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Baspinar O, Kocer D, Kiraz A, Tokmak TT, Dizdar OS. Osteopontin as an early predictor of atherosclerosis in attack-free Familial Mediterranean fever patients. Medicine (Baltimore) 2023; 102:e35137. [PMID: 37773839 PMCID: PMC10545283 DOI: 10.1097/md.0000000000035137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/18/2023] [Indexed: 10/01/2023] Open
Abstract
Familial Mediterranean fever (FMF) is an autoinflammatory disease that is associated with endothelial dysfunction and atherosclerosis. Osteopontin which is a multifunctional protein involved in the modulation of inflammatory processes may contribute to the development of atherosclerosis in FMF patients. Therefore, this cross-sectional study investigated the relationship of osteopontin with carotid intima media thickness (CIMT) and atherogenic indices in patients with FMF. Serum osteopontin levels, CIMT, Castelli risk index I and II, plasma atherogenic index (PAI), non - high-density lipoprotein cholesterol, and atherogenic coefficient (AC) in 64 attack-free FMF patients were compared with levels in 23 healthy control subjects. The serum osteopontin level, CIMT, Castelli risk index I, AC and PAI were significantly higher, and high-density lipoprotein cholesterol was significantly lower in FMF patients (P < .001, P < .001, P = .045, P = .016, P = .045, and P = .024; respectively). There were significant positive correlations between osteopontin and CIMT, PAI, AC, and Castelli risk index I (R = 0.580, R = 0.259, R = 0.233, R = 0.277; respectively) and there was significant negative correlation between osteopontin and high-density lipoprotein cholesterol (r= -0.309). Patients who had homozygote mutations had significantly higher osteopontin, PAI, Castelli risk index I and II level. The current study is the first to demonstrate significantly increased serum osteopontin levels in attack-free FMF patients compared with healthy controls. It was also associated with CIMT and many atherogenic indices. This finding provides a new experimental basis to understand the pathogenesis of inflammation-induced atherosclerosis in FMF patients. Furthermore, patients who had homozygote mutations had worse atherogenic indices than those with heterozygote mutations.
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Affiliation(s)
- Osman Baspinar
- Department of Internal Medicine, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Derya Kocer
- Department of Biochemistry, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Aslihan Kiraz
- Department of Medical Genetics, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Turgut Tursem Tokmak
- Department of Radiology, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Oguzhan Sitki Dizdar
- Department of Internal Medicine and Clinical Nutrition, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey
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Gorkem H, Dizdar OS, Yesiltepe A, Dondurmaci E, Ozkan E, Gunal AI. Volume Status, Echocardiographic Findings, and Endothelial Functions in Primary Hypertension Patients Who Do Not Have Kidney Failure. Turk J Nephrol 2021. [DOI: 10.5152/turkjnephrol.2021.4334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Ertugrul DT, Kan E, Tura CB, Tugtekin HB, Ayakta H, Celebioglu M, Yılmaz C, Utebay O, Yetkin I, Gurkan E, Sezer K, Gen R, Ozcaylak S, Okuturlar Y, Coskun M, Giynas NG, Aysal H, Erdem AS, Aydemir M, Bakiner O, Cicekli E, Gezer D, Kaya R, Kebapcilar L, Cinkir U, Ulu MS, Ersoy C, Kagan MT, Ekiz BD, Kilinc F, Onbasi K, Cengiz M, Celik M, Guclu M, Sarıkaya M, Ozbag O, Sari R, Ucler R, Sezikli S, Araz M, Gundogan E, Bozkurt E, Akbas M, Bozkus R, Akinci B, Karakilic E, Medeni M, Keskek O, Goncuoglu ES, Zuhur SS, Sahin AZ, Dal K, Eren MA, Arkan T, Taskiran B, Kilinc G, Bozkirli E, Kafesciler SO, Kafesciler N, Sen EC, Doganay S, Koseoglu C, Tetiker T, Bayraktaroglu T, Oguz A, Ataoglu E, Demirpence MM, Tursun S, Anaforoglu I, Tabak O, Emral R, Karsidag K, Dizdar OS, Tuzcu AK, Caliskan M, Sirmatel P, Kocaoz Y, Dogan H, Fenkci SM, Sahin I, Karaca Z. Add-on therapy with dapagliflozin in routine outpatient care of type 2 diabetes patients from Turkey: a retrospective cohort study on HbA1c, body weight, and blood pressure outcomes. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-00954-4] [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: 11/24/2022] Open
