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İpek G, Tanaçan A, Peker A, Ağaoğlu Z, Kara Ö, Şahin D. Systemic Inflammation Response Index as a diagnostic and prognostic predictor of intrahepatic cholestasis of pregnancy: A case-control study from a tertiary center. Int J Gynaecol Obstet 2024; 165:717-722. [PMID: 37922220 DOI: 10.1002/ijgo.15216] [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: 05/04/2023] [Revised: 09/15/2023] [Accepted: 10/12/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVE To investigate the diagnostic and prognostic value of the Systemic Inflammation Response Index (SIRI) in intrahepatic cholestasis of pregnancy (ICP). METHODS The present case-control study comprised 386 participants, including 192 women with ICP and 194 gestational age-matched pregnant women. Increased fasting biliary acid (FBA) levels (≥10 μmol/L) were accepted as ICP criteria. SIRI values were calculated for the first trimester (SIRI 1), time of diagnosis (SIRI 2), and time of delivery (SIRI 3). The ICP and control groups were compared based on SIRI values, and on obstetrical and neonatal outcomes. The ICP subgroups based on FBA levels (severe ICP [FBA ≥40 μmol/L] and mild ICP [FBA <40 μmol/L]) were also compared for SIRI and pregnancy outcomes. RESULTS Adverse outcomes were significantly higher in the ICP group (P < 0.001). SIRI 2 and SIRI 3 showed negative significant differences between the ICP and control groups, with P values of 0.001 and 0.009, respectively. A significant difference in ICP severity subgroups (P = 0.046) was observed for SIRI 3. In receiver operating characteristics curve analyses, optimal cut-off values for the prediction of ICP were found to be 2.01 and 2.08 for SIRI 2 and SIRI 3, respectively. A cut-off value 1.74 was determined to predict the disease severity for SIRI 3. CONCLUSION SIRI has clinical significance in accordance with the inflammatory etiology of ICP. SIRI might be used with other clinical and laboratory findings for ICP diagnosis and prediction.
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Affiliation(s)
- Göksun İpek
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanaçan
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ayça Peker
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Zahid Ağaoğlu
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
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Farisoğullari N, Tanaçan A, Sakcak B, Denizli R, Baştemur AG, Başaran E, Kara Ö, Yazihan N, Şahin D. Evaluation of maternal serum VEGF, TNF-alpha, IL-4, and IL-10 levels in differentiating placenta accreta spectrum from isolated placenta previa. Cytokine 2024; 176:156513. [PMID: 38262117 DOI: 10.1016/j.cyto.2024.156513] [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: 11/17/2023] [Revised: 12/26/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVE Our study aimed to differentiate patients with placenta accreta spectrum (PAS) from those with placenta previa (PP) using maternal serum levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-alpha), interleukin-4 (IL-4), and IL-10. METHODS The case group consisted of 77 patients with placenta previa, and the control group consisted of 90 non-previa pregnant women. Of the pregnant women in the case group, 40 were diagnosed with PAS in addition to placenta previa and 37 had placenta previa with no invasion. The maternal serum VEGF, TNF-alpha, IL-4, and IL-10 levels were compared between the case and control groups. Then the success of these markers in differentiating between PP and PAS was evaluated. RESULTS We found the VEGF, TNF-alpha, and IL-4 levels to be higher and the IL-10 level to be lower in the case group compared to the control group (p < 0.001). We observed a statistically significantly lower IL-10 level in the patients with PAS than those with PP (p = 0.029). In the receiver operating characteristic analysis, the optimal cut-off of IL-10 in the detection of PAS was 0.42 ng/mL). In multivariate analysis, the risk of PAS was significant for IL-10 (odds ratio (OR) 0.45, 95 % confidence interval (CI) 0.25-0.79, p = 0.006) and previous cesarean section (OR 2.50, 95 % Cl 1.34-4.66, p = 0.004). The model's diagnostic sensitivity and specificity, including previous cesarean section, preoperative hemoglobin (Hb), TNF-alpha, and IL-10 were 75 % and 72.9 %, respectively. CONCLUSION The study showed that the IL-10 level was lower in patients with PAS than in those with PP. A statistical model combining risk factors including previous cesarean section, preoperative Hb, TNF-alpha, and IL-10 may improve clinical diagnosis of PAS in placenta previa cases. Cytokines may be used as additional biomarkers to the clinical risk factors in the diagnosis of PAS.
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Affiliation(s)
- Nihat Farisoğullari
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Atakan Tanaçan
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Bedri Sakcak
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ramazan Denizli
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ayşe Gülçin Baştemur
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ezgi Başaran
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Nuray Yazihan
- Department of Pathophysiology, Internal Medicine, Ankara University Medical School, Ankara, Turkey
| | - Dilek Şahin
- University of Health Sciences, Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
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Kara M, Kara Ö, Durmuş ME, Analay P, Şener FE, Çıtır BN, Korkmaz GO, Ünlü Z, Tiftik T, Gürçay E, Mülkoğlu C, Yalçınkaya B, Bağcıer F, Aksakal MF, Erdoğan K, Sertçelik A, Çakır B, Kaymak B, Özçakar L. The Relationship Among Probable SARCopenia, Osteoporosis and SuprasPinatus Tendon Tears in Postmenopausal Women: The SARCOSP Study. Calcif Tissue Int 2024; 114:340-347. [PMID: 38342790 PMCID: PMC10957602 DOI: 10.1007/s00223-024-01183-7] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/05/2024] [Indexed: 02/13/2024]
Abstract
We aimed to investigate the relationship among probable sarcopenia, osteoporosis (OP) and supraspinatus tendon (SSP) tears in postmenopausal women. Postmenopausal women screened/followed for OP were recruited. Demographic data, comorbidities, exercise/smoking status, and handgrip strength values were recorded. Probable sarcopenia was diagnosed as handgrip strength values < 20 kg. Achilles and SSP thicknesses were measured using ultrasound. Among 1443 postmenopausal women, 268 (18.6%) subjects had SSP tears. Unilateral tears were on the dominant side in 146 (10.1%) and on the non-dominant side in 55 women (3.8%). In contrast to those without, women with SSP tears had older age, lower level of education, thinner SSP and lower grip strength (all p < 0.05). In addition, they had higher frequencies of hypertension, hyperlipidemia, DM, OP and probable sarcopenia, but lower exercise frequency (all p < 0.05). Binary logistic regression modeling revealed that age [odds ratio (OR): 1.046 (1.024-1.067 95% CI)], hypertension [OR: 1.560 (1.145-2.124 95% CI)], OP [OR: 1.371 (1.022-1.839 95% CI)] and probable sarcopenia [OR: 1.386 (1.031-1.861 95% CI)] were significant predictors for SSP tears (all p < 0.05). This study showed that age, presence of hypertension, probable sarcopenia and OP were related with SSP tears in postmenopausal women. To this end, although OP appeared to be related to SSP tears, SSP tear/thickness evaluation can be recommended for OP patients, especially those who have other risk factors such as older age, higher BMI, hypertension, and probable sarcopenia.
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Affiliation(s)
- Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Özgür Kara
- Department of Physical Medicine and Rehabilitation, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Mahmut Esad Durmuş
- Department of Physical Medicine and Rehabilitation, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Pelin Analay
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.
| | - Fatıma Edibe Şener
- Department of Physical Medicine and Rehabilitation, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Beyza Nur Çıtır
- Department of Physical Medicine and Rehabilitation, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Gizem Olgu Korkmaz
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Zeliha Ünlü
- Department of Physical Medicine and Rehabilitation, Celal Bayar University, Manisa, Turkey
| | - Tülay Tiftik
- Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey
| | - Eda Gürçay
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
| | - Cevriye Mülkoğlu
- Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey
| | - Berkay Yalçınkaya
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Fatih Bağcıer
- Department of Physical Medicine and Rehabilitation, Basaksehir Cam Sakura Hospital, Istanbul, Turkey
| | - Mahmud Fazıl Aksakal
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Kübra Erdoğan
- Department of Physical Medicine and Rehabilitation, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Ahmet Sertçelik
- Department of Public Health, Division of Epidemiology, Hacettepe University Medical School, Ankara, Turkey
| | - Banu Çakır
- Department of Public Health, Division of Epidemiology, Hacettepe University Medical School, Ankara, Turkey
| | - Bayram Kaymak
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Denizli R, Tanacan A, Bastemur AG, Sakcak B, Farisogullari N, Kara Ö, Kutman HGK, Neselioglu S, Erel Ö, Sahin D. Evaluation of maternal serum thiol and ischemia-modified albumin levels in cases of placenta previa: A case-control study in a tertiary center. J Obstet Gynaecol Res 2024; 50:611-617. [PMID: 38325805 DOI: 10.1111/jog.15898] [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: 07/10/2023] [Accepted: 01/23/2024] [Indexed: 02/09/2024]
Abstract
AIM We aim to compare the maternal serum thiol and ischemia-modified albumin (IMA) levels between pregnant women with placenta previa and those with uncomplicated pregnancies and to determine whether changes in these levels were useful in predicting cases of abnormally invasive placenta (AIP). METHODS Fifty-five pregnant women diagnosed with placenta previa according to the diagnostic criteria (case group) were compared to 100 women with uncomplicated pregnancies of similar demographic characteristics (control group). The patients with placenta previa were further divided into two subgroups: AIP (n = 20) and placenta previa without invasion (n = 35). The maternal serum native thiol, total thiol, disulfide, and IMA levels of the groups were evaluated. RESULTS The native thiol, total thiol, and IMA values were significantly lower in the case group than in the control group (p < 0.001). The disulfide values were similar between the study and control groups (p = 0.488). When the AIP and placenta previa without invasion groups were compared, the levels of native thiol, total thiol, disulfide, and IMA were similar (p > 0.05). CONCLUSIONS Maternal serum thiol and IMA levels were lower in placenta previa cases compared to the control group. However, these parameters were not useful in predicting AIP cases.
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Affiliation(s)
- Ramazan Denizli
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ayşe Gülçin Bastemur
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Bedri Sakcak
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Nihat Farisogullari
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | | | - Salim Neselioglu
- Department of Biochemistry, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Özcan Erel
- Department of Biochemistry, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Dilek Sahin
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
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Durak M, Tanaçan A, Kara Ö, Şahin D. Evaluation of postpartum shock index in hypertensive diseases of pregnancy: a case-control study from a tertiary reference center. J Perinat Med 2024; 52:298-303. [PMID: 38231005 DOI: 10.1515/jpm-2023-0219] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 12/27/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVES To compare the postpartum shock index (SI) values between pregnant women with hypertensive disease of pregnancy (HDP) and normotensive controls. METHODS The present study was conducted in Ankara City Hospital Perinatology Clinic. Postpartum SI was compared between the pregnant women with HDP (n=217) and normotensive controls (n=219). A logistic regression analysis was performed to assess the independent predictors of maximum SI ≥1. Finally, a ROC analysis was performed to calculate optimal cut-off values for postpartum SI's measured at different periods in the prediction of postpartum Hb (hemoglobin) decrease ≥2 g/dL. RESULTS Peripartum SI (p<0.001), 15th min SI (p<0.001), 30th min SI (p<0.001), 2nd h SI (p<0.001), 6th h SI (p) of the HDP group (p<0.001) and max SI (p<0.001) values were found to be significantly lower in the study group. A weak positive and statistically significant correlation was found between the maximum SI and the decrease in Hb ≥2 g/dL (r=0.209; p=0.002). Optimal cutoff values for SI were; 0.7 at peripartum 0.7 at 15 min, 0.73 at 30 min, 0.6 at 2 h, and 0.7 at 6 h, respectively. CONCLUSIONS Clinically significant blood loss may develop at lower SI values in hypertensive pregnant women.
