and by ELISA, respectively, before and 2 months after therapy (rifampicin+isoniazid+ethambutol and pyrazinamide) of patients with TB and before and 15 days after therapy (ampicillin-sulbactam) of CAP. Results: Serum ADA activity and neopterin levels were significantly higher in patients with TB than those in pneumonia and controls. Serum neopterin levels were significantly higher in patients with CAP than controls. No significant differences were found in ADA levels between pneumonia and control subjects. The ADA and neo...
Giris ve Amac: Poliserozit birden fazla seroz zarin inflamasyonuna verilen addir. Poliserozite de... more Giris ve Amac: Poliserozit birden fazla seroz zarin inflamasyonuna verilen addir. Poliserozite degisik hastaliklar neden olabilmektedir. Biz bu calismada hastaneye yatirilan ve poliserozit saptanan olgularimizi ayrintili olarak incelemeyi amacladik. Gerec ve Yontem: Cerrahpasa Tip Fakultesi, Ic Hastaliklari Anabilim Dali'nda 1 Ocak 2001 ve 31 Aralik 2004 tarihleri arasinda yatirilarak tetkik edilen toplam 12,485 hastanin dosyasi ayrintili sekilde incelendi. Poliserozit saptanan 40 olgu demografik, klinik ve etyolojik acidan ele alindi. Bulgular: Toplam 12,485 hastanin 40'i (%0.3) poliserozit tanisi almisti (22 kadin, 18 hasta). Bu hastalarda poliserozitin en sik nedeni 15 hasta (%37.5) ile maligniteler idi (4 hastada Non-Hodgkin Lenfoma, 2'sinde over kanseri, 2'sinde sarkom, birer hastada ise akciger, meme, mide, serviks ve endometrium kanseri, Burkitt lenfomasi, primeri bilinmeyen karacigere metastaz yapmis adenokanser ve Hepatit B ve Hepatit C zemininde gelisen hep...
Poliserozit birden fazla seröz zarda inflamasyona verilen add›r. Poliserozite de¤iflik hastal›kla... more Poliserozit birden fazla seröz zarda inflamasyona verilen add›r. Poliserozite de¤iflik hastal›klar neden olabilmektedir. Seröz zarlardan hangisinin tutulumu ön planda ise klinik tablo ona göre flekillenebilmektedir. Örne¤in bir tüberküloz plörö-perikardit olgusunda hastal›¤›n akut formunda kardiyak tamponad klini¤i geliflebilece¤i gibi, kronik formunda hasta sadece asit ile de karfl›m›za gelebilmektedir. Bazen ise seröz zarlar›n tutulumu sistemik bir Girifl ve Amaç: Poliserozit birden fazla seröz zar›n inflamasyonuna verilen add›r. Poliserozite de¤iflik hastal›klar neden olabilmektedir. Biz bu çal›flmada hastaneye yat›r›lan ve poliserozit saptanan olgular›m›z› ayr›nt›l› olarak incelemeyi amaçlad›k. Gereç ve Yöntem: Cerrahpafla T›p Fakültesi, ‹ç Hastal›klar› Anabilim Dal›’nda 1 Ocak 2001 ve 31 Aral›k 2004 tarihleri aras›nda yat›r›larak tetkik edilen toplam 12,485 hastan›n dosyas› ayr›nt›l› flekilde incelendi. Poliserozit saptanan 40 olgu demografik, klinik ve etyolojik aç›dan ele al›...
Background/Aim: Cardiovascular involvement in patients with coronavirus disease 2019 (COVID-19) i... more Background/Aim: Cardiovascular involvement in patients with coronavirus disease 2019 (COVID-19) is closely related to the course of the disease; however, this issue has not been adequately studied in Turkey. Thus, we aimed to investigate the electrocardiography (ECG) findings in noncritical patients with COVID-19 in Turkey. Methods: This retrospective cohort study was conducted on non-critical patients with COVID-19 with no history of any cardiac disease. The laboratory parameters and ECG findings of the patients at the time of admission were analyzed. Results: In total, 100 patients with a mean age of 56.8 (16.7) years were included in the study, among which 54 were males. The rate of patients having at least one abnormal ECG finding, ST segment pathology, and elevated troponin level were 58%, 26%, and 48%, respectively. The respiratory rate and mean troponin level were higher and the mean lymphocyte count was lower in patients with ST segment pathology than in patients without. Th...
Background Cognitive functions are affected by thyroid hormones. In this study, we aimed to inves... more Background Cognitive functions are affected by thyroid hormones. In this study, we aimed to investigate the selective attention and information processing speed in thyrotoxic Graves’ disease. Methodology This study was conducted among 40 patients with thyrotoxic Graves’ disease and age and gender-matched 40 healthy controls. Stroop Color and Word test were applied to healthy controls once and to patients with Graves’ disease during thyrotoxic and euthyroid periods. Stroop interference effect was calculated. Results The mean age was 34.67 ± 11 in the Graves’ group and 34.72 ± 9.16 in the control group (p > 0.05). The number of errors and self-corrections in Stroop Color and Word test was higher in patients with thyrotoxic Graves’ disease than both patients with euthyroid Graves’ disease and healthy controls (p < 0.05). Stroop interference effect was significantly longer in patients with thyrotoxic Graves’ disease than both patients with euthyroid Graves’ disease and healthy con...
