PubMed Açık Erişimli Yayınlar

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Effect of HLA on Hepatitis C Virus Clearance and Persistence in Anti-HCV-positive End-stage Renal Disease Patients
(2014) Ocal, Serkan; Selcuk, Haldun; Korkmaz, Murat; Altun, Reskan; Yildirim, Abdullah E.; Akbas, Enver; 24976281
Background/Aims: The efficacy of immune response against hepatitis C virus (HCV) is determined by human leukocyte antigen (HLA) molecules of the host which present HCV antigens to CD4+ and CD8+ Tlymphocytes. In this study, we aimed to investigate the possible relationship between the frequencies of certain HLA class I-II alleles and the natural history of HCV in patients with end-stage renal disease (ESRD). Settings and Design: This is a retrospective cohort study conducted in a university hospital. Patients and Methods: The present study comprised 189 ESRD patients (candidates for renal transplantation) who had positive anti-HCV antibody test. The results concerning HCV and HLA status were gathered from patients files. The viral persistence was compared between the groups that were determined by HLA sub-typing. Statistical Analysis: Statistical evaluation was performed using Mann-Whitney U-test, Chi-square test, and Fisher's exact test. Level of error was set at 0.05 for all statistical evaluations, and P values < 0.05 were considered statistically significant. Results: We found possible association between the course of HCV infection and specific HLA alleles. HLA class I Cw*6 and HLA class II DRB*10 alleles were observed more frequently in the viral clearance group (P < 0.05). The HLA class I B*38 allele group was more prone to develop chronic hepatitis C (P < 0.01). Conclusions: These findings suggest that HLA class I Cw*6 and HLA class II DRB*10 alleles may be associated with immunological elimination of HCV in Turkish patients on hemodialysis. HLA sub-typing could help predict the prognosis of HCV infection.
Can serial monitoring of serum Vascular Endothelial Growth Factor (VEGF), Nitric Oxide (NO), and Angiotensin II (ANGII) levels have predictive role during Bevacizumab treatment?
(2014) Sumbul, Ahmet Taner; Disel, Umut; Sezgin, Nurzen; Sezer, Ahmet; Kose, Fatih; Besen, Ali Ayberk; Sumbul, Zehra; Abali, Huseyin; Ozyilkan, Ozgur
Background: Standard treatment of colorectal cancer includes both cytostatic chemotherapy and targeted therapies. Bevacizumab, targeting the VEGF receptor, is one of the primary targeted therapies that achieve better response rate and survival rate as compared to combination chemotherapy. To the best of our knowledge, there is no established single marker that can be used as a predictive marker in bevacizumab therapy. Material/Methods: We enrolled 24 patients with the diagnosis of metastatic colorectal cancer in our study. During the study, 2 blood samples were drawn from patients before the first cycle and after the sixth cycle of bevacizumab therapy. Serum levels of VEGF, ANG II, and NO were recorded. Results: While the change across VEGF levels was found to be a statistically significant decreasing trend (p=0.009), this decrease was not found to be correlated with treatment response and hypertension development. Additionally, no statistically significant difference was found in terms of NO and ANG II levels. Conclusions: This study showed a significant decrease in serum VEGF, but failed to show a significant change in NO and ANG II levels during bevacizumab treatment. Although no significant correlation was found between the presence of hypertension and markers, most patients (83%) had an increase in their blood pressure. Our results suggest that dynamic monitoring of NO and ANG II, along with VEGF, may not be useful as predictive markers for bevacizumab treatment in colorectal cancer.