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Affiliation(s)
- Melek Durak
- Perinatology Clinic, Ankara City Hospital, Ankara, Türkiye
| | - Atakan Tanaçan
- Perinatology Clinic, Ankara City Hospital, Ankara, Türkiye
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye
| | - Özgür Kara
- Perinatology Clinic, Ankara City Hospital, Ankara, Türkiye
| | - Dilek Şahin
- Perinatology Clinic, Ankara City Hospital, Ankara, Türkiye
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye
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Farisoğullari N, Tanaçan A, Sakcak B, Denizli R, Başaran E, Kara Ö, Yazihan N, Şahin D. Evaluation of maternal serum vascular endothelial growth factor C and D levels in intrahepatic cholestasis of pregnancy. Int J Gynaecol Obstet 2024; 164:979-984. [PMID: 37680091 DOI: 10.1002/ijgo.15107] [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: 07/05/2023] [Revised: 08/01/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE This study aimed to investigate maternal serum vascular endothelial growth factor (VEGF) C and D levels in patients with intrahepatic cholestasis of pregnancy (ICP). METHODS A total of 83 patients, including 41 patients with ICP and 42 healthy pregnant women, were included in the study. We first compared the maternal serum VEGF-C and VEGF-D levels between the ICP and control groups and then examined the correlation between the serum VEGF-C level and the bile acid level in patients with severe ICP. RESULTS We observed statistically significantly higher serum VEGF-C levels and lower VEGF-D levels in the ICP group compared with the healthy controls (P < 0.001 and P = 0.015, respectively). According to receiver operating characteristic analysis, the optimal cutoff value for ICP was 147 ng/mL in the determination of the VEGF-C level (specificity and sensitivity: 76%). In patients with severe ICP, the serum VEGF-C statistically significantly correlated with the bile acid level (P = 0.019). CONCLUSION This study showed that the maternal serum VEGF-C level was higher and the VEGF-D level was lower in patients with ICP compared with healthy pregnant women. We also found that the VEGF-C level was correlated with the serum bile acid level in patients with severe ICP. Serum VEGF-C level can be used in the diagnosis and follow-up of intrahepatic pregnancy cholestasis.
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Affiliation(s)
- Nihat Farisoğullari
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Turkish Ministry of Health, Ankara, Turkey
| | - Atakan Tanaçan
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Turkish Ministry of Health, Ankara, Turkey
| | - Bedri Sakcak
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Turkish Ministry of Health, Ankara, Turkey
| | - Ramazan Denizli
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Turkish Ministry of Health, Ankara, Turkey
| | - Ezgi Başaran
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Turkish Ministry of Health, Ankara, Turkey
| | - Özgür Kara
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Turkish Ministry of Health, Ankara, Turkey
| | - Nuray Yazihan
- Department of Pathophysiology, Internal Medicine, Ankara University Medical School, Ankara, Turkey
| | - Dilek Şahin
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Turkish Ministry of Health, University of Health Sciences, Ankara, Turkey
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Erdoğan K, Durmuş ME, Kara Ö, Kara M, Özçakar L. Prompt Sonographic Assessment of Body Composition After Bariatric Surgery. Obes Surg 2024; 34:666-667. [PMID: 37964163 DOI: 10.1007/s11695-023-06775-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/10/2023] [Accepted: 07/14/2023] [Indexed: 11/16/2023]
Affiliation(s)
- Kübra Erdoğan
- Department of Internal Medicine, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
| | - Mahmut Esad Durmuş
- Department of Internal Medicine, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Özgür Kara
- Department of Internal Medicine, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Anuk AT, Tanacan A, Kara Ö, Sahin D. Assessing adverse pregnancy outcomes in women with uncontrolled asthma vs. mild asthma: a retrospective comparative analysis. Arch Gynecol Obstet 2024:10.1007/s00404-023-07347-4. [PMID: 38276984 DOI: 10.1007/s00404-023-07347-4] [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: 10/10/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024]
Abstract
PURPOSE The aim of this study was to evaluate perinatal outcomes between the uncontrolled asthma group and the mild asthma group and to reveal the relationship between disease severity and adverse maternal-fetal outcomes in this study. METHODS This retrospective cohort study analyzed 180 pregnant women diagnosed with asthma, hospitalized, and delivered at our center between September 1, 2019, and December 1, 2021. We compared two groups: 160 with mild asthma and 20 with uncontrolled asthma. Data encompassed maternal characteristics, obstetrical complications, medication use, emergency department admissions for exacerbations, smoking status, and neonatal outcomes. RESULTS In the uncontrolled asthma group, hospitalization rates, use of inhaled short-acting β-agonist (SABA), and systemic corticosteroids were significantly higher compared to the mild asthma group (p < 0.01). Maternal and fetal complications were more prevalent in the uncontrolled group, including asthma exacerbations (45% vs. 1.2%), anemia (10% vs. 4.4%), prematurity (25% vs. 9.6%), and intrauterine fetal demise (IUFD) (10% vs. 0.6%). Neonatal outcomes in the uncontrolled group showed higher rates of admission to the neonatal intensive care unit (NICU) (50% vs. 25%), respiratory distress syndrome (RDS) (30% vs. 14%), and intraventricular hemorrhage (IVH) (5% vs. 0%) compared to the mild asthma group. CONCLUSION Uncontrolled asthma during pregnancy is associated with higher adverse maternal-fetal and neonatal outcomes compared to mild asthma.
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Affiliation(s)
- Ali Taner Anuk
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye.
| | - Atakan Tanacan
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Özgür Kara
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Dilek Sahin
- Division of Perinatology, Department of Obstetrics and Gynecology, University of Health Sciences, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
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Farisoğullari N, Tanaçan A, Sakcak B, Denizli R, Özkavak OO, Turgut E, Kara Ö, Yazihan N, Şahin D. The Association of Serum Midkine Level with Invasion in Placenta Previa: A Case-Control Study from a Tertiary Reference Center. J Interferon Cytokine Res 2023; 43:557-564. [PMID: 38126935 DOI: 10.1089/jir.2023.0106] [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] [Indexed: 12/23/2023] Open
Abstract
We aimed to examine the relationship between serum midkine levels and placental invasion in pregnant women with placenta previa. The study group consisted of 43 pregnant women diagnosed with placenta previa, whereas the control group consisted of 60 healthy pregnant women. Serum midkine levels were compared between pregnant women with placenta previa and the control group in this study's first part. Thereafter, the utility of midkine in the prediction of the abnormally invasive placenta (AIP) was investigated and optimal cutoff values were calculated. Significantly higher serum midkine level was observed in placenta previa cases than in the controls (1.16 ng/mL vs. 0.18 ng/mL, P < 0.001). Serum midkine level was also significantly higher in the AIP group among the placenta previa cases (P = 0.004). In the receiver operating characteristic analysis, the cutoff value of the midkine level in predicting AIP was 1.19 ng/mL. This study revealed that the serum midkine level is higher in pregnant women with AIP. Maternal serum midkine level may be used as a complementary biomarker to the radiological and clinical findings for the prediction of the AIP in placenta previa cases.
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Affiliation(s)
- Nihat Farisoğullari
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Cankaya, Turkey
| | - Atakan Tanaçan
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Cankaya, Turkey
| | - Bedri Sakcak
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Cankaya, Turkey
| | - Ramazan Denizli
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Cankaya, Turkey
| | - Osman Onur Özkavak
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Cankaya, Turkey
| | - Ezgi Turgut
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Cankaya, Turkey
| | - Özgür Kara
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Cankaya, Turkey
| | - Nuray Yazihan
- Department of Pathophysiology, Internal Medicine, Ankara University Medical School, Cankaya, Turkey
| | - Dilek Şahin
- Division of Perinatology, Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
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Ersak DT, Tanacan A, Laleli Koç B, Sınacı S, Kara Ö, Şahin D. The utility of complete blood parameter indices to predict stillbirths. J Matern Fetal Neonatal Med 2023; 36:2183747. [PMID: 36859825 DOI: 10.1080/14767058.2023.2183747] [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: 03/03/2023]
Abstract
OBJECTIVE In this study, we aimed to investigate the relationship between unexplained stillbirth (SB) cases and the complete blood parameter indices and we compared them with uncomplicated healthy cases. METHODS Patients diagnosed with unexplained SB cases in a tertiary center between 2019-2022 were included in this retrospective case-control study. The gestational age threshold for SBs was accepted as births after the 20th week of pregnancy. Consecutive patients with no adverse obstetric outcomes were accepted as the control group. Patients' complete blood parameter results at the time of the first admission to the hospital until 14 weeks were labeled as "1'' and at the time of delivery were labeled as "2'' and recorded. As inflammatory parameters, neutrophile-lymphocyte ratio, derivated neutrophile-lymphocyte ratio, platelet-lymphocyte ratio, lymphocyte-monocyte ratio (LMR), and hemoglobin-lymphocyte ratio (HLR) were calculated from complete blood results and recorded. RESULTS There were statistically significant differences between the groups' LMR1 (p = .040). Additionally, whereas HLR1 of the study group was 0.693 (0.38-2.72), it was 0.645 (0.15-1.82) in the control group (p = .026). However, the HLR2 of the study group was significantly lower than the control group (p = .021). CONCLUSION Necessary precautions such as fetal biophysical profile examination can be taken more frequently in the antenatal follow-up in patients considered to be at high risk of SB by using HLR. It is a novel marker that can be easily accessible and calculated from the complete blood parameters.
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Affiliation(s)
- Duygu Tugrul Ersak
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Bergen Laleli Koç
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Selcan Sınacı
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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11
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Denizli R, Tanaçan A, Sakcak B, Farisoğulları N, Ağaoğlu Z, Turgut E, Kara Ö, Şahin D. Evaluation of the Caval aortic index in fetal growth restriction: A case-control study in a tertiary center. Int J Gynaecol Obstet 2023; 163:186-193. [PMID: 37128746 DOI: 10.1002/ijgo.14808] [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: 02/21/2023] [Revised: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To examine the inferior vena cava (IVC) diameter, aortic diameter, and caval aortic index in fetuses with growth restriction and to compare the findings with fetuses from uncomplicated pregnancies at similar gestational weeks. METHODS This prospective study was conducted with a total of 176 pregnant women. According to the diagnostic criteria, 84 pregnancies diagnosed with fetal growth restriction (FGR) were compared with a control group of 92 uncomplicated pregnancies at similar gestational weeks. RESULTS The aortic and IVC diameter values were significantly lower in the FGR group (P < 0.001), whereas the caval aortic index was similar between the two groups. The examination of the ultrasound parameters of the cases with FGR according to the neonatal intensive care requirement revealed similar aortic diameter and caval aortic index values but a significantly smaller IVC diameter in the cases requiring neonatal intensive care (P = 0.022). CONCLUSION We determined that the aortic and IVC diameter values were smaller in the fetuses with growth restriction, but the caval aortic index was similar in the two groups. The measurement of the IVC diameter in FGR may be useful in predicting the neonatal intensive care requirements of these fetuses.