Amaç: Kolorektal polipler gastrointestinal sistemde mukoza ve submukozadan köken alan ve barsak l... more Amaç: Kolorektal polipler gastrointestinal sistemde mukoza ve submukozadan köken alan ve barsak lümeni içine uzanan doku kütlesidir. Poliplerin kanserleşme riski olduğundan tespit edilen polip kolonoskopiyle çıkarılarak histopatolojik incelenmelidir. Çalışmamızda kolonoskopi ile tespit edilen ve çıkarılan poliplerin sıklığı, boyutu, lokalizasyonu ve histopatolojik olarak özelliklerini değerlendirmeyi amaçladık.
International Journal for Vitamin and Nutrition Research, 2021
. Purpose: This study aimed to investigate the effect of the nutritional status, as assessed by t... more . Purpose: This study aimed to investigate the effect of the nutritional status, as assessed by the prognostic nutritional index (PNI) on the disease prognosis of patients with COVID-19. Methods: This retrospective study included 282 patients with COVID-19. The PNI score of all patients, 147 of whom were male, with a mean age of 56.4±15.3 years, was calculated. According to the PNI score, the patients with normal and mild malnutrition constituted group-1 (n=159) and the patients with moderate-to-severe and serious malnutrition constituted group-2 (n=123). Results: The PNI score was correlated with age (r=−0.146, p=0.014); oxygen saturation (r=0.190, p=0.001); heart rate (r=−0.117, p=0.05); hospitalization duration (r=−0.266, p&amp;amp;amp;amp;lt;0.001); white blood cells (r=0.156, p=0.009); hemoglobin (r=0.307, p&amp;amp;amp;amp;lt;0.001); C-reactive protein (CRP) (r=−0.346, p&amp;amp;amp;amp;lt;0.001); creatinine (r=−0.184, p=0.002); D-dimer (r=−0.304, p&amp;amp;amp;amp;lt;0.001); ferritin (r=−0.283, p&amp;amp;amp;amp;lt;0.001); procalcitonin (r=−0.287, p&amp;amp;amp;amp;lt;0.001); the confusion, urea, respiratory rate, blood pressure, and age ≥65 years score (r=−0.217, p&amp;amp;amp;amp;lt;0.001); and the quick sequential organ failure assessment score (r=−0.261, p&amp;amp;amp;amp;lt;0.001) in patients with COVID-19. Mortality was significantly higher in Group 2 (p&amp;amp;amp;amp;lt;0.001). Survival was significantly higher if PNI score was &amp;amp;amp;amp;gt;41.2 (p&amp;amp;amp;amp;lt;0.001, sensitivity: 78.7% and specificity: 84.2%). In multivariate regression analysis, among various other parameters, only PNI score and oxygen saturation had a significant effect on the disease course (p=0.02 and p=0.045, respectively). Conclusion: PNI, calculated from the serum albumin concentration and total lymphocyte count, is a simple and objective indicator that assesses the immune nutritional status of patients with COVID-19. The presence of malnutrition has a high predictive value in predicting the severity of COVID-19. Our data suggest that the PNI might be useful for risk stratification of patients with COVID-19 in clinical practice.
INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), 2021
Тиреотоксический гипокалиемический периодический паралич является редким наследственным заболеван... more Тиреотоксический гипокалиемический периодический паралич является редким наследственным заболеванием, характеризующимся периодической потерей силы мышц. В проведенном исследовании диагностирован периодический гипокалиемический паралич в результате обследования пациента в отделении неотложной помощи. Поскольку этот случай редкий, представлен обзор литературы. 43-летний пациент мужского пола с известной грыжей поясничного диска в анамнезе был доставлен в экстренную службу больницы с жалобой на невозможность движения телом после пробуждения в 6:00 утра. Пациент принимал метимазол в таблетках 12 часов назад из-за жалоб на головную боль. Ужин состоял из продуктов с высоким содержанием углеводов. Клинический осмотр выявил артериальное давление 105/70 мм рт.ст., частоту сердечных сокращений 93 в 1 мин, температуру 36,8 градуса, общую потерю силы в четырех конечностях и тетраплегию. Потери чувствительности, офтальмопатии, тремора не обнаружено, изохорический и световой рефлекс зрачков двуст...
Background: Hypertension is one of the principal risk factors for cardiovascular disease. We aime... more Background: Hypertension is one of the principal risk factors for cardiovascular disease. We aimed to evaluate the impact of hypertension on fibrinolytic balance and endothelial function by measuring plasma levels of plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator antigen (tPA), tPA/PAI-1 complex and fibrinogen. Methods: Patients enrolled into the study were divided into four groups: 22 essential hypertensive (EH), 22 white coat hypertensive (WCH), 22 renovascular hypertensive (RH) and 22 normotensive control subjects. Plasma PAI-1, tPA, tPA/PAI-1 complex levels were measured by enzyme linked immunosorbent assays. Results: There was no difference in the systolic and diastolic blood pressure measurements of the EH and RH groups. The four groups were comparable for age, gender, smoking habits and BMI. Patients with EH, RH and WCH had increased plasma levels of PAI-1, tPA, tPA/PAI-1 complex and fibrinogen compared with controls. No fibrinolytic parameter was ass...
The main cause of obesity is a change in the energy balance in favor of intake. Communication bet... more The main cause of obesity is a change in the energy balance in favor of intake. Communication between the hypothalamus and other organs occurs through special peptides, such as ghrelin, leptin, and orexin-A, to provide energy balance. The purpose of this study was to investigate the effects of a laparoscopic gastric band application on insulin resistance and the peptides involved in appetite in morbidly obese patients. The study group consisted of 20 patients who were operated on for morbid obesity (body mass index [BMI], 48.3±6.7 kg/m2) and the control group contained 20 healthy, normal-weight subjects (BMI, 22.6±2 kg/m2). We obtained blood samples from the study subjects before surgery and one month after surgery, and once from the control group. We measured plasma levels of ghrelin, leptin, orexin-A, and plasma glucose. Significant weight loss was achieved after surgery (P<0.05). Plasma ghrelin levels were lower in morbidly obese patients (P=0.033), but increased postoperative...