Analysis and injury paterns of walnut tree falls in central anatolia of turkey
(2014) Ersoy, Suleyman; Sonmez, Bedriye Muge; Yilmaz, Fevzi; Kavalci, Cemil; Ozturk, Derya; Altinbilek, Ertugrul; Alagoz, Fatih; Cesur, Fatma; Yildirim, Ali Erdem; Uckun, Ozhan Merzuk; Akin, Tezcan
Introduction: Falls are the second most common cause of injury-associated mortality worldwide. This study aimed to analysis the injuries caused by falls from walnut tree and assess their mortality and morbidity risk. Methods: This is a retrospective hospital-based study of patients presenting to emergency department (ED) of Ahi Evran Univercity between September and October 2012. For each casualty, we computed the ISS (defined as the sum of the squares of the highest Abbreviated Injury Scale (AIS) score in each of the three most severely injured body regions). Severe injury was defined as ISS >= 16. The duration of hospital stay and final outcome were recorded. Statistical comparisons were carried out with Chi-Square test for categorical data and non-parametric spearman correlation tests were used to test the association between variables. A p value less than 0.05 was considered to be statistically significant. Results: Fifty-four patients admitted to our emergency department with fall from walnut tree. Fifty (92.6%) patients were male. The mean age was 48 +/- 14 years. Spinal region (44.4%) and particularly lumbar area (25.9%) sustained the most of the injuries among all body parts. Wedge compression fractures ranked first among all spinal injuries. Extremities injuries were the second most common injury. None of the patients died. Morbidity rate was 9.25%. Conclussion: Falls from walnut trees are a significant health problem. Preventive measures including education of farmers and agricultural workers and using mechanized methods for harvesting walnut will lead to a dramatic decrease in mortality and morbidity caused by falls from walnut trees.
TREATMENT PATTERNS AND QUALITY OF LIFE OF PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION: AN EXPERIENCE OF A TERTIARY HEALTH CARE CENTERS (TREQ-AF STUDY)
(2014) Ozin, B.; Aytemir, K.; Arslan, O.; Ozcan, T.; Kanadasi, M.; Demir, M.; Gokce, M.; Sucu, M. M.; Ozdemir, M.; Yiğit, Z.; Yavuzkir, M.F.; Oto, A.; 27201487
Endovascular treatment of an iliac artery rupture caused by invasive Salmonella spondylodiscitis
(2014) Kursun, Ebru; Turunc, Tuba; Ozkan, Ugur; Demiroglu, Yusuf Ziya; 25230272
The rate of non-typhoid Salmonella infections has increased remarkably in recent years. Endovascular system infection is one of the most serious forms of extraintestinal Salmonella infection. The abdominal aorta is frequently involved, while bone and joint involvement are rarely seen. We present a rare case of successful endovascular treatment of a left iliac artery rupture and pseudoaneurysm both occurring due to the direct invasion of lumbar spondylodiscitis caused by Salmonella typhimurium.
Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies
(2014) Ozyilmaz, Ezgi; Ugurlu, Aylin Ozsancak; Nava, Stefano
Background: Identifying the predictors of noninvasive ventilation (NIV) failure has attracted significant interest because of the strong link between failure and poor outcomes. However, very little attention has been paid to the timing of the failure. This narrative review focuses on the causes of NIV failure and risk factors and potential remedies for NIV failure, based on the timing factor. Results: The possible causes of immediate failure (within minutes to <1 h) are a weak cough reflex, excessive secretions, hypercapnic encephalopathy, intolerance, agitation, and patient-ventilator asynchrony. The major potential interventions include chest physiotherapeutic techniques, early fiberoptic bronchoscopy, changing ventilator settings, and judicious sedation. The risk factors for early failure (within 1 to 48 h) may differ for hypercapnic and hypoxemic respiratory failure. However, most cases of early failure are due to poor arterial blood gas (ABGs) and an inability to promptly correct them, increased severity of illness, and the persistence of a high respiratory rate. Despite a satisfactory initial response, late failure (48 h after NIV) can occur and may be related to sleep disturbance. Conclusions: Every clinician dealing with NIV should be aware of these risk factors and the predicted parameters of NIV failure that may change during the application of NIV. Close monitoring is required to detect early and late signs of deterioration, thereby preventing unavoidable delays in intubation.