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Affiliation(s)
- Ramazan Denizli
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanaçan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Bedri Sakcak
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Nihat Farisoğulları
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Zahid Ağaoğlu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ezgi Turgut
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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12
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Tugrul Ersak D, Şerbetçi H, Laleli Koç B, Kara Ö, Bütün Türk Ş, Kadıoğlu Şimşek G, Canpolat FE, Moraloğlu Tekin Ö, Şahin D. Placental Pathology and Its Importance in Preterm Infants. Fetal Pediatr Pathol 2023; 42:746-752. [PMID: 37341537 DOI: 10.1080/15513815.2023.2223297] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/05/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVE We evaluated what placental pathologies were associated with adverse preterm births. MATERIALS AND METHODS Placental findings, classified according to the Amsterdam criteria, were correlated with infant outcomes. The fetal vascular lesions, inflammatory responses other than histological chorioamnionitis (HCA), and placentas with combined maternal vascular malperfusion (MVM) and HCA were excluded. RESULTS A total of 772 placentas were evaluated. MVM was present in 394 placentas, HCA in 378. Early neonatal sepsis, retinopathy of prematurity, necrotizing enterocolitis, and neonatal death occurred more often in the MVM-only group than HCA-only group. The frequency of bronchopulmonary dysplasia (BPD) was 38.6% in the HCA-only group, and it was 20.3% in the MVM-only group (p < 0.001). HCA was the most important independent risk factor for BPD (OR 3.877, 95% CI 2.831-5.312). CONCLUSION Inflammation in the placenta influences fetal and neonatal outcomes. HCA is an independent risk factor for BPD.
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Affiliation(s)
| | - Hakkı Şerbetçi
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | | | - Özgür Kara
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Şeyma Bütün Türk
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | | | | | | | - Dilek Şahin
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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13
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Denizli R, Farısoğulları N, Sakcak B, Özkavak OO, Kara Ö, Tanaçan A, Şahin D. Comparison of H-Hayman uterine compression suture with conventional vertical sutures: A cross-sectional study in a tertiary center. Int J Gynaecol Obstet 2023; 163:123-130. [PMID: 37415278 DOI: 10.1002/ijgo.14985] [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: 04/23/2023] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE To compare H-Hayman, a modified uterine compression suturing technique (UCS) that we describe for the first time in the literature, with conventional vertical UCS techniques. METHODS The H-Hayman technique was used in 14 women and the conventional UCS technique in 21 women. In order to provide standardization in the study, only patients who had developed upper-segment atony during cesarean section were recruited for the study. RESULTS Bleeding control was achieved in 85.7% (12/14) of the cases using the H-Hayman technique. In the remaining two patients with persistent hemorrhage in this group, bleeding control was provided with bilateral uterine artery ligation, and a hysterectomy was avoided in all cases. With the conventional technique, bleeding control was achieved in 76.1% (16/21) of the patients, and the overall success rate was 95.2% after bilateral uterine artery ligation in those with persistent hemorrhage. In addition, the estimated blood loss and the need for erythrocyte suspension transfusion were significantly lower in the H-Hayman group (P = 0.01 and P = 0.04, respectively). CONCLUSION We found the H-Hayman technique to be at least as successful as conventional UCS. In addition, patients who underwent suturing with the H-Hayman technique had less blood loss and a lower requirement for erythrocyte suspension transfusion.
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Affiliation(s)
- Ramazan Denizli
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Nihat Farısoğulları
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Bedri Sakcak
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Osman Onur Özkavak
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanaçan
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Division of Perinatology, Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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14
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Farisoğulları N, Denizli R, Sakcak B, Tanaçan A, Kara Ö, Şahin D. The Effect of SARS-CoV-2 İnfection on Perinatal Outcomes in Hypertensive Disorders of Pregnancy. Rev Bras Ginecol Obstet 2023; 45:e439-e446. [PMID: 37683655 PMCID: PMC10491470 DOI: 10.1055/s-0043-1772184] [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: 11/02/2022] [Accepted: 02/01/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVE To evaluate the fetal and maternal effects of the severe acute respiratory syndrome virus 2 (SARS-CoV-2) infection in women with hypertensive disorders of pregnancy. METHODS Patients with hypertensive disorders of pregnancy and SARS-CoV-2 polymerase chain reaction (PCR) positivity (n = 55) were compared with cases with similar characteristics and PCR negativity (n = 53). The study group was further divided into two groups as severe (n = 11) and nonsevere (n = 44) coronavirus disease 2019 (COVID-19). The groups were compared in terms of clinical characteristics and perinatal outcomes. RESULTS The study and control groups were similar in terms of maternal age, parity, gestational age at diagnosis, type of hypertensive disorders, magnesium sulfate administration rate, gestational age at birth, birth weight, Apgar scores, and maternal complications. However, all cases of fetal loss (n = 6) were observed in the SARS-CoV-2 positive group (p = 0.027). From the 6 cases, there were 5 in the nonsevere group and 1 patient in the severe SARS-CoV-2 positive group. Moreover, higher rates of maternal complications, lower oxygen saturation values, and intensive care unit admissions were observed in the severe COVID-19 group. CONCLUSION Physicians should be cautious about the management of hypertensive disorders of pregnancy cases with SARS-CoV-2 positivity. Fetal loss seems to be more common in cases with SARS-CoV-2 positivity and severe COVID-19 seems to be associated with higher rates of maternal complications. Close follow-up for fetal wellbeing and active management of severe cases in terms of maternal complications seem to be favorable.
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Affiliation(s)
- Nihat Farisoğulları
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Ramazan Denizli
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Bedri Sakcak
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Atakan Tanaçan
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Özgür Kara
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Dilek Şahin
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
- Division of Perinatology, Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
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15
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Denizli R, Sakcak B, Farisoğulları N, Erdinç AS, Kara Ö, Tanacan A, Şahın D. Effect of Ramadan Fasting in Turkey Upon Fetal Well-being and Perinatal Outcomes During the Last-Trimester of Pregnancy. J Relig Health 2023; 62:879-887. [PMID: 36689062 DOI: 10.1007/s10943-023-01744-4] [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] [Subscribe] [Scholar Register] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Ramadan, a one-month period in which eating and drinking are prohibited from sunrise to sunset, is considered sacred by Muslims. According to Islamic rules, fasting is obligatory for adults and healthy people, but patients and travelers are exempted from this rule. It is not clear whether pregnant women can fast during Ramadan. This cross-sectional case-control study included low-risk pregnant women at 32-37 weeks of gestation in Turkey. We examined healthy women in the last period of their pregnancy and found similar perinatal outcomes between the fasting and nonfasting participants. In the evaluation of fetal well-being, a decrease in the number of accelerations in the non-stress test (NST) and the need to repeat the test were found to be statistically significantly higher in fasting pregnant women. We consider that this may prolong the evaluation period and increase unnecessary hospitalizations due to nonreactive NST results. More randomized controlled trials are needed to conclude that fasting during pregnancy is safe.
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Affiliation(s)
- Ramazan Denizli
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey.
| | - Bedri Sakcak
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
| | - Nihat Farisoğulları
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
| | - Ayşe Seval Erdinç
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
| | - Dilek Şahın
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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16
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Tugrul Ersak D, Kara Ö, Yakut K, Tokmak A, Sanhal CY, Yücel A, Şahin D. The Association between Placental Abruption and Platelet Indices. Fetal Pediatr Pathol 2023; 42:367-375. [PMID: 36715068 DOI: 10.1080/15513815.2023.2166798] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Objective: Placental abruption (PA) is an obstetric emergency. This study investigated the use of platelet indices in PA in its early stages to determine if it could aid in diagnosis. Materials and Methods: Sixty-two pregnant women with PA and 130 pregnant women who delivered due to idiopathic preterm delivery were included in this case-control study. Blood samples including platelet indices, biochemical, and coagulation parameters were obtained before cesarean section. Maternal and neonatal outcomes were recorded. Results: There was no significant difference between the groups as to hemoglobin, hematocrit, and white blood count. Platelet, mean platelet volume (MPV), and platelet to lymphocyte ratio (PLR) were significantly lower, platelet distribution width (PDW) was significantly higher in the PA patients. Conclusion: In the current study, MPV and PLR were lower and PDW was higher in PA patients. These parameters may be useful in assessment of PA.
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Affiliation(s)
- Duygu Tugrul Ersak
- Ankara Dr. Zekai Tahir Burak Women's Health Training Research Hospital, Ankara, Turkey
| | - Özgür Kara
- Ankara Dr. Zekai Tahir Burak Women's Health Training Research Hospital, Ankara, Turkey
| | - Kadriye Yakut
- Ankara Dr. Zekai Tahir Burak Women's Health Training Research Hospital, Ankara, Turkey
| | - Aytekin Tokmak
- Ankara Dr. Zekai Tahir Burak Women's Health Training Research Hospital, Ankara, Turkey
| | - Cem Yaşar Sanhal
- Ankara Dr. Zekai Tahir Burak Women's Health Training Research Hospital, Ankara, Turkey
| | - Aykan Yücel
- Ankara Dr. Zekai Tahir Burak Women's Health Training Research Hospital, Ankara, Turkey
| | - Dilek Şahin
- Ankara Dr. Zekai Tahir Burak Women's Health Training Research Hospital, Ankara, Turkey
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17
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Durmuş ME, Kara Ö, Kara M, Kaya TC, Şener FE, Durmuş M, Sertçelik A, Çakır B, Özçakar L. The relationship between vitamin D deficiency and mortality in older adults before and during COVID-19 pandemic. Heart Lung 2023; 57:117-123. [PMID: 36182862 PMCID: PMC9482848 DOI: 10.1016/j.hrtlng.2022.09.007] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Vitamin D is an essential fat-soluble vitamin thought to be associated with chronic diseases, mortality and COVID-19. OBJECTIVE To investigate the association between 25(OH) vitamin D levels and mortality of chronic diseases in subjects aged ≥65 years before and during COVID-19 pandemic. METHODS A single-center, retrospective study was performed using the hospital database of subjects aged 65 years and older who had undergone vitamin D measurement between 01.01.2019 and 31.12.2021. All patients with vitamin D measurement (N = 2155) were followed as a cohort from the date of serum vitamin D analysis through death date or 01.01.2022. Age, gender, chronic diseases, survival status, date of death of the deceased, laboratory values including complete blood count, liver/renal functions and 25(OH) vitamin D levels were all noted. Subjects were classified into three groups according to their 25(OH) vitamin D levels; severe deficient group (<10 ng/ml), moderate deficient group (10-19.9 ng/ml), and control group (≥20 ng/ml). RESULTS Data of 1949 subjects were included in this retrospective analysis and 206 of them (10.6%) had at least two vitamin D measurements. Until the time of data collection (01.01.2022), 94 of the cases had died within the last three years, and only five of them had repeated measurements. While the mean vitamin D level was lower, age and frequency of dyslipidemia, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), arrhythmia, dementia and severe vitamin D deficiency (<10 ng/ml) were higher in subjectswho died (all p<0.05). According to the Cox proportional hazards model; age, presence of CAD, COPD, arrhythmia, dementia, anemia and severe vitamin D deficiency were independently related with mortality (all p<0.05). After adjusted by age, gender, and comorbidities, the probability of death was found to be 1.91 (95% CI=1.12-3.24) times higher in the severe vitamin D deficient group. CONCLUSIONS The results of this study have shown that - after having adjusted for potential factors - severe vitamin D deficiency (<10 ng/ml) seems to be an independent predictor for non-cancer mortality. Although vitamin D measurement/treatment is very easy and cheap where, on the contrary, severe vitamin D deficiency can be quite mortal.