International Journal of Antimicrobial Agents, 2007
Objectives: A twofold cross-sectional field study was performed at Manyemen Presbyterian Medical ... more Objectives: A twofold cross-sectional field study was performed at Manyemen Presbyterian Medical Institutions, Cameroon. First, the prevalence of syphilis among people in the reproductive age (men: 15−60 years, women: 15−50 years) living in the Manyemen Catchment Area (MCA) was assessed. Second, the Abbott determine Syphilis TP ® rapid test (Abbott test) was compared to the syphilis rapid test that is presently used in the MCA (local test). Methods: The studied population was tested on syphilis with two different rapid tests: the Abbott test and the local test. People with at least one positive test were treated with benzathin penicillin. A questionnaire was used to obtain additional information about the studied population. Blood was collected on filter paper in order to perform the FTA-abs test in The Netherlands, which was used both for determination of the prevalence and as a confirmation test in order to differentiate between the two rapid tests. All positive blood samples according to the rapid tests performed in Cameroon, and a control group of randomly selected negative blood samples were (re)tested with the FTA-abs test. Results: A total of 1,128 (539 men and 589 women) participated in this study. Of this population, 114 people (10.1%) had at least one positive rapid test. After cross-reference using FTA-abs a syphilis prevalence of only 2.9% was determined for the MCA. The Abbott test has a greater positive predictive value (18% versus 16%) and a slightly greater specificity (93% versus 92%). The local rapid test on the other hand is more sensitive (52% versus 48%). Using the ASSURED method, the Abbott test showed advantages over the local test mainly in affordability, user-friendliness, and robustness. Conclusions: This study shows that the syphilis prevalences worldwide might be much lower than is believed at this moment. The striking higher number of positives that was found using the rapid tests can be explained by the appearance of false positive tests due to cross-reactions that have occurred in these non-specific rapid tests. The Abbott test can be considered superior to the currently used local test, although the local test is slightly more sensitive. However, the Abbott test has many advantages over the local test in the field. Hospitals and health centres in the MCA are advised to switch to the Abbott test.
Apoptosis and oxidative injury are recognized as the most important causes of hepatocyte injury i... more Apoptosis and oxidative injury are recognized as the most important causes of hepatocyte injury in non-alcoholic fatty liver disease (NAFLD). We aimed to search for the association between serum alanine aminotransferase (ALT) levels and hepatocyte apoptosis and oxidative stress parameters in NAFLD. Fifty patients (24 male / 26 female, mean age: 47.3 ± 10.1 years) with biopsy-proven NAFLD were studied. While ALT was in normal range in 24 subjects, it was elevated in 26. Upper range of normal was set to 19 U/L for women and 30 U/L for men. While non-alcoholic fatty liver (NAFL) denotes simple steatosis, nonalcoholic steatohepatitis (NASH) denotes the presence of inflammation, ballooned hepatocytes and fibrosis. Liver oxidative stress was estimated on the basis of tissue gluthathione concentration, and superoxide dismutase (SOD), and malondialdehyde (MDA) activities in tissue and serum specimens. Immunohistochemistry was performed for activated caspase 3 and 8, nuclear factor kB (NF-kB), antiapoptotic Bcl-2 protein, and tumor necrosis factor receptor (TNF-sRp55). The mean caspase 3 and 8 activity scores, oxidative stress parameters, mean necroinflammatory grade and prevalence of severe fibrosis were comparable across the groups with normal versus elevated ALT. Only patients with NASH had significantly higher caspase 3 and 8 activity, and serum MDA levels than those with NAFL (54.81±18.06, 39.81±27.43, p=0.04; 49.62±17.66, 26.17±15.03, p=0.03, and 5.09±0.77, 3.58±0.50, p= 0.049, respectively). Multiple regression analysis revealed that ALT elevation was not a risk factor for advanced necroinflammatory grade and fibrosis (OR:0.99, p=0.74, CI: 0.99-1.00, and OR:0.99, p=0.71, CI:0.98-1.00, respectively). Area under the receiver operating characteristic curve (AUROC) did not show any significant sensitivity and specificity for discriminative power of ALT (according to the upper limits above) for the necroinflammatory and fibrosis severity (AUROC 0.49; 95 % CI: 0.57-0.91, and AUROC 0.43; 95 % CI: 0.19-0.67, and respectively). In conclusion, we demonstrated that apoptosis and oxidative stress are the main events contributing to disease progression in NAFLD and serum ALT values do not correlate well with the parameters of these injurious processes or the severity of resultant histological changes.
OBJECTIVES: The aim of this study was to investigate the activities of serum paraoxonase and aryl... more OBJECTIVES: The aim of this study was to investigate the activities of serum paraoxonase and arylesterase in patients with ankylosing spondylitis with respect to those of healthy controls, to assess whether these enzyme levels are related to disease activity and functional capacity. METHODS: The study included 32 patients with ankylosing spondylitis whose diagnoses were made according to the modified New York criteria as well as 25 healthy controls matched for age and sex. The Bath Ankylosing Spondylitis Disease Activity Index and the Bath Ankylosing Spondylitis Functional Index were applied to the ankylosing spondylitis patients. As laboratory parameters, the erythrocyte sedimentation rate and serum C-reactive protein level were measured in patients and control subjects. Paraoxonase and arylesterase enzyme activities were measured using appropriate methods. RESULTS: No statistically significant differences (p>0.05) were found between the ankylosing spondylitis patients and controls in terms of serum paraoxonase or arylesterase levels. Furthermore, there was no correlation between clinical and laboratory parameters in patients with ankylosing spondylitis. CONCLUSION: Serum paraoxonase and arylesterase levels in ankylosing spondylitis patients may not differ from those of healthy controls, and there is no significant correlation between antioxidant parameters and the Bath Ankylosing Spondylitis Disease Activity Index or Bath Ankylosing Spondylitis Functional Index scores in ankylosing spondylitis patients. Further research is needed to provide deeper understanding of this disease.
