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Yayın Albumin, hemoglobin, body mass index, cognitive and functional performance in elderly persons living in nursing homes(Elsevier, 2010) Önem, Yalçın; Terekeci, Murat Hakan; Küçükardalı, Yaşar; Şahan, Burak; Solmazgül, Emrullah; Şenol, Mehmet Güney; Nalbant, Selim; Sayan, Özkan; Top, Cihan; Öktenli, ÇağatayThe aim of this study is to produce the relation between cognitive and functional performance and some biochemical parameters in elderly population. So, we searched for the correlation between the activities of daily living (ADL), mini-mental state examination (MMSE) and body weight, age, hemoglobin, albumin, serum sodium level of 180 elderly people in five nursing homes. Face-to-face interviews and questionnaires were applied to evaluate ADL. To evaluate the cognitive function we used the MMSE. The average age of 180 people contacted was 71.5+/-5.1 (+/-S.D.), ranging 65-91 years; 112 of them were women (62.2%), 68 were men (37.8%). Of these elderly people, 25% had no medically diagnosed illnesses, whereas 17 of them (9.4%) were bedridden. There was a positive correlation between ADL and hemoglobin, albumin, body weight, cognitive function parameters and a negative one with age and serum sodium. There was a positive correlation between cognitive functions and hemoglobin, body weight, ADL and a negative one with serum sodium. Hemoglobin concentrations indicating anemia were observed in 30% of subjects, 3.9% of them had hyponatremia and 26.7% displayed a hypernatremia. There was a positive correlation between cognitive and physical function scores and hemoglobin, albumin levels in elderly patients. These results suggest that restoration of hemoglobin and albumin levels could improve cognitive and physical functional status in the elderly population.Yayın Blood oxidative stres biomarkers in patients with Familial Mediterranean Fever (FMF)(Thieme Publishing Group, 2010) Çelik, Serkan; Öktenli, Çağatay; Terekeci, Murat Hakan; İpçioğlu, Osman; Sanisoğlu, Yavuz S.; Sayan, Özkan; Yeşilova, Zeki; Yıldız, Oğuzhan; Tunca, Yusuf; Nalbant, SelimInterest in the relationship between oxidative stress and inflammation has increased in recent years. Familial Mediterranean fever (FMF) represents a suitable autoinflammatory disease model for investigation of this relationship. We aimed to determine blood oxidative stress biomarkers in patients with FMF in both acute attacks and in attack-free periods, and to evaluate its associations with pyrine mutations and C-reactive protein (CRP) levels. The mean levels of CRP and serum lipid hydroperoxide were higher and serum superoxide dismutase and catalase activities were lower in patients with FMF than in healthy volunteers. Serum lipid hydroperoxide levels were higher and antioxidants were lower in FMF patients during an acute attack than in the attack-free period. Serum lipid hydroperoxide levels were significantly higher, and antioxidants were significantly lower in patients with the M694V homozygous mutations than the other genotypes. Our data imply that higher serum lipid hydroperoxide and lower antioxidant enzyme activities in FMF may indicate inflammation-related 'oxidative stress'. Our findings also raise interesting questions on oxidative stress and its associations with pyrine mutations in FMF and awaits further investigations.Yayın Effects of fluvastatin treatment on insulin sensitivity in patients with hyperlipidaemia(Sage Journals, 2002) Top, C.; Terekeci, Murat Hakan; Keskin, O.; Önde, Mehmet EminThis study aimed to determine the effects of fluvastatin treatment on insulin sensitivity in patients with hyperlipidaemia. Non-obese, normoglycaemic, normotensive patients with hyperlipidaemia (n = 20) and a reference group of healthy subjects of similar age, sex, and body mass index (n = 20) were evaluated. Patients with other causes of peripheral insulin resistance were excluded. All participants underwent a diagnostic protocol, which included measurements of insulin sensitivity index and other metabolic parameters. Insulin sensitivity was assessed by Homeostasis Model Assessment (HOMA). Serum insulin levels were tested by radioimmunoassay. Patients were treated with fluvastatin 40 mg once daily for 3 months. Before fluvastatin treatment, fasting serum insulin levels were significantly raised in patients with hyperlipidaemia compared with subjects from the reference group (19.1 ± 13.4 versus 8.1 ± 3.4 ?lU/ml). The fasting serum insulin levels and HOMA-estimated insulin sensitivity were correlated in the whole group. Correlation analysis showed a significant relationship between HOMA-estimated insulin resistance and plasma cholesterol and triglyceride concentrations. Patients with hyperlipidaemia had reduced insulin sensitivity that was reflected by