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Besci O, Foss de Freitas MC, Guidorizzi NR, Guler MC, Gilio D, Maung JN, Schill RL, Hoose KS, Obua BN, Gomes AD, Yıldırım Şimşir I, Demir K, Akinci B, MacDougald OA, Oral EA. Deciphering the Clinical Presentations in LMNA-related Lipodystrophy: Report of 115 Cases and a Systematic Review. J Clin Endocrinol Metab 2024; 109:e1204-e1224. [PMID: 37843397 PMCID: PMC10876415 DOI: 10.1210/clinem/dgad606] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/19/2023] [Accepted: 10/10/2023] [Indexed: 10/17/2023]
Abstract
CONTEXT Lipodystrophy syndromes are a heterogeneous group of rare genetic or acquired disorders characterized by generalized or partial loss of adipose tissue. LMNA-related lipodystrophy syndromes are classified based on the severity and distribution of adipose tissue loss. OBJECTIVE We aimed to annotate all clinical and metabolic features of patients with lipodystrophy syndromes carrying pathogenic LMNA variants and assess potential genotype-phenotype relationships. METHODS We retrospectively reviewed and analyzed all our cases (n = 115) and all published cases (n = 379) curated from 94 studies in the literature. RESULTS The study included 494 patients. The most common variants in our study, R482Q and R482W, were associated with similar metabolic characteristics and complications though those with the R482W variant were younger (aged 33 [24] years vs 44 [25] years; P < .001), had an earlier diabetes diagnosis (aged 27 [18] vs 40 [17] years; P < .001) and had lower body mass index levels (24 [5] vs 25 [4]; P = .037). Dyslipidemia was the earliest biochemical evidence described in 83% of all patients at a median age of 26 (10) years, while diabetes was reported in 61% of cases. Among 39 patients with an episode of acute pancreatitis, the median age at acute pancreatitis diagnosis was 20 (17) years. Patients who were reported to have diabetes had 3.2 times, while those with hypertriglyceridemia had 12.0 times, the odds of having pancreatitis compared to those who did not. CONCLUSION This study reports the largest number of patients with LMNA-related lipodystrophy syndromes to date. Our report helps to quantify the prevalence of the known and rare complications associated with different phenotypes and serves as a comprehensive catalog of all known cases.
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Affiliation(s)
- Ozge Besci
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
- Division of Pediatric Endocrinology, Dokuz Eylul University, Izmir 35340, Turkey
| | | | | | - Merve Celik Guler
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
- Division of Internal Medicine, Dokuz Eylul University, Izmir 35340, Turkey
| | - Donatella Gilio
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Clinical and Translational Sciences, University of Pisa, Pisa 56126, Italy
| | - Jessica N Maung
- Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI 48105, USA
| | - Rebecca L Schill
- Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI 48105, USA
| | - Keegan S Hoose
- Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI 48105, USA
| | - Bonje N Obua
- Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI 48105, USA
| | - Anabela D Gomes
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ilgın Yıldırım Şimşir
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Ege University, Izmir 35100, Turkey
| | - Korcan Demir
- Division of Pediatric Endocrinology, Dokuz Eylul University, Izmir 35340, Turkey
| | - Baris Akinci
- DEPARK, Dokuz Eylul University & Izmir Biomedicine and Genome Center, Izmir, Turkey
- Izmir Biomedicine and Genome Center, Izmir 35340, Turkey
| | - Ormond A MacDougald
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, MI 48105, USA
| | - Elif A Oral
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
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Demirkoparan M, Vahabi A, Özbek B, Mert M, Yıldırım Şimşir I, Erdem HA, Öztürk AM, Çetinkalp Ş. Efficacy of telemedicine applications in patients with diabetic foot ulcers: A focus on mortality and major amputation rates. Int Wound J 2023; 20:3955-3962. [PMID: 37340728 PMCID: PMC10681535 DOI: 10.1111/iwj.14283] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/22/2023] Open
Abstract
Amputations related to diabetic foot ulcers (DFU) are associated with high morbidity and mortality rates. Glycaemic control and close follow-up protocols are essential to prevent such ulcers. Coronavirus disease (COVID) related restrictions and regulations might have a negative impact on patients who are with DFU or candidates for DFU. We retrospectively analysed 126 cases that had DFU underwent amputation surgery. Comparative analyses were done between cases that were admitted before COVID restrictions (Group A) and cases admitted after COVID restrictions (Group B). Two groups were homogenic demographically. There was no significant difference between groups in terms of mortality (p = 0.239) and amputation rates (p = 0.461). The number of emergent cases in the pandemic period doubled the number in pre-pandemic period even though this finding was not statistically significant (p = 0.112). Fastly adapted consulting practice and follow-up protocols to compensate for the problems created by COVID-related regulations seem to be effective in terms of mortality and amputation rates.
