Browsing by Author "Topal, C"

Now showing 1 - 12 of 12

Coexistence of Subacute Thyroiditis and Renal Cell Carcinoma
(Canadian Medical Association, 2003) Algün, E; Alici, S; Topal, C; Ugras, S; Erkoç, R; Sakarya, ME; Özbey, N
RENAL CELL CARCINOMA IS CHARACTERIZED by varied manifestations, which include unusual metastatic sites and paraneoplastic and vascular syndromes. We describe the case of a 57-year-old man who presented with high fever, weight loss, palpitations and a tender goitre. We suggest that, in this patient, subacute thyroiditis manifested as a paraneoplastic syndrome of renal cell carcinoma.
Effect of Glucose Concentration on Peritoneal Inflammatory Cytokines in Continuous Ambulatory Peritoneal Dialysis Patients
(Hindawi Ltd, 2004) Sayarlioglu, H; Topal, C; Sayarlioglu, M; Dulger, H; Dogan, E; Erkoc, R
OBJECTIVE : It is known that glucose concentrations of peritoneal dialysis solutions are detrimental to the peritoneal membrane. In order to determine the effect of glucose concentration on cytokine levels of peritoneal fluid of continuous ambulatory peritoneal dialysis (CAPD) patients, a cross-sectional study was performed. Methods: Nine non-diabetic CAPD patients participated in two 8-h dwell sessions of overnight exchanges in consecutive days, with 1.36% and 3.86% glucose containing peritoneal dialysis solutions (Baxter - Eczacibasi). Peritoneal dialysis fluid tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 levels were measured. Results: TNF-alpha levels after 1.36% and 3.86% glucose used dwells were 23 +/- 14 pg/ml and 28 +/- 4 pg/ml, respectively (p = 0.78). The IL-6 levels were 106 +/- 57 pg/ml and 115 +/- 63 pg/ ml ( p = 0.81), respectively. Conclusion: In our in vivo study we found that the glucose concentration of the conventional lactate-based CAPD solution has no effect on basal IL-6 and TNF-alpha levels of peritoneal fluid. Further in vivo studies with non-lactate-based CAPD solutions are needed in order to determine the effect of glucose concentration per se on cytokine release.
Effect of Indapamide on Urinary Calcium Excretion in Patients With and Without Urinary Stone Disease
(Sage Publications inc, 2005) Ceylan, K; Topal, C; Erkoc, R; Sayarlioglu, H; Can, S; Yilmaz, Y; Gonulalan, H
Background: Indapamide is an anti hypertensive agent similar to thiazides, but with some different effects. Thiazide and thiazide-like diuretics are useful in preventing recurrent urinary stone formation due to their hypocalciuric effects. OBJECTIVE: To determine the hypocalciuric and other effects on certain laboratory parameters of indapamide 1.5 mg in different patient groups. METHODS: Four groups of patients recruited from urology and nephrology outpatient departments were experiencing non-hypercalciuric urinary stone disease (group 1), idiopathic hypercalciuria (group 2), urinary stone disease with hypercalciuria (group 3), and essential hypertension (group 4). In all patients, fasting serum uric acid, calcium, sodium, potassium, cholesterol, triglyceride, parathyroid hormone (PTH) values, and morning second-spot urine calcium and creatinine levels were assessed before and 8 weeks after treatment with indapamide. RESULTS: Urinary calcium excretion was reduced significantly in all groups: group 1 from 0.10 +/- 0.02 to 0.07 +/- 0.03 (mean +/- SD; 30% reduction; p < 0.001), group 2 from 0.30 +/- 0.15 to 0.15 +/- 0.10 (50% reduction; p < 0.001), group 3 from 0.35 +/- 0.15 to 0.20 +/- 0.10 (43% reduction; p < 0.001), and group 4 from 0.10 +/- 0.03 to 0.08 +/- 0.02 (20% reduction; p < 0.0010). These results should be interpreted with caution since no control group was included in this study. Mean serum uric acid and triglyceride levels were significantly increased, and mean PTH and potassium levels and diastolic and systolic blood pressure were significantly decreased in all groups. Few temporary adverse effects, such as dizziness and fatigue, were noticed and none of them caused discontinuation of treatment. CONCLUSIONS: Indapamide 1.5 mg/day is effective in decreasing calciuria in patients with non-hypercalciuric urinary stone disease, idiopathic hypercalciuria, urinary stone disease with hypercalciuria, and essential hypertension. This could be achieved with few adverse effects similar to those of thiazides and indapamide 2.5 mg. Indapamide decreased the PTH levels in all groups. Long-term clinical benefits of these effects should be evaluated prospectively with further randomized studies.