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Ayyildiz T, Dolar E, Ugras N, Dizdar OS, Erturk B, Adim SB, Yercı O. The expression and relationship of AdipoR1/R2 in gastric intestinal metaplasia. Niger J Clin Pract 2021; 24:608-613. [PMID: 33851685 DOI: 10.4103/njcp.njcp_302_20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Adiponectin (ApN) is a 244-amino acid protein mainly secreted from the adipose tissue and involved in various physiological functions. ApN exerts its metabolic effects by binding to two major receptors: adiponectin receptor-1 (Adipo-R1) and adiponectin receptor-2 (Adipo-R2). Recent studies have reported ApN's involvement in the progression of cancer. However, there are no studies evaluating the relationship between Adipo-R1/R2 expression and gastric intestinal metaplasia (IM), which is a predisposing factor in gastric cancer (GC) development, and Helicobacter pylori H. pylori infection. Aims In this study we aimed to investigate the relationship between the Adipo-R1/-R2 expression and H. pylori infection in patients with GC and gastric IM. Materials and Methods Forty patients that underwent gastric resection and 56 patients that developed gastric IM were included in the study. The Adipo-R1/-R2 expression and the presence of H. pylori were examined immunohistochemically. The univariate analyses showed that the expression of Adipo-R1/-R2 in GC patients was significantly lower compared to both complete metaplasia (CM) and incomplete metaplasia (ICM) patients (p <0.0001 for both). Results According to multiple multinomial logistic regression analysis, Adipo-R1/-R2 expression in the CM group was significantly higher than in the GC group (p = 0.05, p = 0.014, respectively). Moreover, Adipo-R1/-R2 expression was significantly higher in ICM group compared to the GC group (p=0.012, p=0.045, respectively). However, in both analyses no significant difference was determined in terms of H. pylori positivity between the groups. Conclusion The resulting data suggests that ApN plays a role in GC processes via Adipo-R1/-R2 receptors.
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Affiliation(s)
- T Ayyildiz
- Department of Gastroenterology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - E Dolar
- Department of Gastroenterology, School of Medicine, Uludag University, Bursa, Turkey
| | - N Ugras
- Department of Pathology, School of Medicine, Uludag University, Bursa, Turkey
| | - O S Dizdar
- Department of Internal Medicine, School of Medicine, Uludag University, Bursa, Turkey
| | - B Erturk
- Department of Internal Medicine, School of Medicine, Erciyes University, Kayseri, Turkey
| | - S B Adim
- Department of Pathology, School of Medicine, Uludag University, Bursa, Turkey
| | - O Yercı
- Department of Pathology, School of Medicine, Uludag University, Bursa, Turkey
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Bayram F, Sonmez A, Haymana C, Sabuncu T, Dizdar OS, Gurkan E, Carlioglu AK, Agbaht K, Ozdemir D, Demirci I, Barcin C, Salman S, Tetiker T, Balci MK, Kebapci N, Ersoy C, Yumuk V, Toth PP, Satman I. Utilization of statins and LDL-cholesterol target attainment in Turkish patients with type 2 diabetes - a nationwide cross-sectional study (TEMD dyslipidemia study). Lipids Health Dis 2020; 19:237. [PMID: 33176832 PMCID: PMC7659134 DOI: 10.1186/s12944-020-01408-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/19/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Attaining acceptable levels of LDL Cholesterol (LDL-C) significantly improves cardiovascular (CV) outcomes in patients with type 2 diabetes mellitus (T2DM). The LDL-C target attainment and the characteristics of patients attaining these targets were investigated in this study. Furthermore, the reasons for not choosing statins and the physicians' attitudes on the treatment of diabetic dyslipidemia were also examined. METHODS A nationwide, cross-sectional survey was conducted in tertiary centers for diabetes management. Adult patients with T2DM, who were under follow-up for at least a year in outpatient clinics, were consecutively enrolled for the study. LDL-C goals were defined as below 70 mg/dL for patients with macrovascular complications or diabetic nephropathy, and below 100 mg/dL for other patients. Data about lipid-lowering medications were self-reported. RESULTS A total of 4504 patients (female: 58.6%) were enrolled for the study. The mean HbA1c and diabetes duration was 7.73 ± 1.74% and 10.9 ± 7.5 years, respectively. The need for statin treatment was 94.9% (n = 4262); however, only 42.4% (n = 1807) of these patients were under treatment, and only 24.8% (n = 448) of these patients achieved LDL-C targets. The main reason for statin discontinuation was negative media coverage (87.5%), while only a minority of patients (12.5%) mentioned side effects. Physicians initiated lipid-lowering therapy in only 20.3% of patients with high LDL-C levels. It was observed that the female gender was a significant independent predictor of not attaining LDL-C goals (OR: 0.70, 95% CI: 0.59-0.83). CONCLUSIONS Less than 50 % of patients with T2DM who need statins were under treatment, and only a quarter of them attained their LDL-C targets. There exists a significant gap between the guideline recommendations and the real-world evidence in the treatment of dyslipidemia in T2DM.