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Affiliation(s)
- Mesut Demirkoparan
- Department of Orthopedics and TraumatologyEge University School of MedicineIzmirTurkey
| | - Arman Vahabi
- Department of Orthopedics and TraumatologyEge University School of MedicineIzmirTurkey
| | - Berker Özbek
- Department of Orthopedics and TraumatologyEge University School of MedicineIzmirTurkey
| | - Merve Mert
- Department of Infectious Diseases and Clinical MicrobiologyEge University School of MedicineIzmirTurkey
| | - Ilgın Yıldırım Şimşir
- Department of Internal Medicine, Division of Endocrinology and Metabolism DisordersEge University School of MedicineIzmirTurkey
| | - Hüseyin Aytaç Erdem
- Department of Infectious Diseases and Clinical MicrobiologyEge University School of MedicineIzmirTurkey
| | - Anıl Murat Öztürk
- Department of Orthopedics and TraumatologyEge University School of MedicineIzmirTurkey
| | - Şevki Çetinkalp
- Department of Internal Medicine, Division of Endocrinology and Metabolism DisordersEge University School of MedicineIzmirTurkey
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Vahabi A, Mert M, Erdem HA, Yıldırım Şimşir I, Taşbakan MI, Öztürk AM. Safe Use of Hyperbaric Oxygen Therapy in the Treatment of Diabetic Foot Ulcers: A Multidisciplinary Approach to Minimize Adverse Effects. Interdiscip Perspect Infect Dis 2023; 2023:9154038. [PMID: 37534331 PMCID: PMC10393520 DOI: 10.1155/2023/9154038] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023] Open
Abstract
Purpose The purpose of this study is to evaluate the side effects associated with hyperbaric oxygen therapy and provide recommendations to prevent them in patients with diabetic foot ulcers. Introduction The use of hyperbaric oxygen therapy in the treatment of diabetic foot ulcers remains a contentious issue, and minimizing side effects is critical. While the incidence of side effects related to hyperbaric oxygen (HBO2) therapy is low, it is essential to evaluate cases in a multifaceted and interdisciplinary manner to prevent adverse outcomes. Methods A retrospective cohort study was conducted over the period of 2018-2020, involving a dataset of 100 patients. The primary objective of the study was to examine the frequency and types of side effects experienced by patients who underwent hyperbaric oxygen therapy (HBO) for diabetic foot ulcers (DFUs). In addition, we analyzed various wound characteristics, characteristics of hospitalizations, the surgical or medical interventions received by patients, and laboratory parameters including CRP levels, total blood count, culture results, HbA1c levels, duration of diabetes, treatment received for diabetes, and antibiotic therapy regimens. Results The percentage of patients who experienced side effects was as low as 6%, and none of them were critical. The most common side effect was discomfort due to the confined space in the chamber. Conclusion Appropriate patient selection, combined with a multidisciplinary approach to evaluate eligibility, is crucial to avoid adverse side effects. Patient education and early screening for side effects are also essential. Since various treatment protocols exist for HBO2 therapy, pooled data from different protocols may be misleading. Further studies focused on side effects with specific indications are necessary.
