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Kisa PT, Hismi BO, Kocabey M, Gulten ZA, Huddam B, Ekinci S, Bozkaya E, Akar H, Pekuz OKK, Aydogan A, Arslan N. Experience with cascade screening: A comprehensive family pedigree analysis of two index patients with Fabry disease. Am J Med Genet A 2024:e63552. [PMID: 38372211 DOI: 10.1002/ajmg.a.63552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 01/06/2024] [Accepted: 01/15/2024] [Indexed: 02/20/2024]
Abstract
The wide range of clinical symptoms observed in patients with Fabry disease (FD) often leads to delays in diagnosis and initiation of treatment. Delayed initiation of therapy may result in end-organ damage, such as chronic renal failure, hypertrophic cardiomyopathy, and stroke. Although some tools are available to identify undiagnosed patients, new comprehensive screening methods are needed. In this study, the outcomes of the cascade screening applied to three index cases with FD from 2 familes were investigated. In the pedigree analysis, 280 individuals were included; out of them, 131 individuals underwent genetic testing and cascade screening for FD. During the screening program, a total of 45 individuals were diagnosed, with a diagnostic ratio of 1:15. The average age at diagnosis for all individuals was 30.9 ± 17.7 years, and %25 were pediatric cases (mean age 9.5 ± 5.9 years). Thirty affected relatives were diagnosed from the two index cases in Family 1 and 15 individuals were diagnosed from one index case in Family 2. There were 13 consanguineous marriages observed among 2 pedigres, in two both spouses were affected, leading to two homozygous affected daughters in one couple. In regions where there is a high prevalence of consanguineous marriages, implementing the cascade screening approach to identify all individuals at risk can be beneficial for patients with FD, specifically women and children.
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Affiliation(s)
- Pelin Teke Kisa
- Department of Pediatrics, Division of Inherited Metabolic Diseases, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Burcu Ozturk Hismi
- Department of Pediatrics, Division of Inherited Metabolic Diseases, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Kocabey
- Department of Medical Genetics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Zumrut Arslan Gulten
- Department of Pediatrics, Division of Inherited Metabolic Diseases, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Bulent Huddam
- Department of Nephrology, Department of Internal Medicine, Mugla Sitki Kocman University, Faculty of Medicine, Mugla, Turkey
| | - Selim Ekinci
- Department of Cardiology, Health Sciences University Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Evrim Bozkaya
- Department of Nephrology, Denizli State Hospital, Denizli, Turkey
| | - Harun Akar
- Department of Internal Medicine, Health Sciences University Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Ozge K Karalar Pekuz
- Department of Pediatrics, Division of Inherited Metabolic Diseases, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Ayca Aydogan
- Department of Pediatrics, Division of Inherited Metabolic Diseases, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Nur Arslan
- Department of Pediatrics, Division of Inherited Metabolic Diseases, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
- Izmir Biomedicine and Genome Center, Izmir, Turkey
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Bacaksız EG, Hakim GD, Yıldız C, Akar H. Which is the best choice for Helicobacter pylori eradication? Dual therapy or quadruple therapy? Prz Gastroenterol 2022; 17:138-145. [PMID: 35664028 PMCID: PMC9165331 DOI: 10.5114/pg.2022.116373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/21/2021] [Indexed: 11/21/2022]
Abstract
Introduction Standard triple therapy used to be the first-line treatment for Helicobacter pylori (Hp) infection, but today it is a treatment regimen with a low eradication rate due to increasing resistance to the antibiotics included in the triple therapy.Aim: To compare the eradication rates of dual treatment regimens and quadruple treatment regimens. Material and methods Patients over 18 years of age, who were indicated to undergo upper gastrointestinal system (GIS) endoscopy for any reason, had their upper gastrointestinal endoscopy performed, were detected to have Hp as a result of the histopathological evaluation of the biopsy material, and in whom eradication control was also performed by histopathological evaluation, were included in the study. These patients were divided into 4 groups, each containing 50 people. Results Considering the eradication rates of Hp-positive patients according to different treatment options, 78% (n = 39) of the patients in Group 1 were eradicated after the treatment while 66% (n = 33) of the patients in Group 3, 58% of the patients in Group 2 (n = 29), and 58% (n = 29) of the patients in Group 4 had Hp negative results after treatment. When high-dose dual treatments were compared, the highest eradication rate was obtained with rabeprazole, but no statistically significant difference was detected (p = 0.11). Conclusions This is the first study to include dual therapies consisting of 3 different PPIs at the same time. The low eradication rates obtained in our study suggest that the determination of individualized treatment strategies in which CYP2C19 polymorphism is detected may result in higher eradication rates.
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Affiliation(s)
- Elif Gram Bacaksız
- Department of Internal Medicine, Tepecik Research and Training Hospital, Izmir, Turkey
| | - Gozde Dervis Hakim
- Department of Gastroenterology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Coskun Yıldız
- Department of Gastroenterology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Harun Akar
- Department of Internal Medicine, Tepecik Research and Training Hospital, Izmir, Turkey
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Yarkıcı H, Derviş Hakim G, Arı EM, Akar H, Çolak A. Can Ischemia Modified Albumin (IMA) Levels Be a Predictor of Acute Pancreatitis? Turk J Gastroenterol 2021; 32:327-335. [PMID: 34160363 DOI: 10.5152/tjg.2021.191054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND We aimed to evaluate the value of ischemia modified albumin (IMA) as a prognostic marker in acute pancreatitis (AP) patients, determine whether it is efficient in assessing the disease severity or not, and to estimate the correlation between IMA and the inflammatory markers, prognostic markers and scoring systems routinely used in clinical practice. METHODS 100 adult patients (18 years and older) who have been hospitalized and evaluated with AP diagnosis in Tepecik Training and Research Hospital,, Department of Gastroenterology, between April 1, 2017 and April 1, 2018 have been enrolled in the study. Patients have been stratified disease etiology (biliary or non-biliary). The non-biliary group has been divided into subgroups as alcoholic, lipemic, or idiopathic. Disease severity has been categorized as mild, moderate, or severe pancreatitis according to the Atlanta classification. Ranson, Harmless Acute Pancreatitis Score (HAPS), Bedside Severity Index for Acute Pancreatitis (BISAP) scores have been determined for each patient. Patients have been grouped as necrotizing or edematous according to the Atlanta classification. RESULTS According to our findings, IMA has been found to be correlated with disease severity, Ranson and BISAP scores, and procalcitonin levels. We have observed that some laboratory parameters including blood urea nitrogen and hematocrit levels and HAPS scoring system are not correlated to IMA. CONCLUSION Our study is the first study to compare multiple prognostic factors with IMA in AP patients. In our study, the association between IMA and AP has been evaluated in the context of prognostic scoring and disease severity.
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Affiliation(s)
- Hakan Yarkıcı
- Department of Internal Medicine, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Gözde Derviş Hakim
- Department of Gastroenterology, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Elif Merve Arı
- Department of Biochemistry, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Harun Akar
- Department of Internal Medicine, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Ayfer Çolak
- Department of Biochemistry, Tepecik Training and Research Hospital, İzmir, Turkey
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Akay S, Binicier OB, Cakir E, Akar H. Serum iron and vitamin B 12 deficiency could indicate celiac disease by flexible spectral imaging color enhancement. ACTA ACUST UNITED AC 2020; 66:818-823. [PMID: 32696864 DOI: 10.1590/1806-9282.66.6.818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 02/26/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Celiac disease (CeD) is an autoimmune disease that can be delayed in diagnosis due to the presence of atypical and asymptomatic cases in adulthood. Herein we aimed to study the frequency of CeD and evaluate whether magnified endoscopy and magnified/FICE (flexible spectral imaging color enhancement) techniques contribute to the diagnosis in patients with serum iron and vitamin B12 deficiency. METHODS We evaluated 50 adult patients (10 males and 40 females) who had serum iron and vitamin B12 deficiency, prospectively. All the patients had undergone upper gastrointestinal system endoscopy by the same endoscopist. The second part of the duodenum was evaluated with white light, magnified, and magnified/FICE endoscopy. Biopsy specimens were evaluated by the same pathologist. The specimens diagnosed as CeD were classified according to the Modified Marsh-Oberhuber criteria. RESULTS 10 of 50 patients (20%) were diagnosed as CeD. The average age was 41±11 years (20-67 years). Thirty percent of CeD diagnosed patients had typical CeD symptoms. Six of 10 patients (60%) who were diagnosed as CeD had typical endoscopic images under white lighted endoscopy. All of these 10 patients (100%) showed villous irregularity, partial villous atrophy, or total villous atrophy consistent with CeD with magnified and magnified/FICE endoscopy. CONCLUSION The practical use of magnified/FICE endoscopy allows us to differentiate mucosal abnormalities of the duodenum and minimize false-negative results that indicate normal mucosal findings with conventional endoscopy.