Therapeutic Potential of Apigenin, a Plant Flavonoid, for Imatinib-Sensitive and Resistant Chronic Myeloid Leukemia Cells
(2014) Solmaz, Soner; Gokbulut, Aysun Adan; Cincin, Birsu; Ozdogu, Hakan; Boga, Can; Cakmakoglu, Bedia; Kozanoglu, Ilknur; Baran, Yusuf
Despite the presence of many therapeutic regimens like imatinib and other tyrosine kinase inhibitors, the development of resistance, intolerance, and side effects makes chronic myeloid leukemia (CML) therapy challenging. Thus, there is a need to discover novel drugs for CML patients. In this study, we attempted to assess apigenin, a common plant dietary flavonoid, in terms of its cytotoxic, apoptotic, and cytostatic effects on imatinib-sensitive and resistant Philadelphia-positive CML cells. We analyzed apigenin's effects on cell proliferation, apoptosis, caspase-3 activity, loss of mitochondrial membrane potential, and cell cycle progression in K562 and K562/IMA3 cells. Furthermore, we described genes and gene networks that are modulated in CML in response to apigenin. Results of our study revealed that apigenin has cytotoxic and apoptotic effects on both cell types. We also displayed that apigenin induced G2/M arrest in K562 cells while arresting K562/IMA3 cells in S phase especially at the highest apigenin concentration. The expression analysis identified a set of genes that were regulated by apigenin in K652 and K562/IMA3 cells. Association of modulated genes with biological functional groups identified several networks affected by apigenin including cell survival, proliferation, cell death, cell cycle, and cell signalling pathways.
Gastrointestinal endoscopy in pregnancy
(2014) Savas, Nurten; 25386072
Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
Triggering drug use in patients with psoriasis: an investigative report from Turkey
(2014) Ogretmen, Zerrin; Askin, Ulku; Hiz, Meliha Merve; Cevizci, Sibel; 25395925
Introduction: The patients clinically diagnosed with psoriasis were investigated for drug use that may trigger psoriasis. Aim: To minimize the triggering drug use and help the medical treatment of psoriasis patients. Material and methods: The study involved 289 psoriatic patients who attended our clinic in 2010-2012 and were asked to bring their drug lists of the last year, which they obtained from the pharmacy's record system. They were advised not to use the drugs that may trigger psoriasis. Data analyses were performed using SPSS program version 19.0. Results: A total of 289 patients were included in the study. Two hundred and twenty-one patients were using non-steroidal anti-inflammatory drugs; 133 patients were using anti-reflux drugs; 35 patients were using antidiabetic drugs; 31 patients were using calcium-channel blockers and 24 patients were using beta-blockers. In our study group, there was no significantly difference between median PASI scores of the patients using a triggering drug and those of who are not using a triggering drug. However, there was a positive low correlation between PASI rates and numbers of drugs used (r = 0.180, p = 0.013). Conclusions: Many other factors may trigger psoriasis, therefore the effect of stopping or minimizing the drug use on disease remission is not known. Because of the high triggering drug use rate, it is important to enlighten psoriasis patients about triggering drugs.