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Affiliation(s)
- Arman Vahabi
- Ege University School of Medicine, Department of Orthopedics and Traumatology, İzmir, Turkey
| | - Merve Mert
- Ege University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, İzmir, Turkey
| | - Hüseyin Aytaç Erdem
- Ege University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, İzmir, Turkey
| | | | - Meltem Işıkgöz Taşbakan
- Ege University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, İzmir, Turkey
| | - Anıl Murat Öztürk
- Ege University School of Medicine, Department of Orthopedics and Traumatology, İzmir, Turkey
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Abedi AH, Yıldırım Şimşir I, Bayram F, Onay H, Özgür S, Mcintyre A, Toth P, Hegele R. Genetic Variants Associated with Severe Hypertriglyceridemia: LPL, APOC2, APOA5, GPIHBP1, LMF1, and APOE. Turk Kardiyol Dern Ars 2023; 51:10-21. [PMID: 36689289 DOI: 10.5543/tkda.2022.98544] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE High triglyceride (TG) levels are associated with an increased risk for atherosclerotic cardiovascular disease (ASCVD) and pancreatitis. The objectives for this study were to evaluate for the coexistence of severe HTG and pancreatitis in two different geographic regions of Turkey and to identify rare variants that cause monogenic HTG in our country. METHODS In our study from 2014 to 2019, patients with severe HTG who presented to the endocrinology outpatient clinics with TG levels >500 mg/dL (5.7 mmol/L) were evaluated. The LPL, APOC2, APOA5, GPIHBP1, LMF1, and APOE genes were sequenced using next generation sequencing to screen for potentially pathogenic variants. RESULTS Potentially pathogenic variants were identified in 64 (47.1%) of 136 patients. Variants in LPL were seen in 42 (30.9%) cases, APOA5 variants in 10 (7.4%) cases, APOC2 variants in 5 (3.7%) cases, LMF1 variants in 5 (3.7%) cases, and APOE mutations in 2 (1.5%) cases. In the subgroup that experienced pancreatitis (n = 76, 56.3%), LPL variants were seen at higher frequency (P <0.001) than in the subgroup with no history of pancreatitis (n = 60, 43.7%). Patients who developed pancreatitis (56.3%) demonstrated a median TG of 2083 mg/dL (23.5 mmol/L), and patients without pancreatitis (43.7%) demonstrated a median TG of 1244.5 mg/dL (14.1 mmol/L) (P <0.001). CONCLUSION Accurate approach to HTG diagnosis is important for the prevention of pancreatitis and ASCVD. Evaluation of variants in primary HTG after excluding secondary causes may help provide a patient-centric precision treatment plan.
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Affiliation(s)
- Amir Hossein Abedi
- Erciyes University Faculty of Medicine, Department of Internal Medicine, Kayseri, Türkiye
| | - Ilgın Yıldırım Şimşir
- Ege University Faculty of Medicine, Division of Endocrinology and Metabolism Disorders, Izmir, Türkiye
| | - Fahri Bayram
- Erciyes University Faculty of Medicine, Division of Endocrinology and Metabolism Disorders, Kayseri, Türkiye
| | - Huseyin Onay
- Ege University Faculty of Medicine, Department of Medical Genetics, Izmir, Türkiye
| | - Su Özgür
- Ege University Faculty of Medicine, Department of Biostatistics and Medical Informatics, Izmir, Türkiye
| | - Adam Mcintyre
- Robarts Research Institute, Schulich School of Medicine, Western University, London ON, Canada
| | - Peter Toth
- Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert Hegele
- Robarts Research Institute, Schulich School of Medicine, Western University, London ON, Canada
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Cüreklibatır Encan B, Marmaralı A, Bayraktar D, Çetinkalp Ş, Şimşir IY. Clinical performance evaluation of a newly developed sock for people with diabetes. Proc Inst Mech Eng H 2021; 235:701-708. [PMID: 33730958 DOI: 10.1177/09544119211002074] [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] [Indexed: 11/16/2022]
Abstract
Diabetes mellitus (DM) is a chronic disease that has become a global health problem. As the population of people with diabetes is growing worldwide, the prevalence of complications associated with DM, such as diabetic foot, also increases. Neuropathy and high plantar pressure are the two most frequent causes of foot ulceration. Since diabetic wounds tend to heal slowly, it is crucial to prevent diabetic foot ulcers before they occur. In this study, the efficacy of a sock developed for diabetes in the previous research of the authors was investigated in a clinical study with the participation of patients with diabetes over a 6-month period. At the end of the study, it was observed that none of the participants had experienced any new ulcers, bacterial or fungal infections, or callus formation during this research. Moreover, a slight decrease in pressure was observed for the first, second, and third metatarsal bones when the socks were worn on day 1. On the other hand, pressure reduction was identified for the fourth and fifth metatarsal bones in all following measurements. However, analyses revealed that duration of usage did not have a statistically significant effect on overall plantar pressure. It was also found that pressure on the fourth and fifth metatarsal bones significantly decreased. Assessment of wearing comfort revealed the satisfaction of the patients, as well. Based on the promising outcomes of this clinical evaluation, these socks developed for people with diabetes can be strongly expected to help avoid diabetic foot ulcers.
