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Sengul N, Gültürk I, Yilmaz M, Celik E, Paksoy N, Yekedüz E, Ürün Y, Basaran M, Özgüroğlu M. Safety and efficacy of nivolumab therapy in patients with metastatic renal cell carcinoma and impaired kidney function. Actas Urol Esp 2024:S2173-5786(24)00029-5. [PMID: 38570033 DOI: 10.1016/j.acuroe.2024.04.002] [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: 12/19/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Patients with renal insufficiency, usually defined as those with creatinine clearance < 40 mL/min, were excluded from pivotal clinical trials, especially in studies involving nivolumab therapy in patients with renal cell carcinoma (RCC). The aim of the study is to evaluate the efficacy and safety of nivolumab in patients with metastatic RCC (mRCC) stratified according to creatinine clearance. MATERIAL AND METHODS Data from mRCC patients treated with nivolumab were retrospectively analyzed. Patients were classified into two categories according to their estimated glomerular filtration rate (eGFR); the first category (C1) included patients with eGFR < 40 mL/min/1.73 m2 and the second category (C2) included those with eGFR ≥ 40 mL/min/1.73 m2. RESULTS Of the 95 patients enrolled, 1. group included 26 patients (27.4%) and 2. group included 69 patients (72.6%). None of the pts in category 1 were on hemodialysis. Overall incidence of adverse events was not statistically different between the two groups (P = .469). The overall response rate ORR was 50% in the first group and 42.0% in the second group (P = .486). Median overall survival (OS) was longer with 23.3 months in the 2. group versus 11 months in the 1. group (P = .415). CONCLUSION Renal insufficiency is a common problem in patients with advanced renal cancer since they often undergo nephrectomy and their renal function may also worsen while receiving tyrosine kinase inhibitor therapy. We found that there is no significant difference in the safety and efficacy of nivolumab treatment between two groups. Nivolumab appears to be a safe and effective agent in patients with renal impairment.
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Affiliation(s)
- N Sengul
- Servicio de Oncología Médica, Facultad de Medicina Cerrahpasa, Universidad de Estambul-Cerrahpasa, Estambul, Turkey
| | - I Gültürk
- Departamento de Oncología Médica, Bakirkoy Hospital de Formación e Investigación Dr. Sadi Konuk, Estambul, Turkey.
| | - M Yilmaz
- Departamento de Oncología Médica, Bakirkoy Hospital de Formación e Investigación Dr. Sadi Konuk, Estambul, Turkey
| | - E Celik
- Servicio de Oncología Médica, Facultad de Medicina Cerrahpasa, Universidad de Estambul-Cerrahpasa, Estambul, Turkey
| | - N Paksoy
- Servicio de Oncología Médica, Instituto de Oncología, Facultad de Medicina, Universidad de Estambul, Estambul, Turkey
| | - E Yekedüz
- Servicio de Oncología Médica, Facultad de Medicina, Universidad de Ankara, Ankara, Turkey
| | - Y Ürün
- Servicio de Oncología Médica, Facultad de Medicina, Universidad de Ankara, Ankara, Turkey
| | - M Basaran
- Servicio de Oncología Médica, Instituto de Oncología, Facultad de Medicina, Universidad de Estambul, Estambul, Turkey
| | - M Özgüroğlu
- Servicio de Oncología Médica, Facultad de Medicina Cerrahpasa, Universidad de Estambul-Cerrahpasa, Estambul, Turkey
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Çil G, Yilmaz M, Sahin Y, Ulus I, Canıtez IO, Kandıralı IE. The preoperative predictive factors for pathological T3a upstaging and positive surgical margin of clinical T1 renal cell carcinoma. Actas Urol Esp 2024:S2173-5786(24)00011-8. [PMID: 38369290 DOI: 10.1016/j.acuroe.2024.02.004] [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: 07/11/2023] [Accepted: 09/28/2023] [Indexed: 02/20/2024]
Abstract
OBJECTIVES The objective of this study is predict positive surgical margin (PSM) and pathological T3a (pT3a) upstaging in patients with clinical T1 (cT1) renal cell carcinoma (RCC). MATERIALS AND METHODS 159 patients who underwent radical nephrectomy (RN) or partial nephrectomy (PN) for RCC. Patients' demographic, laboratory, radiological and pathological data that could predict PSM and pT3a upstaging pre-operatively were evaluated. The categorical and continuous variables were compared between the patient groups with or without PSM and/or pT3a upstaging using Pearson's chi-square test, and independent samples t-test or the Mann-Whitney U test, respectively. RESULTS PT3a upstaging was detected in 32 (20.1%) patients, and PSM was detected in 28 (17.6%) patients. PT3a upstaging was detected in 27 and 5 patients who underwent open surgery and laparoscopic surgery, respectively (P < .001). In addition, pT3a upstaging was detected in 6 and 26 patients who underwent RN and PN, respectively (P < .001). Peritumoral fatty tissue thickness was 11.97 and 15.38 in the pT1 and pT3a patient groups, respectively (P = .022). In patients with pT3a upstaging, tumor size was larger, and renal nephrometry score and systemic immune-inflammation index (SII) were higher (P < .001, P < .001, and P = .022, respectively). It was determined that De Ritis ratio (DRR) and albumin-to-alkaline phosphatase (ALP) ratio (AAPR) parameters had significant prognostic values in predicting PSM (P = .024, and P = .001, respectively). ROC analysis indicated that tumor size predicted pT3a upstaging with 100% sensitivity and 98.6% specificity when its cut-off value was taken as 6.85 mm (AUC: 1.000, P < .001). In addition, logistic regression analysis revealed AAPR and DRR as significant predictors of PSM (P < .001, and P = .009, repsectively). CONCLUSION The findings of this study indicated that the surgical technique of choice and the type of operation, tumor size, RNS value, peritumoral fatty tissue thickness, HU values of peritumoral and tumor side fatty tissues, and DRR and SII values can predict pT3a upstaging of patients with cT1 RCC, and that AAPR and DRR values can predict PSM.
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Affiliation(s)
- G Çil
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey.
| | - M Yilmaz
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey
| | - Y Sahin
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey
| | - I Ulus
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey
| | - I O Canıtez
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey
| | - I E Kandıralı
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de Formación e Investigación Bagcilar, Estambul, Turkey
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Karaaslan M, Olcucuoglu E, Kurtbeyoglu S, Tonyali S, Yilmaz M, Odabas O. Erector spinae plane block prior to extracorporeal shock wave lithotripsy decreases fluoroscopy time and promise a comfortable procedure for renal stones: A prospective randomized study. Actas Urol Esp 2023; 47:566-572. [PMID: 37084807 DOI: 10.1016/j.acuroe.2023.04.001] [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: 01/17/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION AND OBJECTIVES To compare the efficacy of erector spinae plane block (ESPB) and intramuscular (i.m.) diclofenac sodium in regard to pain management and impact on stone-free status in patients undergoing SWL. PATIENTS AND MATERIALS The study included patients who underwent SWL for kidney stones in our institution. The patients were randomly assigned to the ESPB (Group 1: n = 31) and i.m. 75 mg diclofenac sodium (Group 2: n = 30) groups. The demographic data of the patients, fluoroscopy time during SWL, number of need of targeting, total shocks given, voltage, stone free rates (SFR), analgesy method, number of SWL sessions, VAS score, stone location, maximum stone size, stone volume and Hounsfield unit (HU) were also recorded. RESULTS A total of 61 patients were included the study. There was no statistically significant difference between the two groups according to stone size, volume and density, SWL duration, total shocks given, voltage, BMI, stone-free status and stone location. Fluoroscopy time and number of need for stone targeting were significantly lower in group 1 than group 2 (p = 0.002, p = 0.021, respectively). The VAS score was significantly lower for group 1 compared to group 2 (p < 0.001). CONCLUSIONS We observed that the VAS score was lower in the ESPB group compared to i.m. diclofenac sodium group and although it was not statistically significant, we achieved a higher rate of stone-free status in the first session in ESPB group. Most importantly, the patients in the ESPB group were exposed to less fluoroscopy and radiation.
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Affiliation(s)
- M Karaaslan
- Servicio de Urología, Hospital Estatal de Bingol, Bingol, Turkey.
| | - E Olcucuoglu
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de la Ciudad de Ankara, Ankara, Turkey
| | - S Kurtbeyoglu
- Servicio de Anestesiología y Reanimación, Universidad de Ciencias de la Salud, Hospital Municipal de Ankara, Ankara, Turkey
| | - S Tonyali
- Facultad de Medicina, Universidad de Estambul, Servicio de Urología, Estambul, Turkey
| | - M Yilmaz
- Servicio de Urología, Centro Médico Universitario de Friburgo, Facultad de Medicina, Friburgo, Germany
| | - O Odabas
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de la Ciudad de Ankara, Ankara, Turkey
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Yilmaz M, Dokuyucu R. Assessment of sensitivity to the anesthesia in a diabetic rat model. Eur Rev Med Pharmacol Sci 2023; 27:9029-9033. [PMID: 37843315 DOI: 10.26355/eurrev_202310_33927] [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] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
OBJECTIVE Diabetes mellitus and glucose regulation are important in deciding on surgical intervention in pre-surgical assessments. In our study, we aimed to investigate the correlations between the induction time of anesthesia, glucose level, and weight in a diabetic rat model. MATERIALS AND METHODS Weight-matched adult male Wistar rats were grouped as control (n=8) and diabetic (n=8). In the latter group, diabetes was induced with a single intraperitoneal injection of 50 mg/kg streptozotosin. 72 hours after the injection, animals possessing a blood glucose concentration above 300 mg/kg were considered diabetic. The weights and blood glucose levels were observed for 7 days. In the end, 80 mg/kg ketamine and 12 mg/kg xylazine were administered to both groups, and the induction time of anesthesia was recorded. The success of anesthesia was confirmed with toe pinching by using a clamp. The Student's t- and Pearson's correlation tests were used for statistical analyses. RESULTS The induction time of anesthesia was significantly reduced in the diabetic group compared to the controls (p<0.01). Diabetic animals weighed less than the control group (p<0.01). The correlation analysis in the diabetic group showed that the weight and blood glucose level of animals did not influence the induction time of anesthesia (respectively, p=0.80, r: 0.150; p=0.68, r: -0.300). A negative correlation between blood glucose concentration and weight was found in diabetics (p<0.05, r: -0.828). CONCLUSIONS The dosage of anesthetic agents is important in the effectiveness of anesthesia, and surgical complications. Since our results indicate the susceptibility of diabetics to anesthesia, we suggest that the dose of anesthetics should be finely adjusted considering the presence of diabetes.