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Affiliation(s)
- Mahmut Esad Durmuş
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey.
| | - Özgür Kara
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey
| | - Murat Kara
- Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey
| | - Tuğçe Cansu Kaya
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey
| | - Fatıma Edibe Şener
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey
| | - Merve Durmuş
- Hacettepe University Medical School, Department of Family Medicine, Ankara, Turkey
| | - Ahmet Sertçelik
- Hacettepe University Medical School, Department of Public Health, Division of Epidemiology, Ankara, Turkey
| | - Banu Çakır
- Hacettepe University Medical School, Department of Public Health, Division of Epidemiology, Ankara, Turkey
| | - Levent Özçakar
- Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey
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18
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Ülger Z, Ayçiçek GŞ, Kara Ö, Kara M. Ultrasonographic/regional muscle measurements for diagnosing sarcopenia in older adults with and without dementia. Turk J Med Sci 2022; 52:1926-1932. [PMID: 36945995 PMCID: PMC10390111 DOI: 10.55730/1300-0144.5540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/12/2022] [Accepted: 06/26/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Sarcopenia and dementia are growing concerns among older adults that muscle and brain atrophy may cooccur. We aimed to compare the age-related loss of muscle mass by using ultrasound (US), and skeletal muscle mass index (SMI) by bioelectrical impedance analysis in older adults with and without dementia. METHODS A total of 221 older adults aged ≥65 years were included in the study. The diagnosis of sarcopenia was established if low muscle mass according to either SMI or sonographic gastrocnemius (GC) muscle thickness was combined with low grip strength. The diagnosis of dementia was based on the National Institute of Aging and Alzheimer's Association criteria and the major neurocognitive disorder definition in the Diagnostic and Statistical Manual of Mental Disorders-V. Muscle strength was measured by hand dynamometer and physical performance was assessed by 4-meter usual gait speed. RESULTS There were similar/moderate correlation coefficients between GC muscle thickness and SMI with functional parameters (all p < 0.01). Forty-six patients (20.8%) had dementia, and 21 (45.7%) of them had sarcopenia diagnosed by GC thickness (p < 0.001). Age was older but weight, body mass index, and all sarcopenia-related parameters were lower in dementia patients (all p < 0.01). When clinical variables were taken into binary logistic regression analyses, age [OR = 1.095 (95% CI: 1.028-1.167)], weight [OR = 0.918 (95% CI: 0.887-0.950)], and presence of dementia [OR = 5.109 (95% CI: 2.002-13.033)] were independently associated with sarcopenia diagnosed with GC muscle thickness (all p < 0.05). DISCUSSION This study showed that sarcopenia is highly prevalent in older adults with dementia (45.7%) than without dementia (11.4%). Amongst different factors, increased age, having low body weight, and the presence of dementia independently increased the risk of sarcopenia diagnosed by GC muscle thickness (but not diagnosed by SMI) in older adults. Thus, we can evaluate easily and successfully the loss of (regional) muscle mass in dementia patients by using US in outpatient clinics.
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Affiliation(s)
- Zekeriya Ülger
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Gözde Şengül Ayçiçek
- Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Özgür Kara
- Department of Internal Medicine, Division of Geriatrics, Gülhane Faculty of Medicine, Ankara Oncology Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Murat Kara
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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19
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Tugrul Ersak D, Oluklu D, Uyan Hendem D, Turgut E, Göncü Ayhan Ş, Kara Ö, Şahin D. The assessment of fetal cardiac output in maternal hypothyroidism under levothyroxine treatment. Echocardiography 2022; 39:1434-1438. [PMID: 36266738 DOI: 10.1111/echo.15474] [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: 07/20/2022] [Revised: 09/13/2022] [Accepted: 10/02/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE In this study, we investigated whether maternal hypothyroidism has a role in the cardiac output (CO) of the fetus or not. METHODS Pregnant women between 33 and 37 gestational weeks known to have hypothyroidism and using levothyroxine were accepted as the case group. Gestational age-matched healthy euthyroid pregnant women constituted the control group. Fetal echocardiography was performed. Diameters and the velocity waveform of the pulmonary artery (PA) and aortic valves were measured. Velocity time integral (VTI) was also measured from the ventricular outflow tract. CO was calculated using VTI × π (Aortic Valve or Pulmonary Valve diameter/2) 2 × heart rate formula. RESULTS The aortic and PA annulus were measured larger in the control group. (p = .003, p = .005, respectively). Furthermore, the right and left CO of the case group were lower than the control group. Whereas the mean combined CO (ml/min) of the case group was 674.8 ± 146.2, it was 827.8 ± 167.9 in the control group (p < .001). Additionally, a negative correlation was observed between thyroid-stimulating hormone and aortic VTI (r:-.480; p:.006). CONCLUSION The findings of our study suggest that the CO of the fetus may be affected by maternal hypothyroidism.
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Affiliation(s)
- Duygu Tugrul Ersak
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Deniz Oluklu
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Derya Uyan Hendem
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ezgi Turgut
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Şule Göncü Ayhan
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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Denızlı R, Sakcak B, Farisoğulları N, Peker MEM, Sınacı S, Kara Ö, Tanacan A, Tekın ÖM, Şahın D. The İmpact of Elevated Liver Enzymes and İntrahepatic Cholestasis of Pregnancy on the Course of COVID-19 in Pregnant Women. SN Compr Clin Med 2022; 4:184. [PMID: 35971435 PMCID: PMC9366840 DOI: 10.1007/s42399-022-01267-1] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/05/2022] [Indexed: 12/15/2022]
Abstract
This study aims to investigate the perinatal outcomes in COVID-19 pregnant women with intrahepatic cholestasis of pregnancy (ICP) and elevated liver enzymes. Present study was carried out on pregnant women with COVID-19 between March 11, 2020, and August 11, 2021. Patients with liver enzyme levels higher than twice the upper limit of the reference range for aspartate aminotransferase(AST) and/or alanine aminotransferase (ALT) were included. Patients with unexplained pruritus and elevated fasting biliary acid (FBA) levels were considered ICP. The remaining cases were used as the control group. There were a total of 1751 patients in the study period. Among them, 126 had elevated liver enzymes. Nineteen of these cases had also ICP. AST and ALT values were statistically higher in the ICP group. Demographic features, clinical characteristics, and perinatal outcomes were similar between the groups. The rate of ICP in pregnant women with COVID-19 was similar to the literature in this study. Although the preterm delivery rates for both groups were higher than in the current literature, the preterm delivery rates in the study and control groups were similar. Elevated liver enzymes can be observed in pregnant women with COVID-19 with higher rates of preterm delivery compared to the previous literature. However, the diagnosis of ICP in addition to elevated liver enzymes seems to have no significant impact on the perinatal outcomes. Future studies conducted on larger populations are necessary to confirm these results.
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Affiliation(s)
- Ramazan Denızlı
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800 Turkey
| | - Bedri Sakcak
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800 Turkey
| | - Nihat Farisoğulları
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800 Turkey
| | - Melis Ece Men Peker
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800 Turkey
| | - Selcan Sınacı
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800 Turkey
| | - Özgür Kara
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800 Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800 Turkey
| | - Özlem Moraloğlu Tekın
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800 Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahın
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800 Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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Sakcak B, Alkan M, Denizli R, Farisoğullari N, Kara Ö, Ayhan ŞG, Tanacan A, Şahin D. Point shear wave velocity(pSWV) evaluation of the placenta of pregnant women who had recovered from COVID-19: A prospective cohort study from a tertiary pandemic center. Placenta 2022; 128:57-61. [PMID: 36067701 PMCID: PMC9395301 DOI: 10.1016/j.placenta.2022.08.003] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 07/03/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022]
Abstract
Introduction To assess the placental elasticity using point shear wave velocity (pSWV) in pregnant women who had recovered from coronavirus COVID-19. Methods A total of 40 pregnant women who had recovered from moderate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 40 healthy pregnant women were included in this study. We evaluated placental elasticity by using transabdominal pSWV method. Three measurements were made, and their average was accepted as the mean placental velocity value in each case. The results were compared between the post-COVID-19 and control groups. Results The mean pSWV values were significantly higher in the post-COVID-19 group compared to the control group, indicating that the women with a history of COVID-19 had stiffer placentas. Furthermore, the pSWV values were significantly and positively correlated with the uterine artery pulsatility index. We also found that the NICU requirement was statistically higher in the post-COVID 19 group. Discussion The pregnant women who had recovered from COVID-19 had rigid placentas than the healthy controls. The use of pSWV for the assessment of placental velocity may provide valuable information in the diagnosis and management of post-COVID-19 patients as a complementary tool to the existing ultrasonography methods.
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Affiliation(s)
- Bedri Sakcak
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Mihriban Alkan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ramazan Denizli
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Nihat Farisoğullari
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Şule Göncü Ayhan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey; University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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Yeşil A, Güngör B, Ceylan C, Güngör S, Yılmaz B, İnal SY, Şenol E, Kara E, Konuk A, Bolat D, Erdoğan P, Kara Ö, Özden Ö, Avcı V, Başer T, Uğur T, Bilici N. Detector selection impact on small-field dosimetry of collecting beam data measurements among Elekta Versa HD 6MV FFF Beams: a multi-institutional variability analysis. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00148-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Ekiz T, Kara M, Ata AM, Ricci V, Kara Ö, Özcan F, Özçakar L. Rewinding sarcopenia: a narrative review on the renin-angiotensin system. Aging Clin Exp Res 2021; 33:2379-2392. [PMID: 33394457 DOI: 10.1007/s40520-020-01761-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 09/29/2020] [Accepted: 11/21/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS The purpose of this review was two-fold. First, we aimed to provide an in-depth glance on the relationship between renin-angiotensin system (RAS) dysregulation and sarcopenia. Second, we aimed to touch upon potential treatments of sarcopenia (including RAS blockers, vitamin D, and exercise) in light of the pertinent literature. METHODS Currently available research regarding the effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers on knee extensor strength, grip strength, chair stand test, gate speed together with the effects of exercise on muscle mass, strength, physical performance, blood pressure and cognitive tests (particularly in older adults) was reviewed. RESULTS Although some studies have shown favorable effects of ACEIs on muscle strength and/or physical function tests, some studies have reported no/negative association in between. The favorable impact of exercise on reducing blood pressure is shown, and exercise treatment is widely recommended in the relevant literature. Different types of exercises (aerobic, resistance, dancing, music movement, water-based, golf, knitting activities or multicomponent exercises) have shown improvement in cognitive functions as well. CONCLUSION Classical RAS activity results in deleterious effects not only on the cardiovascular but also on the neuromusculoskeletal system. Therefore, treatments targeting inhibition of the classical RAS activity seem to be important in the management of several age-related pathologies, including sarcopenia. As such, ACEIs, vitamin D, exercise, and healthy diet can have prominent effects not only on the modulation of RAS but also on physical and cognitive functions and sarcopenia as well.