high serum fasting insulin levels. Anti-hyperlipidaemic treatment with fluvastatin increases insulin sensitivity.Yayın The effects of valsartan on insulin sensitivity in patients with primary hypertension(Sage Journals, 2002) Top, C.; Terekeci, Murat Hakan; Küçükardalı, Yaşar; Önde, Mehmet Emin; Danacı, MehmetInsulin resistance is an important risk factor of cardiovascular disease. This study was performed to determine the effects of valsartan on insulin sensitivity in patients with primary hypertension. In this study, non-obese subjects with primary hypertension and a reference group of healthy subjects matched by age, sex and body mass index were evaluated; patients with any other causes of peripheral insulin resistance and hyperlipidaemia were excluded. The effect of valsartan on insulin resistance, assessed by homeostasis model assessment (HOMA-IR), fasting serum insulin levels, determined by radioimmunoassay, and fasting blood glucose concentrations, measured by the glucose oxidase method, were evaluated. All obtained data were evaluated by Pearson correlation analysis. Before valsartan treatment, the fasting serum insulin levels were significiantly elevated in the 20 hypertensive patients with primary hypertension compared with the 20 subjects in the reference group (19.6 ± 7.1 versus 8.7 ± 1.9 ?IU/ml). The fasting serum insulin levels correlated with HOMA-IR. Correlation analysis also showed a significant relationship between HOMA-IR and both systolic and diastolic blood pressures (r = 0.71 and r = 0.77, respectively). In our study, we showed that patients with primary hypertension have a decreased insulin sensitivity that was reflected in high serum fasting insulin levels. Anti-hypertensive treatment with valsartan increases insulin sensitivity.Yayın Familial Mediterranean fever attacks do not alter functional and morphologic tissue Doppler echocardiographic parameters(Springerlink, 2008) Terekeci, Murat Hakan; Ulusoy, Rıfat Eralp; Küçükarslan, Mustafa Nezihi; Nalbant, Selim; Öktenli, ÇağatayThe aim of this study is to investigate the tissue Doppler echocardiographic (TDE) characteristics of acute familial Mediterranean fever (FMF) attack on young Turkish males. Thirty-four young males with FMF were investigated utilizing echocardiography both before and after FMF attacks. Echocardiographic findings were assessed by two cardiologist utilizing Vingmed system V echocardiography machine and a 2.5 MHz probe by two-dimensional and color Doppler examination, as well as tissue Doppler parameters. The incidence of pericardial effusion was found to be 23.3% during acute FMF attack. There was no significant difference between the patients in attack-free period and attack period with respect to TDE measurements. TDE measurements did not differ between the patients with and without pericardial effusion. There was no correlation between pericardial effusion and disease duration, family history, and physical findings. In conclusion, our results suggest preserved systolic and diastolic ventricular functions in attack period. Pericardial effusion is not associated with impaired TDE parameters.Yayın High frequency of MEFV gene mutations in patients with myeloid neoplasm(SpringerLink., 2010) Öktenli, Çağatay; Sayan, Özkan; Çelik, Serkan; Erikçi, A. Alev; Tunca, Yusuf; Terekeci, Murat Hakan; Erkuvan Umur, Elçin; Sanisoğlu, Yavuz S.; Torun, Deniz; Tangı, Fatih; Şahan, Burak; Nalbant, SelimWe aimed to investigate the rate of MEFV, the gene mutated in familial Mediterranean fever, mutations in patients with myeloid neoplasm and to determine if known mutations of MEFV cause a tendency for myeloid neoplasms. The frequency of the five most common MEFV gene mutations (M694V, M680I, V726A, E148Q and M694I) was determined in 26 patients with myeloid neoplasm. We identified 1 homozygous (E148Q/E148Q), 1 compound heterozygous (M694V/E148Q) and 5 heterozygous MEFV gene mutations; none had their own and/or family history compatible with familial Mediterranean fever. The mean overall mutation rate was 0.269. We found a high frequency of carriers in patients with myelodysplastic syndrome (66.6%), polycythemia vera (33.3%) and acute myeloid leukemia (28.6%). However, there was no MEFV gene mutation in patients with chronic myeloid leukemia. In conclusion, this study reports for the first time a possibly high prevalence of MEFV gene mutations in patients with myeloid neoplasm, especially myelodysplastic syndrome, polycythemia vera and acute myeloid leukemia. Our findings could open new perspectives for MEFV gene mutations in myeloid neoplasms and its association with tumor promotion. Further research is needed to determine the actual role of MEFV gene mutations in these malignancies.Yayın Increased asymmetric dimethylarginine levels in young men with familial Mediterranean fever (FMF): is it early evidence of interaction between inflammation and endothelial dysfunction in FMF?