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Affiliation(s)
- Seval Akay
- Department of Internal Medicine, Kutahya Health Sciences University, Kutahya, Turkey
| | - Omer Burcak Binicier
- Department of Gastroenterology, Tepecik Education and Research Hospital, Izmir, Turkey
| | - Ebru Cakir
- Departament of Pathology, Katip Celebi University, Izmir, Turkey
| | - Harun Akar
- Department of Internal Medicine, Tepecik Education and Research Hospital, Izmir, Turkey
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Ates K, Öztemel A, Nergizoglu G, Ertürk S, Keven K, Akar H, Karatan O, Duman N, Erbay B, Ertug AE. Peritoneal Protein Losses Do Not Have a Significant Impact on Nutritional Status in CAPD Patients. Perit Dial Int 2020. [DOI: 10.1177/089686080102100516] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kenan Ates
- Department of Nephrology Ankara University School of Medicine Ankara, Turkey
| | - Aysegül Öztemel
- Department of Nephrology Ankara University School of Medicine Ankara, Turkey
| | - Gökhan Nergizoglu
- Department of Nephrology Ankara University School of Medicine Ankara, Turkey
| | - Sehsuvar Ertürk
- Department of Nephrology Ankara University School of Medicine Ankara, Turkey
| | - Kenan Keven
- Department of Nephrology Ankara University School of Medicine Ankara, Turkey
| | - Harun Akar
- Department of Nephrology Ankara University School of Medicine Ankara, Turkey
| | - Oktay Karatan
- Department of Nephrology Ankara University School of Medicine Ankara, Turkey
| | - Neval Duman
- Department of Nephrology Ankara University School of Medicine Ankara, Turkey
| | - Bülent Erbay
- Department of Nephrology Ankara University School of Medicine Ankara, Turkey
| | - A. Ergün Ertug
- Department of Nephrology Ankara University School of Medicine Ankara, Turkey
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Ersan S, Liv F, Demiral Sezer S, Colak H, Alp A, Ceylan C, Akar H. Therapeutic Plasma Exchange in Renal Diseases: A Three-Year Retrospective Analysis. Turk J Nephrol 2019. [DOI: 10.5152/turkjnephrol.2019.3360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Altın Z, Atabay Y, Özer S, Karakoyun M, Ekmekçi S, Yürekli EY, Akar H. Primary intestinal lymphangiectasia and a review of the current literature. Turk J Gastroenterol 2019; 29:714-716. [PMID: 30381277 DOI: 10.5152/tjg.2018.18596] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Zeynep Altın
- Department of Internal Medicine, Health Sciences University, İzmir Tepecik Health Practice and Research Center, İzmir, Turkey
| | - Yusuf Atabay
- Department of Internal Medicine, Health Sciences University, İzmir Tepecik Health Practice and Research Center, İzmir, Turkey
| | - Serhat Özer
- Department of Gastroenterology, Artvin State Hospital, Artvin, Turkey
| | - Miray Karakoyun
- Department of Pediatric Gastroenterology, Health Sciences University, İzmir Tepecik Health Practice and Research Center, İzmir, Turkey
| | - Sümeyye Ekmekçi
- Pathology Clinics, Health Sciences University, İzmir Tepecik Health Practice and Research Center, İzmir, Turkey
| | - Ezgi Yıldız Yürekli
- Department of Internal Medicine, Health Sciences University, İzmir Tepecik Health Practice and Research Center, İzmir, Turkey
| | - Harun Akar
- Department of Internal Medicine, Health Sciences University, İzmir Tepecik Health Practice and Research Center, İzmir, Turkey
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Günalay S, Öztürk YK, Akar H, Mergen H. The relationship between malnutrition and quality of life in haemodialysis and peritoneal dialysis patients. ACTA ACUST UNITED AC 2019; 64:845-852. [PMID: 30673007 DOI: 10.1590/1806-9282.64.09.845] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 01/06/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND One of the most important factors affecting the quality of life of chronic kidney disease (CKD) patients is nutrition. Prevention of malnutrition increases patients' quality and length of life. In this study, we aimed to determine the frequency of malnutrition, quality of life, and the relationship between them in patients with end-stage renal disease (ESRD). METHOD The study was conducted with a total of 60 CKD patients including 50 haemodialysis patients and 10 peritoneal dialysis patients. Patients' data associated with socio-demographics, body mass index (BMI), waist circumference, triceps skin-fold thickness (TSFT), pre-dialysis systolic and diastolic blood pressure, Kt/V and urea reduction ratio (URR) values, laboratory parameters, Mini-Nutritional Assessment-Short Form (MNA-SF) and European Quality of Life 5-Dimensions (EQ5D) scale were recorded. FINDINGS Of the total 60 patients; 27 were male (45%), 33 were female (55%), 83.3% were receiving haemodialysis treatment (HD), and 16.7% were receiving peritoneal dialysis treatment (PD). The mean MNA-SF score was 10.4 ± 2.8 in the HD group and 10.5 ± 2.9 in the PD group; there was no difference between the scores of the HD and PD groups. The mean EQ5D score was 0.60 ± 0.29 in the HD group and 0.68 ± 0.33 in the PD group, no significant difference was found between the HD group and the PD group. The quality of life was found lower in malnourished group (p=0.001). CONCLUSION The quality of life needs to be increased by early diagnosis and treatment of malnutrition in patients at risk.
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Affiliation(s)
- Serkan Günalay
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center - Department of Family Medicine, Yenişehir/İzmir, Turkey
| | - Yasemin Kiliç Öztürk
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center - Department of Family Medicine, Yenişehir/İzmir, Turkey
| | - Harun Akar
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center, Department of Internal Medicine, Izmir,Turkey
| | - Haluk Mergen
- . University of Health Sciences, Izmir Tepecik Health Research and Application Center - Department of Family Medicine, Yenişehir/İzmir, Turkey
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Cakiroglu U, Akdam H, Eryilmaz U, Akgullu C, Ozbek O, Büyüköztürk AK, Akar H, Yenicerioglu Y. The effect of hemodialysis on the body composition and cardiovascular disease markers in recently diagnosed end stage renal disease patients. ACTA ACUST UNITED AC 2018; 64:354-360. [PMID: 30133615 DOI: 10.1590/1806-9282.64.04.354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 12/14/2017] [Indexed: 11/22/2022]
Abstract
AIM Uremic toxins and excess fluid contributes to increased cardiovascular (CV) risk. We aimed to determine the body fluid status in patients who are just starting hemodialysis (HD) and to determine the effects of excess fluid removed by HD on the CV system. METHODS A total of 52 patients with chronic kidney disease (CKD) who had just started HD were included. Before the HD, the left atrial diameter was measured, the volumes were calculated, the pulse wave velocity (PWV) and the augmentation index (AIx) were measured, the bioimpedance analysis (BIA) was performed, the blood was taken for brain natriuretic peptide (BNP). When patients reached their dry weight with HD, the same measurements were repeated. RESULTS Measurements were made to determine the volume status, and all parameters except the fat tissue index decreased significantly after HD. With the removal of fluid by HD, there was an average weight reduction of 4.38 kilograms. Positive correlations between PWV and age and cardiothoracic ratio (CTR) before HD were determined. Negative correlations were found between PWV and lean tissue mass (LTM) and intracellular water (ICW) before HD. At the end of the last HD, PWV was positively correlated with age, CTR, central pulse pressure Correlation between pulse wave velocity and LTI was negative. CONCLUSIONS HD significantly improves PWV in patients reaching dry weight. Reduction of fluid excess by ultrafiltration in HD patients may reduce CV mortality by reducing arterial stiffness.
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Affiliation(s)
- Umut Cakiroglu
- Adnan Menderes University, Medical School, Department of Nephrology, Aydın/Turkey
| | - Hakan Akdam
- Adnan Menderes University, Medical School, Department of Nephrology, Aydın/Turkey
| | - Ufuk Eryilmaz
- Adnan Menderes University, Medical School, Department of Cardiology, Aydın/Turkey
| | - Cagdas Akgullu
- Adnan Menderes University, Medical School, Department of Cardiology, Aydın/Turkey
| | - Ozgul Ozbek
- Adnan Menderes University, Medical School, Department of Nephrology, Aydın/Turkey
| | | | - Harun Akar
- University of Health Sciences, Izmir Tepecik Health Research and Application Center, Department of Internal Medicine, Izmir/Turkey
| | - Yavuz Yenicerioglu
- Adnan Menderes University, Medical School, Department of Nephrology, Aydın/Turkey
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10
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Ugur M, Atabay Y, Akar H. Hemophilia patient with difficulty in blood pressure control. Sanamed 2018. [DOI: 10.24125/sanamed.v13i3.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Hypertension prevalence is increasing in patients with hemophilia. Therefore it is an important complication of hemophilia. We aimed to present a 49-year-old male patient with hemophilia-A who presented with acute hemarthrosis and hypertensive attack. The patient was treated in our internal medicine clinic.
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Komac A, Gram E, Gulec F, Akar H. Secret Underlying Unexplained Abdominal Pain, Neurological Symptoms and Intermittent Hypertension: Acute Intermittent Porphyria. BANTAO Journal 2017. [DOI: 10.1515/bj-2017-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
A 21-year-old female patient with abdominal pain, vomiting and constipation was admitted to the hospital with the possible diagnosis of diabetic ketoacidosis. Due to increased abdominal pain and constipation the patient underwent a surgery with the diagnosis of ileus. However, no pathological findings were found in the abdominal organs apart from serous fluid in the abdominal cavity. The patient became hypertensive, tachycardic and had an episode of seizures postoperatively. Neurological manifestations with unexplained abdominal pain indicated a diagnosis of acute intermittent porphyria (AIP). Acute intermittent porphyria diagnosis is based on elevated urinary δ-aminolevulinic acid (ALA) and porphobilinogen (PBG) levels as well as hydroxymethylbilane synthase (HMBS) IVS13-2 A>G heterozygous mutation. Familial Mediterranean Fever (FMF) gene mutations were not confirmed. Porphyria should be considered in the differential diagnosis of patients with recurrent abdominal pain, neurological symptoms and lack of FMF gene polymorphism.
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Affiliation(s)
- Andac Komac
- University of Health Sciences, Izmir Tepecik Health Research and Application Center, Department of Internal Medicine, Izmir , Turkey
| | - Elif Gram
- University of Health Sciences, Izmir Tepecik Health Research and Application Center, Department of Internal Medicine, Izmir , Turkey
| | - Feray Gulec
- University of Health Sciences, Izmir Tepecik Health Research and Application Center, Department of Neurology, Izmir , Turkey
| | - Harun Akar
- University of Health Sciences, Izmir Tepecik Health Research and Application Center, Department of Internal Medicine, Izmir , Turkey
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12
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Caliskan LB, Karadeniz T, Ekmekci S, Avcioglu BY, Tanrisev M, Kaypak MA, Yarkici H, Ceylan C, Akar H. A Case of Multiple Myeloma Diagnosed by Renal Biopsy. BANTAO Journal 2017. [DOI: 10.1515/bj-2016-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Multiple myeloma is a malignant disease that results in the proliferation of a single plasma cell clone. The clinical manifestations are anemia, bone pain, bone fractures, hypercalcemia, hypergammaglobulinemia, increased erythrocyte sedimentation rate, rouleaux formation on the peripheral blood smear and rarely increased serum viscosity. Rarely cast nephropathy associated with acute renal failure may be the first finding of multiple myeloma. We report a clinical case of a 44-year-old female patient who presented with acute renal failure due to cast nephropathy without myeloma’s typical clinical and laboratory findings. In the clinical case presented here, we highlight that multiple myeloma can be presented with acute renal failure and without any other typical symptoms.