Aim: We aimed to evaluate the circulating thrombospondin-1 (TSP-1) and nuclear factor kappa B (NF... more Aim: We aimed to evaluate the circulating thrombospondin-1 (TSP-1) and nuclear factor kappa B (NF-κB) in nonalcoholic fatty liver disease (NAFLD) in order to integrate these signaling pathways in the inflammatory and fibrogenic processes of this liver disorder. Methods: Ninety-five NAFLD patients were recruited in the study. The study also included 83 age-sex matched healthy controls. Results: The number of patients with metabolic syndrome (MetS) criteria was 57 (60%). TSP-1 level was found to be statistically significantly lower in the NAFLD group compared to the control group (p=0.037). However, NF-κB level was found to be significantly higher in the NAFLD group compared to the control group (p=0.004). There was a significant negative correlation between plasma TSP-1 levels with glucose (r=-0.235, p=0.022), alanine aminotransferase (r=-0.261, p=0.011) and aspartate transaminase (r=-0.328, p=0.001) levels. In addition, a significant negative correlation was found between plasma TSP...
Aim: To evaluate the impact of relevant patient-level characteristics on the efficacy and safety ... more Aim: To evaluate the impact of relevant patient-level characteristics on the efficacy and safety of subcutaneous, once-weekly semaglutide in subjects with type 2 diabetes. Materials and Methods: Exploratory post hoc analyses of pooled SUSTAIN 1-5 (phase 3a) randomized, controlled trials examined the change from baseline in HbA1c and body weight (BW), and the proportions of subjects achieving the composite endpoint (HbA1c < 7.0% [53 mmol/mol]), without weight gain or severe/blood glucose-confirmed symptomatic hypoglycaemia at week 30 with semaglutide (0.5/1.0 mg) across clinically relevant patient subgroups: baseline HbA1c (≤7.5%, >7.5%-8.0%, >8.0%-8.5%, >8.5%-9.0% and > 9.0%), background medications, diabetes duration and pancreatic beta-cell function. Results: Mean HbA1c (% point) reductions increased from lowest to highest HbA1c subgroups (−0.9%, −1.2%,-1.5%, −1.7% and −2.3% [effect of subgroup within treatment: P = 0.247] for semaglutide 0.5 mg, and −1.1%, −1.4%, −1.9%, −2.1% and −2.7% [P = 0.045] for semaglutide 1.0 mg), with mean HbA1c ranges at week 30 of 6.3%-7.3% and 6.1%-6.9%, respectively. The corresponding BW reductions generally decreased with increasing baseline HbA1c (−4.4, −3.9, −3.9, −3.3 and −2.9 kg [P = 0.004], and −6.4, −5.9, −5.2, −4.5 and −4.8 kg [P < 0.001], respectively). HbA1c and BW reductions were consistently greater for semaglutide 1.0 mg versus 0.5 mg across background medication, diabetes duration and pancreatic beta-cell function subgroups. Adverse events with semaglutide were consistent with the glucagon-like peptide-1 receptor agonist class, with gastrointestinal events the most common. Conclusions: Semaglutide was consistently efficacious across the continuum of diabetes care in a broad spectrum of patient subgroups with a range of clinical characteristics.
Giriş: Mikroanjiopatik hemolitik anemiler (MAHA) oldukça nadir görülen ve tedavi edilmediğinde mo... more Giriş: Mikroanjiopatik hemolitik anemiler (MAHA) oldukça nadir görülen ve tedavi edilmediğinde mortal seyreden bir grup hastalığa verilen isimdir. Amaç: Bu çalışmadaki amacımız; trombositopeni saptanan ve özellikle de end-organ tutulumu olmayan hastalarda ayırıcı tanıda MAHA'nın hatırlanması gerekliliğini vurgulamaktır. Aynı zamanda erken tanı ve tedavide mortalite oranının düştüğünü gösterebilmektir. Gereç ve yöntem: Eylül 2017-mayıs 2019 tarihlerinde arasında iç hastalıkları servisinde tanısı koyularak takip ve tedavi edilen vakaları retrospektif olarak inceledik. Tanı kriterlerine uyan toplam 15 hasta çalışmaya alındı. Hastalardan, ilk başvuruda; tam kan sayımı, sedimentasyon, periferik yayma, direkt coombs, CRP, koagülasyon testleri ve biyokimyasal tetkikler çalışıldı. Ayrıca her plazmaferez işleminden önce ve sonra; tam kan sayımı, üre, kreatin, LDH, indirek bilirubin düzeyleri bakıldı. Bulgular: Hastaların E/K oranı 8 /7 (% 53.3/ 46.6) ve yaş ortalaması 46.8 (25-79) bulundu. Hastaların etyolojik sınıflandırılması sonucu; 8 hasta (%53.3) TTP(Trombotik trombositopenik purpura) olarak, 4 hasta (%26.6) vitamin B 12 eksikliğine bağlı, 1 hasta sistemik lupus eritamatozus (%6.6), 1 hasta (%6.6) atipik hemolitik üremik sendrom ve 1 hasta (%6.6) da ilaç ilişkili MAHA olarak değerlendirildi. Sonuç: Çalışmaya alınan 15 hastadan 11 hastanın (%73.3) iyileşme, 4 hastanın (%20) izlemi esnasında exitus, 1 hastanın (%6.6) taburculuktan sonra, toplamda 5 (%33.3) hastanın exitus olduğu tespit edildi.