Effect of Valsartan on Erythropoietin and Hemoglobin Levels in Stage Iii-Iv Chronic Kidney Disease Patients
(Wiley, 2005) Durmus, A; Dogan, E; Erkoc, R; Sayarlioglu, H; Topal, C; Dilek, I
Angiotensin-converting enzyme inhibitors (ACEIs) were accepted as a potential cause of inadequate epoetin response in chronic kidney disease (CKD) patients. We aimed to determine the effects of valsartan, an angiotensin receptor blocker (ARB), on serum ertyhropoietin levels and on certain biochemical and haematological parameters in hypertensive CKD patients. Twenty-two stage III-IV CKD patients (mean age; 56.8 +/- 8.9 years, 12 male 10 female) were included in the study. Before initiating the treatment, current anti-hypertensive treatments (if any) were discontinued, and blood samples were collected after a washout period of 3 weeks. Valsartan 80 mg/day was started, and additional anti-hypertensive agents were given according to study protocol if needed. One way Anova and paired t-tests were used for statistical comparisons. Serum blood urea nitrogen (BUN), creatinine, uric acid, potassium, haemoglobin and erythropoietin values were measured, and glomerular filtration rates were calculated before and 3, 6 and 90 days after valsartan treatment, a significant reduction in EPO level was observed at 3rd (19.6 +/- 24.0 vs. 13.8 +/- 8.5, p = 0.010), 6th (12.1 +/- 7.6, p = 0.009), and 90th days (8.3 +/- 5.4, p = 0.007). When pre-treatment values were compared with 90th day results, no significant change was observed in terms of hgb, htc, serum BUN, creatinine, uric acid, potassium, and GFR values. In conclusion, valsartan, an ARB, did not decrease haemoglobin levels In stage III-IV CKD patients despite significant reduction in serum erryhropoietin levels, so ARBs may be preferred to ACEIs in CKD patients when indicated.
Effects of Late Referral To a Nephrologist in Patients With Chronic Renal Failure
(Wiley, 2005) Dogan, E; Erkoc, R; Sayarlioglu, H; Durmus, A; Topal, C
Background: We lack information about the role of late diagnosis of end-stage renal disease (ESRD), late nephrological referral and its impact on biochemical variables and first hospitalization in East Anatolia, Turkey. Methods and Results: For a total of 101 ESRD patients, dialysis was initiated between January 1998 and December 2002 at the Yuzuncu Yil University Hospital. Early referral (ER) and late referral (LR) were defined as the time of first referral or admission to a nephrologist greater or less than 12 weeks, respectively, before initiation of haemodialysis (HD). Results: The need for urgent dialysis was less among the early referral cases compared with the late referral cases (P = 0.03). Patients with LR started dialysis with lower levels of haemoglobin (8.6 vs 9.5 g/dL, P < 0.05) bicarbonate (16 vs 12 mEq/lt, P < 0.03) and albumin (2.9 vs 3.29 mg/dL, P < 0.02) and with higher serum levels of blood urea nitrogen (173 vs 95 mg/dL, P < 0.001), creatinine (10 vs 7.9 mg/dL, P < 0.001) and potassium (5.3 vs 4.8, P < 0.04). Hospitalization duration beginning at dialysis was significantly longer in the LR group (27.3 +/- 24) compared with the ER group (13.4 +/- 7.5, P < 0.001). When the groups were compared in terms of distance between the patients home and hospital, there were significantly more patients living far away from hospital (i.e. > 100 km) in the LR group compared with the ER (P < 0.0001) group. Conclusion: Early referral to a nephrology unit and/or early diagnosis of ESRD results in better biochemical variables, shorter first hospitalization length and a higher percentage of elective construction of AVF and the availability to start with an alternative dialysis modality (i.e. CAPD).
