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Öğe Hyperhomocysteinaemia in Behçet's disease(2001) Aksu K.; Turgan N.; Oksel F.; Keser G.; Özmen D.; Kitapçioglu G.; Gümüşdiş O.; Bayindir G.; Doganavşargil E.Objective. Arterial and venous thrombosis are among the clinical features of Behçet's disease (BD), the pathogenesis of which is not completely understood. In this study, we investigated whether hyperhomocysteinaemia, being a well known risk factor for thrombosis, is also a contributive risk factor for the arterial and venous thrombosis of BD. Methods. Eighty-four patients fulfilling the criteria of the International Study Group for Behçet's Disease (54 males, 30 females, mean age 36 ± 9 yr) were enrolled. All the patients were carefully screened for a history of venous thrombosis and were separated into two groups with respect to thrombosis history. Thirty-six healthy individuals (23 males, 13 females), matched for age and sex with the BD group, were included as a negative control group. Patients were excluded if they had any condition that might affect plasma homocysteine concentration. As methotrexate (MTX) causes hyperhomocysteinaemia, we also included 29 rheumatoid arthritis patients (five males, 24 females) receiving MTX weekly. Fasting plasma homocysteine concentrations were measured by high-performance liquid chromatography. The data were analysed with the ?2 test and Student's t-test. Results. The highest homocysteine concentrations were found in the MTX group (17.5 ± 5.3 µmol/l). Mean plasma homocysteine concentrations in BD patients were significantly higher than in the healthy controls (11.5 ± 5.3 vs 8.8 ± 3.1 µmol/l, P < 0.001). Among BD patients with a history of thrombosis, 20 of 31 (64%) had hyperhomocysteinaemia, and this was significantly higher than in those without thrombosis (9%). On the other hand, there was no significant difference between patients with non-thrombotic BD and healthy controls (P > 0.05). In patients with thrombosis, we found no correlation between the duration of the post-thrombotic period and homocysteine concentration. Among all the variables investigated, only hyperhomocysteinaemia was found to be related to thrombosis. Conclusion. Hyperhomocysteinaemia may be assumed to be an independent risk factor for venous thrombosis in BD. Unlike the factor V Leiden mutation, hyperhomocysteinaemia is a correctable risk factor. This finding might lead to new avenues in the prophylaxis of thrombosis in BD.Öğe Low prevalence of erosive esophagitis and Barrett esophagus in a tertiary referral center in Turkey(2008) Bayrakçi B.; Kasap E.; Kitapçioglu G.; Bor S.Background/aims: The purpose of upper gastrointestinal endoscopy in gastroesophageal reflux disease is to detect the complications; both Barrett esophagus and erosive esophagitis are common in developed countries. We aimed to investigate the ratio of esophageal complications in gastroesophageal reflux disease and the relationship between reflux symptoms and erosive esophagitis. Methods: Six hundred forty-five consecutive adult patients presenting to the Reflux Outpatient Clinic were evaluated prospectively. One hundred sixty patients who underwent upper gastrointestinal endoscopy and who complained of heartburn or regurgitation occurring at least weekly were selected. The complaints and general features of patients were queried via a detailed questionnaire. Results: Twenty-seven patients (17%) had endoscopic evidence of erosive esophagitis. Barrett esophagus was found in 3 patients (2%). Neither esophageal stricture nor adenocarcinoma was found. Esophagitis was low grade (grades A and B) in 25 of the 27 (92%) with erosive esophagitis. Patients with erosive esophagitis consumed less alcohol than patients with non-erosive reflux disease. No difference was found between the severity of symptoms in patients with erosive esophagitis and non-erosive reflux disease. Conclusions: Barrett esophagus and erosive esophagitis were less common compared to the literature although the study was conducted in a tertiary reference center for gastroesophageal reflux disease. The presence of severe symptoms in gastroesophageal reflux disease is not an indication for upper gastrointestinal endoscopy. No impact of Helicobacter pylori on the severity of esophagitis or symptoms was shown.Öğe A pregnant woman's feelings "I have fears" [Gebe bir kadinin hissettikleri "korkuyorum"](2007) Yanikkerem E.; Sevil Ü.; Yüksel D.; Kitapçioglu G.Pregnancy is an event that changes many perspectives of a woman's life. During pregnancy a woman prepares men tally for permanent life changes and new responsibilities after the birth of the infant. One in five pregnant women experiences moderate fear of childbirth, and 6-13 % of pregnant women experience severe, disabling fear of child birth. In this study 26 weeks pregnant woman's negative and positive experiences were examined. The counseling and support about pregnancy, giving birth and postnatal infant care should be effective.Öğe Turkish health professional's attitude toward Euthanasia(2008) Karadeniz G.; Yanikkerem E.; Pirinçci E.; Erdem R.; Esen A.; Kitapçioglu G.The cross-sectional study was administrated between April and September 2006. Participants are doctors, nurses, and midwives. Between these dates we met only 750 health staff (doctor, nurse, and midwife). Six hundred thirty-two of them responded to our questionnaire, 122 of them were in Manisa city, and 510 of them in Erciyes. We sought to identify variables that contribute to euthanasia attitude, including demographics, in order to demonstrate Turkish doctors, nurses', and midwives' attitudes toward euthanasia and to compare their attitudes in this regard. The data was collected by a two-part questionnaire. The first part included questions about the health personnel; the second part comprised the euthanasia (Medical Staff's Attitude toward Euthanasia) scale. The scale was developed by the researcher to measure the attitude of healthy staff euthanasia. The SPSS was used to analyze the data. Student t-test, ANOVA, Mann Whitney U, and Kruskal Wallis were used to evaluate the data. The p value 0.05 (95% confidence interval) was accepted as significant. In our study, professional groups are compared with all the factors but there is a significant difference only between social cost and professional groups. © 2008, Baywood Publishing Co., Inc.