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Affiliation(s)
- Fahri Bayram
- Department of Endocrinology and Metabolism, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey.
| | - Tevfik Sabuncu
- Department of Endocrinology and Metabolism, Harran University, School of Medicine, Sanliurfa, Turkey
| | - Oguzhan Sitki Dizdar
- Department of Endocrinology and Metabolism, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Eren Gurkan
- Department of Endocrinology and Metabolism, Mustafa Kemal University, School of Medicine, Hatay, Turkey
| | - Ayse Kargili Carlioglu
- Department of Endocrinology and Metabolism, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Kemal Agbaht
- Department of Endocrinology and Metabolism, Private Defne Hospital, Hatay, Turkey
| | - Didem Ozdemir
- Department of Endocrinology and Metabolism, Yildirim Beyazit University, School of Medicine, Ankara, Turkey
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Cem Barcin
- Department of Cardiology, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Private Liv Hospital, Istanbul, Turkey
| | - Tamer Tetiker
- Department of Endocrinology and Metabolism, Cukurova University, School of Medicine, Adana, Turkey
| | - Mustafa Kemal Balci
- Department of Endocrinology and Metabolism, Akdeniz University, School of Medicine, Antalya, Turkey
| | - Nur Kebapci
- Department of Endocrinology and Metabolism, Osmangazi University, School of Medicine, Eskisehir, Turkey
| | - Canan Ersoy
- Department of Endocrinology and Metabolism, Uludag University, School of Medicine, Bursa, Turkey
| | - Volkan Yumuk
- Department of Endocrinology and Metabolism, Istanbul University, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Peter P Toth
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Preventive Cardiology, CGH Medical Center, Sterling, IL, USA
| | - Ilhan Satman
- Department of Endocrinology and Metabolism, Istanbul University, School of Medicine, Istanbul, Turkey
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Sonmez A, Haymana C, Bayram F, Salman S, Dizdar OS, Gurkan E, Kargili Carlıoglu A, Barcin C, Sabuncu T, Satman I. Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study). Diabetes Res Clin Pract 2018; 146:138-147. [PMID: 30244051 DOI: 10.1016/j.diabres.2018.09.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 09/04/2018] [Accepted: 09/13/2018] [Indexed: 12/12/2022]
Abstract
AIMS Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. METHODS A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c < 7%, home arterial blood pressure (ABP) < 135/85 mmHg, or LDL-C < 100 mg/dL. Achieving all parameters indicated triple metabolic control. RESULTS HbA1c levels of patients (n = 5211) were 8.6 ± 1.9% (71 ± 22 mmol/mol) and 7.7 ± 1.7% (61 ± 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, non-smoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. CONCLUSIONS Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease.