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Affiliation(s)
- Timur Ekiz
- Department of Physical Medicine and Rehabilitation, Türkmenbaşı Medical Center, Türkmenbaşı Bulvarı Botanik Evleri Osmanbey Apt. C Blok No:3/B Seyhan, 01130, Adana, Turkey.
| | - Murat Kara
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
| | - Ayşe Merve Ata
- Department of Physical Medicine and Rehabilitation, Dr. Ayten Bozkaya Spastic Children Hospital and Rehabilitation Center, Bursa, Turkey
| | - Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Department of Biomedical and Neuromotor Science, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Özgür Kara
- Geriatrics Unit, Yenimahalle Training and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey
| | - Fırat Özcan
- Department of Cardiology, Ankara City Hospital, Health Sciences University, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
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Tuna Doğrul R, Doğan Varan H, Cemal Kızılarslanoğlu M, Kılıç MK, Kara Ö, Arık G, Halil MG, Cankurtaran M, Doğu BB. Association of Physical Frailty with Cognitive Function and Mood in Older Adults without Dementia and Depression. Turk J Med Sci 2021; 51:2334-2340. [PMID: 33932967 DOI: 10.3906/sag-2011-277] [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: 11/25/2020] [Accepted: 05/01/2021] [Indexed: 11/03/2022] Open
Abstract
Aim & Background: Physical frailty is thought to be related with a decline in cognitive function, mood, and social activities, especially in patients with depression and dementia. It is not clear whether or not physical frailty is associated with an impairment in cognitive function and mood in patients without dementia and depression. In this study, we evaluated the association of physical frailty with cognitive function and mood in geriatric patients without dementia and depression. MATERIAL AND METHODS In this study, 612 patients aged 65 years and over were evaluated. Physical frailty was assessed by using Fried criteria. Furthermore, comprehensive geriatric assessment was performed to each patient. RESULTS Median age of the patients was 72 years (min-max: 65-93), 58% were female, and 6.5% were frail. Clock drawing (p<0.001), MMSE (p<0.001), and Yesevage Geriatric Depression Scale (p=0.010) test results were worse in frail patients compared to pre-frail and robust ones. Age (p=0.009), being university graduate (p=0.031), three words recall test (p=0.014), Activities of Daily Living (ADL) (p=0.006), Instrumental Activities of Daily Living (IADL) (p<0.001), and MNA-SF(p=0.001) scores were determined to be independent related factors of frailty. CONCLUSION We have demonstrated that cognitive function and mood might be associated with physical frailty in patients without dementia and depression.
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Affiliation(s)
- Rana Tuna Doğrul
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hacer Doğan Varan
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Muhammet Cemal Kızılarslanoğlu
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Kemal Kılıç
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Özgür Kara
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Güneş Arık
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Meltem Gülhan Halil
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Cankurtaran
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burcu Balam Doğu
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Ata AM, Kara M, Ekiz T, Kara Ö, Culha MA, Ricci V, Koyuncu EG, Özcan F, Kaymak B, Özçakar L. Reassessing Sarcopenia in Hypertension: STAR and ACE Inhibitors Excel. Int J Clin Pract 2021; 75:e13800. [PMID: 33108697 DOI: 10.1111/ijcp.13800] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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] [Received: 05/12/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Hypertension and sarcopenia are commonly seen in older adults. The renin-angiotensin system and the therapeutic use of angiotensin-converting enzyme (ACE) inhibitors have been on the agenda of sarcopenia in different perspectives. Our aim was to explore the frequency of sarcopenia in patients with hypertension and to investigate the association between the use of ACE inhibitors and sarcopenia. METHODS A total of 272 community-dwelling adults were recruited. Anterior thigh muscle thickness was measured by ultrasound. Handgrip strength, gait speed, and chair stand test were evaluated. Low muscle mass was diagnosed in the presence of low sonographic thigh adjustment ratio (STAR) values and sarcopenia was diagnosed if low STAR values were coupled with low functional tests. RESULTS 136 subjects (50.0%) had no comorbid disease; 102 (37.5%) had one, 21 (7.7%) had two, nine (3.3%) had three and four (1.5%) had four comorbid diseases. Both low muscle mass (41.9% vs 13.2%) and sarcopenia (32.2% vs 7.8%) were more commonly seen in hypertensive when compared with normotensive older adults. Subgroup analysis of older adults with hypertension revealed that sarcopenia was less prevalent (P = .003) in patients using ACE inhibitors (8.7%) than those using angiotensin II receptor blockers (48.7%) and other antihypertensive drugs (46.4%). After binary logistic regression analyses; only the presence of hypertension seemed to independently predict the development of sarcopenia in older adults [OR = 6.5 (95% CI: 2.4-17.8, P < .001)]. CONCLUSIONS Sarcopenia is highly prevalent in hypertensive older adults. Amongst many antihypertensive medications, ACE inhibitors seem to have favourable effects on both disorders.
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Affiliation(s)
- Ayşe Merve Ata
- Department of Physical and Rehabilitation Medicine, Bursa Doctor Ayten Bozkaya Spastic Children Hospital and Rehabilitation Center, Bursa, Turkey
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Timur Ekiz
- Department of Physical Medicine and Rehabilitation, Türkmenbaşi Medical Center, Adana, Turkey
| | - Özgür Kara
- Geriatrics Unit, Yenimahalle Training and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey
| | - Mehmet Ali Culha
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Vincenzo Ricci
- Department of Biomedical and Neuromotor Science, Physical and Rehabilitation Medicine Unit, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Esra Gizem Koyuncu
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Fırat Özcan
- Department of Cardiology, Ministry of Health Ankara City Hospital, Health Sciences University, Ankara, Turkey
| | - Bayram Kaymak
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Korkut S, Oğuz Y, Bozkaya D, Türkmen GG, Kara Ö, Uygur D, Oğuz ŞS. Evaluation of the Effects of Delayed Cord Clamping in Infants of Diabetic Mothers. Am J Perinatol 2021; 38:242-247. [PMID: 31563135 DOI: 10.1055/s-0039-1695799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study aimed to investigate the effect of delayed cord clamping (DCC) in infants of diabetic mothers. STUDY DESIGN Women who had diabetes throughout their pregnancy and gave birth at 37 weeks of gestation or later were included in the study along with their babies. Early cord clamping was performed as soon as possible after birth, while DCC was performed by clamping 60 second after birth. The two groups were compared in terms of venous hematocrit (htc) levels and rates of hypoglycemia, jaundice requiring phototherapy, and respiratory distress. RESULTS Venous htc levels at postnatal 6 and 24 hours were significantly higher in the DCC group (p = 0.0001). Polycythemia rates were higher in the DCC group at both 6 and 24 hours, but partial exchange transfusion (PET) was not needed in either group. There were no differences between the groups with regard to the rates of hypoglycemia or jaundice requiring phototherapy. Rate of admission to the neonatal intensive care unit (NICU) was lower in the DCC group. CONCLUSION Although DCC increased the rate of polycythemia, it did not result in PET requirement. Moreover, DCC reduced the severity of respiratory distress and the rate of admission to NICU due to respiratory distress.
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Affiliation(s)
- Sabriye Korkut
- Department of Neonatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara 06230, Turkey
| | - Yüksel Oğuz
- Department of Perinatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara, Turkey
| | - Davut Bozkaya
- Department of Neonatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara 06230, Turkey
| | - Gülenay Gençosmanoğlu Türkmen
- Department of Perinatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara, Turkey
| | - Özgür Kara
- Department of Perinatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara, Turkey
| | - Dilek Uygur
- Department of Perinatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara, Turkey
| | - Şerife Suna Oğuz
- Department of Neonatology, University of Health Sciences, Faculty of Medicine, Zekai Tahir Burak Women's Helath Training and Research Hospital, Ankara 06230, Turkey
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Kara M, Kaymak B, Ata AM, Özkal Ö, Kara Ö, Baki A, Şengül Ayçiçek G, Topuz S, Karahan S, Soylu AR, Çakır B, Halil M, Özçakar L. STAR-Sonographic Thigh Adjustment Ratio: A Golden Formula for the Diagnosis of Sarcopenia. Am J Phys Med Rehabil 2020; 99:902-908. [PMID: 32941253 DOI: 10.1097/phm.0000000000001439] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [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: 12/16/2022]
Abstract
OBJECTIVE The aim of the study was to explore an individualized sonographic muscle thickness ratio and its cutoff values in the diagnosis of sarcopenia. DESIGN A total of 326 community-dwelling adults were included in this cross-sectional study. Total skeletal muscle mass was evaluated by bioelectrical impedance analysis, and nine-site muscle thickness measurements using ultrasound. Isometric handgrip and knee extension strengths were assessed. Physical performance was evaluated by usual Gait Speed, Chair Stand Test, and Timed Up and Go Test. RESULTS Because the anterior thigh muscle thickness was the most significantly decreasing measurement with aging and the most significantly related value with body mass and height; sonographic thigh adjustment ratio was calculated by dividing it with body mass index. Using the two standard deviation values of our healthy young adults, sonographic thigh adjustment ratio cutoff values were found as 1.4 and 1.0 for male and female subjects, respectively. Sonographic thigh adjustment ratio values were negatively correlated with Chair Stand Test and Timed Up and Go Test in both sexes (all P < 0.05) and positively correlated with gait speed in female subjects and knee extension strength in male subjects (both P < 0.05). CONCLUSIONS Our results imply that regional (rather than total) muscle mass measurements should be taken into consideration for the diagnosis of sarcopenia.