(The Journal of Rheumatology Publishing Co. Ltd., 2008) Terekeci, Murat Hakan; Öktenli, Çağatay; Özgürtaş, Taner; Nalbant, Selim; Top, Cihan; Çelik, Serkan; Tapan, Serkan; Küçükardalı, Yaşar; Sanisoğlu, Yavuz S.; Solmazgül, Emrullah; Şahan, Burak; Sayan, ÖzkanObjective: Unlike in many other chronic inflammatory rheumatic diseases, studies investigating endothelial dysfunction and atherosclerosis in familial Mediterranean fever (FMF) are limited, and the results are controversial. Asymmetric dimethylarginine (ADMA) is considered an indicator for endothelial dysfunction and a sensitive marker for cardiovascular risk. There have been no reports on serum ADMA levels in patients with FMF. Methods: We aimed (1) to determine serum ADMA concentrations in 38 young male patients with FMF and 23 age- and body mass index-matched healthy volunteers; (2) to evaluate its correlations with MEFV mutations, C-reactive protein (CRP) levels, and lipid profile; and (3) to compare effects of colchicine on circulating ADMA concentrations. Results: In patients with FMF, ADMA and CRP levels were higher than in healthy controls. The mean levels of ADMA and CRP were higher during acute attacks than in attack-free periods. Patients taking colchicine had lower serum ADMA levels than non-colchicine users. There was a positive strong correlation between ADMA and CRP in patients with FMF. Stepwise linear regression analysis in patients with FMF revealed that age and CRP levels were independently associated with serum ADMA levels. Conclusion: Our data imply that higher serum ADMA levels in FMF may indicate inflammation-related "endothelial dysfunction." It seems likely that regular use of colchicine is effective in preventing the development of and reversing not only amyloidosis but also endothelial dysfunction in patients with FMF.Yayın Increased circulating asymmetric dimethylarginine (ADMA) levels in active stage of Behçet’s Syndrome(Thieme Publishing Group, 2009) Terekeci, Murat Hakan; Nalbant, Selim; Özgürtaş, Taner; Çelik, Serkan; Tapan, Serkan; Sanisoğlu, Yavuz S.; Şahan, Burak; Sayan, Özkan; Küçükardalı, Yaşar; Top, Cihan; Öktenli, ÇağatayThere is little evidence in the literature about circulating asymmetric dimethylarginine (ADMA) levels in Behçet's syndrome (BS). The aim of the present study was 1. to measure the levels of ADMA in male patients with BS, 2. to compare ADMA levels with healthy volunteers, and 3. to evaluate whether there is any difference between patients both with / without thrombosis and in active / inactive stage. In patients with BS, CRP levels were higher than controls. The mean ADMA and C-reactive protein (CRP) levels were significantly higher in active stage patients and patients with thrombosis than in patients during the inactive stage and without thrombosis. In conclusion, we did not find any significant difference in ADMA levels between patients with BS and healthy controls. Serum ADMA concentrations, however,Yayın Leucocytoclastic vasculitis after citric acid intoxication(Internet Scientific Publications, 2008) Terekeci, Murat Hakan; Şahan, Burak; Nalbant, Selim; Yücetürk, Tolga Enver; Haholu, Aptullah; Çelik, Serkan; Tangi, Fatih; Öktenli, ÇağatayBackground: Citric acid is widely used in detergent industry. Information about citric acid intoxication is limited. Its ingestion is a life-threatening condition that requires a multidisciplinary approach.Case report: A 44 year-old male patient arrived to the hospital after a suicide attempt by taking 150 ml of dishwasher polisher. Vomiting was induced by his relatives before coming to hospital 4 hours after. Arterial blood-gas and electrolytes evaluation revealed blood-pH and potassium to be 7.15 and 6.13 mg/dL, respectively, and an increased plasma anion gap. Two weeks later, bilateral vocal cord paralysis was diagnosed and tracheostomy was performed. Internal Medicine consultation revealed a initial diagnosis of vasculitis and he was admitted to Internal Medicine Department. There was a diffuse cutaneous petechial rash which was nonpalpable and the largest one was about 2 cm diameter. The pathological punch biopsy sample taken from the lower part of the left leg, where there was diffuse rash, revealed leucocytoclastic vasculitis. One mg/kg prednizolone was started after vasculitis was confirmed pathologically. Cutaneous lesions recovered dramatically. Discussion: Many drugs are indicated to cause leucocytoclastic vasculitis. Antibiotic, especially those of penicilin group and clarithromycin are reported to cause leucocytoclastic vasculitis and henoch-schönlein purpura. Other agents that may cause leucocytoclastic vasculitis development are non-steroid anti-inflammatory drugs, proplytiouracil, paracetamol, simetidin, streptokinase, metformin and acenocumaral. There’s no other case in literature as ours who took foreign substances such as citric acid for suicidal purposes rather than treatment purposes. The only case found in literature about citric acid had metabolic acidosis with high level of anion gap, which recovered after ionized calcium infusion; however, its follow up do not report a leucocytoclastic vasculitis similar to our case.Yayın Mean Platelet Volume (MPV) in Intensive Care Unit (ICU) Patients: Is it a useful parameter in assessing prediction for mortality?