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Affiliation(s)
- M Yilmaz
- Department of Orthopedic Surgery, 25 Aralik State Hospital, Gaziantep, Turkey.
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Atilgan N, Ipek B, Duman N, Orhan O, Yilmaz M. Can anterolateral thigh flap be a rescuer in lower extremity injuries? Eur Rev Med Pharmacol Sci 2023; 27:7005-7011. [PMID: 37606109 DOI: 10.26355/eurrev_202308_33272] [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] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
OBJECTIVE The lower extremity contains a variety of functional structures therefore re-establishing soft tissue coverage in large-scale injuries is a challenging procedure. Microsurgery has made progress in reducing donor morbidity and achieving a functional and aesthetic appearance in recent years. This study aimed to apply anterolateral thigh (ALT) flap to tissue defects in the lower extremity and to discuss the results. PATIENTS AND METHODS Twenty-three patients who were admitted to our hospital with lower extremity trauma and underwent ALT flap surgery due to soft tissue defect between November 2020 and March 2022 were included in the study. Patients' demographic data, the applied surgical procedure, the development of postoperative complications, and postoperative functional results were evaluated. RESULTS Twenty-three patients were included in this research. The mean age of the patients was 36.56±14.67 (10-61). Of these patients, 3 were female (13%), and 20 were male (87%). The most common etiology was traffic accident (n=8, 34%), followed by gunshot injuries (n=5, 21%), electrical burn (n=4, 17%), open fractures (n=2, 7%), infection (n=2, 7%), diabetic foot (n=1, 4%), skin tumor (n=1, 4%). Flaps were raised from the contralateral extremity in twelve patients (52%) and on the ipsilateral extremity in eleven patients (48%). The average time from first trauma to free flap surgery was 10.7±5 days (4-22). The average postoperative hospitalization was 13.6 days (9-23 days). The average follow-up time of patients was 8 months (3-13 months). The donor site is closed with primary saturation in 19 patients (82%) and closed with split-thickness skin grafting in 4 patients (18%). Our overall success rate was 96%. We had only one total flap failure out of twenty-three patients (4%). CONCLUSIONS ALT-free flap is an excellent choice for reconstructing lower extremity complex defects. For experienced surgeons, the ALT flap can be used successfully in the treatment of soft tissue defects of variable size in the lower extremity.
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Affiliation(s)
- N Atilgan
- Department of Hand Surgery, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.
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Cebeci S, Aydos U, Yeniceri A, Pula D, Duzlu M, Atay LO, Yilmaz M. Diagnostic performance of FDG PET/MRI for cervical lymph node metastasis in patients with clinically N0 head and neck cancer. Eur Rev Med Pharmacol Sci 2023; 27:4528-4535. [PMID: 37259734 DOI: 10.26355/eurrev_202305_32459] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Treatment management in cases of head and neck squamous cell cancer (HNSCC) that are clinically negative for lymph node metastases (cN0) is still an important topic of discussion. There is increasing interest in sensitive imaging modalities that can detect the risk of occult metastases at levels below 20%. This study aimed to examine the efficacy of integrated positron emission tomography (PET)/magnetic resonance imaging (MRI) in determining neck nodal metastasis status in cN0 patients with HNSCC. PATIENTS AND METHODS In this retrospective study, 44 patients who underwent neck dissection with the diagnosis of HNSCC between January 2018 and August 2020 were analyzed. Clinical examinations, including ultrasonography, were performed to identify cervical metastases in HNSCC patients with preoperative cN0. A nuclear medicine specialist visually evaluated the MRI, PET, and PET/MRI results. RESULTS Histopathologically, 86.4% of patients were classified as N0. According to the histopathological results, MRI showed 50% sensitivity, 89.5% specificity, 91.8% negative predictive value (NPV), 42.8% positive predictive value (PPV) and 84% accuracy, while PET showed 83.3% sensitivity, 68.4% specificity, 96.2% NPV, 29.4% PPV and 70.4% accuracy. PET/MRI was more successful in distinguishing pathological N0 and N+ patients (83.3% sensitivity, 92.1% specificity, 97.2% NPV, 62.5% PPV and 90.9% accuracy). CONCLUSIONS PET/MRI is more sensitive and has a higher NPV compared to MRI alone, while its sensitivity was found to be comparable to that of PET. In addition, with its ability to detect pathological N0 patients, PET/MRI may significantly decrease the number of unnecessary neck dissections.
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Affiliation(s)
- S Cebeci
- Department of Otorhinolaryngology/Head and Neck Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
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Karaaslan M, Olcucuoglu E, Kurtbeyoglu S, Tonyali S, Yilmaz M, Odabas O. El bloqueo del plano del erector espinal antes de leoch reduce el tiempo de fluoroscopia y garantiza la comodidad durante el tratamiento de la litiasis renal: estudio prospectivo aleatorizado. Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2023.02.005] [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: 03/13/2023]
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Atescelik M, Yilmaz M. Ubiquitin C-terminal hydrolase 1 is increased in migraine attack. Rev Neurol (Paris) 2023; 179:201-207. [PMID: 36163088 DOI: 10.1016/j.neurol.2022.06.010] [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: 02/16/2022] [Revised: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aimed to determine the serum level of Ubiquitin C-terminal hydrolase 1 enzyme during a migraine attack and after its treatment. METHODS Blood samples of 43 patients and 30 healthy controls who presented to the emergency department with migraine attacks were analysed. Study sample was classified into three groups: Group 1 (patients presenting with migraine attack), Group 2 (4thhour after dexketoprofen treatment) and Group 3 (healthy control). Demographic data of patients, visual analogue scale and Ubiquitin C-terminal hydrolase 1 levels were analysed. RESULTS Median (IQR) Ubiquitin C-terminal hydrolase 1 levels were 13.70 (10.75-18.92) in Group 1, 9.45 (6.95-11.56) in Group 2 and 6.04 (3.88-8.72) ng/mL in Group 3; the Kruskal-Wallis test result showed a significant difference between the groups (P<0.001). Following the Kruskal-Wallis test, the post-hoc Dunn test was performed for binary comparison between the groups, which revealed significant differences between all groups (Group 1-Group 2, Group 1-Group 3 and Group 2-Group 3 with P=0.001, P<0.001 and P=0.008, respectively). Moreover, a significant positive correlation was found between VAS score and UCHL1 levels before treatment (r=0.884, P<0.001). CONCLUSION UCHL1 levels of patients with migraine increase during acute attack and they can be used to assess the severity of attack and response to treatment.
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Affiliation(s)
- M Atescelik
- Department of Medicine, Firat University of Emergency Medicine, Yunus Emre road, 23200 Elazig, Turkey
| | - M Yilmaz
- Department of Medicine, Firat University of Emergency Medicine, Yunus Emre road, 23200 Elazig, Turkey.
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Atilgan N, Duman N, Colak TS, Korucu IH, Demiryurek M, Yilmaz M. Comparison of the results of percutaneous and open screw fixation in the treatment of scaphoid nonunion fractures. Eur Rev Med Pharmacol Sci 2022; 26:9204-9211. [PMID: 36591832 DOI: 10.26355/eurrev_202212_30673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Our study aims to compare the clinical results of percutaneous screw fixation and non-vascularized bone grafting with open screw fixation in patients who did not achieve union due to failure in diagnosis and treatment after a scaphoid fracture. PATIENTS AND METHODS Forty-three patients with scaphoid nonunion fractures corresponding to the first three Slade and Dodds classification were divided into two groups. Non-vascularized bone grafting with open reduction and internal fixation (ORIF) was applied to 24 patients in the first group, and 19 patients in the second group were treated with a closed reduction and internal fixation (CRIF) (percutaneous screw fixation). The patients were followed up for preoperative and postoperative functional scores and time to union. RESULTS Our study found that the scaphoid was most commonly fractured in the waist of the scaphoid. In our study, we found that distal scaphoid fractures had the highest union rate (100%), followed by the waist fractures (93.2%) and the weakest union (50%) in the proximal pole fractures. We observed that the fastest union had occurred in the fractures of the waist. We also observed that the union was completed earlier in patients who operated with ORIF than those with CRIF. We found union in 87.5% of patients who underwent ORIF, in 84.2% of patients who underwent CRIF. CRIF operation duration was shorter than expected from ORIF operation duration. CONCLUSIONS We found that similar union rates could be achieved in the patient groups who underwent percutaneous and open screw fixation by selecting the appropriate patient in scaphoid nonunion fractures. Union was faster and functional results were more satisfactory in the ORIF group. The operation time was shorter in the CRIF group.
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Affiliation(s)
- N Atilgan
- Department of Hand Surgery, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.
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Yilmaz M, Aydin M, Capkin S. Acetabular dysplasia: a comparison of periacetabular osteotomy results of patients older and younger than 35 years. Eur Rev Med Pharmacol Sci 2022; 26:8303-8310. [PMID: 36459013 DOI: 10.26355/eurrev_202211_30362] [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] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Patient age has been reported to be an important determinant of treatment success in developmental dysplasia of the hip (DDH). This study aimed to determine the efficacy of periacetabular osteotomy (PAO) in DDH patients aged ≥ 35 years and to compare patient-reported and radiological outcomes with a control cohort of younger patients. PATIENTS AND METHODS This retrospective analysis included 43 patients (23 aged < 35 years; 20 aged ≥ 35 years) who underwent unilateral Bernese PAO for symptomatic DDH, between May 2001 and August 2015. Patients with a history of ipsilateral pelvic osteotomy or other pelvic pathologies were excluded. To evaluate the morphology of the dysplastic hip joints, 11 conventional radiographic measures were taken. Preoperative and postoperative Harris Hip Scores, postoperative visual analogue scale scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and hip range of motion measurements were used for clinical evaluation. RESULTS Of the 43 patients, 31 (72.1%) were women and 14 (27.9%) were men. The average age was 32 (range: 19-45) years. Regarding sex, surgery site, mean body mass index and mean follow-up time, there were no significant differences between the groups. Both groups showed significant differences in radiographic parameters before and after the PAO. There were no significant differences in preoperative or postoperative clinical outcomes between the groups, except for the WOMAC score. CONCLUSIONS PAO can be performed safely to treat acetabular dysplasia in patients aged ≥ 35 years, before the onset of femoroacetabular osteoarthritis, with satisfactory clinical and functional outcomes.
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Affiliation(s)
- M Yilmaz
- Haseki Training and Research Hospital, Sultangazi, Istanbul, Turkey.