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Affiliation(s)
| | - Arzu Marmaralı
- Textile Engineering Department, Faculty of Engineering, Ege University, Izmir, Turkey
| | - Dilek Bayraktar
- Department of Orthopedics and Traumatology, Gait Laboratory, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Şevki Çetinkalp
- Department of Endocrinology and Metabolism Disorders, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ilgın Yıldırım Şimşir
- Department of Endocrinology and Metabolism Disorders, Faculty of Medicine, Ege University, Izmir, Turkey
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Eskidemir Ü, Şimşir A, Yıldırım Şimşir I, Kızılay F, Özyurt C. Evaluation of Lower Urinary Tract Functions in Diabetic Patients. jus 2019. [DOI: 10.4274/jus.galenos.2018.2314] [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: 12/01/2022] Open
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7
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Altay C, Seçil M, Demir T, Atik T, Akıncı G, Özdemir Kutbay N, Keskin Temeloğlu E, Yıldırım Şimşir I, Özışık S, Demir L, Eren E, Tuna EB, Aytaç H, Onay H, Akıncı B. Determining residual adipose tissue characteristics with MRI in patients with various subtypes of lipodystrophy. Diagn Interv Radiol 2018; 23:428-434. [PMID: 29044029 DOI: 10.5152/dir.2017.17019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to investigate residual adipose tissue with whole-body magnetic resonance imaging to differentiate between subtypes of lipodystrophy. METHODS A total of 32 patients (12 with congenital generalized lipodystrophy [CGL], 1 with acquired generalized lipodystrophy [AGL], 12 with familial partial lipodystrophy [FPLD], and 7 with acquired partial lipodystrophy [APL]) were included. RESULTS Despite generalized loss of metabolically active adipose tissue, patients with CGL1 caused by AGPAT2 mutations had a significant amount of residual adipose tissue in the scalp, earlobes, retro-orbital region, and palms and soles. No residual adipose tissue was noted particularly in the head and neck, palms and soles in CGL2 caused by BSCL2 mutations. CGL4 caused by mutations in the PTRF gene was characterized with well-preserved retro-orbital and bone marrow fat in the absence of any visible residual adipose tissue in other areas. No residual adipose tissue was observed in AGL. Despite loss of subcutaneous fat, periarticular adipose tissue was preserved in the lower limbs of patients with FPLD. Retro-orbital adipose tissue was surprisingly preserved in APL, although they lacked head and neck fat. CONCLUSION Lipodystrophies are a heterogeneous group of disorders characterized by generalized or partial loss of adipose tissue, which can be congenital or acquired. Our results suggest that residual adipose tissue characteristics can help distinguish different subtypes of lipodystrophy.
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Affiliation(s)
- Canan Altay
- Department of Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey.
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Taşbakan MS, Başoğlu ÖK, Yıldırım Şimşir I, Saygılı F. Obstructive sleep apnea characteristics in patients with well-controlled acromegaly and their compliance with positive airway pressure therapy. Turk J Med Sci 2017; 47:1348-1353. [PMID: 29151303 DOI: 10.3906/sag-1612-139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim: Acromegaly is often associated with obstructive sleep apnea syndrome (OSAS) with a frequency between 40% and 80%. The aim of the present study was to evaluate the clinical and polysomnographic characteristics of acromegaly patients with sleep apnea symptoms and to identify positive airway pressure (PAP) adherence in acromegaly patients with OSAS diagnosis.Materials and methods: Twenty-eight well-controlled acromegaly patients (17 males, mean age 48.7 ± 10.1 years) with sleep apnea symptoms were included in this prospective study. Demographic data, anthropometric measurements, and medical history were evaluated. Full-night in-laboratory polysomnography was performed.Results: Polysomnography results showed that 25 patients (89.3%) had OSAS with a mean apnea-hypopnea index (AHI) of 37.7 ± 28.8/h. All 17 male patients were diagnosed with OSAS, whereas 8 female patients (72.7%) had OSAS (P = 0.05). Male patients also had more severe OSAS than females (AHI 48.3 ± 29.0 vs. 21.3 ± 20.1 events/h, respectively; P = 0.012). Twenty-two patients out of 28 were considered to be eligible candidates for PAP therapy. The PAP adherence rate was found to be 50% during follow-up. Conclusion: Our results confirm OSAS as a common disorder in acromegaly patients as well as PAP therapy being required for a majority of patients. Therefore, all acromegaly patients should be assessed in terms of OSAS and be followed closely for the evaluation of PAP adherence.
