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Öğe ALPHA-GALACTOSIDASE A DEFICIENCY AMONG TURKISH MALE HEMODIALYSIS PATIENTS(Academic Press Inc Elsevier Science, 2009) Ucar, S. Kalkan; Sozmen, E. Yildirim; Duman, S.; Babci, A.; Coker, M.Öğe ALPHA-GALACTOSIDASE A DEFICIENCY AMONG TURKISH MALE HEMODIALYSIS PATIENTS(Academic Press Inc Elsevier Science, 2009) Ucar, S. Kalkan; Sozmen, E. Yildirim; Duman, S.; Babci, A.; Coker, M.Öğe Assessment of geriatric patients at the internal medicine intensive care unit (IMICU)(Springer, 2013) Sahin, S.; Timur, O.; Alp, A.; Oven, B.; Duman, S.; Akcicek, F.Background: The aim of this study was to evaluate the general characteristics of geriatric patients hospitalized at the internal medicine intensive care unit (IMICU). Methods: All patients aged above 65 years and admitted to the intensive care unit of the internal medicine department at Ege University Hospital October 2010 to February 2011 were included in the study. Files of the patients were accessed retrospectively and the following information was recorded: age, gender, main cause of intensive care admission, number of chronic diseases, laboratory results, drug use and other therapeutic procedures, length of stay, outcomes in terms of survival and mortality. Secondary outcomes were defined to compare patients admitted to the intensive care unit from the emergency ward with those transferred from the internal medicine wards. Results: The total number of patients admitted to the internal medicine intensive care unit during the study period was 357, of whom 171(47.99%) were aged above 65 years, a mean age of 74 +/- 6.6 years without any statistically significant difference between gender (P = 0.859). Days of hospitalization at the intensive care were 15.7 +/- 4.8, in patient mortality was found to be 17.7%, The mean number of chronic diseases per patient was 2.2 +/- 1.3. and the most frequent chronic diseases were arterial hypertension 57%. The most frequent pathology of the patients was found to be renal dysfunction 38.6% (n = 66), followed by anaemia 38.0% (n = 65) and liver dysfunction 11.7% (n = 20). The ratio of haemodialysis (HD) was found as 11.7%. When the patients were assessed in terms of invasive interventions by grouping them into those admitted from the emergency unit and those transferring from the internal medicine departments, it was seen that foley, intravenous catheterization, nasogastric tube insertion and HD were significantly higher for the patients admitted from the emergency unit. Mortality rate was found to be significantly higher for same group (44% versus 17, P < 0.001). Conclusion: The proportion of elderly in the intensive care unit is increasing. In the present study renal dysfunction is the most common organ failure. Infection seems to be one of the common problems in IMICU. Organ failure and invasive intervention needs are high in elderly patient admitted from the emergency ward to intensive care. (c) 2012 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.Öğe Assessment of geriatric patients at the internal medicine intensive care unit (IMICU)(Springer, 2013) Sahin, S.; Timur, O.; Alp, A.; Oven, B.; Duman, S.; Akcicek, F.Background: The aim of this study was to evaluate the general characteristics of geriatric patients hospitalized at the internal medicine intensive care unit (IMICU). Methods: All patients aged above 65 years and admitted to the intensive care unit of the internal medicine department at Ege University Hospital October 2010 to February 2011 were included in the study. Files of the patients were accessed retrospectively and the following information was recorded: age, gender, main cause of intensive care admission, number of chronic diseases, laboratory results, drug use and other therapeutic procedures, length of stay, outcomes in terms of survival and mortality. Secondary outcomes were defined to compare patients admitted to the intensive care unit from the emergency ward with those transferred from the internal medicine wards. Results: The total number of patients admitted to the internal medicine intensive care unit during the study period was 357, of whom 171(47.99%) were aged above 65 years, a mean age of 74 +/- 6.6 years without any statistically significant difference between gender (P = 0.859). Days of hospitalization at the intensive care were 15.7 +/- 4.8, in patient mortality was found to be 17.7%, The