Amaç: Trombosit-lenfosit oranı (PLR) ve nötrofil-lenfosit oranı (NLR) kanser hastalarında yaygın ... more Amaç: Trombosit-lenfosit oranı (PLR) ve nötrofil-lenfosit oranı (NLR) kanser hastalarında yaygın araştırılan non-invaziv enflamasyon belirteçleri olup; non-alkolik steatohepatit ve kronik hepatit B'li (KHB) hastalarda fibrozis ile ilişkisini gösteren bazı çalışmalar bulunmaktadır. Amacımız, KHB'li hastalarda karaciğer histopatolojisi ve viral yük parametrelerinin; NLR, PLR ve ortalama trombosit hacmi (MPV) ile olan ilişkisini incelemektir. Gereç ve Yöntemler: İç hastalıkları ve gastroenteroloji polikliniğine 2016-2019 yılları arasında başvuran karaciğer biyopsisi yapılan 224 KHB hastası geriye dönük incelendi. Çalışma verileri, hasta dosyaları ve elektronik kayıtlardan elde edildi.
Objective: Adenosine deaminase (ADA) and neopterin are increased in disorders that stimulate cell... more Objective: Adenosine deaminase (ADA) and neopterin are increased in disorders that stimulate cells involved in the immune system. We investigated the effect of therapy on serum ADA activity and neopterin levels in patients with pulmonary tuberculosis (TB) and with community-acquired pneumonia (CAP). Methods: Seventeen pulmonary TB, 24 CAP, and a control group of 20 healthy volunteers were included in this study. ADA and neopterin assay was performed colorimetrically and by ELISA, respectively, before and 2 months after therapy (rifampicin+isoniazid+ethambutol and pyrazinamide) of patients with TB and before and 15 days after therapy (ampicillin-sulbactam) of CAP. Results: Serum ADA activity and neopterin levels were significantly higher in patients with TB than those in pneumonia and controls. Serum neopterin levels were significantly higher in patients with CAP than controls. No significant differences were found in ADA levels between pneumonia and control subjects. The ADA and neo...
Giris ve Amac: Poliserozit birden fazla seroz zarin inflamasyonuna verilen addir. Poliserozite de... more Giris ve Amac: Poliserozit birden fazla seroz zarin inflamasyonuna verilen addir. Poliserozite degisik hastaliklar neden olabilmektedir. Biz bu calismada hastaneye yatirilan ve poliserozit saptanan olgularimizi ayrintili olarak incelemeyi amacladik. Gerec ve Yontem: Cerrahpasa Tip Fakultesi, Ic Hastaliklari Anabilim Dali'nda 1 Ocak 2001 ve 31 Aralik 2004 tarihleri arasinda yatirilarak tetkik edilen toplam 12,485 hastanin dosyasi ayrintili sekilde incelendi. Poliserozit saptanan 40 olgu demografik, klinik ve etyolojik acidan ele alindi. Bulgular: Toplam 12,485 hastanin 40'i (%0.3) poliserozit tanisi almisti (22 kadin, 18 hasta). Bu hastalarda poliserozitin en sik nedeni 15 hasta (%37.5) ile maligniteler idi (4 hastada Non-Hodgkin Lenfoma, 2'sinde over kanseri, 2'sinde sarkom, birer hastada ise akciger, meme, mide, serviks ve endometrium kanseri, Burkitt lenfomasi, primeri bilinmeyen karacigere metastaz yapmis adenokanser ve Hepatit B ve Hepatit C zemininde gelisen hep...
Poliserozit birden fazla seröz zarda inflamasyona verilen add›r. Poliserozite de¤iflik hastal›kla... more Poliserozit birden fazla seröz zarda inflamasyona verilen add›r. Poliserozite de¤iflik hastal›klar neden olabilmektedir. Seröz zarlardan hangisinin tutulumu ön planda ise klinik tablo ona göre flekillenebilmektedir. Örne¤in bir tüberküloz plörö-perikardit olgusunda hastal›¤›n akut formunda kardiyak tamponad klini¤i geliflebilece¤i gibi, kronik formunda hasta sadece asit ile de karfl›m›za gelebilmektedir. Bazen ise seröz zarlar›n tutulumu sistemik bir Girifl ve Amaç: Poliserozit birden fazla seröz zar›n inflamasyonuna verilen add›r. Poliserozite de¤iflik hastal›klar neden olabilmektedir. Biz bu çal›flmada hastaneye yat›r›lan ve poliserozit saptanan olgular›m›z› ayr›nt›l› olarak incelemeyi amaçlad›k. Gereç ve Yöntem: Cerrahpafla T›p Fakültesi, ‹ç Hastal›klar› Anabilim Dal›’nda 1 Ocak 2001 ve 31 Aral›k 2004 tarihleri aras›nda yat›r›larak tetkik edilen toplam 12,485 hastan›n dosyas› ayr›nt›l› flekilde incelendi. Poliserozit saptanan 40 olgu demografik, klinik ve etyolojik aç›dan ele al›...