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Affiliation(s)
- Lutfiye Bilge Caliskan
- Department of Internal Medicine, Tepecik Educational and Research Hospital, Izmir , Turkey
| | - Tugba Karadeniz
- Department of Pathology, Tepecik Educational and Research Hospital, Izmir , Turkey
| | - Sumeyye Ekmekci
- Department of Pathology, Tepecik Educational and Research Hospital, Izmir , Turkey
| | - Banu Yilmaz Avcioglu
- Department of Nephrology, Tepecik Educational and Research Hospital, Izmir , Turkey
| | - Mehmet Tanrisev
- Department of Nephrology, Tepecik Educational and Research Hospital, Izmir , Turkey
| | - Muhammed Ali Kaypak
- Department of Internal Medicine, Tepecik Educational and Research Hospital, Izmir , Turkey
| | - Hakan Yarkici
- Department of Internal Medicine, Tepecik Educational and Research Hospital, Izmir , Turkey
| | - Cengiz Ceylan
- Department of Hematology, Tepecik Educational and Research Hospital, Izmir , Turkey
| | - Harun Akar
- Department of Internal Medicine, Tepecik Educational and Research Hospital, Izmir , Turkey
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13
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Erkul B, Engin B, Ugur MC, Ekmekci S, Akay E, Akar H. Psoas as an Unusual and Overlooked Place for a Metastatic Tumor. BANTAO Journal 2017. [DOI: 10.1515/bj-2016-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
We report a case of a 60-year-old hemodialysis patient who clinically mimicked psoas abscess, which was subsequently proven to be from metastatic disease seconddary to uroepithelial tumor. The patient presented with 3 weeks history of fever, weight loss and back pain. Computer tomography (CT) scan of abdomen and pelvis revealed psoas muscle infiltration not amenable to drainage by interventional radiology. Careful history to provide additional clues to the diagnosis is of paramount importance in this condition.
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Affiliation(s)
- Bengu Erkul
- Department of Internal Medicine, Tepecik Education and Research Hospital, Izmir , Turkey
| | - Bahar Engin
- Department of Internal Medicine, Tepecik Education and Research Hospital, Izmir , Turkey
| | - Mehmet Can Ugur
- Izmir Tepecik Education and Training Hospital, Department of Internal Medicine, Izmir , Turkey
| | - Sumeyye Ekmekci
- Department of Pathology, Tepecik Education and Research Hospital, Izmir , Turkey
| | - Emrah Akay
- Department of Radiology, Tepecik Education and Research Hospital, Izmir , Turkey
| | - Harun Akar
- Department of Internal Medicine, Tepecik Education and Research Hospital, Izmir , Turkey
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14
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Elyigit F, Akar H, Soyaltın UE, Ekinci F. A Rare Outcome Induced by Metformin Intoxication: Severe Lactic Acidosis and Hepatotoxicity. BANTAO Journal 2017. [DOI: 10.1515/bj-2016-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Metformin is a widely used oral anti-diabetic agent that decreases insulin resistance. Lactic acidosis rarely develops with this medication. Metformin-induced hepatotoxicity has been rarely reported in the literature. We describe a patient, who presented with lactic acidosis and hepatotoxicity after ingestion of 40 pills of metformin in order to commit suicide. The most important treatment step in patients with metformin-associated lactic acidosis (MALA) is high-volume hemodialysis and hemofiltration.
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Affiliation(s)
- Faruk Elyigit
- Izmir Tepecik Training and Research Hospital, Department of Internal Medicine, Izmir , Turkey
| | - Harun Akar
- Izmir Tepecik Training and Research Hospital, Department of Internal Medicine, Izmir , Turkey
| | - Utku Erdem Soyaltın
- Izmir Tepecik Training and Research Hospital, Department of Internal Medicine, Izmir , Turkey
| | - Ferhat Ekinci
- Izmir Tepecik Training and Research Hospital, Department of Internal Medicine, Izmir , Turkey
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15
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Yildirim TD, Ugur MC, Soyaltin UE, Akar H. Bardet Biedel Syndrome: a Rare Cause of Chronic Kidney Disease. BANTAO Journal 2017. [DOI: 10.1515/bj-2016-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Bardet Biedl syndrome (BBS) is characterized by obesity, retinitis pigmentosa, hypogonadism, mental retardation and polydactyly. Additionally, renal, cardiac and neurological manifestations may be seen. We report a case of BBS with chronic kidney disease (CKD) at the age of 43.
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Affiliation(s)
| | - Mehmet Can Ugur
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir , Turkey
| | - Utku Erdem Soyaltin
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir , Turkey
| | - Harun Akar
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir , Turkey
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16
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Prokaeva T, Akar H, Spencer B, Havasi A, Cui H, O'Hara CJ, Gursky O, Leszyk J, Steffen M, Browning S, Rosenberg A, Connors LH. Hereditary Renal Amyloidosis Associated With a Novel Apolipoprotein A-II Variant. Kidney Int Rep 2017; 2:1223-1232. [PMID: 29270531 PMCID: PMC5733886 DOI: 10.1016/j.ekir.2017.07.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/18/2017] [Accepted: 07/24/2017] [Indexed: 10/25/2022] Open
Affiliation(s)
- Tatiana Prokaeva
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Harun Akar
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Brian Spencer
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Andrea Havasi
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Nephrology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Haili Cui
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Carl J O'Hara
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Olga Gursky
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Physiology and Biophysics, Boston University School of Medicine, Boston, Massachusetts, USA
| | - John Leszyk
- Proteomics and Mass Spectrometry Facility and Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Martin Steffen
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Sabrina Browning
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Allison Rosenberg
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Lawreen H Connors
- Amyloidosis Center, Boston University School of Medicine, Boston, Massachusetts, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
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17
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Taşkıran E, Yaşar Taş M, Hışmi B, Demet İnce F, Ekmekçi S, Solakoğlu Kahraman D, Akar H. A late diagnosis of alkaptonuria in an elderly patient. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2016.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Ekinci F, Soyaltin U, Kutbay Y, Yaşar H, Demirci Yıldırım T, Akar H. JAK2 V617F MUTATION SCANNING IN PATIENTS WITH ADRENAL INCIDENTALOMA. Acta Endocrinol (Buchar) 2017; 13:150-153. [PMID: 31149166 PMCID: PMC6516447 DOI: 10.4183/aeb.2017.150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Adrenal incidentaloma are lesions which are stated incidentally by imaging methods when there is no suspicion of any disease in adrenal gland. Inappropriate Jak2 signaling causes some solid and hematological malignancies. But the Jak2 mutation has not been previously evaluated with regard to adrenal tumors. In this study, we aimed to positivity of the Jak2 mutation in patients with non functioning adrenal incidentaloma (NFAI). METHODS 45 (38 female-7 male) patients, who were followed due to NFAI at Tepecik Training and Research Hospital, Department of Endocrinology and Internal Medicine between February 2014 and March 2015, and 45 (31 female-14 male) healthy controls were included in the study. RESULTS The average age was 54.02±11.7 years and 38 patients were female, 7 were men. All patients underwent the following analyses for excluding a functioning adrenal mass, overnight dexamethasone suppression test, 24 hour urinary metanephrine and normetanephrine, plasma aldosterone/ renin activity ratio. Jak2 mutation of the patients who were diagnosed as NFAI was all negative. CONCLUSION We could not identify the JAK2 gene mutation positivity in any sample. Since other possible mechanisms may throw fresh light on the etiology of adrenal incidentaloma, further clinical studies are needed on this subject.
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Affiliation(s)
- F. Ekinci
- Tepecik Training and Research Hospital - Dept. of Internal Medicine, Izmir, Turkey
| | - U.E. Soyaltin
- Tepecik Training and Research Hospital - Dept. of Internal Medicine, Izmir, Turkey
| | - Y.B. Kutbay
- Tepecik Training and Research Hospital - Dept. of Genetics, Izmir, Turkey
| | - H.Y. Yaşar
- Tepecik Training and Research Hospital - Dept. of Endocrine, Izmir, Turkey
| | - T. Demirci Yıldırım
- Tepecik Training and Research Hospital - Dept. of Internal Medicine, Izmir, Turkey
| | - H. Akar
- Tepecik Training and Research Hospital - Dept. of Internal Medicine, Izmir, Turkey
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19
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Ekinci F, Soyaltın UE, Akar H, Ugur MC, Ersoy E, Komac A, Yildirım TD. Idiopatic Systemic Capillary Leak Syndrome Treated Successfully with High-Dose Intravenous Immunoglobulins. BANTAO Journal 2016. [DOI: 10.1515/bj-2015-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Idiopathic systemic capillary leak syndrome (ISCLS) is characterized by a triad of hypotension, hemoconcentration and hypoalbuminemia due to a shift of intravascular fluid and albumin to the extravascular area. We describe a hypovolemic patient with hemoconcentration and hypoalbuminemia who was successfully treated with high-dose intravenous immunoglobulins (IVIG). The purpose of this case report is to discuss the clinical management of idiopathic systemic capillary leak syndrome on the background of relevant literature review.