Pneumorrhachis and Pneumocephalus with Severe Chest Pain Symptom: A Rare Complication of Epidural Steroid Injection
(2014) Ergenoglu, Pinar; Bali, Cagla; Akin, Sule; Ozyilkan, Nesrin B.; Aribogan, Anis
Plasma fetuin-A levels are reduced in patients with hypothyroidism
(2014) Bakiner, Okan; Bozkirli, Emre; Ertugrul, Derun; Sezgin, Nurzen; Ertorer, Eda
Objective: To determine plasma fetuin-A levels in hypothyroid patients before and after treatment with L-thyroxine (T-4) and to determine the relation between plasma fetuin-A levels with cardiovascular risk factors. Design: A prospective, controlled, single-blind study. Methods: Forty-four treatment-naive female patients diagnosed with hypothyroidism and 39 age-and sex-matched control subjects were enrolled. Anthropometric measurements, blood pressure, plasma TSH, fetuin-A, free T-4, LDL-cholesterol, triglyceride, C-reactive protein, fibrinogen levels, and brachial artery flow-mediated dilatation were measured. All measurements were repeated after 3 months in the control group and 3 months after the attainment of euthyroidism with (L)-T4 replacement in the hypothyroid group. Baseline data were compared between the two groups. Posttreatment plasma fetuin-A levels of hypothyroid patients were compared with baseline levels of both groups. The relationship between plasma fetuin-A, TSH levels, and other cardiovascular risk factors was evaluated. Results: Plasma fetuin-A levels were similar to 20% lower in hypothyroid female patients compared with the controls (P=0.0001). Fetuin-A levels increased by similar to 20% in hypothyroid patients after achievement of euthyroidism (P=0.0001) and were no longer different compared with controls (P=0.38). There was a negative correlation between plasma TSH and fetuin-A levels (r=-0.79; P=0.001). There was no significant correlation between plasma fetuin-A levels and cardiovascular risk factors within or between groups. The fetuin-A levels were normalized with thyroid hormone treatment. Conclusion: Plasma fetuin-A levels are reduced in female patients with hypothyroidism, which are restored to normal during restoration of euthyroidism. There was no relation with cardiovascular risk factors.
Surgical and interventional management of complications caused by acute pancreatitis
(2014) Karakayali, Feza Y.; 25309073
Acute pancreatitis is one of the most common gastrointestinal disorders worldwide. It requires acute hospitalization, with a reported annual incidence of 13 to 45 cases per 100000 persons. In severe cases there is persistent organ failure and a mortality rate of 15% to 30%, whereas mortality of mild pancreatitis is only 0% to 1%. Treatment principles of necrotizing pancreatitis and the role of surgery are still controversial. Despite surgery being effective for infected pancreatic necrosis, it carries the risk of long-term endocrine and exocrine deficiency and a morbidity and mortality rate of between 10% to 40%. Considering high morbidity and mortality rates of operative necrosectomy, minimally invasive strategies are being explored by gastrointestinal surgeons, radiologists, and gastroenterologists. Since 1999, several other minimally invasive surgical, endoscopic, and radiologic approaches to drain and debride pancreatic necrosis have been described. In patients who do not improve after technically adequate drainage, necrosectomy should be performed. When minimal invasive management is unsuccessful or necrosis has spread to locations not accessible by endoscopy, open abdominal surgery is recommended. Additionally, surgery is recognized as a major determinant of outcomes for acute pancreatitis, and there is general agreement that patients should undergo surgery in the late phase of the disease. It is important to consider multidisciplinary management, considering the clinical situation and the comorbidity of the patient, as well as the surgeons experience. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
Effects of ozone therapy and taurine on ischemia/reperfusion-induced testicular injury in a rat testicular torsion model
(2014) Aydos, Tolga Resat; Basar, Mehmet Murad; Kul, Oguz; Atmaca, Hasan Tank; Uzunalioglu, Tuba; Kisa, Ucler; Efe, Oguzhan Ekin; 25539540
Background/aim: To investigate the effect of ozone and/or taurine treatment comparatively on testicular damage due to ischemia/reperfusion (I/R) injury in an experimental torsion model in rats. Materials and methods: Adult Wistar rats with and without torsion/detorsion were used. In order to monitor the effect of ozone and/or taurine treatment on testicular damage due to I/R injury, following histopathological investigation apoptotic indexes were scored by TUNEL method. Moreover, tumor necrosis factor receptor 1 (TNFR1), caspase 3, caspase 8, endothelial nitric oxide synthase (eNOS), tumor necrosis factor alpha (TNF alpha), and cytochrome C immunostainings were performed and the levels of malondialdehyde, glutathione peroxidase, superoxide dismutase, catalase, total sulthydryl, and nitric oxide were determined in the testicular tissue. Results: Intraperitoneal ozone and/or taurine treatment prevented both histopathological damage and increase in the apoptotic index. Torsion did not exert an effect on the levels of TNFa and cytochrome C. Ozone and/or taurine treatment prevented increases in TNFR1, caspase 3, and caspase 8. The level of oxidative stress markers was unchanged. The increases in NO level and eNOS expression were prevented by ozone and/or taurine treatment in I/R groups. Conclusion: Using ozone therapy and/or taurine before reperfusion may be a solution for germ cell degeneration resulting from testicular torsion and related infertility.