Background/Aim: Cardiovascular involvement in patients with coronavirus disease 2019 (COVID-19) i... more Background/Aim: Cardiovascular involvement in patients with coronavirus disease 2019 (COVID-19) is closely related to the course of the disease; however, this issue has not been adequately studied in Turkey. Thus, we aimed to investigate the electrocardiography (ECG) findings in noncritical patients with COVID-19 in Turkey. Methods: This retrospective cohort study was conducted on non-critical patients with COVID-19 with no history of any cardiac disease. The laboratory parameters and ECG findings of the patients at the time of admission were analyzed. Results: In total, 100 patients with a mean age of 56.8 (16.7) years were included in the study, among which 54 were males. The rate of patients having at least one abnormal ECG finding, ST segment pathology, and elevated troponin level were 58%, 26%, and 48%, respectively. The respiratory rate and mean troponin level were higher and the mean lymphocyte count was lower in patients with ST segment pathology than in patients without. Th...
Background Cognitive functions are affected by thyroid hormones. In this study, we aimed to inves... more Background Cognitive functions are affected by thyroid hormones. In this study, we aimed to investigate the selective attention and information processing speed in thyrotoxic Graves’ disease. Methodology This study was conducted among 40 patients with thyrotoxic Graves’ disease and age and gender-matched 40 healthy controls. Stroop Color and Word test were applied to healthy controls once and to patients with Graves’ disease during thyrotoxic and euthyroid periods. Stroop interference effect was calculated. Results The mean age was 34.67 ± 11 in the Graves’ group and 34.72 ± 9.16 in the control group (p > 0.05). The number of errors and self-corrections in Stroop Color and Word test was higher in patients with thyrotoxic Graves’ disease than both patients with euthyroid Graves’ disease and healthy controls (p < 0.05). Stroop interference effect was significantly longer in patients with thyrotoxic Graves’ disease than both patients with euthyroid Graves’ disease and healthy con...
Amaç: Kolorektal polipler gastrointestinal sistemde mukoza ve submukozadan köken alan ve barsak l... more Amaç: Kolorektal polipler gastrointestinal sistemde mukoza ve submukozadan köken alan ve barsak lümeni içine uzanan doku kütlesidir. Poliplerin kanserleşme riski olduğundan tespit edilen polip kolonoskopiyle çıkarılarak histopatolojik incelenmelidir. Çalışmamızda kolonoskopi ile tespit edilen ve çıkarılan poliplerin sıklığı, boyutu, lokalizasyonu ve histopatolojik olarak özelliklerini değerlendirmeyi amaçladık.
International Journal for Vitamin and Nutrition Research, 2021
. Purpose: This study aimed to investigate the effect of the nutritional status, as assessed by t... more . Purpose: This study aimed to investigate the effect of the nutritional status, as assessed by the prognostic nutritional index (PNI) on the disease prognosis of patients with COVID-19. Methods: This retrospective study included 282 patients with COVID-19. The PNI score of all patients, 147 of whom were male, with a mean age of 56.4±15.3 years, was calculated. According to the PNI score, the patients with normal and mild malnutrition constituted group-1 (n=159) and the patients with moderate-to-severe and serious malnutrition constituted group-2 (n=123). Results: The PNI score was correlated with age (r=−0.146, p=0.014); oxygen saturation (r=0.190, p=0.001); heart rate (r=−0.117, p=0.05); hospitalization duration (r=−0.266, p&amp;amp;amp;amp;lt;0.001); white blood cells (r=0.156, p=0.009); hemoglobin (r=0.307, p&amp;amp;amp;amp;lt;0.001); C-reactive protein (CRP) (r=−0.346, p&amp;amp;amp;amp;lt;0.001); creatinine (r=−0.184, p=0.002); D-dimer (r=−0.304, p&amp;amp;amp;amp;lt;0.001); ferritin (r=−0.283, p&amp;amp;amp;amp;lt;0.001); procalcitonin (r=−0.287, p&amp;amp;amp;amp;lt;0.001); the confusion, urea, respiratory rate, blood pressure, and age ≥65 years score (r=−0.217, p&amp;amp;amp;amp;lt;0.001); and the quick sequential organ failure assessment score (r=−0.261, p&amp;amp;amp;amp;lt;0.001) in patients with COVID-19. Mortality was significantly higher in Group 2 (p&amp;amp;amp;amp;lt;0.001). Survival was significantly higher if PNI score was &amp;amp;amp;amp;gt;41.2 (p&amp;amp;amp;amp;lt;0.001, sensitivity: 78.7% and specificity: 84.2%). In multivariate regression analysis, among various other parameters, only PNI score and oxygen saturation had a significant effect on the disease course (p=0.02 and p=0.045, respectively). Conclusion: PNI, calculated from the serum albumin concentration and total lymphocyte count, is a simple and objective indicator that assesses the immune nutritional status of patients with COVID-19. The presence of malnutrition has a high predictive value in predicting the severity of COVID-19. Our data suggest that the PNI might be useful for risk stratification of patients with COVID-19 in clinical practice.
INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), 2021
Тиреотоксический гипокалиемический периодический паралич является редким наследственным заболеван... more Тиреотоксический гипокалиемический периодический паралич является редким наследственным заболеванием, характеризующимся периодической потерей силы мышц. В проведенном исследовании диагностирован периодический гипокалиемический паралич в результате обследования пациента в отделении неотложной помощи. Поскольку этот случай редкий, представлен обзор литературы. 43-летний пациент мужского пола с известной грыжей поясничного диска в анамнезе был доставлен в экстренную службу больницы с жалобой на невозможность движения телом после пробуждения в 6:00 утра. Пациент принимал метимазол в таблетках 12 часов назад из-за жалоб на головную боль. Ужин состоял из продуктов с высоким содержанием углеводов. Клинический осмотр выявил артериальное давление 105/70 мм рт.ст., частоту сердечных сокращений 93 в 1 мин, температуру 36,8 градуса, общую потерю силы в четырех конечностях и тетраплегию. Потери чувствительности, офтальмопатии, тремора не обнаружено, изохорический и световой рефлекс зрачков двуст...