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Affiliation(s)
- Ferhat Ekinci
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Utku Erdem Soyaltın
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Harun Akar
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Mehmet Can Ugur
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Ercan Ersoy
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Andac Komac
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
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20
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Yeniçerioğlu Y, Akdam H, Dursun B, Alp A, Sağlam Eyiler F, Akın D, Gün Y, Hüddam B, Batmazoğlu M, Gibyeli Genek D, Pirinççi S, Ersoy İR, Üzüm A, Soypaçacı Z, Tanrısev M, Çolak H, Demiral Sezer S, Bozkurt G, Akyıldız UO, Akyüz Ünsal Aİ, Ünübol M, Uslu M, Eryılmaz U, Günel C, Meteoğlu İ, Yavaşoğlu İ, Ünsal A, Akar H, Okyay P. Screening Fabry's disease in chronic kidney disease patients not on dialysis: a multicenter study. Ren Fail 2016; 39:104-111. [PMID: 27832731 PMCID: PMC6014365 DOI: 10.1080/0886022x.2016.1254656] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Fabry's disease is an X-linked inherited, rare, progressive, lysosomal storage disorder, affecting multiple organs due to the deficient activity of α-galactosidase A (α-Gal A) enzyme. The prevalence has been reported to be 0.15-1% in hemodialysis patients; however, the information on the prevalence in chronic kidney disease not on dialysis is lacking. This study aimed to determine the prevalence of Fabry's disease in chronic kidney disease. METHODS The patients older than 18 years, enclosing KDIGO 2012 chronic kidney disease definitions, not on dialysis, were enrolled. Dried blood spots on Guthrie papers were used to analyze α-Gal A enzyme and genetic analysis was performed in individuals with enzyme activity ≤1.2 μmol/L/h. RESULTS A total of 1453 chronic kidney disease patients not on dialysis from seven clinics in Turkey were screened. The mean age of the study population was 59.3 ± 15.9 years. 45.6% of patients were female. The creatinine clearance of 77.3% of patients was below 60 mL/min/1.73 m2, 8.4% had proteinuria, and 2.5% had isolated microscopic hematuria. The mean value of patients' α-Gal A enzyme was detected as 2.93 ± 1.92 μmol/L/h. 152 patients had low levels of α-Gal A enzyme activity (≤1.2 μmol/L/h). In mutation analysis, A143T and D313Y variants were disclosed in three male patients. The prevalence of Fabry's disease in chronic kidney disease not on dialysis was found to be 0.2% (0.4% in male, 0.0% in female). CONCLUSION Fabry's disease should be considered in the differential diagnosis of chronic kidney disease with unknown etiology even in the absence of symptoms and signs suggestive of Fabry's disease.
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Affiliation(s)
- Yavuz Yeniçerioğlu
- a Department of Internal Medicine, Division of Nephrology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - Hakan Akdam
- a Department of Internal Medicine, Division of Nephrology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - Belda Dursun
- b Department of Internal Medicine, Division of Nephrology , Pamukkale University School of Medicine , Denizli , Turkey
| | - Alper Alp
- a Department of Internal Medicine, Division of Nephrology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | | | - Davut Akın
- d Denizli State Hospital Nephrology , Denizli , Turkey
| | - Yelda Gün
- c Aydın State Hospital Nephrology , Aydın , Turkey
| | - Bülent Hüddam
- e Department of Nephrology , Muğla Sıtkı Koçman University Education and Research Hospital , Muğla , Turkey
| | | | - Dilek Gibyeli Genek
- e Department of Nephrology , Muğla Sıtkı Koçman University Education and Research Hospital , Muğla , Turkey
| | - Serhat Pirinççi
- f Department of Public Health , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - İsmail Rıfkı Ersoy
- g Department of Nephrology, İzmir Katip Çelebi University Education and Research Hospital , İzmir , Turkey
| | - Atilla Üzüm
- g Department of Nephrology, İzmir Katip Çelebi University Education and Research Hospital , İzmir , Turkey
| | - Zeki Soypaçacı
- g Department of Nephrology, İzmir Katip Çelebi University Education and Research Hospital , İzmir , Turkey
| | - Mehmet Tanrısev
- h Department of Nephrology , İzmir Tepecik Education and Research Hospital Internal Medicine , İzmir , Turkey
| | - Hülya Çolak
- h Department of Nephrology , İzmir Tepecik Education and Research Hospital Internal Medicine , İzmir , Turkey
| | - Sibel Demiral Sezer
- h Department of Nephrology , İzmir Tepecik Education and Research Hospital Internal Medicine , İzmir , Turkey
| | - Gökay Bozkurt
- i Department of Genetics , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - Utku Oğan Akyıldız
- j Department of Neurology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - Ayşe İpek Akyüz Ünsal
- k Department of Ophthalmology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - Mustafa Ünübol
- l Department of Internal Medicine, Division of Endocrinology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - Meltem Uslu
- m Department of Dermatology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - Ufuk Eryılmaz
- n Department of Cardiology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - Ceren Günel
- o Department of Otorhinolaryngology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - İbrahim Meteoğlu
- p Department of Pathology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - İrfan Yavaşoğlu
- q Department of Internal Medicine, Division of Hematology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - Alparslan Ünsal
- r Department of Radiology , Adnan Menderes University School of Medicine , Aydın , Turkey
| | - Harun Akar
- h Department of Nephrology , İzmir Tepecik Education and Research Hospital Internal Medicine , İzmir , Turkey
| | - Pınar Okyay
- f Department of Public Health , Adnan Menderes University School of Medicine , Aydın , Turkey
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Affiliation(s)
- Seval Akay
- Department of Internal Medicine, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Süleyman Günay
- Department of Gastroenterology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Ömer Burçak Binicier
- Department of Gastroenterology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Zehra Betül Paköz
- Department of Gastroenterology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Harun Akar
- Department of Internal Medicine, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
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22
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Taşkıran E, Erbaş O, Yiğittürk G, Meral A, Akar H, Taşkıran D. Exogenously administered adenosine attenuates renal damage in streptozotocin-induced diabetic rats. Ren Fail 2016; 38:1276-82. [PMID: 27418253 DOI: 10.1080/0886022x.2016.1207054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Diabetic nephropathy (DNP) is one of the most serious complications of diabetes mellitus (DM). In the present study, we investigated the potential of adenosine as a therapeutic candidate for preventing DNP. METHODS Twenty-one adult male rats were included in the study. Fourteen rats were administered a single dose of 60 mg/kg streptozotocin (STZ) to induce diabetes. Seven rats served as normal control group. Diabetic rats were randomly divided into two groups: one group was treated with 1 mL/kg saline/day (DM + saline) and the other group was treated with 5 mg/kg/day adenosine (DM + adenosine) for 6 weeks. After 6 weeks, biochemical parameters including urea, creatinine, blood urea nitrogen (BUN), kidney injury molecule-1 (KIM-1) and tumor necrosis factor-α (TNF-α) were measured in plasma samples. Also, kidneys were removed for histopathological assessment. RESULTS Both of plasma KIM-1 and TNF-α levels were significantly higher in DM + saline group compared to controls. However, treatment of diabetic rats with adenosine significantly decreased the plasma KIM-1 and TNF-α levels compared to DM + saline group. Significant histopathological changes were observed in diabetic rats whereas adenosine treatment effectively prevented these changes. CONCLUSIONS The findings of the present study suggest that adenosine may be a useful therapeutic agent for preventing DNP.
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Affiliation(s)
- Emin Taşkıran
- a Department of Internal Medicine , Tepecik Training and Research Hospital , Izmir , Turkey
| | - Oytun Erbaş
- b School of Medicine Department of Physiology , İstanbul Bilim University , Istanbul , Turkey
| | - Gürkan Yiğittürk
- c School of Medicine Department of Histology and Embryology , Ege University , Izmir , Turkey
| | - Ayfer Meral
- d School of Medicine Department of Biochemistry , Dumlupinar University , Kütahya , Turkey
| | - Harun Akar
- a Department of Internal Medicine , Tepecik Training and Research Hospital , Izmir , Turkey
| | - Dilek Taşkıran
- e School of Medicine Department of Physiology , Ege University , Izmir , Turkey
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23
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Komac A, Yildirim M, Gunay S, Kaypak M, Yildiz C, Akar H. Successful management of idiopathic gastric necrosis in a geriatric patient. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2016.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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24
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Taskiran E, Erbas O, Yigitturk G, Taskiran D, Akar H. MP074NEPHROPROTECTIVE EFFECT OF ADENOSINE IN STREPTOZOTOCIN INDUCED DIABETIC RATS. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw183.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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25
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Torun D, Arslan M, Akar H, Karaer K, Ünay B, Tunca Y. Central nervous system abnormalities and psychomotor retardation in a girl with a 15.4-MB deletion of 14q12→q21.2 and a 550-KB deletion of 18p11.23: microarray delineation of an unbalanced chromosome rearrangement and a literature review. Genet Couns 2016; 27:165-176. [PMID: 29485807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This paper describes the presence of a 15.4 Mb deletion of 14q12→q21.2 and a 550-KB deletion of 18p11.23 in a patient with an apparently balanced translocation between chromosomes 14 and 18 [t( 14; 18) (ql2; pi 11)]. The patient had developmental delay, truncal hypotonia, hyperreflexia and spasticity of the lower extremities, prominent forehead, fullness of the periorbital region, hypertelorism, upslanted palpebral fissures, systagmus, a depressed nasal bridge, down-turned conrners of the mouth, a prominent philtrum, thin upper lip, pointed chin, and deep palmar creases. Cranial MRI revealed agenesis of the corpus callosum, diffuse cerebral atrophy, and enlargement of the third and lateral ventricles. Here, we review and compare published cases with proximal 14q deletions to establish a genotype-phenotype correlation according to the deleted regions involving the 14q12, 14q13, 14q21, and 14q22q23. We also examined the literature to find cases with deleted regions overlapping the deletion in our patient to establish a clinical spectrum in proximal 14q deletions.
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Soyaltin UE, Ekinci F, Ayatan D, Turemis C, Yildirim M, Akar H. Successful Continuation of Peritoneal Dialysis after "Sweet" Hydrothorax. BANTAO Journal 2015. [DOI: 10.1515/bj-2015-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
A 44-year-old woman with end-stage renal disease presented with dyspnea on exertion and a vague chest pain about two weeks after commencing continuous ambulatory peritoneal dialysis (CAPD) four months ago. A chest x-ray revealed massive unilateral right-sided pleural effusion. Laboratory analysis of the effusion revealed low protein and lactate dehydrogenase but elevated glucose levels were consistent with transudate and pleuroperitoneal leakage. Pleural glucose concentration was much higher than patients’ serum glucose concentration, which was suggestive of "sweet" hydrothorax because of this high glucose concentration. It is advisable to keep this condition in mind among the differenttial diagnoses of hydrothorax in patients on CAPD.