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Affiliation(s)
- Murat Kara
- From the Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (MK, BK, AB, LÖ) Department of Physical and Rehabilitation Medicine, Doctor Ayten Bozkaya Spastic Children Hospital and Rehabilitation Center, Bursa, Turkey (AMA); Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey (ÖÖ, ST); Geriatrics Unit, Yenimahalle Training and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey (ÖK); Department of Geriatrics, Hacettepe University Medical School, Ankara, Turkey (GŞA, MH); Department of Biostatistics, Hacettepe University Medical School, Ankara, Turkey (SK); Department of Biophysics, Hacettepe University Medical School, Ankara, Turkey (ARS); and Department of Public Health, Hacettepe University Medical School, Ankara, Turkey (BÇ)
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Balci C, Bolayir B, Eşme M, Arik G, Kuyumcu ME, Yeşil Y, Varan HD, Kara Ö, Güngör AE, Doğu BB, Cankurtaran M, Halil M. Comparison of the Efficacy of the Global Leadership Initiative on Malnutrition Criteria, Subjective Global Assessment, and Nutrition Risk Screening 2002 in Diagnosing Malnutrition and Predicting 5‐Year Mortality in Patients Hospitalized for Acute Illnesses. JPEN J Parenter Enteral Nutr 2020; 45:1172-1180. [DOI: 10.1002/jpen.2016] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Cafer Balci
- Department of Internal Medicine, Division of Geriatric Medicine Hacettepe University Faculty of Medicine Ankara Turkey
| | - Başak Bolayir
- Department of Internal Medicine, Division of Endocrinology and Metabolism Gazi University Faculty of Medicine Ankara Turkey
| | - Mert Eşme
- Department of Internal Medicine, Division of Geriatric Medicine Hacettepe University Faculty of Medicine Ankara Turkey
| | - Güneş Arik
- Department of Geriatric Medicine Ankara City Hospital Ankara Turkey
| | - Mehmet Emin Kuyumcu
- Department of Internal Medicine, Division of Geriatric Medicine Hacettepe University Faculty of Medicine Ankara Turkey
| | - Yusuf Yeşil
- Department of Internal Medicine, Division of Geriatric Medicine Hacettepe University Faculty of Medicine Ankara Turkey
| | - Hacer Doğan Varan
- Department of Internal Medicine, Division of Geriatric Medicine Hacettepe University Faculty of Medicine Ankara Turkey
| | - Özgür Kara
- Department of Geriatric Medicine Ankara Yenimahalle Education and Research Hospital Ankara Turkey
| | - A. Evrim Güngör
- Department of Nutrition and Dietetics Ankara Güven Hospital Ankara Turkey
| | - Burcu Balam Doğu
- Department of Internal Medicine, Division of Geriatric Medicine Hacettepe University Faculty of Medicine Ankara Turkey
| | - Mustafa Cankurtaran
- Department of Internal Medicine, Division of Geriatric Medicine Hacettepe University Faculty of Medicine Ankara Turkey
| | - Meltem Halil
- Department of Internal Medicine, Division of Geriatric Medicine Hacettepe University Faculty of Medicine Ankara Turkey
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Ata AM, Kara M, Kara Ö, Kaymak B, Akıncı A, Özçakar L. Ultrasonographic measurements of the skin, fat and muscle in vitamin D deficiency. Int J Clin Pract 2020; 74:e13494. [PMID: 32100441 DOI: 10.1111/ijcp.13494] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/13/2020] [Accepted: 02/24/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Vitamin D is a steroid hormone and it is essential for the musculoskeletal system health. The relationship among vitamin D levels and adiposity was shown. However, there is only one study seems to have examined the relationship between skinfold thickness and vitamin D levels. METHODS A total of 116 healthy subjects who had a recent vitamin D measurement were included. Skin, subcutaneous fat and muscle thicknesses were measured by ultrasound (US). Hand grip strength and usual gait speed were evaluated. RESULTS Subjects were classified into two groups according to 25-OH vitamin D levels. Skin thicknesses of anterior forearm in women and of anterior tibia in men, and trochanteric fat thicknesses of both genders were higher in lower 25-OH vitamin D group (both P < .05). There were no differences between the groups regarding muscle thicknesses, grip strength and gait speed (all P > .05). For identifying vitamin D deficiency (≤20 ng/mL); optimal skin thickness value was 1.25 mm in women (sensitivity: 91.3%, specificity: 54.7%), and optimal trochanteric fat thickness was 1.79 cm in men (sensitivity: 87.5%, specificity: 76.9). The specificity was increased to 79.2% if the cut-off value was taken as 1.35 mm for anterior forearm skin thickness in women. CONCLUSION We imply that skin thicknesses (anterior forearm and tibia) and subcutaneous fat (trochanteric region) increase in subjects with low vitamin D levels. Having also ascertained the relevant cut-off values, we underscore the possible role of these measurements as regards the assessment of vitamin D status.
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Affiliation(s)
- Ayşe Merve Ata
- Doctor Ayten Bozkaya Spastic Children Hospital and Rehabilitation Center, Bursa, Turkey
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Özgür Kara
- Geriatrics Unit, Yenimahalle Training and Research Hospital, Yıldırım Beyazıt University, Ankara, Turkey
| | - Bayram Kaymak
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Ayşen Akıncı
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Affiliation(s)
- Özgür Kara
- Division of Geriatrics, Department of Internal Medicine, Ankara Yenimahalle Education and Research Hospital, Ankara, Turkey
| | - Murat Kara
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Ankara, Turkey
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Gençosmanoğlu Türkmen G, Vural Yilmaz Z, Dağlar K, Kara Ö, Sanhal CY, Yücel A, Uygur D. Low serum vitamin D level is associated with intrahepatic cholestasis of pregnancy. J Obstet Gynaecol Res 2018; 44:1712-1718. [DOI: 10.1111/jog.13693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/13/2018] [Indexed: 12/27/2022]
Affiliation(s)
| | - Zehra Vural Yilmaz
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
| | - Korkut Dağlar
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
| | - Özgür Kara
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
| | - Cem Yaşar Sanhal
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
| | - Aykan Yücel
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
| | - Dilek Uygur
- Zekai Tahir Burak Women's Health Care; Training and Research Hospital; Ankara Turkey
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Kara Ö, Kirbas A, Yakut K, Daglar K, Timur H, Ozturk İnal Z, Engin-Ustun Y. Assessment of circulating betatrophin levels in intrahepatic cholestasis of pregnancy. J Matern Fetal Neonatal Med 2018; 32:4067-4072. [PMID: 29890866 DOI: 10.1080/14767058.2018.1481382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/15/2022]
Abstract
Objective: To investigate maternal serum levels of betatrophin and their relationship with total bile acid (TBA) levels in patients with intrahepatic cholestasis of pregnancy (ICP).Materials and methods: Fifty-nine pregnant women with ICP (31 patients with severe and 28 patients with mild disease classifications) and 23 healthy women with uncomplicated pregnancies as the control group included the study. The maternal betatrophin, fasting blood glucose, fasting insulin (FI), and homeostatic model assessment of insulin resistance (HOMA-IR) levels of the groups were compared.Results: Serum betatrophin levels were significantly higher in the ICP groups than in the control group (p = .04 and p < .001, respectively). The FI levels and HOMA-IR values were significantly higher in the severe ICP group than in the control group (p = .006 and p = .001, respectively). While a significant positive correlation was found between betatrophin levels and fasting and postprandial TBA levels, there was no significant correlation among betatrophin and HOMA-IR or FI levels.Conclusions: Betatrophin levels were shown to correlate with TBA levels, it provides a model for future studies to understand the physiopathology of ICP, a complex metabolic disease. Changes in betatrophin levels may shed light on the pathogenesis of ICP.
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Affiliation(s)
- Özgür Kara
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Ayşe Kirbas
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Kadriye Yakut
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Korkut Daglar
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Hakan Timur
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Zeynep Ozturk İnal
- Department of Obstetrics and Gynecology, Konya Education and Research Hospital, Konya, Turkey
| | - Yaprak Engin-Ustun
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
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Bolayir B, Arik G, Yeşil Y, Kuyumcu ME, Varan HD, Kara Ö, Güngör AE, Yavuz BB, Cankurtaran M, Halil MG. Validation of Nutritional Risk Screening-2002 in a Hospitalized Adult Population. Nutr Clin Pract 2018; 34:297-303. [DOI: 10.1002/ncp.10082] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Başak Bolayir
- Faculty of Medicine; Department of Internal Medicine; Hacettepe University
| | - Güneş Arik
- Faculty of Medicine; Department of Internal Medicine; Division of Geriatric Medicine; Hacettepe University
| | - Yusuf Yeşil
- Faculty of Medicine; Department of Internal Medicine; Division of Geriatric Medicine; Hacettepe University
| | - Mehmet Emin Kuyumcu
- Faculty of Medicine; Department of Internal Medicine; Division of Geriatric Medicine; Hacettepe University
| | - Hacer Doğan Varan
- Faculty of Medicine; Department of Internal Medicine; Division of Geriatric Medicine; Hacettepe University
| | - Özgür Kara
- Faculty of Medicine; Department of Internal Medicine; Division of Geriatric Medicine; Hacettepe University
| | - Anil Evrim Güngör
- Department of Nutrition and Dietetics; Güven Hospital; Ankara Turkey
| | - Burcu Balam Yavuz
- Faculty of Medicine; Department of Internal Medicine; Division of Geriatric Medicine; Hacettepe University
| | - Mustafa Cankurtaran
- Faculty of Medicine; Department of Internal Medicine; Division of Geriatric Medicine; Hacettepe University
| | - Meltem Gülhan Halil
- Faculty of Medicine; Department of Internal Medicine; Division of Geriatric Medicine; Hacettepe University
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Gok M, Karabaş VL, Aslan MS, Kara Ö, Karaman S, Yenihayat F. Tissue plasminogen activator-assisted vitrectomy for submacular hemorrhage due to age-related macular degeneration. Indian J Ophthalmol 2017. [PMID: 28643713 PMCID: PMC5508459 DOI: 10.4103/ijo.ijo_129_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Purpose: The purpose of this study was to evaluate the treatment efficacy of vitrectomy combined with subretinal recombinant tissue plasminogen activator (r-tPA) and factors affecting visual improvement in patients with submacular hemorrhage (SMH) due to neovascular age-related macular degeneration (nAMD). Materials and Methods: Medical records of 17 consecutive patients diagnosed with SMH secondary to nAMD were retrospectively reviewed. The initial surgical procedure involved a 23-gauge transconjunctival vitrectomy, subretinal r-tPA application through a self-sealing inferior retinotomy, and sulfur hexafluoride gas for tamponade in all patients. The duration, size, and thickness of the hemorrhage and the pre- and post-operative visual acuity (VA) using a Snellen chart were recorded. VA was converted to logMAR for statistical analysis. Results: The average duration and size of the SMH were 12.8 ± 18.2 days and 8.6 ± 5.3 disc areas, respectively. The mean follow-up time was 16.9 ± 4.7 months. A statistically significant visual improvement was found when comparing initial VA with postoperative best-corrected VA (BCVA) and final BCVA (Wilcoxon rank test, P ≤ 0.01). There was no significant correlation between the size of the hemorrhage and postoperative BCVA and final BCVA (Spearman's rho test). There was no statistically significant correlation between the initial VA and postoperative BCVA and final BCVA (Spearman's rho test). There was no significant correlation between the duration of hemorrhage and postoperative BCVA and final BCVA (Spearman's rho test). The preoperative thickness of hemorrhage (747.5 ± 30 μm) was not correlated with postoperative BCVA or final BCVA (Pearson's test). Conclusions: Vitrectomy combined with subretinal r-tPA injection and gas tamponade is an effective surgical intervention to preserve VA in selected patients with apparent SMH.