mean number of chronic diseases per patient was 2.2 +/- 1.3. and the most frequent chronic diseases were arterial hypertension 57%. The most frequent pathology of the patients was found to be renal dysfunction 38.6% (n = 66), followed by anaemia 38.0% (n = 65) and liver dysfunction 11.7% (n = 20). The ratio of haemodialysis (HD) was found as 11.7%. When the patients were assessed in terms of invasive interventions by grouping them into those admitted from the emergency unit and those transferring from the internal medicine departments, it was seen that foley, intravenous catheterization, nasogastric tube insertion and HD were significantly higher for the patients admitted from the emergency unit. Mortality rate was found to be significantly higher for same group (44% versus 17, P < 0.001). Conclusion: The proportion of elderly in the intensive care unit is increasing. In the present study renal dysfunction is the most common organ failure. Infection seems to be one of the common problems in IMICU. Organ failure and invasive intervention needs are high in elderly patient admitted from the emergency ward to intensive care. (c) 2012 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.Öğe Bioimpedance and echocardiography used interchangeably in volume comparison of dialysis patients(Lithographia, 2012) Hur, E.; Yildiz, G.; Kose, Budak S.; Kokturk, F.; Musayev, O.; Gungor, O.; Magden, K.; Yildirim, I; Duman, S.; Ok, E.Background: Euvolemia is a major issue in chronic kidney disease. The present study compares cardiac condition and volume status in peritoneal dialysis (PD) and hemodialysis (HD) patients and points out importance of volume control. Methods: From a single-center center, 81 PD and 89 HD patients were enrolled. Echocardiography and body composition analysis using bioimpedance spectroscopy (BIS) technique were performed. Overhydration (OH) and extracellular water (ECW) in liters and OH/ECW % were used as volume indices. Results: Patients were younger (47.6 +/- 14. 5 and 53.1 +/- 11.8 years, p< 0.05), daily urine volume higher (1068 +/- 926 vs 290 +/- 444 ml, p <0.001) and dialysis vintage was shorter (30.1 +/- 18.6 vs 53.6 +/- 35.4 months, p<0.001), systolic blood pressure was lower (127.5 +/- 15.4 vs 140.3 +/- 18.9 mmHg, p<0.001) in PD than HD group respectively. Volume indices were (OH, OH/ECW %, ECW/height, ECW to Intracellular Water ratios (E/I) (p< 0.05)) significantly higher in HD patients compared to PD patients. Over all 66 of 170 patients (39%) had OH/ECW % <5 and OH/ECW % ratio was positively correlated with Left atrium index (R-2:0.105, p<0.05). Interventricular septum diameter and Left ventricular mass index (1.41 +/- 0.24 and 159.6 +/- 48.2 vs. 1.27 +/- 0.17 cm and 115.8 +/- 37 g/m(2), p<0.001) were increased in HD than in PD group. After multivariate adjustment OH/ECW increased with: HD and diabetic patients. LVH increased with: HD group, OH/ECW (%) and SBP significantly. Conclusion: Overhydration was more common among HD. Excess fluid may lead adverse effect in organ functions especially cardiac condition. This indicates that the current clinical and technical tools to achieve euvolemia are insufficient and that an additional tool, such as BIS, could be useful in the diagnosis of overhydration.Öğe Can Palosuran, as an Urotensin II Receptor Antagonist, Protect Kidneys from Calcineurins(Lippincott Williams & Wilkins, 2012) Bozkurt, D.; Olukman, M.; Hur, E.; Bicak, S.; Tuna, S.; Sen, S.; Akcicek, F.; Duman, S.Öğe EFFECTS OF ALOE VERA LEAF GEL EXTRACT ON RAT PERITONITIS MODEL(Springer, 2009) Sonmez, F.; Altincik, A.; Yenisey, C.; Duman, S.; Can, A.; Akev, N.; Kirdar, S.; Semerci, N.; Sezak, M.; Girisgen, I.Öğe EFFECTS OF ALOE VERA LEAF GEL EXTRACT ON RAT PERITONITIS MODEL(Springer, 2009) Sonmez, F.; Altincik, A.; Yenisey, C.; Duman, S.; Can, A.; Akev, N.; Kirdar, S.; Semerci, N.; Sezak, M.; Girisgen, I.