The Effects of Volatile Anesthetics on the Q-Tc Interval
(W B Saunders Co, 2001) Güler, N; Kati, I; Demirel, CB; Bilge, M; Eryonucu, B; Topal, C
Objective: To examine the effects of halothane, isoflurane, and sevoflurane on Q-Tc interval (corrected for heart rate) during inhalation induction of anesthesia. Design: Prospective, double-blind, randomized study. Setting: Departments of Cardiology and Anesthesiology in a university hospital. Participants: Patients undergoing noncardiac surgery. Interventions: A total of 65 American Society of Anesthesiologists physical status I-II patients, aged 16 to 50 years, undergoing general anesthesia, were randomly allocated to receive halothane, isoflurane, or sevoflurane. Measurements and Main Results: The time to reach the predetermined end-tidal concentrations of 3 minimum alveolar concentration was 6 to 10 minutes. When compared with preinduction values, heart rate decreased after halothane (p < 0.01) and sevoflurane (p < 0.05) administration; in contrast, heart rate increased after induction of anesthesia with isoflurane (p < 0.05). The mean QRS intervals were not significantly changed after halothane, isoflurane, or sevoflurane. The Q-Tc interval was increased with isoflurane compared with baseline (465 +/- 23 441 +/- 18 msec, p < 0.01), not changed with sevoflurane (441 +/- 17 434 +/- 19 ms, p > 0.05), and shortened with halothane (426 +/- 23 nu 445 +/- 21 msec, p < 0.01). Conclusions: Sevoflurane or halothane may be preferred to isoflurane patients with conditions that are known to induce a prolonged Q-Tc interval. The effects of Q-Tc interval changes resulting from different anesthetic agents on morbidity and the incidence of arrhythmias during anesthesia warrant further investigation. Copyright (C) 2001 by W.B. Saunders Company.
Mycophenolate Mofetil Use in Hepatitis B Associated-Membranous and Membranoproliferative Glomerulonephritis Induces Viral Replication
(Harvey Whitney Books Co, 2005) Sayarlioglu, H; Erkoc, R; Dogan, E; Sayarlioglu, M; Topal, C
Nephropathy and Retinopathy in Type 2 Diabetic Patients Living at Moderately High Altitude and Sea Level
(Marcel dekker inc, 2005) Sayarlioglu, H; Erkoc, R; Dogan, E; Topal, C; Algun, E; Erem, C; Cmal, A
Background: High-altitude-induced hypoxia results in various diseases, such as chronic mountain sickness and high altitude retinal edema, and may affect severity and incidence of some cardiovascular diseases. In order to evaluate the effects of moderately high altitude on diabetic nephropathy and retinopathy, a cross-sectional study was planned. Material Method: Long-term type II diabetic residents of sea level (n = 75, 38 male, 37 female, mean age 51.9 +/- 10.5 in Trabzon and Zonguldak cities) and moderately high altitude (h = 1,727 m, n = 73, 28 male, 45 female, mean age 48.3 +/- 12.1, Van city) were compared. Results: No difference was observed in terms of age, gender, diabetes duration, body mass index, smoking, systolic, diastolic, and mean arterial blood pressure values, serum glucose levels, cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, hemoglobin, HbAlC, hypertension control, or blood pressure medications and retinopathy incidence. Mean 24 h protein excretion (210.0 +/- 139.9, 127.8 +/- 112.1 mg: P = 0.00). proteinuria prevalence (57.5% versus 33.3%, p = 0.003), and serum creatinine levels (1.04 +/- 0.22 versus 0.84 +/- 0.21,p = 0.00) were significantly higher in the highlanders, glomerular filtration rate (GFR) was significantly lower in sea level (SL) patients (90.9 +/- 26.5 versus 83 +/- 21.1: p = 0.05). Conclusion: Tendency to diabetic nephropathy as indicated by higher proteinuria and creatinine levels is increased among type 2 diabetic patients living at moderately high altitude. Prospective studies are needed to confirm these findings.