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Affiliation(s)
- Mustafa Gok
- Department of Ophthalmology, Ministry of Health, Ordu University Research and Training Hospital, Ordu, Turkey
| | - V Levent Karabaş
- Department of Ophthalmology, Medical School, Kocaeli University, Kocaeli, Turkey
| | - Mehmet S Aslan
- Department of Ophthalmology, Arnavutköy Government Hospital, İstanbul, Turkey
| | - Özgür Kara
- Department of Ophthalmology, Fatsa Government Hospital, Ordu, Turkey
| | | | - Fatih Yenihayat
- Department of Ophthalmology, Medical School, Kocaeli University, Kocaeli, Turkey
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Kara M, Ekiz T, Kara Ö, Tiftik T, Malas FÜ, Özbudak Demir S, Özgirgin N. Does vitamin D affect muscle strength and architecture? An isokinetic and ultrasonographic study. Asia Pac J Clin Nutr 2017; 26:85-88. [PMID: 28049266 DOI: 10.6133/apjcn.102015.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES The objective of this study was to explore the association between 25- hydroxyvitamin D (25(OH)D) and muscle strength/architecture. METHODS AND STUDY DESIGN Thirty patients (27 women, 3 men) were allocated into Group I (n=15, mean age; 44.4±9.4 years) and Group II (n=15, mean age; 39.0±9.9 years) according to the median of 25(OH)D (<13.7 ng/mL vs >13.7 ng/mL, respectively). Peak torque/body weight of the knee flexor/extensor muscles at 60°/sec and 180°/sec and those of ankle flexor/ extensor muscles at 30°/sec and 90°/sec were evaluated by using a Biodex System 3 Pro Multijoint System isokinetic dynamometer. A 7-12 MHz linear array probe was used to evaluate thickness (MT), pennation angle (PA) and fascicle length (FL) of medial gastrocnemius and vastus lateralis muscles. RESULTS Mean of 25(OH)D was 9.4±2.5 ng/mL and 20.7±8.3 ng/mL in Groups I and II, respectively. Although all isokinetic strength parameters were lower in Group I, significant differences were found in knee flexion at 180°/sec (p=0.007), knee extension at 30°/sec (p=0.038) and 180°/sec (p=0.001), and ankle extension at 30°/sec (p=0.002) and 90°/sec (p=0.007). On the other hand, no significant difference was found between the groups regarding MT, PA and FL values (all p>0.05). CONCLUSION In light of our results, we can argue that 25(OH)D is associated with muscle strength but not with muscle architecture. Further studies concerning the long-term follow-up effects of 25(OH)D treatment on muscle strength are awaited.
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Affiliation(s)
- Murat Kara
- Hacettepe University Medical School, Department of Physical Medicine and Rehabilitation, Ankara, Turkey
| | - Timur Ekiz
- Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
| | - Özgür Kara
- Gazi University Medical School, Department of Internal Medicine, Divison of Geriatrics, Ankara, Turkey
| | - Tülay Tiftik
- Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Fevziye Ünsal Malas
- Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Sibel Özbudak Demir
- Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Neşe Özgirgin
- Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
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Yılmaz ZV, Akkaş E, Türkmen GG, Kara Ö, Yücel A, Uygur D. Dietary sodium and potassium intake were associated with hypertension, kidney damage and adverse perinatal outcome in pregnant women with preeclampsia. Hypertens Pregnancy 2016; 36:77-83. [DOI: 10.1080/10641955.2016.1239734] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Zehra Vural Yılmaz
- Zekai Tahir Burak Women’s Health Education and Training Hospital, Department of Perinatology, Ankara, Turkey
| | - Elif Akkaş
- Dr. Sami Ulus Women’s and Children’s Health Training and Research Hospital, Department of Obstetrics and Gynaecology, Ankara, Turkey
| | | | - Özgür Kara
- Zekai Tahir Burak Women’s Health Education and Training Hospital, Department of Perinatology, Ankara, Turkey
| | - Aykan Yücel
- Zekai Tahir Burak Women’s Health Education and Training Hospital, Department of Perinatology, Ankara, Turkey
| | - Dilek Uygur
- Zekai Tahir Burak Women’s Health Education and Training Hospital, Department of Perinatology, Ankara, Turkey
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Kara Ö, Arık G, Kızılarslanoglu MC, Kılıc MK, Varan HD, Sümer F, Esme M, Altıner S, Kuyumcu ME, Yesil Y, Yavuz BB, Cankurtaran M, Halil M. Potentially inappropriate prescribing according to the STOPP/START criteria for older adults. Aging Clin Exp Res 2016; 28:761-8. [PMID: 26661647 DOI: 10.1007/s40520-015-0475-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 05/08/2015] [Accepted: 10/09/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND The aim of this study was to demonstrate the prevalence and possible predictors of potentially inappropriate medications (PIMs) and potentially prescription omissions (PPOs) according to the Screening Tool of Older Person's Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) criteria in geriatric patients. METHODS A total of 374 patients (140 male, 234 female) aged ≥65 years were included. Comprehensive demographic and clinical data including age, gender, current diagnoses/medications, comorbid diseases and medical problems were noted. RESULTS There were 154 (41.2 %) patients with at least one PIM. Most common PIMs were proton pump inhibitors for peptic ulcer disease (9.6 %), calcium-channel blockers (6.4 %) and anticholinergic/antispasmodic drugs (5.9 %) in chronic constipation. There were 274 (73.3 %) patients with at least one PPO. Most common PPOs were calcium-vitamin D supplement in osteoporosis (OP) (39.6 %), statin (22.5 %) and antiplatelet therapies (16.0 %) in diabetes mellitus (DM) with cardiovascular risk factors. PIM was independently associated with female gender (OR = 2.21, p = 0.003), number of medications (OR = 1.35, p < 0.001), Katz scores of daily life activities (OR = 0.87, p = 0.013) and OP (OR = 0.29, p < 0.001). PPO was independently associated with age (OR = 1.06, p = 0.009), Geriatric Depression Scale score (OR = 1.20, p = 0.007), DM (OR = 6.50, p < 0.001), chronic obstructive pulmonary disease (COPD) (OR = 5.29, p = 0.010), number of medications (OR = 0.88, p = 0.019), and incontinence (OR = 0.39, p = 0.043). CONCLUSION High prevalence of PIMs and PPOs were found in geriatric patients. Number of medications, female gender, and dependency were associated with PIM. Age, higher scores of Geriatric Depression Scale, DM, and COPD were related with PPOs.
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Affiliation(s)
- Özgür Kara
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey.
| | - Güneş Arık
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | | | - Mustafa Kemal Kılıc
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Hacer Dogan Varan
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Fatih Sümer
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Mert Esme
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Seda Altıner
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Mehmet Emin Kuyumcu
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Yusuf Yesil
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Burcu Balam Yavuz
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Mustafa Cankurtaran
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Meltem Halil
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
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Kuyumcu ME, Halil M, Kara Ö, Çuni B, Çağlayan G, Güven S, Yeşil Y, Arık G, Yavuz BB, Cankurtaran M, Özçakar L. Ultrasonographic evaluation of the calf muscle mass and architecture in elderly patients with and without sarcopenia. Arch Gerontol Geriatr 2016; 65:218-24. [PMID: 27107379 DOI: 10.1016/j.archger.2016.04.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 04/04/2016] [Accepted: 04/07/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND/OBJECTIVES To sonographically assess the muscle mass and architecture of sarcopenic elderly subjects, and to explore the utility of ultrasound (US) measurements in predicting sarcopenia. METHODS One hundred elderly subjects were enrolled in this cross-sectional study. Mean age value of our study population was 73.08±6.18years. The diagnosis of sarcopenia was confirmed by measuring fat-free mass index (using bioelectrical impedance analysis) and handgrip strength. Calf circumference was measured and US evaluations comprised bilateral gastrocnemius muscle (MG) thickness, fascicle length and pennate angles; subcutaneous fat and dermis thicknesses in the calf. RESULTS Bilateral muscle thickness and fascicle length values were significantly lower in patients with sarcopenia (both p<0.05). Sarcopenic and nonsarcopenic subjects had similar pennate angles, subcutaneous fat and dermis thicknesses. Median thickness ratio (100×t (MG)/[t (subcutaneous tissue)+t (dermis)+t (MG)]) values were 64% (40-88%) in the right and 64% (38-86%) in the left calf. Bilateral MG thickness and fascicle length values showed high sensitivity in predicting sarcopenia (all values>76.92%). CONCLUSIONS Gastrocnemius muscle thickness and fascicle length values are lower in sarcopenic elderly and these two parameters can serve as alternative measurements for predicting/quantifying sarcopenia. Calf circumference measurements alone may not be appropriate for assessing sarcopenia. Instead, US imaging can conveniently be used to evaluate different compartments of the musculoskelal system in (sarcopenic) elderly.
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Affiliation(s)
- Mehmet Emin Kuyumcu
- Hacettepe University Medical School, Department of Internal Medicine Division of Geriatric Medicine, 06100 Sıhhıye, Ankara, Turkey.
| | - Meltem Halil
- Hacettepe University Medical School, Department of Internal Medicine Division of Geriatric Medicine, 06100 Sıhhıye, Ankara, Turkey
| | - Özgür Kara
- Hacettepe University Medical School, Department of Internal Medicine Division of Geriatric Medicine, 06100 Sıhhıye, Ankara, Turkey
| | - Bledjan Çuni
- Hacettepe University Medical School, Department of Physical and Medicine Rehabilitation, 06100 Sıhhıye, Ankara, Turkey
| | - Gökhan Çağlayan
- Hacettepe University Medical School, Department of Physical and Medicine Rehabilitation, 06100 Sıhhıye, Ankara, Turkey
| | - Serdar Güven
- Hacettepe University Medical School, Department of Physical and Medicine Rehabilitation, 06100 Sıhhıye, Ankara, Turkey
| | - Yusuf Yeşil
- Hacettepe University Medical School, Department of Internal Medicine Division of Geriatric Medicine, 06100 Sıhhıye, Ankara, Turkey
| | - Güneş Arık
- Hacettepe University Medical School, Department of Internal Medicine Division of Geriatric Medicine, 06100 Sıhhıye, Ankara, Turkey
| | - Burcu Balam Yavuz
- Hacettepe University Medical School, Department of Internal Medicine Division of Geriatric Medicine, 06100 Sıhhıye, Ankara, Turkey
| | - Mustafa Cankurtaran
- Hacettepe University Medical School, Department of Internal Medicine Division of Geriatric Medicine, 06100 Sıhhıye, Ankara, Turkey
| | - Levent Özçakar
- Hacettepe University Medical School, Department of Physical and Medicine Rehabilitation, 06100 Sıhhıye, Ankara, Turkey
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Kara Ö, Sari E, Akşit H, Yay A, Akşit D, Dönmez MI. Effects of selenium on ischaemia-reperfusion injury in a rat testis model. Andrologia 2016; 48:1267-1273. [PMID: 26992892 DOI: 10.1111/and.12571] [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] [Accepted: 01/28/2016] [Indexed: 11/28/2022] Open
Abstract
Selenium is shown to have beneficial effects on ischaemia-reperfusion (IR) injury. Our aim was to assess the effects of selenium on IR-induced testicular damage in terms of biochemical and histopathological evaluation. A total of 32 rats were randomised into four groups: control, IR, IR + selenium (IR + S) and S. Detorsion was applied after 3 h of torsion. Testicular tissue superoxide dismutase (SOD), glutathione (GSH), malondialdehyde (MDA), total antioxidant capacity (TAC) and DNA fragmentation levels were determined. Testicular tissue samples were examined by histopathological examination and terminal deoxynucleotidyl transferase dUTP nick end-labelling staining. The control, IR and IR + S groups had higher SOD values compared with the S group; SOD levels of the control and IR + S groups were higher than those of the IR group (P < 0.05). Further, MDA levels of the IR group were higher than those in the other three groups (P < 0.05). The IR group revealed lower TAC levels than the three groups (P < 0.05 for all). GSH levels of the IR group were significantly lower than those in the other three groups (P < 0.05 for all). In contrast, GSH levels of the IR + S group increased compared with those of the S group. The IR group had more DNA fragmentation than the control and S groups (P < 0.05). It is concluded that selenium possibly reduces oxidative stress and apoptosis caused by testicular IR injury in rats. The testicular protective effect of selenium appears to be mediated through its anti-apoptotic and antioxidative effects. However, selenium does not affect DNA fragmentation.