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Affiliation(s)
- Utku Erdem Soyaltin
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Ferhat Ekinci
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Denizhan Ayatan
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Cihangir Turemis
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Mustafa Yildirim
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Harun Akar
- Tepecik Education and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
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Ugur MC, Ekinci F, Soyaltın UE, Akar H. Contrast Induced Nephropathy in Patients with Acute Coronary Syndrome. BANTAO Journal 2015. [DOI: 10.1515/bj-2015-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction. Contrast-induced nephropathy (CIN) is associated with increased morbidity and mortality after percutaneous coronary intervention (PCI). On the other hand, CIN is a serious complication in patients with diabetes or renal impairment undergoing percutaneous coronary intervention (PCI). CIN after PCI may be associated with prolonged hospitalization, increased rates of kidney injury, and short- and long-term mortality. Factors that have been associated with CIN include: diabetes mellitus, congestive heart failure, recent acute myfocardial infarction, cardiogenic shock, and pre-existing renal impairment. In this study, we investigated contrast nephropathy development after coronary angiography (CAG) in patients presenting with acute coronary syndrome, who were hospitalized initially in the Coronary Care Unit and subsequenttly referred to the Internal Medicine Clinic in a tertiary care hospital.
Methods. We’ve analyzed 335 patients’ records retrospectively in 1 year that were followed-up with acute coronary syndrome (ACS) in the Coronary Care Unit (CCU) and transferred to the Internal Medicine Clinic (IMC). The following parameters were evaluated: age, gender, chronic disease and drug history, biochemical values evaluated before hospitalization to CCU, ejection fraction (EF) and left atrium diameter (LA), with or without previous CAG; values of serum creatinine (sCr) levels before CAG and after 48 hours. Values of p <0.05 were considered to be significant.
Results. 126 of 335 patients were female and 209 were male. The average age of patients was 64.2 years. 122 patients used angiotensin converting enzyme inhibitor (ACEI), 54 patients used furosemide. CIN development rate of CAG patients was 22.8% (n=54). There was no significant relationship with age, gender and chronic disease history in CIN patients. When laboratory findings were compared, there was no significant relationship except for potassium value before CAG. However, potassium values were significantly higher in CIN patients (p=0.001). When drug usage of patients was compared, 48.1% (n=26) of CIN patients used ACEI and there was a significant relationship between ACEI use and CIN development (p=0.026).
Conclusions. CIN development rate was 22.8% and it was relatively high when compared with literature data. Awareness about contrast nephropathy develepment risk and assessment of risk factors before the procedure should be increased in our Center.
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Affiliation(s)
- Mehmet Can Ugur
- Tepecik Training and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
- Department of Internal Medicine, Tepecik Education and Training
| | - Ferhat Ekinci
- Tepecik Training and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Utku Erdem Soyaltın
- Tepecik Training and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
| | - Harun Akar
- Tepecik Training and Research Hospital, Internal Medicine Clinic, Izmir, Turkey
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Kahraman A, Akdam H, Alp A, Huyut MA, Akgullu C, Balaban T, Dinleyen F, Topcu A, Gelmez H, Atakan N, Akar H, Yenicerioglu Y. Impact of Interdialytic Weight Gain (IDWG) on Nutritional Parameters, Cardiovascular Risk Factors and Quality of Life in Hemodialysis Patients. BANTAO Journal 2015. [DOI: 10.1515/bj-2015-0006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction. The amount of interdialytic weight gain (IDWG) considering body weight is of great importance in hemodialysis patients. In general practice, patients are asked to get standard weight between two hemodialysis sessions. However, it should be individualized considering patient’s weight. We aimed to determine the association between the IDWG and the nutritional parameters, cardiovascular risk factors, and quality of life.
Methods. Thrity-two patients receiving hemodialysis at least for one year were enrolled into the study. Patients were monitored for 12 consecutive hemodialysis sessions; and the arithmetic mean of IDWG was calculated. IDWG% was calculated in accordance with patients’ dry weight. Data of patients with IDWG<3% (Group I) and IDWG≥3 (Group II) were compared. Sociodemographic variables, laboratory, anthropometric measurements, blood pressure, left ventricular mass index, Subjective Global Assessment Scale and SF-36 Quality of Life Scale were applied to evaluate the patients.
Results. 59.4% (n=19) and 40.6% (n=13) of patients were included in Group I and Group II, respectively. In Group II, albumin (p=0.02), potassium (p=0.02), phosphorus (p=0.04), nPCR (p=0.03), physical function (p=0.04), role limitations caused by physical problems (p=0.04), general health (p=0.03), physical quality of life (p=0.04) scores were significantly higher. A significant correlation was detected between IDWG and physical and mental quality of life, total score SF-36, albumin, total protein and the potassium values.
Conclusions. Patients with an IDWG ≥ 3% have better nutritional parameters and quality of life scales. The limiting of IDWG to 1-2 kg, ingoring patient weight may give rise to malnutrition and a reduced quality of life.
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Affiliation(s)
- Aysegul Kahraman
- Adnan Menderes University Hospital, Hemodialysis Unit, 09100 Aydın, Turkey; Phone: +90 256 444 1256; Fax: +90 256 214 4086
| | - Hakan Akdam
- Adnan Menderes University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology
| | - Alper Alp
- Adnan Menderes University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology
| | - Mustafa Ahmet Huyut
- Adnan Menderes University, Faculty of Medicine, Department of Cardiology, Aydın, Turkey
| | - Cagdas Akgullu
- Adnan Menderes University, Faculty of Medicine, Department of Cardiology, Aydın, Turkey
| | - Tuba Balaban
- Adnan Menderes University Hospital, Hemodialysis Unit
| | | | - Aynur Topcu
- Adnan Menderes University Hospital, Hemodialysis Unit
| | | | - Nevin Atakan
- Adnan Menderes University Hospital, Hemodialysis Unit
| | - Harun Akar
- Adnan Menderes University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology
| | - Yavuz Yenicerioglu
- Adnan Menderes University, Faculty of Medicine, Department of Internal Medicine, Division of Nephrology
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Alp A, Akdam H, Meteoğlu İ, Ünsal A, Akar H, Yeniçerioğlu Y. Acute kidney injury after near drowning: The way from the beach to hemodialysis. Hemodial Int 2015; 20:E1-4. [PMID: 26058785 DOI: 10.1111/hdi.12321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Acute kidney injury (AKI) occurs in many different situations and may have a variable prognosis influenced by clinical setting, underlying cause, and comorbidity. This is important because of the high mortality and morbidity risk affecting many people around the world. Near-drowning related AKI requiring hemodialysis is very seldom reported in literature. Although cardiovascular and respiratory disorders are more frequently seen after this entity, we aimed to emphasize this rare but dangerous complication in near-drowning patients.
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Affiliation(s)
- Alper Alp
- Department of Internal Medicine, Division of Nephrology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Hakan Akdam
- Department of Internal Medicine, Division of Nephrology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - İbrahim Meteoğlu
- Department of Pathology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Alparslan Ünsal
- Department of Radiology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Harun Akar
- Department of Internal Medicine, Division of Nephrology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Yavuz Yeniçerioğlu
- Department of Internal Medicine, Division of Nephrology, School of Medicine, Adnan Menderes University, Aydin, Turkey
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Öğünç H, Akdam H, Alp A, Gencer F, Akar H, Yeniçerioğlu Y. The effects of single hemodialysis session on arterial stiffness in hemodialysis patients. Hemodial Int 2015; 19:463-71. [PMID: 25650022 DOI: 10.1111/hdi.12277] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Increased arterial stiffness in hemodialysis patients is a strong predictor of cardiovascular morbidity and mortality. Pulse wave velocity (PWV) and augmentation index (AIx), which are markers of arterial stiffness, were used to determine the severity of vascular damage noninvasively. This study aimed to investigate the effects of solute volume removal and hemodynamic changes on PWV and AIx of a single hemodialysis session. Thirty hemodialysis patients were enrolled in the study. Before initiation of hemodialysis, every 15 minutes during hemodialysis, and 30 minutes after the completion of the session, measurements of PWV and AIx@75 (normalized with heart rate 75 bpm) were obtained from each patient. Body composition was analyzed by bioimpedance spectroscopy device before and 30 minutes after completion of the hemodialysis session. During the hemodialysis, no significant change was observed in AIx@75. However, PWV decreased steadily during the session reaching statistically significant level at 135th minute (P = 0.026), with a maximal drop at 210th minute (P < 0.001). At 210th minute, decrease in PWV correlated positively with the decrease in central systolic blood pressure, central diastolic blood pressure, central pulse pressure, augmentation pressure, and AIx@75. Multiple regression analysis showed that decrease in PWV at 210th minute was associated with decrease in central systolic blood pressure and central pulse pressure. Ultrafiltration during hemodialysis had no significant effect on PWV and AIx@75. Delta urea correlated positively with delta PWV at 240th minute. A significant decrease in PWV was observed during hemodialysis and correlated with urea reduction; however, we were unable to document any effect of volume removal on arterial stiffness.