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Işıkgöz Taşbakan M, Yıldırım Şimşir I, Mermer S, Uysal S, Öztürk M, Çetinkalp Ş. Intralesional epidermal growth factor therapy fordiabetic foot ulcers: an evaluation of 15 cases. Turk J Med Sci 2017; 47:1500-1504. [PMID: 29151322 DOI: 10.3906/sag-1703-153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim: Intralesional recombinant epidermal growth factor (EGF) is a new treatment approach for diabetic foot ulcer, approved in 2006. EGF therapy is given as an adjunct to the standard treatment regimen of antibiotics, surgery, and hyperbaric oxygen. EGF accelerates the healing of diabetic foot ulcers and reduces healing time. This single-center study was conducted to evaluate the outcomes of intralesional EGF therapy in patients with diabetic foot ulcers.Materials and methods: We present the data of the follow-up patients treated in our clinics. Fifteen patients with diabetic foot ulcers or infections, who had been followed up and treated in our clinics, were included in this retrospective study. All patients were administered intralesional injections of 75 μg of EGF after treatment for infection on their diabetic foot ulcers, three times a week on alternate days. The patients were monitored with respect to treatment response and side effects of EGF.Results: Thirteen patients (86.7%) developed new granulation tissue, 10 patients (66.7%) had complete wound closure, and three patients (20%) showed partial wound closure. No serious side effects requiring discontinuation of EGF therapy were observed. A total of twenty-one bacterial agents were isolated in thirteen patients, and no bacterial growth was observed in the tissue cultures of two patients. Pseudomonas aeruginosa was the most common isolated infectious agent in the tissue cultures (n: 6, 28%). Conclusion: Intralesional injection of EGF on top of the standard treatment regimen appears to be a useful adjuvant therapy option in selected patients.
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Arda B, Uysal S, Taşbakan M, Şimşir IY, Öztürk M, Ertam İ, Uysal A, Ulusoy S. Use of Tigecycline for Diabetic Foot Infections. Wounds 2017; 29:297-305. [PMID: 28976340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate tigecycline for diabetic foot infections (DFIs). MATERIALS AND METHODS In this prospective observational study, the investigators included patients who had consultation with the Diabetic Foot Council of Ege University Faculty of Medicine (Izmir, Turkey) between March 2013 and July 2015 and who used tigecycline during their treatment. Treatment success was assessed by design-specific criteria for each evaluation. RESULTS The study included 105 cases. Of those, 37 (35.2%) were women (mean [± standard deviation] age, 61.9 ± 11.9 years). The success rate of tigecycline treatment was 93.3% in mild infections, 56.2% in moderate, 57.7% in severe, and 61.9% in all cases. The authors found a 9-fold decrease (P = .046) in the success of tigecycline treatment among those who developed moderate or severe DFIs and a 6.4-fold decrease (P < .0001) among those who had arterial stenosis. For 33 (71.7%) of 46 (43.8%) patients who experienced a side effect, tigecycline treatment was continued as it could be tolerated. CONCLUSIONS If tigecycline is to be the treatment choice, extra attention must be paid to patients with arterial stenosis, severe DFIs, and side effects. The common disadvantage is the high side effect rate, especially nausea. However, it is generally not necessary to discontinue the medication in cases with nausea. Therefore, tigecycline may be used as a choice of therapy in mild DFIs.