Öğe Impedance ratio: a novel marker and a powerful predictor of mortality in hemodialysis patients(Springer, 2016) Demirci, C.; Asci, G.; Demirci, M. S.; Ozkahya, M.; Toz, H.; Duman, S.; Sipahi, S.; Erten, S.; Tanrisev, M.; Ok, E.Impedance ratio (Imp-R) obtained by multifrequency bioimpedance analysis (BIA) has been shown to be associated with volume and nutrition status. In this prospective study, the predictive role of Imp-R for mortality in hemodialysis (HD) patients was investigated. Multifrequency (5-50-100-200 kHz) BIA was applied to 493 prevalent HD patients in March-April 2006. Imp-R was defined as the ratio of 200-5 kHz impedance values. Demographical, clinical and laboratory data at the time of the analysis were recorded. All-cause and cardiovascular (CV) mortality were assessed during 3 years of follow-up. Mean age was 57.7 +/- 13.9 years, HD duration 52.1 +/- 42.6 months and prevalence of diabetes 21.7 %. Imp-R was negatively correlated with nutritional markers including albumin, creatinine and hemoglobin levels. In addition, there was a positive correlation between Imp-R and age, ratio of extracellular water to total body water and high-sensitive C-reactive protein. Over a mean follow-up period of 27.9 +/- 11.1 months, 93 deaths (52 from CV reasons) were observed. In the multivariate analysis, Imp-R was significantly associated with all-cause and CV mortality after adjustments [HR 1.13, 95 % CI (1.04-1.23); p = 0.004 and HR 1.15, 95 % CI (1.03-1.27); p = 0.01, respectively]. The risk of all-cause mortality was 3.4 times higher in the fourth quartile of Imp-R (> 83.5 %) compared to the first Imp-R quartile (< 78.8 %) as reference. Cutoff value of Imp-R for all-cause mortality was 82.0 % with a sensitivity of 65.5 % and specificity of 64 %. Impedance ratio measured by multifrequency in standardized conditions BIA is an independent and powerful predictor of both all-cause and CV mortality in hemodialysis patients.Öğe Non steroidal antiinflammatory drugs may be harmful to normal kidneys: experimental surgery model(Lithographia, 2012) Hur, E.; Duman, E.; Bozkurt, D.; Sozmen, E.; Sen, S.; Taskin, H.; Timur, O.; Kaya, S. O.; Duman, S.Background and aim: The exact effect of analgesics on normal kidneys is not known yet. We aimed to evaluate the impression of non steroidal antiinflammatory drugs (NSAID) used post-operatively on kidneys, in rat (tracheotomy) model. Methods: Twenty-five non-uremic male wistar albino rats were included. For 18 rats, tracheotomy was performed and divided into two groups. First group, NSAID (diclofenac 10 mg/kg/day intramuscular (im)) (NSAID, n=8); second group isotonic (im)(Control, n=10) were administered for a week. For third group (Histological control, n=7) in order to evaluate normal histology neither surgery nor medication were applied. At the end (7th day), 24 hours urine collected then, blood samples were taken by intracardiac punction and were sacrified. One of the kidneys fixed for histological evaluation, the other was preserved for the measurements of tissue enzyme levels. Lipid peroxidation products and antioxidant enzyme levels were measured both from plasma and renal tissues. Histologically inflammation, regeneration, degeneration assessed semiquatitativelly and immunohistochemical dyes were applied. Results: Hemoglobin thiobarbituric acid reactive substance level indicating the increase of lipid peroxidation in NSAID group was higher than control group (673 +/- 204 vs.373 +/- 27nmol/gHb respectively, p>0.05). Superoxide dismutase (one of the antioxidant enzymes responsible for reduction of reactive oxygen substances) and serum nitrate levels were lower in NSAID groups (700 +/- 68 vs.1371 +/- 164U/gHb and 26 +/- 4.4 vs.50.8 +/- 6.8 mu mol/mL respectively, p<0.05). Although tissue levels were parallel to plasma levels but the difference wasn't significant. In histological assessment degeneration was present only in NSAID group (1.3 +/- 0.6 vs.0.0 +/- 0, p<0.05). Inflammation were lower than the control group (0.8 +/- 0.4 vs.1.2 +/- 0.2, p>0.05). Cyclooxygenase-2 expression was disappeared in NSAID group. Conclusions: NSAIDs mostly used post-operatively for analgesia, may cause unfavorable effects on kidneys by oxidative stress. Hippokratia. 2012; 16 (2): 160-165Öğe Prevalence and risk factors of sarcopenia in elderly nursing home residents(Springer, 2015) Tasar, P. T.; Sahin, S.; Karaman, E.; Ulusoy, M. G.; Duman, S.; Berdeli, A.; Akcicek, F.Introduction: Several studies have attempted to define the diagnostic criteria of the geriatric syndrome sarcopenia. Studies of sarcopenia prevalence in Turkey are limited; one reason for this is the absence of standard diagnostic reference values. The aim of this study was to investigate the prevalence of sarcopenia and its influencing factors in the local elderly nursing home residents in accordance with the EWGSOP consensus report. Materials and methods: The study included a total of 211 nursing