Background: Hypertension is one of the principal risk factors for cardiovascular disease. We aime... more Background: Hypertension is one of the principal risk factors for cardiovascular disease. We aimed to evaluate the impact of hypertension on fibrinolytic balance and endothelial function by measuring plasma levels of plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator antigen (tPA), tPA/PAI-1 complex and fibrinogen. Methods: Patients enrolled into the study were divided into four groups: 22 essential hypertensive (EH), 22 white coat hypertensive (WCH), 22 renovascular hypertensive (RH) and 22 normotensive control subjects. Plasma PAI-1, tPA, tPA/PAI-1 complex levels were measured by enzyme linked immunosorbent assays. Results: There was no difference in the systolic and diastolic blood pressure measurements of the EH and RH groups. The four groups were comparable for age, gender, smoking habits and BMI. Patients with EH, RH and WCH had increased plasma levels of PAI-1, tPA, tPA/PAI-1 complex and fibrinogen compared with controls. No fibrinolytic parameter was ass...
The main cause of obesity is a change in the energy balance in favor of intake. Communication bet... more The main cause of obesity is a change in the energy balance in favor of intake. Communication between the hypothalamus and other organs occurs through special peptides, such as ghrelin, leptin, and orexin-A, to provide energy balance. The purpose of this study was to investigate the effects of a laparoscopic gastric band application on insulin resistance and the peptides involved in appetite in morbidly obese patients. The study group consisted of 20 patients who were operated on for morbid obesity (body mass index [BMI], 48.3±6.7 kg/m2) and the control group contained 20 healthy, normal-weight subjects (BMI, 22.6±2 kg/m2). We obtained blood samples from the study subjects before surgery and one month after surgery, and once from the control group. We measured plasma levels of ghrelin, leptin, orexin-A, and plasma glucose. Significant weight loss was achieved after surgery (P<0.05). Plasma ghrelin levels were lower in morbidly obese patients (P=0.033), but increased postoperative...
International Journal of Antimicrobial Agents, 2007
Objectives: A twofold cross-sectional field study was performed at Manyemen Presbyterian Medical ... more Objectives: A twofold cross-sectional field study was performed at Manyemen Presbyterian Medical Institutions, Cameroon. First, the prevalence of syphilis among people in the reproductive age (men: 15−60 years, women: 15−50 years) living in the Manyemen Catchment Area (MCA) was assessed. Second, the Abbott determine Syphilis TP ® rapid test (Abbott test) was compared to the syphilis rapid test that is presently used in the MCA (local test). Methods: The studied population was tested on syphilis with two different rapid tests: the Abbott test and the local test. People with at least one positive test were treated with benzathin penicillin. A questionnaire was used to obtain additional information about the studied population. Blood was collected on filter paper in order to perform the FTA-abs test in The Netherlands, which was used both for determination of the prevalence and as a confirmation test in order to differentiate between the two rapid tests. All positive blood samples according to the rapid tests performed in Cameroon, and a control group of randomly selected negative blood samples were (re)tested with the FTA-abs test. Results: A total of 1,128 (539 men and 589 women) participated in this study. Of this population, 114 people (10.1%) had at least one positive rapid test. After cross-reference using FTA-abs a syphilis prevalence of only 2.9% was determined for the MCA. The Abbott test has a greater positive predictive value (18% versus 16%) and a slightly greater specificity (93% versus 92%). The local rapid test on the other hand is more sensitive (52% versus 48%). Using the ASSURED method, the Abbott test showed advantages over the local test mainly in affordability, user-friendliness, and robustness. Conclusions: This study shows that the syphilis prevalences worldwide might be much lower than is believed at this moment. The striking higher number of positives that was found using the rapid tests can be explained by the appearance of false positive tests due to cross-reactions that have occurred in these non-specific rapid tests. The Abbott test can be considered superior to the currently used local test, although the local test is slightly more sensitive. However, the Abbott test has many advantages over the local test in the field. Hospitals and health centres in the MCA are advised to switch to the Abbott test.
Apoptosis and oxidative injury are recognized as the most important causes of hepatocyte injury i... more Apoptosis and oxidative injury are recognized as the most important causes of hepatocyte injury in non-alcoholic fatty liver disease (NAFLD). We aimed to search for the association between serum alanine aminotransferase (ALT) levels and hepatocyte apoptosis and oxidative stress parameters in NAFLD. Fifty patients (24 male / 26 female, mean age: 47.3 ± 10.1 years) with biopsy-proven NAFLD were studied. While ALT was in normal range in 24 subjects, it was elevated in 26. Upper range of normal was set to 19 U/L for women and 30 U/L for men. While non-alcoholic fatty liver (NAFL) denotes simple steatosis, nonalcoholic steatohepatitis (NASH) denotes the presence of inflammation, ballooned hepatocytes and fibrosis. Liver oxidative stress was estimated on the basis of tissue gluthathione concentration, and superoxide dismutase (SOD), and malondialdehyde (MDA) activities in tissue and serum specimens. Immunohistochemistry was performed for activated caspase 3 and 8, nuclear factor kB (NF-kB), antiapoptotic Bcl-2 protein, and tumor necrosis factor receptor (TNF-sRp55). The mean caspase 3 and 8 activity scores, oxidative stress parameters, mean necroinflammatory grade and prevalence of severe fibrosis were comparable across the groups with normal versus elevated ALT. Only patients with NASH had significantly higher caspase 3 and 8 activity, and serum MDA levels than those with NAFL (54.81±18.06, 39.81±27.43, p=0.04; 49.62±17.66, 26.17±15.03, p=0.03, and 5.09±0.77, 3.58±0.50, p= 0.049, respectively). Multiple regression analysis revealed that ALT elevation was not a risk factor for advanced necroinflammatory grade and fibrosis (OR:0.99, p=0.74, CI: 0.99-1.00, and OR:0.99, p=0.71, CI:0.98-1.00, respectively). Area under the receiver operating characteristic curve (AUROC) did not show any significant sensitivity and specificity for discriminative power of ALT (according to the upper limits above) for the necroinflammatory and fibrosis severity (AUROC 0.49; 95 % CI: 0.57-0.91, and AUROC 0.43; 95 % CI: 0.19-0.67, and respectively). In conclusion, we demonstrated that apoptosis and oxidative stress are the main events contributing to disease progression in NAFLD and serum ALT values do not correlate well with the parameters of these injurious processes or the severity of resultant histological changes.