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Affiliation(s)
- Handan Öğünç
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Hakan Akdam
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Alper Alp
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Fatih Gencer
- Department of Internal Medicine, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Harun Akar
- Department of Internal Medicine Yenisehir, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Yavuz Yeniçerioğlu
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
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Barutca S, Meydan N, Akar H, Yavasoglu I, Kadikoylu G, Bolaman Z. Efficacy and tolerability of amifostine in elderly cancer patients. Curr Ther Res Clin Exp 2014; 65:113-24. [PMID: 24936110 DOI: 10.1016/s0011-393x(04)90011-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/10/2003] [Indexed: 11/19/2022]
Abstract
BACKGROUND Amifostine is a cytoprotective agent used to prevent cisplatin nephrotoxicity. It is associated with dose-limiting acute toxicities of emetic symptoms (nausea and vomiting) and transient hypotension. OBJECTIVE The aim of this study was to analyze the efficacy and tolerability of amifostine in elderly cancer patients. METHODS This 18-month, prospective, comparative study was conducted at the Department of Internal Medicine, Adnan Menderes University Hospital (Aydin, Turkey). Adult (aged 40-<85 years) hospitalized patients with advanced-stage cancer without comorbid diseases were enrolled. Patients were divided into 2 groups: age <70 years (group 1) and ≥70 years (group 2). All patients were treated with amifostine + cisplatin-based chemotherapy (CT). Amifostine 910 mg/m(2) (maximum, 1500 mg) was administered as a 15-minute IV infusion. Clinical systolic and diastolic blood pressures (SBP and DBP, respectively) were measured at 0 minute (baseline), at 8 and 15 minutes of amifostine infusion, and at 30 minutes after the start of amifostine infusion. In addition to physical examination, chest radiography, electrocardiography, blood chemistry (including serum electrolytes and renal function tests), complete blood count, and complete urinalyses were performed before each CT administration and at the post-CT day of toxicity assessment. RESULTS Thirty-five consecutive patients were enrolled (22 men, 13 women; mean [SD] age, 61 [12] years; group 1, n = 22; group 2, n = 13). Patients received a total of 153 CT cycles (median, 4 cycles/patient; group 1, 96 cycles; group 2, 57 cycles). Amifostine caused significant SBP and DBP reductions at 8 minutes of infusion compared with baseline in groups 1 (both P < 0.001) and 2 (P = 0.002 and P = 0.006, respectively). Overall, 20 patients (57.1%) experienced ≥ 1 symptomatic hypotensive episode; these rates were not significantly different between groups 1 (11 cases, 50.0%) and 2 (9 cases, 69.2%). Amifostine infusion was interrupted a similar number of times (6 times in group 1 and 4 times in group 2 [6.3% and 7.0% of administrations, respectively]) due to hypotension, but could be restarted in all. At 15 minutes, mean SBP and DBP values were not significantly different from baseline in either group. The mean baseline SBP values were similar between groups at baseline, and, overall, the differences in mean SBP and DBP values were not significant between groups at any time point. All other toxicities were comparable, and serum creatinine concentrations did not change significantly from baseline with CT in either group. CONCLUSIONS In this study of the efficacy and tolerability of amifostine in elderly patients with advanced-stage cancer without comorbid diseases, amifostine was effective in reducing cisplatin-induced nephrotoxicity, with transient systolic and diastolic hypotension being the most prominent adverse effect. All other toxicities were either low grade or preventable. No significant differences in amifostine tolerability or toxicities were observed between the study groups.
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Affiliation(s)
- Sabri Barutca
- Department of Internal Medicine, Division of Medical Oncology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Nezih Meydan
- Department of Internal Medicine, Division of Medical Oncology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Harun Akar
- Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Irfan Yavasoglu
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Gurhan Kadikoylu
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Zahit Bolaman
- Department of Internal Medicine, Division of Hematology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
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Akdam H, Öğünç H, Alp A, Özbek Ö, Ömürlü İK, Yeniçerioğlu Y, Akar H. Assessment of volume status and arterial stiffness in chronic kidney disease. Ren Fail 2013; 36:28-34. [PMID: 24028203 DOI: 10.3109/0886022x.2013.830224] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM There is limited information about arterial stiffness in chronic kidney disease (CKD) which is an independent risk factor for cardiovascular events. Pulse wave velocity (PWV), augmentation index (AIx) are using to determine arterial stiffness. We aimed to study PWV, AIx, volume status in patients with stage 3B-5 CKD and continuous ambulatory peritoneal dialysis (CAPD). METHODS Sixty-six stage 3B-5 CKD patients, 21 CAPD patients, 34 healthy controls were included. Pulse wave velocity, AIx, volume status was evaluated by Mobil-O-Graph®, and bioimpedance spectroscopy, respectively. RESULTS The Median PWV was 7.5 m/s in CKD, 6.2 m/s in CAPD, 5.9 m/s in healthy controls, and while PWV was found to have increased significantly in CKD patients (p = 0.002), the Alx values were similar in all groups. The median extracellular fluid excess was higher in both the CKD and, CAPD patients when compared with healthy controls (1.26 and 1.21 L, respectively). Overhydration was more prevalent in CKD and CAPD patients (p < 0.001). Age, central systolic blood pressure, body mass index, fat mass, overhydration, CKD, eGFR were the major determinants of PWV. CONCLUSION Increased PWV was found in stage 3B-5 CKD patients. Overhydration may contribute this increment.
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Affiliation(s)
- Hakan Akdam
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Adnan Menderes University , Aydın , Turkey
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Coskun Akar G, Efeoglu C, Alp A, Koseoglu K, Erol H, Yenicerioglu Y, Akar H. Malnutrition due to bisphosphonate-related osteonecrosis of the jaw in a chronic dialysis patient: case report. Ren Fail 2013; 35:1008-12. [DOI: 10.3109/0886022x.2013.809005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cinar M, Akar H, Yilmaz S, Simsek I, Karkucak M, Sagkan RI, Erdem H, Avci IY, Acikel C, Musabak U, Tunca Y, Pay S. THU0351 The Role of Endoplasmic Reticulum Aminopeptidase 1 (ERAP1) in the Pathogenesis of Ankylosing Spondylitis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sargin G, Alp A, Akdam H, Akar H, Yenicerioglu Y. Is bullous skin lesion a risk factor for renal amyloidosis in patients with familial Mediterranean fever? Indian J Nephrol 2013; 23:469-70. [PMID: 24339536 PMCID: PMC3841526 DOI: 10.4103/0971-4065.120355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Fusaro M, Fusaro M, Noale M, Tripepi G, D'angelo A, Miozzo D, Gallieni M, Study Group PV, Tsamelesvili M, Dimitriadis C, Papagianni A, Raidis C, Efstratiadis G, Memmos D, Mutluay R, Konca Degertekin C, Derici U, Deger SM, Akkiyal F, Gultekin S, Gonen S, Tacoy G, Arinsoy T, Sindel S, Sanchez-Perales C, Vazquez E, Merino E, Perez Del Barrio P, Borrego FJ, Borrego MJ, Liebana A, Krzanowski M, Janda K, Dumnicka P, Krasniak A, Sulowicz W, Kim YO, Yoon SA, Yun YS, Song HC, Kim BS, Cheong MA, Pasch A, Farese S, Floege J, Jahnen-Dechent W, Ohtake T, Ohtake T, Furuya R, Iwagami M, Tsutsumi D, Mochida Y, Ishioka K, Oka M, Maesato K, Moriya H, Hidaka S, Kobayashi S, Guedes A, Malho Guedes A, Pinho A, Fragoso A, Cruz A, Mendes P, Morgado E, Bexiga I, Silva AP, Neves P, Oyake N, Suzuki K, Itoh S, Yano S, Turkmen K, Kayikcioglu H, Ozbek O, Saglam M, Toker A, Tonbul HZ, Gelev S, Trajceska L, Srbinovska E, Pavleska S, Amitov V, Selim G, Dzekova P, Sikole A, Bouarich H, Lopez S, Alvarez C, Arribas I, DE Sequera P, Rodriguez D, Fusaro M, Fusaro M, Noale M, Tripepi G, D'angelo A, Miozzo D, Gallieni M, Study Group PV, Tanaka S, Kanemitsu T, Sugahara M, Kobayashi M, Uchida L, Ishimoto Y, Kotera N, Tanimoto S, Tanabe K, Hara K, Sugimoto T, Mise N, Goldstein B, Turakhia M, Arce C, Winkelmayer W, Zayed BED, Said K, Nishimura M, Nishimura M, Okamoto Y, Tokoro T, Nishida M, Hashimoto T, Iwamoto N, Takahashi H, Ono T, Nishimura M, Okamoto Y, Tokoro T, Sato N, Nishida M, Hashimoto T, Iwamoto N, Takahashi H, Ono T, Guedes A, Malho Guedes A, Cruz A, Morgado E, Pinho A, Fragoso A, Mendes P, Bexiga I, Silva AP, Neves P, Raimann J, Usvyat LA, Sands J, Levin NW, Kotanko P, Iwasaki M, Joki N, Tanaka Y, Ikeda N, Hayashi T, Kubo S, Imamura TA, Takahashi Y, Hirahata K, Imamura Y, Hase H, Claes K, Meijers B, Bammens B, Kuypers D, Naesens M, Vanrenterghem Y, Evenepoel P, Boscutti G, Calabresi L, Bosco M, Simonelli