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Uyanik A, Sahin O, Akceylan E, Eymur S, Uyanik I, Yilmaz M. Effect of Calix[4]arene as a Hydrophobic Substituent on Proline Catalysis of Direct Asymmetric Aldol Reactions in the Presence of Water. RUSS J GEN CHEM+ 2022. [DOI: 10.1134/s107036322211024x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Koca I, Ucar M, Arik HO, Yilmaz M, Dokuyucu R. Alpha-lipoic acid could be a promising treatment in steroid-induced osteonecrosis. Eur Rev Med Pharmacol Sci 2022; 26:7404-7412. [PMID: 36314310 DOI: 10.26355/eurrev_202210_30009] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Glucocorticoid-induced osteonecrosis is a serious debilitating health problem. In the present study, we investigated the effects of alpha-lipoic acid on glucocorticoid-induced osteonecrosis in rats. MATERIALS AND METHODS A total of 40 male Wistar albino rats were equally assigned to 4 groups as control, methylprednisolone acetate (MPA), alpha-lipoic acid (ALA), and methylprednisolone acetate with alpha-lipoic acid (MPA+ALA). The animals in MPA group subcutaneously received 15 mg/kg/week for 2 weeks, whereas 100 mg/kg/day alpha-lipoic acid was intraperitoneal administered for 4 weeks to ALA group. The MPA+ALA group was subjected to both treatments in same doses. Osteonecrosis was confirmed and graded histologically. The serum concentrations of glucose, total cholesterol, low- and high-density lipoprotein, triglyceride, as well as the total oxidant and antioxidant status, oxidative stress index, prothrombin time and activated partial thromboplastin time were evaluated. Also, lipid peroxidation and DNA damage were immunohistochemically assessed in the bone. RESULTS Osteonecrotic lesions were narrower in the MPA+ALA group than in the MPA group (p<0.05). As compared to the controls, the biochemical parameters in MPA and MPA+ALA groups were significantly increased (p<0.001). The oxidative stress index was significantly higher in the groups with MPA than the controls (p=0.002), but the animals treated with ALA alongside MPA displayed lesser scores than the ones injected with solely MPA (p=0.03). The administration of MPA elevated lipid peroxidation and DNA damage, which were successfully alleviated by ALA. CONCLUSIONS Alpha-lipoic acid may be suggested to be a protective supplement in glucocorticoid-induced osteonecrosis in rats. The antioxidant capacity of alpha-lipoic acid may involve its beneficial effects.
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Affiliation(s)
- I Koca
- Department of Physical Medicine and Rehabilitation, Private Clinic, Gaziantep, Turkey.
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Kayikcioglu M, Temizhan A, Gungor B, Yilmaz M, Ozdogan O, Cinar O, Oz T, Sinan U, Yuksel U, Tokgözoğlu L. Management of secondary prevention patients with LDL-cholesterol levels < 70mg/dl (1.8mmol/l): An analysis based on Delphi panel approach. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.560] [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: 11/02/2022]
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Kayikcioglu M, Yuksel U, Yilmaz M, Temizhan A, Sinan U, Ozdogan O, Oz T, Kuş M, Gungor B, Tokgözoğlu L. Management of patients with LDL-cholesterol levels >190mg/dl (4.9mmol/l) in Turkey: An analysis based on Delphi panel approach. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.561] [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: 11/02/2022]
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Yilmaz M, Cinar O, Gungor B, Kayikcioglu M, Oz T, Ozdogan O, Sinan U, Temizhan A, Yuksel U, Tokgözoğlu L. Distribution of cardiovascular risk among patients with dyslipidemia in Turkey: Results from a Delphi panel. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.559] [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: 11/02/2022]
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Ozdogan O, Gungor B, Kayikcioglu M, Oz T, Ozcan K, Sinan U, Temizhan A, Yilmaz M, Yuksel U, Tokgözoğlu L. Hospitalization features and mortality rates of very high-risk patients with dyslipidemia in Turkey. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.564] [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: 11/02/2022]
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Pfeiffer P, Yilmaz M, Nordsmark M, Möller S, Elle I, Ladekarl M, Winther S, Qvortrup C, Baeksgaard L. O-4 Trifluridine/tipiracil (TAS-102) with or without bevacizumab in patients with pretreated metastatic esophago-gastric adenocarcinoma (mEGA): A Danish randomized trial (LonGas). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.445] [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: 11/01/2022] Open
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Uzumcu H, Ozpelit E, Ozpelit M, Ercan E, Sahinoglu B, Yilmaz M. The role of coronary CT angiography and person"s lifestyle habits in assessment of risk for primer protection from cardiovascular diseases. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Prevention of atherosclerotic coronary artery disease (CAD), is primarily based on risk assesment. SCORE risk model is the most widely used risk assesment tool which is a comprehensive model of classical risk factors for CAD . However this model does not include several important risk factors such as socioeconomic level, education status, social support , sedantary life style, systemic inflammation and etc.. SCORE model also does not have any component about imaging findings. Actually high Agatston score, which measures coronary artery calcium (CAC) in cardiac computed tomography angiography (CCTA) is an important risk estimator for CAD.
Aim
The aim of this study is to investigate the importance of CCTA findings together with sociocultural and lifestyle characteristics of individuals on top of SCORE risk assesment
Methods
565 patients who applied to the Izmir Medical Park Hospital cardiology outpatient clinic between 15.01.2019-20.01.2020 and underwent CCTA were screened. Patients with known CAD were excluded,497 people were included in the study.Cardiovascular risk factors, socioeconomic and lifestyle characteristics of the person were learned and SCORE risk calculated. Agatston CAC score (CACS), presence of hepatosteatosis, paracardial adipose tissue thickness (PATT) measured in CCTA.Data of individuals were analyzed in terms of presence of Agatston CACS. Parameters that were significant in univariate analysis were included in multivariate analysis. Independent predictors of atherosclerosis were investigated.
Results
Patients were divided into 2 groups according to CAC score: group 1 with an CCS = 0 and group 2 as CCS > 0 . Among several lifestyle and sociocultural characteristics assesed, only having an active working life was found to be significantly associated with CCS = 0 (table 1) However in multivariate analysis, significance was lost for active working ; the only significant predictors of CCS = 0 were SCORE value of <5 and PATT < 5mm. (table 2) The PATT value was a more powerful predictor of atherosclerosis compared to the all other well known metabolic parameters such as BMI, blood glucose and lipid levels
Conclusion
Although SCORE risk model does not include components about lifestyle characteristics of individuals and imaging findings , it was the most powerful estimator of presence of atherosclerosis. No single lifestyle characteristics was able to predict CAD independently. However the PATT which is a marker of visseral obesity with inflamatory roles on heart and coronary arteries, was found to be an independent predictor of atherosclerosis on top of SCORE risk. So we think that The measurement of PATT can be useful to predict an individual"s risk of atherosclerosis. We can use it in our routine practice to make the risk assessment of people more effective. Abstract Figure. Independent Predictors of Being Agatston Abstract Figure. Independent Predictors of Being Agatsto2
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Affiliation(s)
- H Uzumcu
- Sivas Public Hospital, Sivas, Turkey
| | - E Ozpelit
- Dokuz Eylul University, cardiology, Izmir, Turkey
| | - M Ozpelit
- Medical Park Izmir Hospital, cardiology, Izmir, Turkey
| | - E Ercan
- Medical Park Izmir Hospital, cardiology, Izmir, Turkey
| | - B Sahinoglu
- Dokuz Eylul University, cardiology, Izmir, Turkey
| | - M Yilmaz
- Dokuz Eylul University, cardiology, Izmir, Turkey
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Evliyaoglu F, Kurt M, Yilmaz M, Akpolat C. Evaluation of microvascular density and retinal vessel diameter in gestational and type 2 diabetes using swept-source OCT-A technology. J Fr Ophtalmol 2022; 45:430-437. [DOI: 10.1016/j.jfo.2021.06.014] [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: 03/11/2021] [Revised: 06/04/2021] [Accepted: 06/14/2021] [Indexed: 10/19/2022]
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Pedersen B, Jensen M, Yilmaz M, Mørch C, Feilberg C. CN52 A peculiar experience: Everyday life with chronic sensory disturbances after oxaliplatin treatment for colorectal cancer: A phenomenological study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.682] [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: 11/17/2022] Open