home residents. Anthropometric measurements, muscle mass, muscle strength and physical performance were examined. Muscle mass of the nursing home residents was compared to an 18-45-year-old healthy control group. Descriptive values for numerical variables are given as mean, standard deviation; categorical variables are shown as frequency and percentage. Results: A total of 211 nursing home residents were included in the study. The average age was 77.30 +/- 7.20; the participants were 58.8% women and 37.4% young-old. The prevalence of sarcopenia in Turkish nursing home residents was found to be 33.6%. Among sarcopenic participants, 32.4% were women and 67.6% were men. In our study, sarcopenia was more prevalent in men, the young-old, and patients with Parkinson's or chronic obstructive lung disease, while sarcopenia was seen less in obese patients. No relationship was found between the Barthel index and sarcopenia. Conclusions: Sarcopenia prevalence was 33.6% when the diagnostic criteria described by the EWGSOP were used. Sarcopenia prevalence was higher in men and the young-old age groups. Sarcopenia was more frequent in nursing home residents with malnutrition or risk of malnutrition. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.Öğe Prevalence and risk factors of sarcopenia in elderly nursing home residents(Springer, 2015) Tasar, P. T.; Sahin, S.; Karaman, E.; Ulusoy, M. G.; Duman, S.; Berdeli, A.; Akcicek, F.Introduction: Several studies have attempted to define the diagnostic criteria of the geriatric syndrome sarcopenia. Studies of sarcopenia prevalence in Turkey are limited; one reason for this is the absence of standard diagnostic reference values. The aim of this study was to investigate the prevalence of sarcopenia and its influencing factors in the local elderly nursing home residents in accordance with the EWGSOP consensus report. Materials and methods: The study included a total of 211 nursing home residents. Anthropometric measurements, muscle mass, muscle strength and physical performance were examined. Muscle mass of the nursing home residents was compared to an 18-45-year-old healthy control group. Descriptive values for numerical variables are given as mean, standard deviation; categorical variables are shown as frequency and percentage. Results: A total of 211 nursing home residents were included in the study. The average age was 77.30 +/- 7.20; the participants were 58.8% women and 37.4% young-old. The prevalence of sarcopenia in Turkish nursing home residents was found to be 33.6%. Among sarcopenic participants, 32.4% were women and 67.6% were men. In our study, sarcopenia was more prevalent in men, the young-old, and patients with Parkinson's or chronic obstructive lung disease, while sarcopenia was seen less in obese patients. No relationship was found between the Barthel index and sarcopenia. Conclusions: Sarcopenia prevalence was 33.6% when the diagnostic criteria described by the EWGSOP were used. Sarcopenia prevalence was higher in men and the young-old age groups. Sarcopenia was more frequent in nursing home residents with malnutrition or risk of malnutrition. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.Öğe Prevalence and risk factors of sarcopenia in elderly nursing home residents(Springer, 2015) Tasar, P. T.; Sahin, S.; Karaman, E.; Ulusoy, M. G.; Duman, S.; Berdeli, A.; Akcicek, F.Introduction: Several studies have attempted to define the diagnostic criteria of the geriatric syndrome sarcopenia. Studies of sarcopenia prevalence in Turkey are limited; one reason for this is the absence of standard diagnostic reference values. The aim of this study was to investigate the prevalence of sarcopenia and its influencing factors in the local elderly nursing home residents in accordance with the EWGSOP consensus report. Materials and methods: The study included a total of 211 nursing home residents. Anthropometric measurements, muscle mass, muscle strength and physical performance were examined. Muscle mass of the nursing home residents was compared to an 18-45-year-old healthy control group. Descriptive values for numerical variables are given as mean, standard deviation; categorical variables are shown as frequency and percentage. Results: A total of 211 nursing home residents were included in the study. The average age was 77.30 +/- 7.20; the participants were 58.8% women and 37.4% young-old. The prevalence of sarcopenia in Turkish nursing home residents was found to be 33.6%. Among sarcopenic participants, 32.4% were women and 67.6% were men. In our study, sarcopenia was more prevalent in men, the young-old, and patients with Parkinson's or chronic obstructive lung disease, while sarcopenia was seen less in obese patients. No relationship was found between the Barthel index and sarcopenia. Conclusions: Sarcopenia prevalence was 33.6% when the diagnostic criteria described by the EWGSOP were used. Sarcopenia prevalence was higher in men and the young-old age groups. Sarcopenia was more frequent in nursing home residents with malnutrition or risk of malnutrition. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.Öğe Reduced Activity of von Willebrand Factor after Flow-Diverting Stent Implantation for Intracranial Aneurysms: A Link to Acquired von Willebrand Disease?(Amer Soc Neuroradiology, 2020) Oran, I.; Cinar, C.; Bozkaya, H.; Parildar, M.; Duman, S.BACKGROUND AND PURPOSE: Vascular devices generating high shear stress can cause type 2A acquired von Willebrand disease, which is characterized by low von Willebrand factor activity accompanied by hemorrhagic complications. the braided mesh structure of flow-diverting stents with a relatively small strut size can create abnormally high shear stress while arterial blood flows through the stent struts into the aneurysm, and flow-diverting stent may be associated with reduced von Willebrand factor activity. MATERIALS AND METHODS: Aneurysmal morphologic parameters and patient data were examined retrospectively among patients who had an unruptured intracranial aneurysm treated with a flow-diverting stent. the RISTOtest (test for whole blood ristocetin-induced platelet aggregation) for von Willebrand factor activity, as well as tests for aspirin and clopidogrel/prasugrel effectiveness, were performed immediately before the endovascular procedure and 24?hours later by multiple electrode aggregometry. RESULTS: A total of 39 patients with 56 aneurysms were recruited, and statistical analyses were performed in 32 patents with 49 aneurysms. Compared with the baseline values, von Willebrand factor activity was reduced in 16 patients but increased in 23 patients. Aneurysmal variables (eg, neck area, volume, volume-to-neck area ratio, size ratio, and morphologic index) clearly distinguished patients with reduced von Willebrand factor activity from those with nonreduced von Willebrand factor activity. the receiver operating characteristic curve showed that the morphologic index and volume had the highest discriminative power, with an area under the curve of 0.99. CONCLUSIONS: in high-volume/large-neck aneurysms, flow-diverting stent implantation can cause reduced von Willebrand factor activity, which may be linked causally to acquired von Willebrand disease.Öğe TELBIVUDIN: MORE CAUTION IS NEEDED IN LIVER TRANSPLANT RECIPIENTS(Elsevier Science Bv, 2014) Karasu, Z.; Turan, I.; Duman, S.; Sozbilen, M.; Gunsar, F.; Ersoz, G.; Akarca, U.Öğe Telomerase activators derived from Astragalus sapogenins via biotransformation with the recently discovered endophytic fungus Camarosporium laburnicola(Georg Thieme Verlag Kg, 2019) Kucuksolak, M.; Ekiz, G.; Duman, S.; Yilmaz, S.; Ballar-Kirmizibayrak, P.; Bedir, E.[No abstract available]Öğe Trimethylaminuria (fish malodour syndrome) in chronic renal failure(Lithographia, 2012) Hur, E.; Gungor, O.; Bozkurt, D.; Bozgul, S. M. K.; Dusunur, F.; Caliskan, H.; Berdeli, A.; Akcicek, F.; Basci, A.; Duman, S.Trimethylaminuria (fish malodour syndrome) is a rare genetic metabolic disorder presented with a body odour which smells like a decaying fish. This odour is highly objectionable, that can be destructive for the social, and work life of the patient. Trimethylamine is derived from the intestinal bacterial degradation of foods that are rich of choline and carnitine. Trimethylamine is normally oxidised by the liver to odourless trimethylamine N-oxide which is excreted in the urine, so, uremia may worsen the condition. Uremia itself may cause more or less unpleasant odour. Poor uremic control may worsen the odour. We reported this case because Trimethylaminuria is not usually considered in the differential diagnosis of malodour in chronic renal failure and it is the first case that shown the association with Trimethylaminuria and chronic renal failure in the literature. Hippokratia. 2012; 16 (1): 83-85