S, Boer E, Vitali C, Martone M, Mattei PL, Franceschini G, Baligh E, Zayed BED, Said K, El-Shafey E, Ezaat A, Zawada A, Rogacev K, Hummel B, Grun O, Friedrich A, Rotter B, Winter P, Geisel J, Fliser D, Heine GH, Makino JI, Makino KS, Ito T, Genovesi S, Santoro A, Fabbrini P, Rossi E, Pogliani D, Stella A, Bonforte G, Remuzzi G, Bertoli S, Pozzi C, Gallieni M, Pasquali S, Cagnoli L, Conte F, Santoro A, Buzadzic I, Tosic J, Dimkovic N, Djuric Z, Popovic J, Pejin Grubisa I, Barjaktarevic N, DI Napoli A, DI Lallo D, Salvatori MF, Franco F, Chicca S, Guasticchi G, Onofriescu M, Hogas S, Luminita V, Mugurel A, Gabriel V, Laura F, Irina M, Adrian C, Bosch E, Baamonde E, Culebras C, Perez G, El Hayek B, Ramirez JI, Ramirez A, Garcia C, Lago M, Toledo A, Checa MD, Taira T, Hirano T, Nohtomi K, Hyodo T, Chiba T, Saito A, Kim YK, Song HC, Choi EJ, Yang CW, Kim YS, Lim PS, Ming Ying W, Ya-Chung J, Zaripova I, Kayukov I, Essaian A, Nimgirova A, Young H, Dungey M, Watson EL, Baines R, Burton JO, Smith AC, Joki N, Iwasaki M, Tanaka Y, Kubo S, Hayashi T, Ikeda N, Yamazaki K, Hase H, Bossola M, Colacicco L, Scribano D, Vulpio C, Tazza L, Okada T, Okada N, Michibata I, Yura T, Montero N, Soler M, Pascual M, Barrios C, Marquez E, Rodriguez E, Orfila MA, Cao H, Arcos E, Comas J, Pascual J, Ferrario M, Garzotto F, Sironi T, Monacizzo S, Basso F, Garzotto F, Cruz DN, Moissl U, Tetta C, Signorini MG, Cerutti S, Ronco C, Mostovaya I, Grooteman M, Van den Dorpel M, Penne L, Van der Weerd N, Mazairac A, Den Hoedt C, Levesque R, Nube M, Ter Wee P, Bots M, Blankestijn P, Liu J, MA KL, Zhang X, Liu BC, Vladu ID, Mustafa R, Cana-Ruiu D, Vaduva C, Grauntanu C, Mota E, Singh R, Abbasian N, Stover C, Brunskill N, Burton J, Abbasian N, Herbert K, Bevington A, Brunskill N, Burton J, Wu M, Tang RN, Gao M, Liu H, Chen L, LV LL, Liu BC, Nikodimopoulou M, Liakos S, Kapoulas S, Karvounis C, Fedak D, Kuzniewski M, Paulina D, Kusnierz-Cabala B, Kapusta M, Solnica B, Sulowicz W, Junque A, Vicent ES, Moreno L, Fulquet M, Duarte V, Saurina A, Pou M, Macias J, Lavado M, Ramirez de Arellano M, Ryuzaki M, Nakamoto H, Kinoshita S, Kobayashi E, Takimoto C, Shishido T, Enia G, Torino C, Tripepi R, Panuccio V, Postorino M, Clementi A, Garozzo M, Bonanno G, Boito R, Natale G, Cicchetti T, Chippari A, Logozzo D, Alati G, Cassani S, Sellaro A, Zoccali C, Quiroga B, Verde E, Abad S, Vega A, Goicoechea M, Reque J, Lopez-Gomez JM, Luno J, Cabre Menendez C, Moles V, Vives JP, Villa D, Vinas J, Compte T, Arruche M, Diaz C, Soler J, Aguilera J, Martinez Vea A, De Mauri A, David P, Conte MM, Chiarinotti D, Ruva CE, De Leo M, Bargnoux AS, Morena M, Jaussent I, Chalabi L, Bories P, Dion JJ, Henri P, Delage M, Dupuy AM, Badiou S, Canaud B, Cristol JP, Fabbrini P, Sironi E, Pieruzzi F, Galbiati E, Vigano MR, Stella A, Genovesi S, Anpalakhan S, Anpalakhan S, Rocha S, Chitalia N, Sharma R, Kaski JC, Chambers J, Goldsmith D, Banerjee D, Cernaro V, Lacquaniti A, Lupica R, Lucisano S, Fazio MR, Donato V, Buemi M, Segalen I, Segalen I, Vinsonneau U, Tanquerel T, Quiniou G, Le Meur Y, Seibert E, Girndt M, Zohles K, Ulrich C, Kluttig A, Nuding S, Swenne C, Kors J, Werdan K, Fiedler R, Van der Weerd NC, Grooteman MP, Bots M, Van den Dorpel MA, Den Hoedt C, Nube MJ, Wetzels J, Swinkels DW, Blankestijn P, Ter Wee PM, Khandekar A, Khandge J, Lee JE, Moon SJ, Choi KH, Lee HY, Kim BS, Morena M, Tuaillon E, Jaussent I, Rodriguez A, Chenine L, Vendrell JP, Cristol JP, Canaud B, Sue YM, Tang CH, Chen YC, Sanchez-Perales C, Vazquez E, Segura P, Garcia Cortes MJ, Gil JM, Biechy MM, Liebana A, Poulikakos D, Shah A, Persson M, Banerjee D, Dattolo P, Amidone M, Amidone M, Michelassi S, Moriconi L, Betti G, Conti P, Rosati A, Mannarino A, Panichi V, Pizzarelli F, Klejna K, Naumnik B, Koc-Zorawska E, Mysliwiec M, Dimitrie S, Simona H, Mihaela O, Mugurel A, Gabriela O, Radu S, Octavian P, Adrian C, Akdam H, Akar H, Yenicerioglu Y, Kucuk O, Kurt Omurlu I, Goldsmith D, Thambiah S, Roplekar R, Manghat P, Manghat P, Fogelman I, Fraser W, Hampson G, Likaj E, Likaj E, Caco G, Seferi S, Rroji M, Barbullushi M, Thereska N, Onofriescu M, Hogas S, Luminita V, Mugurel A, Serban A, Carmen V, Cristian S, Silvia L, Covic A. Cardiovascular complications in CKD 5D. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Loh ZY, Yap CW, Anantharaman V, How P, Hirata M, Aizawa K, Yogo K, Tashiro Y, Takeda S, Endo K, Fukagawa M, Serizawa KI, Fujii H, Fujii H, Kono K, Nakai K, Goto S, Hirata M, Shinohara M, Kitazawa R, Kitazawa S, Fukagawa M, Nishi S, Oruc A, Korkmaz S, Bal O, Yilmaztepe Oral A, Ersoy A, Gullulu M, Ketteler M, Martin K, Amdahl M, Cozzolino M, Goldsmith D, Sharma A, Khan S, Ketteler M, Martin K, Amdahl M, Cozzolino M, Goldsmith D, Sharma A, Khan S, Chitalia N, Afzali B, Edozie F, Manghat P, Wierzbicki A, Hampson G, Goldsmith D, Corradini M, Iannuzzella F, Manenti L, Ciarrocchi A, Albertazzi L, Somenzi D, Pasquali S, Calabria Baxmann A, Barcellos Menon V, Froeder L, Medina-Pestana JO, Barbosa Carvalho A, Pfeferman Heilberg I, Sola L, De Souza N, Flores J, Perico N, Yuste C, Garcia DE Vinuesa MS, Luno J, Goicoechea MA, Barraca D, Panizo N, Quiroga B, Kim SM, Kwon SK, Kim HY, Cournoyer S, Bell R, Berbiche D, Menard L, Viaene L, Evenepoel P, Meijers B, Overbergh L, Mathieu C, Pasquali M, Rotondi S, Conte C, Pirro G, Mazzaferro S, Frasheri A, Marangella M, Tartaglione L, Park JS, Koo TY, Kim GH, Kang CM, Lee CH, Hiemstra TF, Casian A, Boraks P, Jayne D, Schoenmakers I, Schmiedeke B, Niemann M, Schmiedeke D, Davydenko I, Emmert A, Pilz S, Obermayer-Pietsch B, Weidemann F, Breunig F, Wanner C, Drechsler C, Shiizaki K, Ito C, Onishi A, Nakazawa E, Ogura M, Kusano E, Ermolenko V, Mikhaylova N, Mikhaylova N, Vartanjan K, Levchuk D, Dobrina E, Capusa C, Stancu S, Maria D, Vladu I, Barsan L, Garneata L, Mota E, Mircescu G, Capusa C, Stancu S, Barsan L, Ilyes A, Dorobantu N, Petrescu L, Mircescu G, Martinez-Gallardo R, Martinez-Gallardo R, Ferreira F, Garcia-Pino G, Luna E, Caravaca F, De Jager DJ, Grootendorst DC, Postmus I, De Goeij MCM, Boeschoten EW, Sijpkens YWJ, Dekker FW, Halbesma N, Wuthrich RP, Covic A, Gaillard S, Rakov V, Louvet L, Buchel J, Steppan S, Passlick-Deetjen J, Massy ZA, Akalin N, Akalin N, Altiparmak MR, Trabulus S, Yalin AS, Seyahi N, Ataman R, Serdengecti K, Donate-Correa J, Martinez-Sanz R, Muros-de-Fuentes M, Garcia J, Garcia P, Cazana V, Mora-Fernandez C, Navarro-Gonzalez JF, Chitalia N, Afzali B, Edozie F, Manghat P, Wierzbicki A, Hampson G, Goldsmith D, Berutti S, Marranca D, Soragna G, Erroi L, Migliardi M, Marangella M, Corradini M, Iannuzzella F, Belloni L, Somenzi D, Parmeggiani M, Pasquali S, Camerini C, Pezzotta M, Zani R, Movilli E, Cancarini G, Anwar S, Pruthi R, Kenchayikoppad S, Reyes J, Dasilva I, Furlano M, Calero F, Montanes R, Ayasreh N, Del Pozo M, Estorch M, Rousaud F, Ballarin JA, Bover J, Resende A, Dias CB, Dos Reis L, Jorgetti V, Woronik V, Panuccio V, Panuccio V, Enia G, Tripepi R, Cutrupi S, Pizzini P, Aliotta R, Zoccali C, Yildiz I, Sagliker Y, Demirhan O, Tunc E, Inandiklioglu N, Tasdemir D, Acharya V, Zhang L, Golea O, Sabry A, Ookalkar D, Capusa C, Radulescu D, Garneata L, Mircescu G, Ben Maiz H, Chen CH, Rome JP, Benzegoutta M, Paylar N, Eyupoglu K, Karatepe E, Esenturk M, Yavascan O, Grzegorzevska A, Shilo V, M-Mazdeh M, Francesco RC, Gouda Z, Adam SM, Emir I, Ocal F, Usta E, Kiralp N, Sagliker C, S Ozkaynak P, Sagliker HS, Bassuoni M, El-Wakil HS, Akar H, Yenicerioglu Y, Kose E, Sekin O. Mineral and bone disease - CKD 1-5. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Akar H, Akar GC, Carrero JJ, Stenvinkel P, Lindholm B. Systemic consequences of poor oral health in chronic kidney disease patients. Clin J Am Soc Nephrol 2010; 6:218-26. [PMID: 21115624 DOI: 10.2215/cjn.05470610] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Changes in the oral cavity, such as periodontitis and other manifestations of poor oral health, are common in patients with chronic kidney disease (CKD) and may contribute to increased morbidity and mortality because of systemic consequences such as inflammation, infections, protein-energy wasting, and atherosclerotic complications. Poor oral health in CKD patients may thus represent an important, but often overlooked, problem. Several studies show that uremic patients have higher rates of decayed, missing, and filled teeth, loss of attachment, and periapical and mucosal lesions than the general population. The consequences of poor oral health may be more severe in CKD patients because of advanced age, common comorbidities such as diabetes, concurrent medications, and a state of immune dysfunction that may increase the risk for systemic consequences of periodontitis and other oral and dental pathologic conditions. Poor dentition and other signs of poor oral health should be an alarm clock also at early stages of CKD. However, it remains to be determined whether more successful management of poor oral health and periodontitis will reduce the risk of inflammation, infection, protein-energy wasting, and atherosclerotic complications in CKD patients. This review explores etiological factors and potential systemic consequences of poor oral health in CKD patients as well as possible preventive and therapeutic strategies.