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Affiliation(s)
- Alper Sonmez
- Health Sciences University, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Cem Haymana
- Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
| | - Fahri Bayram
- Erciyes University, Faculty of Medicine, Department of Endocrinology and Metabolism, Kayseri, Turkey
| | - Serpil Salman
- Istinye University, Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Oguzhan Sitki Dizdar
- Kayseri Training and Research Hospital, Department of Endocrinology and Metabolism, Kayseri, Turkey
| | - Eren Gurkan
- Mustafa Kemal University, Faculty of Medicine, Department of Endocrinology and Metabolism, Hatay, Turkey
| | - Ayse Kargili Carlıoglu
- Erzurum Training and Research Hospital, Department of Endocrinology and Metabolism, Erzurum, Turkey
| | - Cem Barcin
- Health Sciences University, Gulhane Faculty of Medicine, Department of Cardiology, Ankara, Turkey
| | - Tevfik Sabuncu
- Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Ilhan Satman
- Istanbul University, Faculty of Medicine, Istanbul, Turkey
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Dizdar OS, Ersoy A, Aksoy S, Ozel Coskun BD, Yildiz A. Analysis of liver function test abnormalities in kidney transplant recipients: 7 year experience. Pak J Med Sci 2016; 32:1330-1335. [PMID: 28083020 PMCID: PMC5216276 DOI: 10.12669/pjms.326.10725] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective: Immunosuppressive drugs, antimicrobial agents and infectious complications may cause liver function test abnormalities (LFTA) in kidney transplant recipients (KTR). The objectives of this study were to identify the outcome of (LFTA). To identify the risk factors affecting development and severity of hepatotoxicity in KTR. Methods: We retrospectively evaluated the medical records of KTR. Hepatotoxicity attacks were defined as impairment in liver function tests that was responsive to drug dose reduction or discontinuation, or treatment of specific causes such as infectious complications. Results: One hundred-fifty-six episodes of hepatotoxicity occurred in 107 patients in 281 KTR, with an incidence of 38%. Patients with hepatotoxicity episodes had a high total mortality rate, higher incidence of positive pre-transplant cytomegalovirus (CMV) IgM test, higher creatinine values during the first month post-transplant, underwent additional acute rejection episodes, and received fewer cyclosporin A based ID. Only positive CMV IgM testing was identified as a significant independent risk factor for hepatotoxicity in our multiple analysis. Mycophenolatemofetil (MMF) related hepatotoxicity was the most common cause of drug related LFTA. Conclusions: Patients with LFTA can have significant complications. Pre-transplant positive CMV IgM tests predispose transplant recipients to the development of LFTA during the post-transplant period. MMF can be a serious hepatotoxic drug.
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Affiliation(s)
- Oguzhan Sitki Dizdar
- Oguzhan Sitki Dizdar, Department of Internal Medicine and Clinical Nutrition, Kayseri Training and Research Hospital, Turkey
| | - Alparslan Ersoy
- Alparslan Ersoy, Professor, Department of Internal Medicine, Division of Nephrology, Uludag University Medical School, Turkey
| | - Savas Aksoy
- Savas Aksoy, Department of Internal Medicine, Division of Nephrology, Uludag University Medical School, Turkey
| | - Banu Demet Ozel Coskun
- Banu Demet Ozel Coskun, Department of Internal Medicine, Division of Gastroenterology, Kayseri Training and Research Hospital, Turkey
| | - Abdulmecit Yildiz
- Abdulmecit Yildiz, Department of Internal Medicine, Division of Nephrology, Uludag University Medical School, Turkey
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Simsek Y, Cakır I, Yetmis M, Dizdar OS, Baspinar O, Gokay F. Effects of Vitamin D treatment on thyroid autoimmunity. J Res Med Sci 2016; 21:85. [PMID: 28163731 PMCID: PMC5244647 DOI: 10.4103/1735-1995.192501] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/14/2016] [Accepted: 06/15/2016] [Indexed: 11/22/2022]
Abstract
Background: Vitamin D was shown to be related to autoimmune thyroid diseases (AITDs) in the previous studies. We aimed to investigate the relationship between Vitamin D and thyroid autoimmunity. Materials and Methods: Eighty-two patients, diagnosed with AITD by the endocrinology outpatient clinic, were included in this prospective study. All of the patients had both AITD and Vitamin D deficiency, defined as serum values <20 ng/mL. They were randomly assigned into two groups. The first group included 46 patients and the second one included 36 patients. The first group was treated with Vitamin D for 1 month at 1000 IU/day. The second group served as the control group and was not treated with Vitamin D replacement. Serum thyroid-stimulating hormone, free T4 (fT4), thyroid peroxidase antibody (TPO-Ab), thyroglobulin antibody (TgAb), and Vitamin D levels were measured at the initiation of the study and again at 1 month in all patients. Results: Two groups were similar with regard to age, sex, and type of thyroid disease. Whereas TPO-Ab (before; 278.3 ± 218.4 IU/ml and after; 267.9 ± 200.7 IU/ml) and TgAb (before; 331.9 ± 268.1 IU/ml and after; 275.4 ± 187.3 IU/ml) levels were significantly decreased by the Vitamin D replacement therapy in group 1 (P = 0.02, P = 0.03, respectively), the evaluated parameters in the control group did not significantly change (P = 0.869, P = 0.530, respectively). In addition, thyroid function tests did not significantly change with Vitamin D replacement in two groups. Conclusion: Vitamin D deficiency may contribute to the pathogenesis of AITDs. Since supplementation of the Vitamin D decreased thyroid antibody titers in this study in Vitamin D deficient subjects, in the future Vitamin D may become a part of AITDs' treatment, especially in those with Vitamin D insufficiency. Further clinical and experimental studies are required to understand the effect of Vitamin D on AITD.
