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    Effects of fluvastatin treatment on insulin sensitivity in patients with hyperlipidaemia
    (Sage Journals, 2002) Top, C.; Terekeci, Murat Hakan; Keskin, O.; Önde, Mehmet Emin
    This 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.
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    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, Mehmet
    Insulin 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.
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    Oncologic emergencies that need supportive care in ICU
    (Internet Scientific Publications, 2001) Küçükardalı, Y.; Cancır, Z.; Özkan, S.; Top, C.; Çakır, O.; Gökben, M.; Danacı, M.
    Patients with oncologic disease have numerous complications that are life- threatening and may require hospitalisation in the intensive care unit. If not recognized and treated appropriately, these complications can be fatal. We reviewed all 840 patients admitted to medical intensive care unit of GATA Haydarpasa Training Hospital during one - year period. 75 (8.9%) oncologic patients with 140 oncologic emergency episodes that needed supportive care were documented. Thirty one (22.1%) emergency episodes were related to gastrointestinal system (bleeding, obstructive icter, ascites, peritonitis, intractable vomiting), 23(16.4 %) respiratory system (pneumonia, obstructive dyspnea ), 22 (15.7%) hematopoietic system (neutropenia, anemia, pancytopenia, disseminated intravascular coagulation), 19 (13.5%) genitourinary system (obstructive renal insufficiency, acute tumour lysis syndrome, severe electrolyte abnormalities, nephrotoxicity, urosepsis), 14 (10%) nervous system (organic brain syndrome, convulsion, seizures, pain ) 10 (7.1%) multiorgan failure, sepsis) 9 (6.4 %) cardiovascular system (superior vena cava syndrome, hypotension, dysrhythmia, cardiotoxicity) 5 (3.5%) malnutrition, 2 (1.4 %) exfoliative dermatitis and 5 (3.5%) were undiagnosed. Quality of life could be improved in 48 (64%) patients with appropriate supportive care and 30 (40%) patients were referred to oncologic therapies after supportive care. Our mortality rate was 36% in this population. We conclude that with appropriate medical and nursing management, these emergencies can be either prevented or their complications minimised.