Is it Accurate to Separate Glucose-6-Phosphate Dehydrogenase Activity in Neonatal Hyperbilirubinemia as Deficient and Normal?
(2014) Kilicdag, Hasan; Gokmen, Zeynel; Ozkiraz, Servet; Gulcan, Hande; Tarcan, Aylin
Background: The aim of this study was to investigate glucose 6-phosphate dehydrogenase (G6PD) activity in term and late preterm babies with severe neonatal hyperbilirubinemia and its relationship to the severity and treatment of this disorder, regardless of level of G6PD activity (deficient/normal). Methods: A total of 529 term and late preterm (>= 35 weeks) infants (228 female, 301 male) who were diagnosed with severe hyperbilirubinemia were included in this study. In each case, serum was collected to evaluate blood group, direct Coombs' test, complete blood cell count, total and direct bilirubin, thyroid-stimulating hormone, and G6PD activity. A partial correlation analysis was carried out to assess the relationship between G6PD activity and total bilirubin levels. Results: A significant correlation was found between the severity of hyperbilirubinemia and G6PD activity in both males and females. Male neonates who had G6PD levels <12 U/g Hb required more phototherapy time than neonates who had G6PD levels >12 U/g Hb; and female neonates who had G6PD levels <16 U/g Hb required more phototherapy time than neonates who had G6PD levels >= 16 U/g Hb (p < 0.0001). When we analyzed only breastfed infants, a significant difference also emerged in both sexes. Decreased G6PD activity was associated with increased phototherapy time and the need for exchange transfusion. Conclusion: Routine checks of G6PD level in hyperbilirubinemic neonates are very important in providing proper medical management to prevent bilirubin-induced neurological dysfunction.
Effects of different orthodontic adhesives and resin removal techniques on enamel color alteration
(2014) Boncuk, Yasemen; Cehreli, Zafer C.; Polat-Ozsoy, Omur
Objective: To investigate the color alterations in enamel following the use of different orthodontic bonding resins and adhesive residue removal burs. Materials and Methods: Metal brackets were bonded to extracted human premolars (n = 175) by using an etch-and-rinse adhesive system, a self-etch adhesive system (SEP), or a resin-modified glass ionomer cement (RMGIC). After 24 hours of photoaging, the brackets were removed and the adhesive residue on the tooth surfaces was cleaned with either a tungsten carbide bur or a Stainbuster bur. Tooth colors were measured with a spectrophotometer at baseline, after adhesive removal, and after additional photoaging. Color evaluation was made, and color differences induced by photoaging were calculated. Statistical evaluation was made using the Kruskal-Wallis test and the Mann-Whitney U-test, with Bonferroni correction. Results: All specimens showed discoloration at varying levels. The highest color change was observed in the etch-and-rinse adhesive/tungsten carbide bur group. When the etch-and-rinse and self-etch adhesives were used, adhesive-remnant removal with Stainbuster burs resulted in significantly lower discoloration. The type of bur did not affect the extent of enamel discoloration in the RMGIC group. Conclusions: Orthodontic treatment alters the original color of enamel, and both the adhesive system and the resin-removal methods are responsible for this change. When brackets are bonded with the etch-and-rinse system or the SEP, cleaning the adhesive residuals with Stainbuster burs is recommended for minimal change. RMGIC can be safely cleaned with tungsten carbide burs.