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Affiliation(s)
- Bilgin Arda
- Department of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, Turkey
| | | | - Meltem Taşbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, Turkey
| | | | - Murat Öztürk
- Department of Orthopedics and Traumatology, Ege University
| | | | - Ayşe Uysal
- Department of Internal Medicine, Ege University
| | - Sercan Ulusoy
- Department of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, Turkey
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Çetinkalp Ş, Koylan N, Özer N, Onat A, Özgen AG, Koldaş ZL, Sain Güven G, Özdoğan Ö, Karşıdağ K, Yiğit Z, Kayıkçıoğlu M, Tokgözoğlu L, Can LH, Tartan Z, Kültürsay H, Karpuz B, Kırılmaz B, Ersanlı M, Ural D, Erbakan AN, Oğuz A, Kayıkçıoğlu ÖR, Temizhan A, Sansoy V, Ceyhan C, Öngen Z, Bayram F, Örem C, Sönmez A, Beyaz Ş, Ükinç K, Şarer Yürekli B, Çoker M, Canda E, Yıldırım Şimşir I. [33 Questions about Triglycerides and Cardiovascular Effects: Expert Answers]. Turk Kardiyol Dern Ars 2017; 45:1-63. [PMID: 28446733 DOI: 10.5543/tkda.2017.77459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Meral Kayıkçıoğlu
- Department of Cardiology, Ege University Faculty of Medicine, İzmir, Turkey.
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12
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Gökdemir Ö, Dalkıran H, Şimşir IY, Kartal M, Saygılı F. Halsizlikle gelen 19 yaşında erkek hastada adrenal yetmezlik. Ege Tıp Dergisi 2016. [DOI: 10.19161/etd.344176] [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: 11/23/2022] Open
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13
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Kutbay NÖ, Yürekli BS, Özışık H, Altun İ, Suner A, Şimşir IY, Fırat Ö, Erdoğan M, Çetinkalp Ş, Özgen G, Saygılı F. Preoperative and Postoperative (1st and 3rd Month) Metabolic Data of Patients Who Underwent Bariatric Surgery. tjem 2015. [DOI: 10.4274/tjem.2717] [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: 12/01/2022] Open
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14
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Cağırgan S, Soyer N, Vural F, Saydam G, Yıldırım Şimşir I, Dönmez A, Akalın T, Biçeroğlu S, Tombuloğlu M. Metastatic pulmonary calcinosis and leukocytoclastic vasculitis in a patient with multiple myeloma. Turk J Haematol 2012; 29:397-400. [PMID: 24385728 PMCID: PMC3781618 DOI: 10.5505/tjh.2012.23600] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Accepted: 03/05/2011] [Indexed: 11/15/2022] Open
Abstract
Both leukocytoclastic vasculitis and metastatic pulmonary calcification are conditions that rarely occur during the course of multiple myeloma. We present a multiple myeloma patient that had severe dyspnea due to metastatic pulmonary calcinosis, and ulceronecrotic skin lesions caused by leukocytoclastic vasculitis. After 3 courses of standarddose chemotherapy all skin and pulmonary lesions disappeared. Autologous peripheral stem cell transplantation was performed and during 1 year of follow-up the patient was in complete remission; after 1 year, laboratory test results indicated disease relapse. Although the patient was treated with bortezomib and dexamethasone, the disease progressed. Non-myeloablative allogeneic stem cell transplantation was performed, but despite of all treatment the patient died due to disease progression. Conflict of interest:None declared.
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Affiliation(s)
- Seçkin Cağırgan
- Ege University, School of Medicine, Department of Hematology, İzmir, Turkey
| | - Nur Soyer
- Ege University, School of Medicine, Department of Hematology, İzmir, Turkey
| | - Filiz Vural
- Ege University, School of Medicine, Department of Hematology, İzmir, Turkey
| | - Güray Saydam
- Ege University, School of Medicine, Department of Hematology, İzmir, Turkey
| | | | - Ayhan Dönmez
- Ege University, School of Medicine, Department of Hematology, İzmir, Turkey
| | - Taner Akalın
- Ege University, School of Medicine, Department of Pathology, İzmir, Turkey
| | - Selen Biçeroğlu
- Ege University, School of Medicine, Department of Radiology, İzmir, Turkey
| | - Murat Tombuloğlu
- Ege University, School of Medicine, Department of Hematology, İzmir, Turkey
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