Simultaneous Occurrence of Papillary Intrafollicular and Microcarcinomas With Bilateral Medullary Microcarcinoma of the Thyroid in a Patient With Multiple Endocrine Neoplasia Type 2a
(Springer-verlag, 2002) Kösem, M; Kotan, Ç; Algün, E; Topal, C
We report the case of a simultaneous occurrence of papillary intrafollicular and microcarcinomas with bilateral medullary microcarcinoma of the thyroid in a patient with multiple endocrine neoplasia type 2A. The concurrent presence of two thyroid carcinomas is rare. The simultaneous occurrence of two different tumors in the same thyroid each being multifocal and smaller than 1 cm in diameter has not been previously reported in the literature. Furthermore, we define the first case of intrafollicular papillary thyroid carcinoma (carcinoma in situ).
Spontaneous Pregnancy in a Patient With Sheehan's Syndrome
(Elsevier Sci Ireland Ltd, 2003) Algün, E; Ayakta, H; Harman, M; Topal, C; Aksoy, H
Tuberculosis in Dialysis Patients, Single Centre Experience From an Endemic Area
(Wiley, 2004) Erkoc, R; Dogan, E; Sayarlioglu, H; Etlik, O; Topal, C; Calka, F; Uzun, K
Because of immunity defect, patients with end-stage renal disease are at increased risk of developing infections, tuberculosis (TB) in particular. The incidence of TB is higher in dialysis patients than in general population. We retrospectively reviewed the charts of dialysis patients with TB in our facility. A total of 287 dialysis patients (153 male, 134 female, 223 haemodialysis (HD), 64 continuous ambulatory peritoneal dialysis (CAPD) patients, mean age 46 +/- 15) were reviewed from October 1997 to January 2002. TB developed in 30 patients (17 male, 13 female, 24 HD and six CAPD). Thirteen patients with TB presented with fever of unknown origin (FUO) and four of them subsequently developed military lesions on chest X-ray. Nine patients had pulmonary TB (four with pleural effusions), five patients had TB lymphadenits, two patients had TB peritonitis and one patient had vertebral TB. TB was presented mostly as FUO among dialysis patients in a region under poor socio-economic conditions. In such areas with endemic TB, dialysis patients who present with FUO should be carefully evaluated for the presence of TB, and test therapy for TB should be performed in otherwise unexplained FUO.
Urinary Beta-2 Microglobulin in Renal Dysfunction Associated With Hypothyroidism
(Wiley, 2004) Algün, E; Topal, C; Öztürk, M; Sekeroglu, MR; Durmus, A
Hypothyroidism is associated with a number of functional renal disorders primarily affecting water and salt handling. In this study, we aim to investigate functional renal disorders in overt and subclinical hypothyroidism. We utilised urinary beta-2 microglobulin (beta2M) as a sensitive marker of tubular dysfunction. Urinary beta2M excretion and tests for renal functions were repeated before and after T4 replacement therapy. Forty-four patients (28 with overt disease, 16 with subclinical disease) and 31 healthy control subjects were involved in the study. There was a significant increase in urinary beta2M in both overt and subclinical hypothyroidism (p < 0.05 in both). TSH levels were correlated with beta2M excretion. Effects of hypothyroidism on renal functions were readily reversible by 3 weeks of thyroid hormone replacement therapy. Urinary beta2M was a sensitive marker of renal tubular dysfunction associated with overt and subclinical hypothyroidism. (C) 2004 Black-well Publishing Ltd.