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Affiliation(s)
- Yasin Simsek
- Department of Endocrinology and Metabolism, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Ilkay Cakır
- Department of Internal Medicine, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Mikail Yetmis
- Department of Internal Medicine, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Oguzhan Sitki Dizdar
- Department of Internal Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Osman Baspinar
- Department of Internal Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Ferhat Gokay
- Department of Endocrinology and Metabolism, Kayseri Training and Research Hospital, Kayseri, Turkey
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Dizdar OS, Ozkocaman V, Sahbazlar M, Pesen E, Kurt E, Ozkalemkas F, Ali R, Tunali A. Severe Hemorrhagic Diathesis in a Patient with Prostat Adenocarsinoma and Diagnostic Approach. Erciyes Med J 2015. [DOI: 10.5152/etd.2015.5076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Ayyildiz T, Dolar E, Ugras N, Dizdar OS, Adim SB, Yerci O. Lack of any prognostic relationship between adiponectin receptor (Adipo R1/R2) expression for early/advanced stage gastric cancer. Asian Pac J Cancer Prev 2015; 15:4711-6. [PMID: 24969908 DOI: 10.7314/apjcp.2014.15.11.4711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Adiponectin (ApN) is a complement C1q-related protein, mainly secreted from adipose tissue, that signals through ApN receptor 1 (Adipo-R1) and ApN receptor 2 (Adipo-R2). Low serum ApN concentrations are associated with obesity-related malignancies. However, there are very few studies on any prognostic role of ApN receptors in gastric cancer. OBJECTIVES The aim of this study is to investigate the relationship between AdipoR1/R2 expression and early/advanced stage gastric cancer in terms of clinicopathologic characteristics and survival. MATERIALS AND METHODS Eighteen patients with early and 39 with advanced stage gastric cancer who underwent surgical gastric resection were included in this study. RESULTS Adipo-R1 expression was low in 2 of the 18 patients with early stage gastric cancer (11.1%), while 4 had low Adipo-R2 expression (22.2%). In those with advanced stage gastric cancer, 7 of 39 had low Adipo-R1 expression (17.9%) and 16 had low Adipo-R2 expression (41%). Adipo-R2 expression was significantly higher (p=0.011) in moderately differentiated tumors when compared to well-differentiated tumors. While there was nearly a statistically significant relationship between TNM stage (T, tumor size; N, regional lymph node; M, whether distant metastases exist) and Adipo-R2 expression (p=0.054), there was no relationship between Adipo-R1/-R2 expression with tumor stage and survival. CONCLUSION Adipo-R1/-R2 expression has no prognostic significance of in early/advanced stage gastric cancer.
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Affiliation(s)
- Talat Ayyildiz
- Department of Gastroenterology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey E-mail : A
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Cander S, Dizdar OS, Oz Gul O, Guclu M, Unal OK, Tuncel E, Erturk E, Imamoglu S, Ersoy C. Comparison of efficacy and safety of once- versus twice-daily insulin detemir added on to oral antidiabetics in insulin-naive type 2 diabetes patients: 24-week, crossover, treat to target trial in a single center. Prim Care Diabetes 2014; 8:256-264. [PMID: 24522170 DOI: 10.1016/j.pcd.2014.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/11/2013] [Revised: 01/17/2014] [Accepted: 01/18/2014] [Indexed: 11/22/2022]
Abstract
AIM To compare once- versus twice-daily insulin detemir added on OADS therapy in insulin-naive type 2 diabetes patients in terms of efficacy and safety. METHODS An open-label study performed at a single center, comprised a randomized, crossover 24 week with insulin-naive type 2 diabetes patients. Insulin detemir was initiated with mean 0.12 U/kg in all patients (Group I once-daily, Group II twice-daily) and titrated for 24 week. RESULTS A total of 50 patients completed the study (Group I n:25, Group II n:25). With use of once- and twice-daily insulin, HbA1c values were decreased by 1.8% (±2.0) and 1.5% (±1.4) within the first 12 weeks (p<0.01), whereas increased by 0.21% (±0.7) and 0.14% (±0.8) in the second 12 weeks (p>0.05). The increases in the insulin doses were found as 0.22 U/kg and 0.35 U/kg with once- and twice-daily insulin use, respectively (p:0.04). Although minor hypoglycemic events were similar in both groups in the first 12 weeks, 2-fold increase was found in the patients shifting from once- to twice-daily dose. Within the first and second periods, the body weight of the patients was observed an increase of 0.4 and 1.6 kg with once-daily dose, whereas a decrease of 0.1 and 2.1 kg in the twice-daily dose, in the same period. CONCLUSION Once-daily use of insulin detemir up to 0.4 U/kg was found to have similar efficacy and safety as twice-daily use. Twice dose use of insulin did not provide a prominent glycemic control advantage on 1.5-fold higher use of insulin.