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Arici ZS, Romano M, Piskin D, Guzel F, Yilmaz M, Demirkaya E. POS1372 EVALUATION OF E148Q AND CONCOMITANT AA AMYLOIDOSIS SECONDARY TO FAMILIAL MEDITERRANEAN FEVER AFTER ADJUSTED CLINICAL-DEMOGRAPHIC CHARACTERISTICS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Amyloid A (AA) amyloidosis, previously known as secondary or reactive amyloidosis, is a long-recognized severe complication of some chronic inflammatory diseases. The pathogenesis and risk factors for amyloidosis in Familial Mediterranean Fever (FMF) remain partially understood (1). The development of AA amyloidosis is dependent on ethnicity and country of residence (2). In the pre-colchicine era, renal AA-amyloidosis was largely reported patients of Turkish (67%) and Sephardic Jewish ancestry (26.5%) (2,3). Currently it’s well known that the MEFV M694V variant associated with high risk of amyloidosis however, mutations on exon 2, specifically E148Q variant remained controversial.Objectives:To evaluate the E148Q mutation variant and concomitant AA Amyloidosis secondary to FMF after adjusted clinical-demographic characteristics.Methods:Patients were recruited from the renal unit at Epigenetic Health Center outpatient clinic in Turkey between September 2003 and February 2020. Patients who had biopsy confirmed FMF related AA amyloidosis were included the study. Tel-Hashomer criteria were applied in the diagnosis of FMF. The clinical characteristics of FMF patients and medication history were recorded by the physician at the time of registry entry. All patients had detailed baseline assessment of clinical features, renal functions, genetic testing, histopathological diagnosis of amyloidosis, and treatment received. We performed multiple comparisons according to the age of diagnosis, demographic features, disease phenotype, allele frequency, type of mutation and mortality. Statistical analysis was performed with Statistical Package of Social Science (SPSS) for Windows, version 15.0 (SPSS Inc, Chicago, IL).Results:Our registry consists of 195 patients with a diagnosis of AA amyloidosis. Complete information on 169 patients (lost to follow up, n=26) were included. The median age was 36 (19-49) years; male/female ratio was 1.6 (104/65). The median follow-up duration was 15.0 years (4-17 years). There were 101 patients diagnosed with FMF <18 years of age and 68 patients diagnosed ≥18 years of age. All participants developed renal amyloidosis before the age of 32 years. Family history of FMF was documented in 56 patients (33.1%) and family history of amyloidosis was present in 41 patients (24.3%). The three most common clinical symptoms were fever (84,6%), abdominal pain (71.6%) and arthritis (66.9%). During the follow-up, 5 patients started dialysis treatment and 9 patients had kidney transplantation. The most common allele frequency across patients was M694V (60.6%), E148Q (21.4%) and M680I (10.3%). The most frequent mutations were M694V/M694V (63.3%), M694V/E148Q (20.8%) and E148Q/E148Q (15.8%). During the follow up period, 15 patients (10 male, 5 female) died. In those that died, the mutations in 14 had M694V/M694Vand one demonstrated E148Q/E148Q.Conclusion:Patients with FMF related AA amyloidosis have an increased risk for mortality. This study confirmed the association between M694V and FMF-associated AA amyloidosis, which has been reported in many studies. Close clinical follow-up and further evaluation of patients with the E148Q mutation is warranted specifically if residing in FMF endemic areas. The possible relationship between E148Q and AA amyloidosis need to be confirmed in other cohorts.References:[1]Erer B, Demirkaya E, Ozen S, Kallinich T. What is the best acute phase reactant for familial Mediterranean fever follow-up and its role in the prediction of complications? A systematic review. Rheumatology international. 2016;36(4):483-7.[2]Touitou I, Sarkisian T, Medlej-Hashim M, Tunca M, Livneh A, Cattan D, et al. Country as the primary risk factor for renal amyloidosis in familial Mediterranean fever. Arthritis and rheumatism. 2007;56(5):1706-12.[3]Pras M, Bronshpigel N, Zemer D, Gafni J. Variable incidence of amyloidosis in familial Mediterranean fever among different ethnic groups. Johns Hopkins Med J. 1982;150(1):22-6.Disclosure of Interests:None declared
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Romano M, Garcia-Bournissen F, Piskin D, Cimaz R, Yilmaz M, Demirkaya E. POS1352 ANTIINFLAMMATORY, ANTIOXIDANT AND ANTI-ATHEROSCLEROTIC EFFECTS OF A COMBINATION OF NATURAL SUPPLEMENTS ON PATIENTS WITH FMF RELATED AA AMYLOIDOSIS: A NON-RANDOMIZED 24 WEEKS OPEN LABEL INTERVENTIONAL STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Few studies have focused on Familial Mediterranean Fever (FMF)-related AA amyloidosis and cardiovascular disease event risk. Systemic inflammation stimulates the development and progression of atherosclerosis which is accelerated by vascular endothelial inflammation and enhanced oxidative stress. Excessive reactive oxygen species (ROS) generation has been reported in FMF, which correlated with attack severity. ROS may also be involved in amyloid formation, and in the pathogenesis of progressive renal injury.Objectives:In this non-randomized, 24 weeks open label interventional study, we aimed to evaluate the effect of a combination of natural products on parameters related to inflammation, endothelial dysfunction and oxidative stress in a cohort of FMF patients with AA amyloidosis.Methods:Morinda citrifolia (anti-atherosclerotic liquid- AAL), omega-3 (anti-inflammatory capsules- AIC) and extract with Alaskan blueberry (anti-oxidant liquid- AOL) were given to patients with FMF related AA amyloidosis. We included patients with biopsy proven AA amyloidosis, older than 18 years who have normal estimated glomerular filtration rate (eGFR) and proteinuria [>3500mg/day]. Flow-mediated dilatation (FMD), asymmetric dimethylarginine (ADMA), hs-CRP, serum PTX3, Carotis intima media thickness (CIMT), malondialdehyde (MDA), Cu/Zn-superoxide dismutase (Cu/Zn-SOD), glutathione peroxidase (GSH-Px) levels were studied in baseline and after 24 weeks.Results:67 FMF-related amyloidosis [52 male (77.6%); median recruitment age 36 years (range 21-66)] were enrolled. M694V mutation was the most common mutation found (74%), with 50.7% of the patients in homozygosity. All patients were treated with colchicine, and most of them (83.6%) has been on colchicine treatment at the time of enrollment. Serum ADMA, MDA, PTX3, hsCRP, cholesterol, and proteinuria were significantly decreased compared to baseline, while CuZn-SOD, GSH-Px and FMD levels were significantly increased following AAL, AIC and AOL therapies (Table 1). The change of the inflammatory markers PTX3, and hsCRP were negatively correlated with the change in FMD and positively correlated with the change of proteinuria, ADMA, MDA, cholesterol and CIMT.Conclusion:24 weeks of AAL, AIC and AOL combined supplementation was significantly associated with reduction in serum inflammatory markers (PTX3 and hsCRP), improved endothelial functions (FMD, ADMA), and oxidative state (MDA). Our findings highlight the link among the three pathogenetic mechanisms including inflammation, endothelial function and oxidative status in progression of atherosclerosis and renal injury in patients with FMF related AA amyloidosis. Efficient control of these three mechanisms can have long term benefits from the cardiovascular and renal perspective of the patients with AA amyloidosis.References:[1]Romano M et al. Sci Rep, 2020[2]Yilmaz M et al. Sci Rep, 2020Table 1.Comparison of clinical and laboratory characteristics at the baseline and after 24 weeks of AAL, AIC and AOL supplementationBaselineMean (SD)24th weekMean (SD)DeltaMean (SD)pTotal Cholesterol (mg/dl)221.2 (60.3)155.8 (35.4**)-65.3 (55.5)<0.001eGFR (ml/min/ 1.73 m2)110.2 (12.8)104.1 (11.2**)-6.1 (11.9)<0.001Malondialdehyde (MDA) (nmol/ml)4.2 (1.8)1.8 (0.5**)-2.2 (1.8)<0.001CuZn-SOD (U/ml)431.5 (154.7)538.1 (146.4**)159.7 (211.8)<0.001GSH-Px (U/ml)47.8 (13.2)74.1 (20.3**)26.3 (21.1)<0.001ADMA (µmol/l)4.5 (2.6)1.3 (0.6**)-3.2 (2.5)<0.001FMD (%)5.0 (0.7)6.4 (0.8**)1.3 (0.9)<0.001CIMT (mm)0.9 (0.2)0.7 (0.1)-0.2 (0.2)<0.001Proteinuria (mg/24h)6855.3 (3116.9)4079.9 (2359.6)-2775.3 (2874.5)<0.001hs-CRP (mg/l)25.5 (4.4-48.0)3.0 (1.0-9.1)*-20.8 (11.2)<0.001PTX3 (ng/ml)13.4 (2.3-67.0)2.3 (0.4-14.5)*-17.5(17.5)<0.001Disclosure of Interests:None declared
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Larsen A, Brøndum Frøkjær J, Fisker R, Yilmaz M, Kristensen S, Thorlacius-Ussing O. PO-23 Hypercoagulabilty in upper gastrointestinal cancer patients: a longitudinal study. Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00196-1] [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: 11/25/2022]
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Atik Altinok Y, Seyidoglu D, Yilmaz M, Bozkurt D, Meseri R, Savas S, Sarac F, Akcicek F. New versus old Ewgsop criteria: Impact on the prevelance of sarcopenia. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.826] [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: 11/25/2022]
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Henderson A, Paterson DL, Chatfield MD, Tambyah PA, Lye DC, De PP, Lin RTP, Chew KL, Yin M, Lee TH, Yilmaz M, Cakmak R, Alenazi TH, Arabi YM, Falcone M, Bassetti M, Righi E, Ba R, Kanj SS, Bhally H, Iredell J, Mendelson M, Boyles TH, Looke DFM, Runnegar NJ, Miyakis S, Walls G, Ai Khamis M, Zikri A, Crowe A, Ingram PR, Daneman NN, Griffin P, Athan E, Roberts L, Beatson SA, Peleg AY, Cottrell KK, Bauer MJ, Tan E, Chaw K, Nimmo GR, Harris-Brown T, Harris PNA. Association between minimum inhibitory concentration, beta-lactamase genes and mortality for patients treated with piperacillin/tazobactam or meropenem from the MERINO study. Clin Infect Dis 2020; 73:e3842-e3850. [PMID: 33106863 DOI: 10.1093/cid/ciaa1479] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [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: 12/08/2019] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION This study aims to assess the association of piperacillin/tazobactam and meropenem minimum inhibitory concentration (MIC) and beta-lactam resistance genes with mortality in the MERINO trial. METHODS Blood culture isolates from enrolled patients were tested by broth microdilution and whole genome sequencing at a central laboratory. Multivariate logistic regression was performed to account for confounders. Absolute risk increase for 30-day mortality between treatment groups was calculated for the primary analysis (PA) and the microbiologic assessable (MA) populations. RESULTS 320 isolates from 379 enrolled patients were available with susceptibility to piperacillin/tazobactam 94% and meropenem 100%. The piperacillin/tazobactam non-susceptible breakpoint (MIC > 16 mg/L) best predicted 30-day mortality after accounting for confounders (odds ratio 14.9, 95% CI 2.8 - 87.2). The absolute risk increase for 30-day mortality for patients treated with piperacillin/tazobactam compared with meropenem was 9% (95% CI 3% - 15%) and 8% (95% CI 2% - 15%) for the original PA population and the post-hoc MA populations, which reduced to 5% (95% CI -1% - 10%) after excluding strains with piperacillin/tazobactam MIC values > 16 mg/L. Isolates co-harboring ESBL and OXA-1 genes were associated with elevated piperacillin/tazobactam MICs and the highest risk increase in 30-mortality of 14% (95% CI 2% - 28%). CONCLUSION After excluding non-susceptible strains, the 30-day mortality difference was from the MERINO trial was less pronounced for piperacillin/tazobactam. Poor reliability in susceptibility testing performance for piperacillin/tazobactam and the high prevalence of OXA co-harboring ESBLs suggests meropenem remains the preferred choice for definitive treatment of ceftriaxone non-susceptible E. coli and Klebsiella.