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Affiliation(s)
- Harun Akar
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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Yeniçerioglu Y, Üzelce Ö, Akar H, Kolatan E, Yilmaz O, Yenisey Ç, Sarioglu S, Meteoglu I. Effects of atorvastatin on development of peritoneal fibrosis in rats on peritoneal dialysis. Ren Fail 2010; 32:1095-102. [DOI: 10.3109/0886022x.2010.508859] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Barlak A, Akar H, Yenicerioglu Y, Yenisey C, Meteoğlu I, Yılmaz O. Effect of sodium bicarbonate in an experimental model of radiocontrast nephropathy. Ren Fail 2010; 32:992-9. [DOI: 10.3109/0886022x.2010.502282] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Koseoglu K, Akar H, Eraslan C. Color Doppler US Evaluation of Feeding Artery after Balloon Angioplasty of the Drainage Vein in Dysfunctional Hemodialysis AVF. Ren Fail 2009; 30:801-7. [DOI: 10.1080/08860220802272597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Akpolat T, Dilek M, Aksu K, Keser G, Toprak Ö, Ci̇ri̇t M, Oğuz Y, Taşkapan H, Adibelli̇ Z, Akar H, Tokgöz B, Arici M, Çeli̇ker H, Di̇ri̇ B, Akpolat I. Renal Behçet's Disease: An Update. Semin Arthritis Rheum 2008; 38:241-8. [PMID: 18221990 DOI: 10.1016/j.semarthrit.2007.11.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2007] [Revised: 11/10/2007] [Accepted: 11/28/2007] [Indexed: 10/22/2022]
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Sagliker Y, Acharya V, Golea O, Sabry A, Bali M, Eyupoglu K, Ookalkar D, Tapiawala S, Durugkar S, Khetan P, Capusa C, Univar R, Yildiz I, Cengiz K, Akar H, Yenicerioglu Y, Sagliker Ozkaynak P, Sabit Sagliker H, Paylar N. Is survival enough for quality of life in Sagliker Syndrome-uglifying human face appearances in chronic kidney disease? J Nephrol 2008; 21 Suppl 13:S134-S138. [PMID: 18446747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND It is known that secondary hyperparathyroidism (SH) and particularly skeletal changes is a severe condition in chronic kidney disease (CKD). Sagliker syndrome (SS) is a very prominent feature in CKD including uglifying human face appearances, short stature, extremely severe maxillary and mandibulary changes, soft tissues in the mouth, teeth-dental abnormalities, finger tip changes and severe psychological problems. METHODS In the last 8 years we have confronted 36 extremely incredible SS cases in CKD by performing an international study in Turkey, India, Malaysia, Romania and Egypt. RESULTS In addition to the uglifying human face appearance, we found extremely severe X-ray and tomographical, pantomographical, histo-pathological changes in the head and whole body. Finally, we compared previous face pictures with recent ones. Just a few years earlier they had been pretty and good-looking young boys and girls. By investigating their history, we understood they had not received proper therapy and were in the late-irreversible period. CONCLUSION SS is a serious and severe complication of CKD. Late and improper treatment leads to abnormalities throughout skeleton particularly in the skull and face. Changes particularly in children and teens become irreversible-disastrous for appearance and psychological health. Appropriate treatment must begin as early as possible in specialized centers. It is possible that SS patients may survive long-term with dialysis, but with all those particular changes could anyone claim this type of life would continue in an acceptable way without extending their height, correcting all the changes in the skull and face, remodeling new faces and most particularly convincing the patients to deal with all those tragi-dramatic psychological problems?
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Affiliation(s)
- Yahya Sagliker
- Division of Nephrology, Cukurova University, Ziya Pasa Bulvari, Sun Sinema Yani, Adana, Turkey.
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Sagliker Y, Acharya V, Ling Z, Golea O, Sabry A, Eyupoglu K, Ookalkar DS, Tapiawala S, Durugkar S, Khetan P, Capusa C, Univar R, Yildiz I, Cengiz K, Bali M, Ozkaynak PS, Sagliker HS, Paylar N, Adam SM, Balal M, Paydas S, Demirhan O, Tasdemir D, Maiz HB, Redulescu D, Garneata L, Mircescu G, Hong-Liang R, Lun L, Yildizer K, Emir I, Yuksekgonul M, Yenicerioglu Y, Akar H, Sagliker C, Esenturk M, Kiralp N. International Study on Sagliker Syndrome and Uglifying Human Face Appearence in Severe and Late Secondary Hyperparathyroidism in Chronic Kidney Disease Patients. J Ren Nutr 2008; 18:114-7. [DOI: 10.1053/j.jrn.2007.10.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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47
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Onbasili AO, Yeniceriglu Y, Agaoglu P, Karul A, Tekten T, Akar H, Discigil G. Trimetazidine in the prevention of contrast-induced nephropathy after coronary procedures. Heart 2006; 93:698-702. [PMID: 17065180 PMCID: PMC1955192 DOI: 10.1136/hrt.2006.097477] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of trimetazidine (TMZ) in the prevention of contrast-induced nephropathy (CIN) in patients with high serum creatinine levels undergoing coronary angiography/angioplasty. METHODS TMZ (20 mg thrice daily) was administered orally for 72 h starting 48 h before the procedure. All patients were given intravenous saline (0.9%) at a rate of 1 ml/kg of body weight per hour for 24 h starting 12 h beforehand. Serum creatinine levels were measured before the procedure, 48 h and 7 days after the procedure. Increase in serum creatinine level exceeding 0.5 mg/day or one quarter of the basal value is considered as CIN. Venous blood samples for serum total antioxidant capacity (TAC) measurement were drawn before and after coronary angiography. RESULTS Basal serum creatinine levels and TAC were similar in TMZ and control groups. Serum creatinine levels in the control group increased significantly 2 days after the procedure, and returned to the baseline values on the seventh day. However, it did not change significantly on the second day, and even significantly decreased on the seventh day in the TMZ group. CIN developed in 2.5% (1/40) of patients in the TMZ group and in 16.6% (7/42) of patients in the control group (p<0.05). TAC values were not different between treatment groups. CONCLUSION TMZ along with isotonic saline infusion is more effective than isotonic saline alone in reducing the risk of CIN in patients with pre-existing renal dysfunction.
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Affiliation(s)
- Alper O Onbasili
- Department of Cardiology, School of Medicine, Adnan Menderes University, Aydin, Turkey.
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Turker H, Onar M, Cengiz N, Akar H, Bayrak O. P30.10 Effects of high stimulus frequencies on central conduction time in median SEPs of patients with Neuro-Behcet’s disease. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Akar H, Seldin DC, Magnani B, O'Hara C, Berk JL, Schoonmaker C, Cabral H, Dember LM, Sanchorawala V, Connors LH, Falk RH, Skinner M. Quantitative serum free light chain assay in the diagnostic evaluation of AL amyloidosis. Amyloid 2005; 12:210-5. [PMID: 16399645 DOI: 10.1080/13506120500352339] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We compared a new serum immunoassay for quantitation of serum free light chains (FLC) with the conventional tests for clonal immunoglobulin production: bone marrow immunohistochemistry, serum immunofixation electrophoresis, and urine immunofixation electrophoresis. Serum samples from 169 patients with AL amyloidosis and 20 controls were examined. Elevated levels of kappa-FLC and lambda-FLC were found in 94% and 93% of patients with the respective clonal disease. However, false positive elevations of kappa-FLC and lambda-FLC were found in 30% and 44% of patients with clonal disease of the other light chain subtype. We found that the FLC level was a reliable test for the diagnosis of clonal disease when the FLC kappa:lambda ratio was abnormal and was comparable to the conventional tests in patients with AL amyloidosis. After a histologic tissue diagnosis of amyloidosis, determining the type as AL amyloidosis relies on a panel of hematologic tests to determine light chain clonality and the exclusion other forms of amyloidosis.
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Affiliation(s)
- Harun Akar
- Amyloid Treatment and Research Program at Boston Medical Center, Boston University School of Medicine, Boston, MA, 02118, USA
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Koseoglu K, Akar H, Cildag B, Ozsunar Y, Gayret P. Resistive Index Measurement of Native Hemodialysis Arteriovenous Fistula Feeding Artery as a Predictor for Fistula Dysfunction. ASAIO J 2004; 50:577-80. [PMID: 15672791 DOI: 10.1097/01.mat.0000145052.75525.77] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of the present study was to evaluate resistive index (RI) in the feeding artery of the functioning and dysfunctioning arteriovenous fistulas (AVFs). Measurement of RI in the feeding artery using Doppler ultrasound was performed in 48 patients on hemodialysis. Twenty-seven upper arm AVFs and 21 radiocephalic AVFs were studied. The patients were categorized into three groups according to clinical function: group 1, AVFs with normal function (n = 21); group 2, AVFs with abnormal clinical function (reduced pump flow) (n = 20); and group 3, AVFs with abnormal clinical function (increased venous pressure) (n = 7). Resistive index measurements and morphologic changes were compared between functioning and dysfunctioning AVFs. Increased RI values were detected in the AVFs with reduced pump flow. The average RI values of feeding artery were 0.47 +/- 0.07 in group 1, 0.67 +/- 0.18 in group 2, and 0.49 +/- 0.05 in group 3. Two brachial artery aneurysms, one brachial artery pseudoaneurysm, ten venous stenoses, and six venous thromboses were detected in the AVFs with diminished pump flow (18/20 patients, 90%). Both increased RI values and vascular complications were detected by Doppler ultrasound in the patients with reduced pump flow during dialysis. This study shows that Doppler ultrasound examination of AVF feeding artery may provide useful data on morphologic and functional characteristics of AVF.
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Affiliation(s)
- Kutsi Koseoglu
- Department of Radiology, Adnan Menderes University, Faculty of Medicine, Aydin, Turkey
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