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Affiliation(s)
- Ö Kara
- Department of Urology, Amasya University Faculty of Medicine, Amasya, Turkey
| | - E Sari
- Department of Urology, Balikesir University Faculty of Medicine, Balikesir, Turkey
| | - H Akşit
- Department of Biochemistry, Balikesir University Faculty of Veterinary, Balikesir, Turkey
| | - A Yay
- Department of Histology and Embriyology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - D Akşit
- Department of Pharmacology, Balikesir University Faculty of Veterinary, Balikesir, Turkey
| | - M I Dönmez
- Department of Urology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
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Yeşil Y, Kuyumcu ME, Kara Ö, Halaçli B, Etgül S, Kizilarslanoğlu MC, Yavuz BB, Özcan M, Halil MG, Sahin Cankurtaran E, Cankurtaran M, Arioğul S. Vitamin D status and its association with gradual decline in cognitive function. Turk J Med Sci 2016; 45:1051-7. [PMID: 26738347 DOI: 10.3906/sag-1405-11] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM To compare plasma vitamin D concentrations among patients with normal cognitive function (control group), mild cognitive impairment (MCI), and Alzheimer disease (AD). MATERIALS AND METHODS In total, 158 patients with AD, 228 patients with MCI, and 603 control subjects were included. Plasma levels of 25-hydroxyvitamin D were measured after comprehensive geriatric assessment and compared among groups. SPSS 15.0 was used for statistical analysis. RESULTS Mean levels of 25-hydroxyvitamin D were significantly different among the 3 groups of AD patients, MCI patients, and controls (P < 0.001). Post hoc analysis revealed that the levels were significantly lower in the MCI group than the control group (P = 0.002) and significantly lower in the AD group than the control group (P = 0.003). Multivariate analysis showed that age (OR: 1.070, 95% CI: 1.025-1.116, P = 0.002), instrumental activities of daily living score (OR: 0.920, 95% CI: 0.850-0.995, P = 0.037), 25-hydroxyvitamin D level (OR: 0.959, 95% CI: 0.932-0.987, P = 0.004), and diabetes mellitus (OR: 2.476, 95% CI: 1.153-5.319, P = 0.020) were factors independently associated with AD. CONCLUSION This study demonstrated that there is a correction between plasma 25-hydroxyvitamin D levels and cognitive functions.
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Kara Ö, Zarakolu P, Aşçioğlu S, Etgül S, Uz B, Büyükaşik Y, Akova M. Epidemiology and emerging resistance in bacterial bloodstream infections in patients with hematologic malignancies. Infect Dis (Lond) 2015; 47:686-93. [PMID: 26024284 DOI: 10.3109/23744235.2015.1051105] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The objective of this study was determine the frequency of bloodstream infections (BSIs) and the causative bacteria and their resistance patterns in patients with hematological malignancies (HMs) in a large tertiary care university hospital in Turkey over a 5-year period. METHODS A total of 2098 patients with HMs with 3703 neutropenic episodes were included. Patients were classified as high-risk (n = 843) and low-risk (n = 1255) groups and evaluated for frequency of BSIs, causative bacteria, and their resistance patterns. RESULTS The frequency of BSIs was 14.5%. The frequency of gram-negative BSIs in high-risk and low-risk groups was 10.7% and 5.4% (p < 0.001), respectively. The frequency of gram-positive BSIs in high-risk and low-risk groups was 7.0% and 3.9% (p < 0.001), respectively. Gram-negative bacteria predominated (52.6%), with Escherichia coli (17.3%) and Klebsiella spp. (11.0%) as the most frequent organisms. Coagulase-negative staphylococci (10.4%) and Corynebacterium spp. (6.3%) were the most common gram-positive bacteria (35.8%). The rate of extended-spectrum beta-lactamase (ESBL) production was 45% for E. coli and 58% for Klebsiella spp. Quinolone resistance was 58% for E. coli and 11% for Klebsiella spp.. The overall frequency of ceftazidime resistance in Pseudomonas aeruginosa was 28%, and 87% of Acinetobacter spp. were multidrug-resistant. Of Staphylococcus aureus isolates, 24.8% were resistant to methicillin. CONCLUSION The dominating causes of BSIs in patients with HMs in our hospital are resistant gram-negative bacteria, which has made empirical antimicrobial choice a highly challenging issue in this patient population.
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Affiliation(s)
- Özgür Kara
- Sections of Infectious Diseases, Department of Internal Medicine, Hacettepe University School of Medicine , Ankara , Turkey
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Kizilarslanoğlu MC, Kara Ö, Yeşil Y, Kuyumcu ME, Öztürk ZA, Cankurtaran M, Rahatli S, Pakaştiçali N, Çinar E, Halil MG, Sener B, Cankurtaran ES, Arioğul S. Alzheimer disease, inflammation, and novel inflammatory marker: resistin. Turk J Med Sci 2015; 45:1040-1046. [PMID: 26738345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Inflammation may play an important role in Alzheimer disease (AD) pathogenesis. A growing amount of evidence indicates that resistin has hallmark regulatory functions such as inflammatory states. The aim of this study was to determine whether plasma resistin levels would be useful in the diagnosis of patients with AD and to investigate the relationships between resistin and other inflammatory markers such as hs-CRP and TNF-α. Materials and methods: In this cross-sectional study, 38 AD patients and 32 control subjects with normal cognitive function aged 65 years and over were included. The diagnosis of AD was made according to DSM-IV and NINCDS-ADRDA criteria. Serum levels of resistin were measured with an enzyme-linked immunosorbent assay method using the human resistin E50 kit. Results: The median resistin level of AD patients was significantly higher than in the control group (86.3 vs. 70.8 pg/mL, P = 0.002). Overall accuracy of resistin in determining AD was 70.66%, with sensitivity, specificity, PPV, and NPV of 75.0%, 65.5%, 73.0%, and 67.9%, respectively. There was no statistically significant difference between AD patients and control subjects with respect to hs-CRP and TNF-α levels. Conclusion: Resistin levels may be considered as a predictor of AD and it may predict activation of the immune system in AD pathophysiology.
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Sarikaya D, Halil M, Kuyumcu M, Kiliç M, Yesil Y, Kara Ö, Öztürk S, Güngör E, Karabulut E, Yavuz B, Cankurtaran M, Arioğul S. PP158-MON: Validation of Short and Long form of Mini Nutritional Assessment Test in Turkish Elderly. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50492-x] [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: 10/24/2022]
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Kuyumcu M, Halil M, Kara Ö, Yesil Y, Arik G, Cağlayan G, Çuni B, Güven S, Yavuz B, Cankurtaran M, Özçakar L. PP055-SUN: Ultrasonographic Evaluation of Muscle Architecture in Older Adults with Sarcopenia. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50097-0] [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: 10/24/2022]
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Arık G, Kara Ö, Kuyumcu M, Yeşil Y, Cemal Kızılarslanoğlu M, Kılıç M, Balam Yavuz B, Halil M, Cankurtaran M, Arıoğul S. Inflammation and oxidative stress in elderly patients with atrial fibrillation. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.082] [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: 11/30/2022]
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Başaran D, Özyüncü Ö, Kara Ö, Şahin N, Turğal M, Önderoğlu LS. Ultrasonographic measurement of amniochorionic membrane in asymptomatic pregnant women is not a useful tool for preterm birth prediction. J Obstet Gynaecol Res 2013; 40:62-6. [PMID: 23937073 DOI: 10.1111/jog.12121] [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] [Received: 11/20/2012] [Accepted: 03/04/2013] [Indexed: 12/01/2022]
Abstract
AIM The objective of this study was to determine the accuracy of ultrasonographic measurement of amniochorionic membrane thickness (AMT) in the prediction of preterm birth among an asymptomatic pregnant population. METHODS One hundred and ninety consecutive singleton pregnant women presenting for prenatal care between May 2010 and August 2011 were recruited for the study. AMT of the patients was measured once between 18 and 22 weeks of gestation and then again between 28 and 32 weeks of gestation with transabdominal ultrasound. The results of measurements were recorded and compared with the perinatal outcome related to prematurity. RESULTS Thirteen of the 190 births were preterm. The mean AMT of the pregnant women who delivered at term were 0.79 ± 0.23 mm in the second trimester and 0.88 ± 0.27 mm in the third trimester. The mean AMT of pregnant women who delivered preterm were 0.77 ± 0.27 mm in the second trimester and 0.91 ± 0.20 mm in the third trimester. There were no statistically significant differences between the second and third trimester AMT of the preterm delivery group and term delivery group (P = 0.542 and P = 0.448, respectively). CONCLUSION In this study, ultrasonographic measurement of fetal membranes was not found to be a useful marker for prediction of preterm birth. The findings of our study may help in understanding ultrasonographic changes in fetal membranes in normal pregnancies.
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Affiliation(s)
- Derman Başaran
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Kara M, Yılmaz S, Kara Ö, Şenol MG, Özdağ F, Özçakar L. Segmental vitiligo in a patient with thoracic outlet syndrome. Rheumatol Int 2012; 32:2941-3. [DOI: 10.1007/s00296-011-2024-6] [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] [Received: 01/29/2011] [Accepted: 07/10/2011] [Indexed: 11/29/2022]
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Önderoğlu LS, Başaran D, Özyüncü Ö, Kara Ö. Diagnostic prénatal de syndrome d’insensibilitépartielle aux androgènes au moyen d’unetechnique échographique 4-D. Journal of Obstetrics and Gynaecology Canada 2012. [DOI: 10.1016/s1701-2163(16)35126-x] [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: 10/22/2022]
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