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Affiliation(s)
- A Henderson
- University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia.,Infection Management Services, Princess Alexandra Hospital, Brisbane, QLD
| | - D L Paterson
- University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
| | - M D Chatfield
- University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
| | - P A Tambyah
- Department of Infectious Diseases, National University Hospital, Singapore
| | - D C Lye
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Infectious Diseases, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore,Hospital, Singapore
| | - P P De
- Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore
| | - R T P Lin
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - K L Chew
- Division of Microbiology, National University Hospital, Singapore
| | - M Yin
- Department of Infectious Diseases, National University Hospital, Singapore
| | - T H Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Infectious Diseases, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - M Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - R Cakmak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - T H Alenazi
- King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Y M Arabi
- King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - M Falcone
- Division of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - M Bassetti
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa and Ospedale Policlinico San Martino Genoa, Italy
| | - E Righi
- Infectious Diseases Clinic, Department of Medicine University of Udine and Santa Maria Misericordia Hospital, Udine, Italy.,Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Rogers Ba
- Monash University, Centre for Inflammatory Diseases, Victoria, Australia.,Monash Infectious Diseases, Monash Health, Victoria, Australia
| | - S S Kanj
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - H Bhally
- Department of Medicine and Infectious Diseases, North Shore Hospital, Auckland
| | - J Iredell
- Marie Bashir Institute for Infectious Disease and Biosecurity, University of Sydney, Sydney, Australia.,Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, Australia
| | - M Mendelson
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - T H Boyles
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - D F M Looke
- Infection Management Services, Princess Alexandra Hospital, Brisbane, QLD.,University of Queensland, Brisbane, Australia
| | - N J Runnegar
- Infection Management Services, Princess Alexandra Hospital, Brisbane, QLD.,University of Queensland, Brisbane, Australia
| | - S Miyakis
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia.,Department of Infectious Diseases, Wollongong Hospital, Wollongong, New South Wales, Australia
| | - G Walls
- Department of Infectious Diseases, Middlemore Hospital, Auckland, New Zealand
| | - M Ai Khamis
- King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - A Zikri
- King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - A Crowe
- Department of Infectious Diseases, St Vincent's Hospital, Melbourne, Australia.,Department of Microbiology, St Vincent's Hospital, Melbourne, Australia
| | - P R Ingram
- School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Australia.,Department of Infectious Diseases, Fiona Stanley Hospital, Murdoch , Australia.,Department of Microbiology, PathWest Laboratory Medicine, Perth, Western Australia
| | - N N Daneman
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - P Griffin
- University of Queensland, Brisbane, Australia.,Department of Medicine and Infectious Diseases, Mater Hospital and Mater Medical Research Institute, Brisbane, Australia.,QIMR Berghofer, Brisbane, Queensland, Australia
| | - E Athan
- Department of Infectious Diseases, Barwon Health and Deakin University, Geelong, Victoria, Australia
| | - L Roberts
- Australian Centre for Ecogenomics, School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia
| | - S A Beatson
- Australian Centre for Ecogenomics, School of Chemistry and Molecular Biosciences, The University of Queensland, Queensland, Australia
| | - A Y Peleg
- Infection & Immunity Program, Biomedicine Discovery Institute, Monash University, Clayton, Australia.,Department of Microbiology, Monash University, Clayton, Australia
| | - K K Cottrell
- University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
| | - M J Bauer
- University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
| | - E Tan
- University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
| | - K Chaw
- Department of Microbiology, Pathology Queensland, Toowoomba Laboratory, Australia.,Department of Microbiology, Mater Pathology, Australia.,Infectious Diseases Department, Redcliffe Hospital, Australia
| | - G R Nimmo
- Department of Microbiology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - T Harris-Brown
- University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
| | - P N A Harris
- University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia.,Department of Microbiology, Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Castaman G, Borchiellini A, Santagostino E, Radossi P, Aksu S, Yilmaz M, Serban M, Uscatescu V, Truica C, Fasulo MR, Mancuso ME, Paladino E, Valpreda A, Guarnieri C, Macchia R, Scarpellini M, Mathew P, Morfini M. Non-Compartment and compartmental pharmacokinetics, efficacy, and safety of Kedrion FIX concentrate. Eur J Pharm Sci 2020; 153:105485. [PMID: 32712218 DOI: 10.1016/j.ejps.2020.105485] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/22/2020] [Accepted: 07/20/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND An open-label phase II, multicenter clinical trial was conducted at 11 Haemophilia Centres in Italy, Romania, and Turkey, to evaluate the pharmacokinetics (PK), efficacy, and safety of high purity, plasma-derived, double virus inactivated and double nano-filtered factor IX (pd-FIX) concentrate (Kedrion FIX), EudraCT Number: 2005-006186-14. MATERIAL AND METHODS 16 previously treated patients (PTPs) with severe or moderately severe haemophilia B were enrolled in the study. At enrolment, 14 underwent the first PK assessment (PK I), and the second PK (PK II) assessment was performed after six months of treatment (5 on-demand and nine prophylaxis) at the end of the study. PK parameters were evaluated by Non-Compartmental Analysis (NCA), One-Compartment model (OCM), and Two-Compartment Model (TCM). Efficacy of Kedrion FIX in all 16 patients was evaluated by the number of bleeding events, and clinical response following the infusions. Periodic FIX inhibitor assays and thrombogenicity tests were scheduled throughout the study to assess the safety of the drug. RESULTS As compared to the published data on PK of pdFIX, Kedrion FIX displayed a longer half-life (22.37-55.73 hrs), reduced clearance, and regular volume of distribution at PK I by both NCA and OCM. The comparison of outcomes of PK II with those of PK I by OCM, also showed significant changes, particularly in patients on prophylaxis, who showed some improved parameters of PK. Due to two outlier values at the end of the trial, the NCA parameters of PK I were not compared to those of PK II. Breakthrough bleeds were successfully treated with 1 or 2 infusions. No significant adverse events were observed during the study. DISCUSSION During the six-month clinical study period, the use of Kedrion FIX resulted in a safe and effective pd-FIX concentrate with excellent PK characteristics.
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Affiliation(s)
- G Castaman
- Azienda Ospedaliero-Universitaria Careggi, Malattie Emorragiche e della Coagulazione, Largo Brambilla 3, 50134 Firenze, Italy
| | - A Borchiellini
- Azienda Ospedaliero-Universitaria, Città della Salute e della Scienza, CRR Malattie emorragiche e Trombotiche dell'adulto Ematologia, Corso Bramante, Torino, Italy
| | - E Santagostino
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Centro Emofilia e Trombosi Angelo Bianchi Bonomi, Via Pace 9, 20122 Milano, Italy
| | - P Radossi
- Regional Hospital and Haemophilia Hospital, Castelfranco Veneto, Italy
| | - S Aksu
- Hacettepe University Medical Faculty, Department of Internal Medicine, Sihhiye/Ankara, Turkey
| | - M Yilmaz
- SANKO University, School of Medicine Sani Konukoglu Application and Research Hospital, Department of Hematology, Gaziantep, Turkey
| | - M Serban
- "Louis Turcanu" Children Clinical Emergency Hospital, 21 Nemoianu str., Timisoara, Romania
| | - V Uscatescu
- Clinical Institute Fundeni, Bucharest 2nd district, Romania
| | - C Truica
- "Dr. Constantin Opris" Country Emergency Hospital, Hematology Department, Baia Mare, Romania
| | - M R Fasulo
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Centro Emofilia e Trombosi Angelo Bianchi Bonomi, Via Pace 9, Milano, Italy
| | - M E Mancuso
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Centro Emofilia e Trombosi Angelo Bianchi Bonomi, Via Pace 9, Milano, Italy
| | - E Paladino
- Azienda Ospedaliero-Universitaria Careggi, Malattie Emorragiche e della Coagulazione Largo Brambilla 3, Firenze, Italy
| | - A Valpreda
- Azienda Ospedaliero-Universitaria, Città della Salute e della Scienza, CRR Malattie emorragiche e Trombotiche dell'adulto Ematologia. Corso Bramante, Torino, Italy
| | - C Guarnieri
- Kedrion Biopharma, Global Medical Affairs, Castelvecchio Pascoli, Lucca, Italy
| | - R Macchia
- Kedrion Biopharma, Global Medical Affairs, Castelvecchio Pascoli, Lucca, Italy
| | - M Scarpellini
- Kedrion Biopharma, Global Medical Affairs, Castelvecchio Pascoli, Lucca, Italy
| | - P Mathew
- Prasad has a account Presbyterian Hospital, Albuquerque, NM, USA; Kedrion Biopharma, TA Lead Haematology, Global Medical Affairs, Fort Lee, NJ, USA
| | - M Morfini
- Italian Association of Haemophilia Centres (AICE), Milan, Italy.