OBJECTIVES: The aim of this study was to investigate the activities of serum paraoxonase and aryl... more OBJECTIVES: The aim of this study was to investigate the activities of serum paraoxonase and arylesterase in patients with ankylosing spondylitis with respect to those of healthy controls, to assess whether these enzyme levels are related to disease activity and functional capacity. METHODS: The study included 32 patients with ankylosing spondylitis whose diagnoses were made according to the modified New York criteria as well as 25 healthy controls matched for age and sex. The Bath Ankylosing Spondylitis Disease Activity Index and the Bath Ankylosing Spondylitis Functional Index were applied to the ankylosing spondylitis patients. As laboratory parameters, the erythrocyte sedimentation rate and serum C-reactive protein level were measured in patients and control subjects. Paraoxonase and arylesterase enzyme activities were measured using appropriate methods. RESULTS: No statistically significant differences (p>0.05) were found between the ankylosing spondylitis patients and controls in terms of serum paraoxonase or arylesterase levels. Furthermore, there was no correlation between clinical and laboratory parameters in patients with ankylosing spondylitis. CONCLUSION: Serum paraoxonase and arylesterase levels in ankylosing spondylitis patients may not differ from those of healthy controls, and there is no significant correlation between antioxidant parameters and the Bath Ankylosing Spondylitis Disease Activity Index or Bath Ankylosing Spondylitis Functional Index scores in ankylosing spondylitis patients. Further research is needed to provide deeper understanding of this disease.
Aim: We aimed to evaluate the circulating thrombospondin-1 (TSP-1) and nuclear factor kappa B (NF... more Aim: We aimed to evaluate the circulating thrombospondin-1 (TSP-1) and nuclear factor kappa B (NF-κB) in nonalcoholic fatty liver disease (NAFLD) in order to integrate these signaling pathways in the inflammatory and fibrogenic processes of this liver disorder. Methods: Ninety-five NAFLD patients were recruited in the study. The study also included 83 age-sex matched healthy controls. Results: The number of patients with metabolic syndrome (MetS) criteria was 57 (60%). TSP-1 level was found to be statistically significantly lower in the NAFLD group compared to the control group (p=0.037). However, NF-κB level was found to be significantly higher in the NAFLD group compared to the control group (p=0.004). There was a significant negative correlation between plasma TSP-1 levels with glucose (r=-0.235, p=0.022), alanine aminotransferase (r=-0.261, p=0.011) and aspartate transaminase (r=-0.328, p=0.001) levels. In addition, a significant negative correlation was found between plasma TSP...
Aim: To evaluate the impact of relevant patient-level characteristics on the efficacy and safety ... more Aim: To evaluate the impact of relevant patient-level characteristics on the efficacy and safety of subcutaneous, once-weekly semaglutide in subjects with type 2 diabetes. Materials and Methods: Exploratory post hoc analyses of pooled SUSTAIN 1-5 (phase 3a) randomized, controlled trials examined the change from baseline in HbA1c and body weight (BW), and the proportions of subjects achieving the composite endpoint (HbA1c < 7.0% [53 mmol/mol]), without weight gain or severe/blood glucose-confirmed symptomatic hypoglycaemia at week 30 with semaglutide (0.5/1.0 mg) across clinically relevant patient subgroups: baseline HbA1c (≤7.5%, >7.5%-8.0%, >8.0%-8.5%, >8.5%-9.0% and > 9.0%), background medications, diabetes duration and pancreatic beta-cell function. Results: Mean HbA1c (% point) reductions increased from lowest to highest HbA1c subgroups (−0.9%, −1.2%,-1.5%, −1.7% and −2.3% [effect of subgroup within treatment: P = 0.247] for semaglutide 0.5 mg, and −1.1%, −1.4%, −1.9%, −2.1% and −2.7% [P = 0.045] for semaglutide 1.0 mg), with mean HbA1c ranges at week 30 of 6.3%-7.3% and 6.1%-6.9%, respectively. The corresponding BW reductions generally decreased with increasing baseline HbA1c (−4.4, −3.9, −3.9, −3.3 and −2.9 kg [P = 0.004], and −6.4, −5.9, −5.2, −4.5 and −4.8 kg [P < 0.001], respectively). HbA1c and BW reductions were consistently greater for semaglutide 1.0 mg versus 0.5 mg across background medication, diabetes duration and pancreatic beta-cell function subgroups. Adverse events with semaglutide were consistent with the glucagon-like peptide-1 receptor agonist class, with gastrointestinal events the most common. Conclusions: Semaglutide was consistently efficacious across the continuum of diabetes care in a broad spectrum of patient subgroups with a range of clinical characteristics.
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