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Affiliation(s)
- Soner Cander
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; Bursa Sevket Yilmaz Education and Research Hospital, Division of Endocrinology and Metabolism, Bursa, Turkey.
| | - Oguzhan Sitki Dizdar
- Uludag University Medical School, Department of Internal Medicine, Bursa, Turkey
| | - Ozen Oz Gul
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; Bursa Sevket Yilmaz Education and Research Hospital, Division of Endocrinology and Metabolism, Bursa, Turkey
| | - Metin Guclu
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; Bursa Sevket Yilmaz Education and Research Hospital, Division of Endocrinology and Metabolism, Bursa, Turkey
| | - Oguz Kaan Unal
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Ercan Tuncel
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Erdinc Erturk
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Sazi Imamoglu
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Canan Ersoy
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
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Dizdar OS, Ersoy A, Akalin H. Pneumonia after kidney transplant: incidence, risk factors, and mortality. EXP CLIN TRANSPLANT 2014; 12:205-211. [PMID: 24907720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Pneumonia is an important cause of morbidity and mortality in recipients of solid-organ transplant. We aimed to determine risk factors for development of pneumonia and associated deaths in kidney transplant recipients. MATERIALS AND METHODS A retrospective review of medical records was performed for all kidney transplant recipients from December 1988, to April 2011. The diagnosis of community-acquired pneumonia was made from symptoms, clinical findings, and chest radiography. The diagnosis of nosocomial pneumonia was made according to published criteria. Laboratory and serologic tests, radiographic findings, cultures of respiratory specimens, and tissue biopsies were reviewed. RESULTS In 406 kidney transplant recipients, there were 82 patients (20%) who had 111 episodes of pneumonia, including 49 nosocomial episodes of pneumonia (44%). Bacterial infections were the most common cause (34 episodes [31%]). In multivariate analysis, significant risk factors associated with pneumonia episodes were older age, hypertension, cardiac disease, history of acute graft rejection, and not using everolimus/mycophenolate mofetil/prednisolone protocol. There were 28 episodes that resulted in death (25%), including 20 nosocomial episodes (71%). In multivariate analysis, significant risk factors associated with death from pneumonia episodes were antibiotic use in the previous 3 months, high C-reactive protein, and low albumin. Cutoff values for increased risk of death from pneumonia included C-reactive protein > 10 mg/dL and procalcitonin > 8.8 ng/mL. CONCLUSIONS Recipients of kidney transplant may be at risk for pneumonia and associated death. Nosocomial pulmonary infections may be associated with marked morbidity and mortality in kidney transplant recipients.
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Ersoy A, Dizdar OS, Koc AO, Akalin H, Ener B. Aspergillus fumigatus spondylodiskitis in renal transplant patient: voriconazole experience. EXP CLIN TRANSPLANT 2011; 9:265-269. [PMID: 21819372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The incidence of invasive aspergillosis has increased after solid organ transplant. However, aspergillus osteomyelitis in vertebrae is rare. We report a case of aspergillus spondylodiskitis after pulmonary aspergillosis in a renal transplant recipient. He was treated by antifungal therapy and surgical intervention. The transplantist should be alert for a diagnosis of aspergillus spondylodiskitis in recipients who developed back pain after aspergillosis infection in other sites.
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Affiliation(s)
- Alparslan Ersoy
- Department of Nephrology, Uludag University Medical School, 16059 Bursa, Turkey.
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