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Montemurro F, Delaloge S, Barrios C, Wuerstlein R, Anton A, Brain E, Hatschek T, Kelly C, Peña-Murillo C, Yilmaz M, Donica M, Ellis P. Trastuzumab emtansine (T-DM1) in patients with HER2-positive metastatic breast cancer and brain metastases: exploratory final analysis of cohort 1 from KAMILLA, a single-arm phase IIIb clinical trial☆. Ann Oncol 2020; 31:1350-1358. [DOI: 10.1016/j.annonc.2020.06.020] [Citation(s) in RCA: 179] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/04/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022] Open
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Tunc L, Yalcin S, Kaya E, Gazel E, Yilmaz S, Aybal H, Yilmaz M, Tokas T. The novel HoLEP technique Omega Sign improves continence outcomes of surgery. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33424-8] [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: 10/23/2022] Open
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Pfeiffer P, Winther S, Yilmaz M, Möller S, Zitnjak D, Poulsen L, Thomsen K, Qvortrup C. PD-7 Updated survival analysis of the Danish randomized study comparing trifluridine/tipiracil with or without bevacizumab in patients with chemo-refractory metastatic colorectal cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.463] [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: 10/23/2022] Open
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Yilmaz M, Romano M, Basarali MK, Elzagallaai A, Karaman M, Demir Z, Demir MF, Seyrek M, Akcay F, Haksever N, Piskin D, Cimaz R, Rieder M, Demirkaya E. FRI0547 THE EFFECT OF CORRECTED INFLAMMATION, OXIDATIVE STRESS AND ENDOTHELIAL DYSFUNCTION ON FMD LEVELS IN PATIENTS WITH SELECTED CHRONIC DISEASES: A QUASI-EXPERIMENTAL STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:While the pathophysiology of chronic disorders varies there are three basic mechanisms - inflammation, oxidative stress and endothelial dysfunction – that are common in many chronic diseases. These mechanisms, which have a dynamic structure, are key to homeostasis. However, the failure of these mechanisms to work synchronously can lead to morbidity complicating the course of many chronic diseases.Objectives:To evaluate the effect of anti-atherosclerotic liquid (AAL), anti-inflammatory capsules (AIC) and anti-oxidant liquid (AOL) supplementation on the flow-mediated dilatation (FMD), inflammatory, oxidative stress and endothelial dysfunction markers in patients with selected chronic diseasesMethods:We analyzed data of 178 patients from cohorts with selected chronic diseases (Rheumatoid arthritis, familial Mediterranean fever, DM type-2, Hypertension, Multiple sclerosis, Chronic obstructive pulmonary disease, Alzheimer disease and Cancer) in this quasi-experimental study. Endothelial dysfunction was determined by FMD and serum asymmetric dimethylarginine (ADMA) levels. Serum ADMA, high sensitive C-reactive protein (hs-CRP), serum PTX3, malondialdehyde (MDA), Cu/Zn-superoxide dismutase (Cu/Zn-SOD), glutathione peroxidase (GSH-Px) levels and FMD were studied in baseline and after 12 weeks of Morinda citrifolia (AAL, 3 ml once per day), omega-3 (AIC, 3 capsules once per day) and extract with Alaskan blueberry and 21 different red purple fruit vegetables (AOL, 30 ml once per day). Stepwise multivariate regression analysis evaluated the association of FMD with clinical and serologic parameters.Results:Serum ADMA, MDA, PTX3, hsCRP and albumin levels, and proteinuria were significantly decreased and CuZn-SOD, GSH-Px and FMD levels were significantly increased following AAL, AIC and AOL therapies. FMD was negatively correlated with serum ADMA, MDA, PTX3, hsCRP levels, SBP and DBP and positively correlated to CuZn-SOD and eGFR levels both at baseline and after the 12-weeks treatment period. Multivariate regression analysis revealed that ADMA and PTX3 levels were independently related to FMD both before and after AAL, AIC and AOL therapies (Table 1, Figure 1).Conclusion:Our study shows that serum ADMA, MDA, PTX3 levels are associated with endothelial dysfunction in patients with selected chronic diseases. Short-term AAL, AIC and AOL therapies significantly improves FMD and normalizes ADMA, PTX3, hsCRP and MDA. This may have implications for adjunctive therapy in a number of chronic disorders.References:[1] Yilmaz MI, Saglam M, Caglar K, Cakir E, Sonmez A, Ozgurtas T et al. The determinants of endothelial dysfunction in CKD: oxidative stress and asymmetric dimethylarginine. Am J Kidney Dis. 2006;47(1):42-50. doi:10.1053/j.ajkd.2005.09.029.Disclosure of Interests:None declared
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Tezcan ME, Şen N, Yilmaz M, Volkan Ö, Tükel E, Yilmaz-Oner S. SAT0541 THE SEVERITY OF FMF MAY BE ASSOCIATED WITH CO-MORBIDITIES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Familial Mediterranean fever (FMF) is an auto inflammatory disease with recurrent attacks of serositis. Frequent attacks and disease related sequels may be associated with co-morbidities in FMF patients.Objectives:One of the tools for evaluating the FMF severity is the international severity scoring system for FMF (ISSF)1. This score includes disease related sequels, acute phase measurements, attack features and exertional leg pain. Therefore, more severe disease may be link with subclinical inflammation, amyloidosis and frequent, prolonged and widespread attacks. All these components may augment the frequency of non-disease related co-morbidities.Methods:We enrolled 158 FMF patients who fulfilled modifiedTel-HashomerDiagnosisCriteria2. The patients dichotomized based upon disease severity (mild disease or severe disease). Patients with ISSF scores lower or equal to 2 were accepted to have mild disease. Then, we compared frequency of non-disease related co-morbidities between the groups. These co-morbidities arehypertension, hypothyroidism, hyperthyroidism cardiovascular diseases, coronary artery diseases, cerebrovascular diseases, chronic renal disease (non-FMF related), chronic obstructive pulmonary diseases, and diabetes mellitus. This study was approved by the Local Research Ethics Committee and carried out in compliance with the Helsinki Declaration. All the patients gave written informed consent. P-value lower than 0.05 was considered as statistically significant.Results:Demographic features, disease duration, smoking history and body mass index (BMI) were similar between the groups. Frequency of co-morbidity in severe disease group was statistically higher than mild disease group (p=0.02). Most frequent co-morbidity was hypertension in both groups.Table.Features of mild and severe FMF groupsMild (n=135)Severe (n=23)pGender (M/F)47/8811/120.23Age36.4±11.336.5±14.30.68Smoking (%)38 (28.1)5 (21.7)0.52BMI (kg/m2)24.3±9.224.0±8.90.34Disease duration (year)7.7±11.38.6±14.30.09Amyloidosis (%)2 (1.4)3 (13.0)0.02Exon 10 homozygote (%)35 (25.9)9 (39.1)0.19Colchicine dosage (mg/day)1.2±0.41.4±0.50.02ISSF scores0.7 ±0.73.4±0.5<0.001Co-morbidity (%)25 (18.5)9 (39.1)0.02Conclusion:In our FMF patient cohort, we found that severity of the disease may be associated with higher frequency of co-morbidities. Therefore, clinicians should be aware of the high possibility of co-morbidities in patients with more severe FMF and addressed these co-morbidities timely and properly.References:[1]Demirkaya E, et al. Development and initial validation of international severity scoring system for familial Mediterranean fever (ISSF). Ann Rheum Dis 2016;75:1051-6.[2]Berkun Y, et al. Diagnostic criteria of familial Mediterranean fever. Autoimmun Rev 2014;13:388-90.Acknowledgments:NoneDisclosure of Interests:None declared
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Romano M, Yilmaz M, Jackson B, Acikel C, Piskin D, Berard R, Demirkaya E. FRI0501 CARDIOVASCULAR DISEASE RISK ASSESSMENT IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER RELATED AMYLOIDOSIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:FMF is an autosomal recessive disorder. Systemic inflammation in autoinflammatory disorders cause secondary systemic AA amyloidosis, which has been suggested as an important contributing factor to the excess cardiovascular disease (CVD) risk in patients with FMF.Objectives:Our aim was to investigate the CVD-related clinical outcomes in patients with FMF-related amyloidosis and to define risk factors for CVD events (CVDEs).Methods:A cross-sectional evaluation with prospective follow-up of consecutive patients with FMF-related amyloidosis or other non-diabetic primary glomerulonephropathy (PGN) was performed. Patients were followed for CVDEs. Flow-mediated dilatation (FMD), FGF-23 levels, serum lipid levels, hsCRP, BMI and homeostasis model assessment (HOMA) were assessed. A Cox regression analysis was performed to evaluate the probability of CVDEs associated with each risk factor.Results:There were 107 patients in FMF-related amyloidosis group and 126 patients with PGN group. Forty-seven CVDEs were registered during the 4.2-years follow up; all 28 patients in the FMF-related amyloidosis versus 14/19 patients with PGN group who developed CVDEs before 40 years of age (P=0.002) (Figure 1). CVD mortality was 2.8 times higher (95% CI 1.02-7.76, p=0.03) in patients with FMF-related amyloidosis (n=12) than PGN (n=5). Mortality due to CVD was higher in patients less than 40 years old with amyloidosis than PGN (12/107 and 3/126 respectively, RR=4.71, 95% CI 1.36-16.25, p=0.006). Patients with CVDEs had higher levels of proteinuria, hsCRP and FGF23, and lower FMD compared to patients without CVDEs. Across both groups, FGF23 and FMD levels were independently associated with the risk of CVDEs (Table 1).Table 1.Multivariate analysis of factors associated with the risk of suffering a cardiovascular eventBHR95.0% CI for Exp(B)pVariablesLowerUpperAll GroupsFGF23.0331.0341.0171.051<.001FMD-.946.388.262.575<.001PrimaryFGF23.0501.0511.0191.084.002glomerulopathyFMD-.651.522.300.908.021AmyloidosisFGF23.0341.0351.0121.058.003FMD-1.531.216.109.430<.001hsCRP-.040.961.9151.009.108FMD, Flow-mediated dilatation; hsCRP, high sensitivity C reactive protein; CI, Confidence intervalFigure 1.Comparison of cardiovascular disease survival between patients with FMF-related amyloidosis or primary glomerulopathy.Conclusion:Patients with FMF-related amyloidosis are at increased risk of CVDEs with early mortality age. These patients should be closely monitored and if inflammation is poorly controlled with colchicine, biological agents must be added to treatment even if they develop amyloidosis. We also found that hsCRP, FGF 23 and FMD levels were the strongest predictors of CVD risk in patients with FMF. These biomarkers can stratify risk of early CVD in patients with FMF-related amyloidosis.References:[1] Yilmaz, M.I., et al.,Endothelial function in patients with familial Mediterranean fever-related amyloidosis and association with cardiovascular events.Rheumatology (Oxford), 2014.53(11): p. 2002-8.Disclosure of Interests:None declared
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Bozkurt Yilmaz HE, Yilmaz M, Şen N, Altin C, Ünsal ZE, Tekin A, Akçay Ş. Assessment of atrial fibrillation and ventricular arrhythmia risk in patients with asthma by P wave/corrected QT interval dispersion. Eur Rev Med Pharmacol Sci 2019; 22:756-762. [PMID: 29461607 DOI: 10.26355/eurrev_201802_14308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Although the relationship between obesity-asthma, obesity-atrial fibrillation (AF) and obesity-sudden cardiac death is clearly known, the risk of AF and ventricular arrhythmia has not been clearly determined in asthmatic patients. The aim of this study was to investigate whether AF, ventricular arrhythmia, and sudden cardiac death risk were increased in asthmatic patients using P wave dispersion (PWD) and corrected QT interval dispersion (CQTD). PATIENTS AND METHODS The study was designed as a cross-sectional study. A total of 164 participants (88 patients with asthma and 76 healthy volunteers) were enrolled into the study. PWD and CQTD were measured and recorded in both groups. The statistical difference between the two groups was examined. RESULTS PWD was higher in the asthma patients than in control subjects (31.53 ± 3.18 vs. 30.33 ± 3.53, p = 0.023). However, there was no statistically difference between the groups in terms of CQTD measurement (43.9 ± 1.84 vs. 43.63 ± 2.06, p = 0.385). In comparison between control group and asthma subgroups (mild, moderate and severe), there was a statistically significant difference among these four groups in terms of PWD (p = 0.017). Subgroup analyses showed that this difference was mainly due to patients with severe asthma. CONCLUSIONS PWD value was elevated in asthmatic compared to the control group. The CQTD was not statistically significant between the groups. These results indicate that the risk of developing AF in asthmatic patients might be higher than in the normal population. Ventricular arrhythmia and sudden cardiac death risk may not be high in asthmatic patients.
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Affiliation(s)
- H E Bozkurt Yilmaz
- Department of Pulmonary Medicine, Baskent University Faculty of Medicine, Adana, Turkey.