(International Research Journals, 2010) Küçükardalı, Yaşar; Önem, Yalçın; Terekeci, Murat Hakan; Tangı, Fatih; Şahan, Burak; Erikçi, A. Alev; Sayan, Özkan; Nalbant, Selim; Öktenli, ÇağatayThe aim of the study is to investigate MPV (mean platelet volume) showing platelet reactivity if it is associated with the severity of the critical illness or mortality in ICU patients. Study group (130 patients) was formed from survivor group (68 patients) and non-survivor group (62 patients). Platelet counts and MPV values were compared between two groups in the first five days of hospitalization. MPV correlation was studied with APACHE II score, age, haemoglobin level, duration in the ICU and as an independent risk factor in mortality. Mean age and APACHE scores were significantly higher in non-survivor group compared to survivor group (p<0.05). There was no significant difference between two groups according to MPV and platelet counts in first five days of hospitalization. There was a unique positive correlation between MPV and APACHE score (r: 0.34, p< 0.05). Only age was independent risk factor in mortality. In our study, we found positive correlation between severity of critical illness and MPV. However, there was no relation between MPV and mortality in heterogenic critical patients. Subgroup analysis of patients in ICU might be useful in assessing prediction for mortality.Yayın Prognostic value of mean platelet volume in patients with upper gastrointestinal bleeding(SpringerLink, 2008) Nalbant, Selim; Çağıltay, Eylem; Terekeci, Murat Hakan; Kaplan, Mustafa; Şahan, Burak; Sayan, Özkan; Öktenli, ÇağatayThis study included patients with upper gastrointestinal hemorrhage who were treated in intensive care unit of GATA Haydarpasa Training Hospital, Division of Internal Medicine during 1 year. Medical and demographic data of the patients were recorded. These patients were followed for 3 months after being discharged from the intensive care unit. Of the 50 patients in the study, 18 were female (36%), 32 were male (64%). The mean age was 47±2 years, and the ages ranged between 17 and 89 years. We did not find any statistically significant results in our evaluation of the relationship between the mean platelet volume and the number of transfusions, endoscopic findings, and prognosis after 3 months of follow-up. This is a preview of subscription content, log in to check access.Yayın The vasoactive intestinal polypeptide (VIP) levels at the patients with ankylosing spondylitis and its association with inflammation markers(Springerlink, 2011) Nalbant, Selim; Çağıltay, Eylem; Şahan, Burak; Terekeci, Murat Hakan; Öktenli, ÇağatayVasoactive intestinal polypeptide (VIP) is a neuropeptide from secretin/glukagon family. Recently, the importance of VIP is becoming more evident, and it is thought that VIP is playing an important regulatory role between neuroendocrine-immune-gastrointestinal systems. In this study, we have tried to evaluate the potential role of VIP in patients with ankylosing spondylitis (AS). In this study, 40 patients (30 male and 10 female) with AS and 40 healthy controls were included. X-ray examinations and scoring of sacroiliac joints of the patients with AS were done according to 1984 Modified New York Criteria for AS. All patients have been assessed with Bath Ankylosing Spondylitis Disease Activity Index. Platelet counts were significantly higher in study group (P < 0.05) in contrast to levels of the hemoglobin. The mean VIP levels were 4.2 ± 1.8 (pg/mL) for study group and 2.8 ± 0.8 (pg/mL) for controls. These results were statistically significant (P < 0.05). There was not any correlation between plasma VIP levels with CRP, ESR, Hb, BASDAI results and radiological scoring of the patients (P > 0.05) in contrast to our expectations. However, platelet counts and VIP levels were correlated significantly (P = 0.03). Our data demonstrate that VIP tended to be high in patients with AS when compared with healthy subjects and correlated with platelet counts significantly, for the first time at the literature. According to this study, VIP may have potential role in the pathogenesis of AS, and it is a potential candidate for many kinds of therapies.
