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Yayın Acute Hepatitis Due to Epstein Barr Virus with Cross-Reacting Antibodies to Cytomegalovirus(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2018) Karadeniz, Asli; Yesilbag, Zuhal; Kaya, Fatih Oner; Akgun, Feride SinemEpstein Ban virus (EBV) is the cause of systemic infection known as infectious mononucleosis with classic presentation of fever, oropharyngitis and lymphadenitis. EBV rarely causes acute hepatitis. in this report, we present a 19-year-old patient presented with nausea, fatigue and jaundice. Her physical examination and laboratory tests revealed the diagnosis as acute hepatitis due to EBV with cross-reacting antibodies to cytomegalovirus.Yayın Are Intervertebral Disc Tissue Cells Damaged When Attempting to Prevent Thrombus Formation Using Dabigatran, A New Oral Anticoagulant?(TURKISH NEUROSURGICAL SOC, 2019) Kaplan, Necati; Karaarslan, Numan; Yilmaz, Ibrahim; Yasar Sirin, Duygu; Akgun, Feride Sinem; Caliskan, Tezcan; Simsek, Abdullah Talha; Ozbek, HanefiAIM: To investigate the effect of dabigatran, a new oral anticoagulant, on human primary cell cultures isolated from intact intervertebral disc tissue. MATERIAL and METHODS: Cell cultures were prepared from tissues obtained from six cases who had undergone surgery due to spinal trauma. Dabigatran, an active pharmacological agent, was applied to intact annulus fibrosus (AF)/nucleus pulposus (NP) primary cell cultures from the study group. After performing cell viability, toxicity, and proliferation tests on all cultures in the control and study groups, the surface morphologies of the samples were evaluated. Subsequently, chondroadherin (CHAD), cartilage oligomeric matrix protein (COMP), and matrix metalloproteinase (MMP)-13 and -19 expressions were measured via a real-time polymerase chain reaction (RT-PCR). Data were analyzed statistically. RESULTS: In the proliferation assays performed on the 20th day of the study, cells in the dabigatran-supplemented group were reported to have lost 46.37% more viability than those in the control group. Expressions of all genes examined except MMP-13 were evaluated in the control group by time, but in contrast to the control group results, COMP and MMP-19 gene expressions decreased in the dabigatran-treated group. No CHAD or MMP-13 expression was noted in these cultures. CONCLUSION: The potential for a systemically applied drug to accumulate in tissue and negatively affect surrounding tissues and microstructures must be emphasized.Yayın Does Mild Hydronephrosis Induced by Full-Bladder Improve Outcomes in Patients Undergoing Shock Wave Lithotripsy for Lower Calyceal Stones?: A Prospective Randomized Study(UROL & NEPHROL RES CTR-UNRC, 2018) Hazar, Ismet Aydin; Cakiroglu, Basri; Sinanoglu, Orhun; Akgun, Feride Sinem; Arda, Ersan; Yuksel, Ilkan; Akdere, HakanPurpose: To compare the outcomes, sessions and shock wave numbers in patients undergoing standard procedure shock wave lithotripsy (SWL) and patients undergoing SWL with mild hydronephrosis induced by full-bladder following oral hydration before SWL procedure for lower calyceal stones. Materials and Methods: Between January 2014-January 2016 a total of 371 patients who underwent SWL, for lower pole calyceal stones 2 cm, were included into the study. 127 patients were treated in the supine position (Group A), 123 in the prone position (Group B) and 121 in the prone position with full bladder and mild hydronephrosis checked by ultrasound before procedure (Group C). There were 286 men and 85 women with a mean SD age of 36 11 years Results: The mean (SD) stone sizes within the group A, group B and group C were 11 mm (+/- 3 mm), 12 mm (+/- 4.1 mm) and 11 mm ( +/- 3.8 mm) respectively. No significant difference was found in age (P =.18) and stone size between 3 groups (P =.07). The median interquartile range (IQR) number of shocks within the group A, group B and group C were 7600 (3855), 6500 (4300) and 6700 (4915) respectively. Significant difference was found in number of shock waves among 3 groups (P <.01). The difference between groups according to stone expulsion rate was found significant in all sessions (P =.01). Conclusion: The present study suggests that mild hydronephrotic status induced by full-bladder before SWL can lower cost and patient discomfort by decrease in number of sessions and increase in stone clearance.Yayın Efficacy of ProBNP and CRP/ Albumin ratio in patients with