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Feitsma H, Yilmaz M, Swennenhuis J, Rakszewska A, Hajo K, Splinter E, Simonis M, Van Min M, Van Wezel T. Targeted proximity ligation assays combined with sequencing for robust detection of translocations in FFPE samples. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rasmussen L, Yilmaz M, Falkmer U, Poulsen LØ, Bojesen S, Vittrup Jensen B, Johansen A, Chen I, Hansen C, Hasselby J, Pfeiffer P, Bjerregaard J, Nielsen S, Andersen F, Holländer N, Bøgsted M, Johansen J. Pre-treatment serum 25-hydroxyvitamin D levels and survival in a Danish cohort of patients with pancreatic cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Qvortrup C, Yilmaz M, Möller S, Zitnjak D, Maltha L, Krogh M, Petersen LN, Hejlesen F, Winther S, Thomsen K, Pfeiffer P. Early response evaluation and CEA response in patients treated in a Danish randomized study comparing trifluridine/tipiracil (TAS-102) with or without bevazicumab in patients with chemorefractory metastatic colorectal cancer (mCRC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.094] [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: 11/12/2022] Open
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Jensen M, Yilmaz M, Pedersen B. Everyday life with long-term chemotherapy induced peripheral neuropathy among patient in adjuvant treatment for colorectal cancer: A multi methods study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz276.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Toprak T, Şahin A, Akgul K, Kutluhan MA, Ramazanoglu MA, Yilmaz M, Sahan A, Verit A. The relationship between anogenital distance and lifelong premature ejaculation. Andrology 2019; 8:353-357. [PMID: 31536679 DOI: 10.1111/andr.12709] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Many diseases have been associated with anogenital distance, as an indicator of intrauterine androgen exposure. OBJECTIVES The aim of this study was to investigate the association between lifelong premature ejaculation and anogenital distance. MATERIALS AND METHODS The study included 140 participants: 70 with lifelong premature ejaculation (group 1) and 70 without any ejaculatory complaints (group 2). Premature Ejaculation Diagnostic Tool and stopwatch intravaginal ejaculatory latency time were recorded from all participants in order to evaluate ejaculatory function. Two variants of anogenital distance were measured: anogenital distance (from anus to the posterior base of the scrotum) from anus to the posterior base of the scrotum and anogenital distance (from anus to the cephalad insertion of the penis) to the cephalad insertion of the penis. We compared differences between groups and correlations between anogenital distance variants and patients' characteristics. RESULTS The groups were similar in terms of age, BMI, and total testosterone levels. The mean anogenital distance (from anus to the posterior base of the scrotum) scores were 59.45 ± 10.76 vs. 55.02 ± 10.13 (p = 0.01), and anogenital distance (from anus to the cephalad insertion of the penis) scores were 128.37 ± 22.2 vs. 126.78 ± 16.21 (p = 0.63) in groups 1 and 2, respectively. Significant correlation was observed between anogenital distance (from anus to the posterior base of the scrotum) and Premature Ejaculation Diagnostic Tool scores (r = 0.199, p = 0.019) and intravaginal ejaculatory latency time (r = -0.185, p = 0.028). There were no statistically significant differences between anogenital distance (from anus to the posterior base of the scrotum) scores and total testosterone levels and between anogenital distance (from anus to the cephalad insertion of the penis) and Premature Ejaculation Diagnostic Tool scores or intravaginal ejaculatory latency time. CONCLUSIONS These results suggest that longer anogenital distance is associated with higher possibility of lifelong premature ejaculation. However, further studies are needed to confirm our results.
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Affiliation(s)
- T Toprak
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - A Şahin
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - K Akgul
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - M A Kutluhan
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | | | - M Yilmaz
- Urology, Ankara City Hospital, Ankara, Turkey
| | - A Sahan
- Department of Urology, Dr. Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - A Verit
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
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Pfeiffer P, Yilmaz M, Möller S, Zitnjak D, Maltha L, Krogh M, Winther S, Petersen L, Hejlersen F, Thomsen K, Qvortrup C. Bevacizumab improves efficacy of trifluridine/tipiracil (TAS-102) in patients with chemorefractory metastatic colorectal cancer: a Danish randomized trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ekingen E, Yilmaz M, Yildiz M, Atescelik M, Goktekin MC, Gurger M, Alatas OD, Basturk M, Ilhan N. Utilization of glial fibrillary acidic protein and galectin-3 in the diagnosis of cerebral infarction patients with normal cranial tomography. Niger J Clin Pract 2019; 20:433-437. [PMID: 28406123 DOI: 10.4103/1119-3077.187311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE It was aimed to determine whether levels of glial fibrillary acidic protein (GFAP) and Galectin-3 contribute to the diagnosis of cerebral infarction in clinically suspected ischemic stroke patients with normal computerized cranial tomography (CCT) in the emergency department. MATERIALS AND METHODS In this study, patients above the age of 18 years who presented to emergency department of Firat University between December 2011-November 2012 and were diagnosed with cerebral infarction were included. Exclusion criteria were as follows: symptom onset exceeding 24 hours, trauma, pregnancy, acute myocardial infarction, acute pulmonary embolism, chronic renal insufficiency and steroid therapy. RESULTS A total of 90 participants, forty patients with ischemic infarction who were diagnosed by CCT and clinical findings (Normal CCT in 17 patients and CCT with an area of infarction in 23 patients) and fifty healthy controls, were included in this study. Compared with the control group, levels of Galectin-3 and GFAP were found to be significantly increased in patients with ischemic infarction (P <0.001 and P = 0.01, respectively). It was found that levels of Galectin-3 and GFAP were significantly increased in ischemic stroke patients with normal CCT compared to the control group (P = 0.04 and P = 0.025, respectively). In ROC curve analysis, we detected %70.59 sensitivity and 70% specificity (AUC = 0.684, P = 0.0213, 95% CI: 0,558-0.792) with a cutoff value of 33.24 ng/ml for GFAP and 76.47% sensitivity and 68% specificity (AUC = 0.734, P = 0.0048, 95% CI: 0.611-0.834) with a cutoff value of 0.84 ng/ml for Galectin-3. No correlation was found between National Institutes of Health Stroke Scale (NIHSS) scores and Galectin-3 and GFAP (r = 0.251, P = 0.118 and r = 0.164, P = 0.311, respectively). CONCLUSION The levels of Galectin-3 and GFAP were increased in acute ischemic stroke patients.
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Affiliation(s)
- E Ekingen
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - M Yilmaz
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - M Yildiz
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - M Atescelik
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - M C Goktekin
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - M Gurger
- Department of Emergency Medicine, Batman State Hospital, Batman, Turkey
| | - O D Alatas
- Department of Emergency Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - M Basturk
- Department of Emergency Medicine, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - N Ilhan
- Department of Biochemistry, School of Medicine, Firat University, Elazig, Turkey
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Pfeiffer P, Glimelius B, Winther S, Qvortrup C, Yilmaz M, Berglund À, Vistisen K, Kersten C, Liposits G, Sorbye H. Randomised trial of cetuximab every 2 weeks with FOLFIRI or cetuximab with alternating FOLFIRI/FOLFOX in patients with RAS and BRAF wild type metastatic colorectal cancer: Nordic 8 results. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Isler B, Keske Ş, Aksoy M, Azap ÖK, Yilmaz M, Yavuz SŞ, Aygün G, Tigen E, Akalın H, Azap A, Ergönül Ö. Antibiotic overconsumption and resistance in Turkey. Clin Microbiol Infect 2019; 25:651-653. [PMID: 30844434 DOI: 10.1016/j.cmi.2019.02.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/19/2019] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
Affiliation(s)
- B Isler
- Infectious Diseases and Clinical Microbiology Department, Istanbul Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ş Keske
- Infectious Diseases and Clinical Microbiology Department, American Hospital, Istanbul, Turkey
| | - M Aksoy
- Turkish Medicines and Medical Devices Agency, Ministry of Health, Ankara, Turkey
| | - Ö K Azap
- Infectious Diseases and Clinical Microbiology Department, Baskent University School of Medicine, Ankara, Turkey
| | - M Yilmaz
- Infectious Diseases and Clinical Microbiology Department, Medipol University, School of Medicine, Istanbul, Turkey
| | - S Ş Yavuz
- Infectious Diseases and Clinical Microbiology Department, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
| | - G Aygün
- Medical Microbiology Department, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - E Tigen
- Infectious Diseases and Clinical Microbiology Department, Marmara University, School of Medicine, Istanbul, Turkey
| | - H Akalın
- Infectious Diseases and Clinical Microbiology Department, Uludağ University School of Medicine, Bursa, Turkey
| | - A Azap
- Infectious Diseases and Clinical Microbiology Department, Ankara University School of Medicine, Ankara, Turkey
| | - Ö Ergönül
- Infectious Diseases and Clinical Microbiology Department, Koç University School of Medicine, Ankara, Turkey.
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Üstün M, Alçı E, Budak S, Demir HB, Yucel C, Şen S, Yilmaz M, Töz H. Evaluation of Cases of Graft Nephrectomy After Graft Loss in Patients With Renal Transplantation. Transplant Proc 2018; 50:3445-3448. [PMID: 30577219 DOI: 10.1016/j.transproceed.2018.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/03/2018] [Accepted: 07/18/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Renal transplantation is undoubtedly considered the best renal replacement therapy. Graft nephrectomy can be performed in patients with renal transplantation because of complications associated with the failed graft. We aimed to retrospectively investigate the characteristics of patients who underwent graft nephrectomy. MATERIALS AND METHODS Between January 2000 and November 2013, the records of 757 patients who had renal transplantation in Ege University Faculty of Medicine Hospital Nephrology-Transplantation outpatient clinic were examined. Sixty-four patients who underwent graft nephrectomy were included in the study. Patients were divided into 2 groups according to the timing of graft nephrectomy. The group of 30 patients who underwent graft nephrectomy in the first 56 days after the renal transplantation was referred to as the "early group" and the group of 34 patients who underwent graft nephrectomy after 56 days was referred to as "late group." RESULTS In our study, we found the body mass index to be significantly higher in those with early graft loss (P = .02). We found that there was a difference between the groups in terms of sex (P = .012). When the mortality and morbidity rates after graft nephrectomy were examined, mortality was observed in 3 of the 64 patients in the study and morbidity in 1 patient. CONCLUSION According to our study, the body mass indices and ages of the subjects who need early graft nephrectomy are higher. However, male sex was significantly more prevalent in patients who underwent graft nephrectomy in the late period compared with the early period.
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Affiliation(s)
- M Üstün
- Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - E Alçı
- Department of General Surgery, Demirci Goverment Hospital, Manisa, Turkey
| | - S Budak
- Department of Urology, Sakarya Training and Research Hospital, Sakarya, Turkey.
| | - H B Demir
- Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - C Yucel
- Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, Turkey
| | - S Şen
- Department of Pathology, Ege University Faculty of Medicine, Izmir, Turkey
| | - M Yilmaz
- Department of Nephrology, Ege University Faculty of Medicine, Izmir, Turkey
| | - H Töz
- Department of Nephrology, Ege University Faculty of Medicine, Izmir, Turkey
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Abstract
Background Percutaneous screw fixation is widely used in acute fractures of the scaphoid. In this study, we aimed to present our results with volar percutaneous screw fixation in patients with scaphoid nonunions. Methodology A total of 12 patients with scaphoid nonunion (≥13 weeks) that underwent volar percutaneous screw fixation were evaluated retrospectively. Two of the patients were female, and 10 were male. Mean age was 27 years (range = 19-41). The mean time that elapsed between the fracture and surgical procedure was 7.5 months (range = 4-12). According to the anatomic location, 33.3% were proximal pole, and 67.7% were waist fractures. All of the patients underwent percutaneous fixation with a headless cannulated screw from volar part under fluoroscopic guidance. Clinical evaluation was performed according to the modified mayo wrist scoring system (MMWS). The absence of a radiolucent fracture line on the radiographs was considered "union" on radiological evaluation. Results The mean follow-up time was 18 weeks (range = 8-36). Union was achieved in all patients (91.6%), except one. The mean time to union was 15.5 weeks (range = 8-30). Based on MMWS system, 8 patients were interpreted as excellent, 3 patients as good. Conclusion Percutaneous fixation in appropriate patients provides satisfactory results with high union and minimal complication rates in scaphoid nonunions.