Skin Care in Organ Transplant Patients Europe Meeting Report from Annual Meeting, Leiden, The Netherlands, 15-18 May 2014
(2014) Hofbauer, Guenther F.L.; Seckin, Deniz; Gjersvik, Petter; Bavinck, Jan Nico Bouwes; 25381765
A rare cause of circulatory shock
(2014) Altin, Cihan; İzmir, Arzu; Osmanoglu, Sevda; Gezmis, Esin; Sagduyu, Afsin; 25233504
Delayed failure of rectovaginal fistula embolization with Amplatzer vascular plug 2
(2014) Kilickesmez, Ozgur; Andic, Cagatay; Oguzkurt, Levent; 25323835
Thyroid volume in patients with glucose metabolism disorders
(2014) Duran, Ayse Ocak; Anil, Cuneyd; Gursoy, Alptekin; Nar, Asli; Inanc, Mevlude; Bozkurt, Oktay; Tutuncu, Neslihan Bascil; 25465604
Objective: Thyroid volume and the prevalence of thyroid nodules are higher in patients with insulin resistance. A relationship between thyroid volume and glucose metabolism disorders (GMD) has not as yet been clarified. The present retrospective study aimed to investigate the association between GMD and thyroid volume. Subjects and methods: We investigated the data of 2,630 patients who were evaluated for thyroid biopsy in our hospital. The study population included 602 patients with GMD, 554 patients with diabetes mellitus (DM) and 1,474 patients with normal glucose metabolism as a control group. We obtained the levels of serum thyroid stimulating hormone (TSH) and the thyroid volumes of those patients retrospectively. Results: The median ages for the control group, GMD group and DM group were 55 (15-91) years, 60 (27-97) years, and 65 (27-91) years respectively and there was a statistically significant difference between the groups with regard to age and gender (p < 0.001). Levels of TSH were similar in all groups. The median total thyroid volumes for patients with DM and GMD were significantly higher than that of the control group [22.5 (3-202) mL, 20.2 (4-190) mL, and 19.2 (3-168) mL respectively, p <= 0.001 for all parameters]. Also the median total thyroid volume for patients with DM was significantly higher than that of the GMD group (p < 0.001). According to the correlation analysis, thyroid volume was significantly correlated with age (r = 0.92, p < 0.001) and TSH (r = 0.435, p < 0.001). Age, gender, TSH levels, GMD and DM diagnosis were independently correlated with thyroid volume. Conclusion: The thyroid gland is one of the target tissues of metabolic disorders. We reported a positive correlation between GMD/type 2 DM and thyroid volume. Further controlled, prospective, randomized studies on this subject are required to gain more information.
Inferior Vena Cava Oxygen Saturation during the First Three Postnatal Days in Preterm Newborns with and without Patent Ductus Arteriosus
(2014) Yapakci, Ece; Ecevit, Ayse; Ince, Deniz Anuk; Gokdemir, Mahmut; Tekindal, M. Agah; Gulcan, Hande; Tarcan, Aylin; 25337418
Background: Inferior vena cava (IVC) oxygen saturation as an indicator of mixed venous oxygenation may be valuable for understanding postnatal adaptations in newborn infants. It is unknown how this parameter progresses in critically ill premature infants. Aims: To investigate IVC oxygen saturation during the first three days of life in preterm infants with and without patent ductus arteriosus (PDA). Study Design: Case-control study. Methods: Twenty-seven preterm infants were admitted to the Neonatal Intensive Care. Preterm infants with umbilical venous catheterization were included in the study. Six umbilical venous blood gas values were obtained from each infant during the first 72 hours of life. Preterm infants in the study were divided into two groups. Haemodynamically significant PDA was diagnosed by echocardiography in 11 (41%) infants before the 72nd hour of life in the study group and ibuprofen treatment was started, whereas 16 (59%) infants who didn't have haemodynamically significant PDA were included in the control group. Results: In the entire group, the highest value of mean IVC oxygen saturation was 79.9% at the first measurement and the lowest was 64.8% at the 72nd hour. Inferior vena cava oxygen saturations were significantly different between the study and control groups. Posthoc analysis revealed that the first and 36th hour measurements made the difference (p=0.01). Conclusion: Inferior vena cava oxygen saturation was found to be significantly different between preterm infants with and without PDA. Further studies are needed to understand the effect of foetal shunts on venous oxygenation during postnatal adaptation in newborn infants.