acute heart failure in the Emergency Department(2020) Karaman, Esra; Akgun, Feride Sinem; Öztürk Demir, TubaAbstractAim: Heart failure (HF) is one of the most common diseases in patients over 65 years of age.It is a clinical condition which is often mortal and requires intensive care follow-up. Therefore, some tests are used to predict the diagnosis, treatment and prognosis. In this study, we aimed to compare the effect of natriuretic peptides (ProBNP) and CRP/albumin ratio on mortality and prognosis in patients who referred to the emergency department (ED) with HF.Material and Methods: The patients with ICD codes of I50 and J81 in two different hospital ED between 2018 and 2019 were analyzed retrospectively. Demographic data of the patients and the parameters planned to be studied were recorded in a Microsoft Excel 2010 file. NCSS (Number Cruncher Statistical System) 2007 software was used for the statistical analysis.Results: Our study consisted of 301 patients. A very weak positive (CRP/albumin ratio increased as the ProBNP value increased) correlation of 0.193 between ProBNP measurements and CRP/albuminratios of the participants was found to be statistically significant(r=0.193; p=0.001; p<0.01).Conclusion: According to our study, no significant correlation was found between ProBNP and CRP/albumin ratio. The CRP/albumin ratio is not appropriate to be used alone to determine the definitive diagnosis and mortality in cases with acute HF. However, since there are not enough studies regarding this subject, more studies need to be done in a more extended period and with more patients.Yayın Is R202 Q Polymorphism Related With Some Atypical Inflammatory Clinical Situations?(2019) Akgun, Feride Sinem; Dabak, Reşat; Uygur Bayramiçli, Oya; Sezgin, Gülbüz; Nalbant, Selim; Akduman Alaşehir, Elçin; Kaya, Fatih ÖnerObjective: To date, especially alterations of genes on exon 10 have beenconsidered in Mediterranean fever (MEFV), but it is not clear whether all thesealterations are disease-causing mutations. This study aims to evaluate theclinical features of the patients with R202Q alteration.Materials and methods: Patients admitted to the emergency department andinternal medicine clinic and diagnosed as Familial Mediterranean Fever (FMF)were included in the study. The medical records of patients with MEFV genemutations were reviewed retrospectively.Results: Total 25 patients with R202Q mutations were obtained. 14 patientshad a classical AAA phenotype with fever and abdominal pain: 10 patients withM694V mutation, and 4 with other mutations. None of the patients with singleR202Q mutation were with the classical FMF phenotype. Patients with singleR202Q mutation showed atypical inflammatory phenotype (4 pericarditis, 1pleurisy, 1 arthritis, 1 psoriatic arthritis). On the other hand, patients withclassical FMF phenotype and with R202Q mutation were with higher colchicineneed and proteinuria.Conclusion: According to our results, R202Q mutation may create a tendencyto inflammation or augment the existing inflammation. However, prospectivecomprehensive studies are needed to further investigate the relationship ofR202Q and clinical findings and severity of the disease.Yayın Kemoterapi Almakta Olan Onkoloji Hastalarında İlaç-ilaç, İlaç-besin Etkileşimlerinin Değerlendirilmesi(2020) Akgun, Feride Sinem; Saglam, Esra; Güneş Özünal, Zeynep; Türken, OrhanAmaç: Kanser tanısı almış hastalarda bitkisel ve destek ürünlerinin kullanımı yaygındır. Bitkisel ve destek ürünlerinin hastalara faydası olabileceği gibi direk toksik etkileri ve ilaç etkisini değiştirebilme olasılıkları da bulunmaktadır. Bu potansiyel etkileşimler acile başvurulara neden olabilmektedir. Bu çalışmada kemoterapi almakta olan hastaların bitkisel ve destek ürünlerinin kullanım sıklığının, ilaç-besin etkileşimi olasılığının değerlendirilmesi planlanmıştır. Yöntem: Kemoterapi alan hastaların tanıları, ilaç tedavileri, bitkisel ve destek ürünlerinin kullanımı ile ilgili bilgiler retrospektif olarak değerlendirildi. Potansiyel ilaç-besin etkileşimi, ilaç-ilaç etkileşimleri Lexicomp® programı ile analiz edildi. İlaç-besin etkileşim riski tespit edilen hastaların acile başvuruları ve acil servisteki tedavileri elektronik kayıtlardan incelendi. Bulgular: Onkoloji servisinde 1-31 Mart 2018 tarihleri arasında kemoterapi alan 38 hastanın verilerine ulaşıldı. Hastaların %57’si bitkisel ve destek ürünleri aldıklarını bildirdi. İlaç dışında kullanılan ajanların %50’sinin bitkisel destek ürünü; %31’inin propolis, arı sütü ve bal gibi arı ilişkili ürünler olduğu belirtildi. Toplam üç hastada ilaç-besin etkileşim riski bulundu. Bu hastaların acil servise başvuruları öngörülen advers etkiler açısından değerlendirildi. Sonuç: Kemoterapi alan hastalarda bitkisel ve destek ürünleri kullanımı sıktır. Potansiyel ilaç-ilaç dışı kullanılan besin desteği etkileşimi, hastanın tedavisi ve genel sağlık durumu açısından önemlidir. Hastanın ilaç dışı destek ürünü kullanımı hekim tarafından mutlaka sorgulanmalı ve potansiyel ilaç-ilaç ve ilaçbesin etkileşimleri çok disiplinli bir ekip tarafından değerlendirilmelidir.Yayın Long-term Effect of Colchicine Treatment in Preventing Urethral Stricture Recurrence After Internal Urethrotomy(UROL & NEPHROL RES CTR-UNRC, 2018) Sinanoglu, Orhun; Kurtulus, Fatih Osman; Akgun, Feride SinemPurpose: Urethral stricture, known as a scar formation leading to urethral lumen stricture in sub-epithelial tissue, is the most common late complication of transurethral prostate resection (TURP). The aim of study is to evaluate efficacy of colchicine treatment in preventing urethral stricture recurrence in patients after internal urethrotomy, and to determine whether colchicine treatment had a sustained effect in decreasing stricture recurrences in patients with concomitant diseases. Methods: Patient data with weak urine stream and/or voiding difficulty, and who had internal urethrotomy in Urology Department of Maltepe University Hospital between dates 01 January 2011 and December 2016 were collected. They were randomized to colchicine receiving, and non-receiving arms. Colchicine was given 1 g/day orally for two months, and primary efficacy point was defined as urethral stricture development in 3, 6, and 12 months after internal urethrotomy. Results: The study was conducted on 84 males with the mean age of 67.7 +/- 7.5 years. The mean ages of colchicine receivers and non-receivers were 68.2 +/- 7.6 and 67.1 +/- 7.6 years, respectively. Recurrence rate of urethral stricture was significantly lower in colchicine receivers (P = .044) than non-receivers. In overall evaluation, recurrence rate of urethral stricture was significantly low, if there was only one comorbidity (P = .006), but rates were significantly higher in presence of three (P = .010) and four (P = .040) comorbidities. No significant difference in recurrence rates was determined in patients without comorbidities or with two comorbidities (P > .05). Conclusion: Combination of oral colchicine with internal urethrotomy reduces recurrence rates of urethral stricture significantly.Yayın The utility of the neutrophil-to-lymphocyte ratio in predicting urolithiasis in acute abdominal pain accompanied by flank pain(2019) Sinanoğlu, Orhun; Akgun, Feride SinemObjectives: To evaluate whether the neutrophil-to-lymphocyte ratio (NLR), can differentiate between urinarystone disease and inflammatory conditions in patients admitted to emergency department having acuteabdominal pain accompanied by flank pain.Methods: Data of 191 patients with acute abdominal pain accompanied by flank pain admitted to emergencydepartment in a single institution during 1 year period was retrospectively reviewed. Complete blood countand urine analysis were evaluated, the definitive diagnosis was established radiologically. The NLR wascalculated as the absolute neutrophil count divided by the absolute lymphocyte count. The cut off value for theNLR in relation to stone status was calculated.Results: Of the 191 patients 51.3% (n = 98) were males, 48.7% (n = 93) were females (p > 0.05). White bloodcounts of the patients according to the presence of stone does not show a statistically significant difference (p> 0.05). NLR measurement of patients according to the presence of stone shows a statistically significantdifference (p = 0.009). NLR of patients with urinary stones were significantly lower than patients withouturinary stones. NLR measurements did not differ significantly according to stone location. A cut-off point of? 2.16 for the NLR was determined according to the stone status of the patients. NLR values were higher inpatients with acute abdominal pain/flank pain due to inflammatory pathologies.Conclusion: As the diagnosis and treatment of urolithiasis take long time and require elaborate methods, NLRmay be used as a simple method in the differential diagnosis of pain due to urinary stone disease orinflammatory condition.