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Affiliation(s)
- M Gurger
- Department of Orthopaedics and Traumatology, Firat University School of Medicine, Elazig, Turkey
| | - M Yilmaz
- Department of Orthopaedics and Traumatology, Firat University School of Medicine, Elazig, Turkey
| | - E Yilmaz
- Department of Orthopaedics and Traumatology, Firat University School of Medicine, Elazig, Turkey
| | - S Altun
- Department of Plastic Reconstructive and Aesthetic Surgery, Firat University School of Medicine, Elazig, Turkey
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Altinoz MA, Yilmaz M, Ucal Y, Ozpinar A, Baskan O, Elmaci I. P04.54 High Dose Progesterone Induces Growth Inhibition in Human U87 and A172 Glioblastoma Cell With Concomitant Changes in Mitochondrial and Cytoskeleton Proteins. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M A Altinoz
- Dept of Neurosurgery, Memorial Hospital, Istanbul, Turkey
| | - M Yilmaz
- Dept of Biochemistry, Acibadem University, Istanbul, Turkey
| | - Y Ucal
- Dept of Biochemistry, Acibadem University, Istanbul, Turkey
| | - A Ozpinar
- Dept of Biochemistry, Acibadem University, Istanbul, Turkey
| | - O Baskan
- Dept of Radiology, Memorial Hospital, Istanbul, Turkey
| | - I Elmaci
- Dept of Neurosurgery, Memorial Hospital, Istanbul, Turkey
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Yilmaz M, Atilla F, Uluer H, Sahin F, Saydam G. Effect of malnutrition on mortality with new espen criteria in patients with hematological malignancies. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1712] [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: 10/28/2022]
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Yilmaz M, Seyidoglu D, Uluer H, Savas S. Validity of turkish version of short nutritional assesment questionaire (SNAQ) for inpatients. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1439] [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: 11/16/2022]
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Aykan S, Temiz MZ, Yilmaz M, Ulus I, Yuruk E, Muslumanoglu AY. Association between male accesory gland infections and prostate cancer in Turkish men: A case-control study. Andrologia 2018; 50:e13038. [PMID: 29740844 DOI: 10.1111/and.13038] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2018] [Indexed: 02/05/2023] Open
Abstract
It is well known that chronic inflammation contributes to several forms of human cancer. Although several studies have investigated the association between prostatitis and prostate cancer, there is a lack of specifically designed study about male accessory gland infections (MAGI) and prostate cancer co-occurrence. We aimed to investigate this association with a case-control study in Turkish men. A total of 155 patients were enrolled to the study. After the pathological examination of the transrectal ultrasound-guided prostate biopsy specimens, patients were divided the two groups as control and prostate cancer and the presence of MAGI was determined. Of 155 patients, 145 met inclusion criteria. In the prostate cancer group, MAGI diagnose was determined in 18 of 31 patients (58.06%), while it was determined in 25 of 114 (21.93%) patients in the control group (p = .001). A significant correlation between MAGI and pathological Gleason score also revealed (p = .0001). We demonstrated that men with MAGI have increased risk for the development of prostate cancer. Moreover, in this population, most of the prostate cancers tend to be clinically significant or high grade.
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Affiliation(s)
- S Aykan
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - M Z Temiz
- Department of Urology, Catalca State Hospital, Istanbul, Turkey
| | - M Yilmaz
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - I Ulus
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - E Yuruk
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - A Y Muslumanoglu
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
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Lemoine L, Dupont C, Capron A, Cerf E, Yilmaz M, Verloop D, Blanckaert K, Senneville E, Alfandari S. Prospective evaluation of the management of urinary tract infections in 134 French nursing homes. Med Mal Infect 2018; 48:359-364. [PMID: 29747905 DOI: 10.1016/j.medmal.2018.04.387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 01/15/2018] [Accepted: 04/06/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Prospective assessment of the management of urinary tract infections (UTI) in the nursing homes of the Hauts-de-France region. PATIENTS AND METHODS A 50-question form had to be filled in for up to five consecutive residents treated for UTI in each nursing home. If necessary, diagnoses were reclassified according to the 2014 French Infectious Diseases Society guidelines. Analyses were presented per supposed (reported) and reclassified diagnoses. RESULTS Of 397 contacted facilities, 134 participated and informed 444 UTI episodes. Reported diagnostic criteria were burning urination (32%), malodorous urine (29%), confusion (28%), and turbid urine (19%). Twenty-one percent of diagnoses were based on erroneous criteria. Less than 50% of residents had a urine dipstick test performed and 94% a urine culture. The main pathogen was Escherichia coli. Reported indications were uncomplicated cystitis (32%), unspecified UTI (26%), complicated cystitis (9%), while no reason was given in 25% of cases. Only 10% of diagnoses were consistent with the guidelines: complicated cystitis (49%), asymptomatic bacteriuria (21%), acute pyelonephritis (21%), male UTI (9%). Almost 85% of prescriptions were active on the isolated bacteria. The empirical antibiotic therapy was consistent with the diagnosis in 16% of cases (30% for reclassified diagnoses). The two most prescribed antibiotic classes were fluoroquinolones (22.1%) and oral third-generation cephalosporins (19.1%). Only two of 157 possible de-escalations were performed. Duration of treatment was adequate for 19% of UTIs (9.6% of reclassified cases). CONCLUSION Our study revealed multiple deficiencies in diagnosis, antibiotic choice, treatment duration, and reevaluation.
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Affiliation(s)
- L Lemoine
- Soins de suite polyvalents, centre hospitalier de Tourcoing, 59200 Tourcoing, France
| | - C Dupont
- ARS Hauts-de-France (anciennement Nord-Pas-de-Calais), 59000 Lille, France
| | - A Capron
- ARS Hauts-de-France (anciennement Nord-Pas-de-Calais), 59000 Lille, France
| | - E Cerf
- ARS Hauts-de-France (anciennement Nord-Pas-de-Calais), 59000 Lille, France
| | - M Yilmaz
- OMEDIT Hauts-de-France (anciennement OMEDIT Nord-Pas-de-Calais), 59000 Lille, France
| | - D Verloop
- ARS Hauts-de-France (anciennement Nord-Pas-de-Calais), 59000 Lille, France
| | - K Blanckaert
- CEPIAS Hauts-de-France (anciennement ARLIN Nord-Pas-de-Calais), 59000 Lille, France
| | - E Senneville
- Service universitaire des maladies infectieuses et du voyageur, centre hospitalier de Tourcoing, 59200 Tourcoing, France
| | - S Alfandari
- Service de réanimation et maladies infectieuses, centre hospitalier de Tourcoing, 59200 Tourcoing, France.
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Altin C, Erol V, Aydin E, Yilmaz M, Tekindal MA, Sade LE, Gulay H, Muderrisoglu H. Impact of weight loss on epicardial fat and carotid intima media thickness after laparoscopic sleeve gastrectomy: A prospective study. Nutr Metab Cardiovasc Dis 2018; 28:501-509. [PMID: 29571589 DOI: 10.1016/j.numecd.2018.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 10/16/2017] [Revised: 01/09/2018] [Accepted: 02/02/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Cardiovascular disease (CVD) is one of the leading causes of mortality in obese patients. We aimed to investigate the influence of significant weight loss following laparoscopic sleeve gastrectomy (LSG) on carotid intima media thickness (CIMT) and epicardial fat thickness (EFT) which are the independent predictors of subclinical atherosclerosis. METHODS AND RESULTS Patients were recruited for standard indications. A total of 105 patients (79 women and 26 men) with the mean age of 43.61 ± 12.42 were prospectively enrolled. On B-mode duplex ultrasound; the mean CIMT at the far wall of both left and right common carotid arteries were measured. EFT was measured on the free wall of the right ventricle at end-diastole from the parasternal long-axis view by standard transthorasic 2D echocardiography. Delta (Δ) values were obtained by subtracting sixth month values from the baseline values. Body mass index (BMI) was significantly reduced from 46.95 ± 7.54 to 33.54 ± 6.41 kg/m2 (p < 0.001) in sixth months after LSG. Both EFT and CIMT were significantly decreased after surgery (8.68 ± 1.95 mm vs. 7.41 ± 1.87 mm; p < 0.001 and 0.74 ± 0.13 mm vs. 0.67 ± 0.11 mm; p < 0.001 respectively). A significant correlation between ΔEFT and ΔBMI (r = 0.431, p < 0.001) was shown. ΔCIMT is significantly correlated with ΔEFT, ΔBMI and Δ systolic blood pressure (r = 0.310, r = 0.285 and r = 0.231 respectively, p < 0.05 for all). In multivariate stepwise linear regression analysis; among variables only ΔBMI was the independent predictor of ΔEFT (β = 153, p = 0.001). CONCLUSION Early atherosclerotic structural changes may be reversed or improved by sustained weight loss after LSG in asymptomatic obese patients.
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Affiliation(s)
- C Altin
- Department of Cardiology, Baskent University Faculty of Medicine Hospitals, İzmir, Turkey.
| | - V Erol
- Department of General Surgery, Baskent University Faculty of Medicine Hospitals, İzmir, Turkey
| | - E Aydin
- Department of Radiology, Baskent University Faculty of Medicine Hospitals, İzmir, Turkey
| | - M Yilmaz
- Department of Cardiology, Baskent University Faculty of Medicine Hospitals, Adana, Turkey
| | - M A Tekindal
- Department of Biostatistics, Selcuk University, Konya, Turkey
| | - L E Sade
- Department of Cardiology, Baskent University Faculty of Medicine Hospitals, Ankara, Turkey
| | - H Gulay
- Department of General Surgery, Baskent University Faculty of Medicine Hospitals, İzmir, Turkey
| | - H Muderrisoglu
- Department of Cardiology, Baskent University Faculty of Medicine Hospitals, Ankara, Turkey
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