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Öğe 46, Xy Gonadal Disgenezisli Olgu Sunumu(2001) Gönen, M. Sait; Sağmanlıgil, Ş. Nur; Güney, İbrahim; Mil, Sibel46, XY Gonadal disgenezis female fenotip, seksüel infantilizm, önikoid yapı ve primer amenore şeklinde görülen bir sendromdur. Streak band şeklindeki gonadlardan tümör gelişmesi % 10-30 dur. Plazma ve üriner gonadotropinlerin düzeyleri artmıştır. Y kromozomu kısa kolu delesyonları, SRY gen mutasyonları, otozomal gen mutasyonları ve X kromozomu DSS lokus duplikasyonları bildirilmiştir. Primer amenore yakınması ile kliğimize başvuran 26 yaşında bayan hastanın klinik ve biokimyasal bulgularının 46,XY Gonadal disgenezis ile uyumlu olması nedeniyle olgu sunumu olarak yayınlanmasına karar verildi.Öğe Amino asitli diyalizatların malnütrisyonlu SAPD hastalarında nütrisyonel ve diğer laboratuar parametreleri üzerine 1 yıllık dönemdeki etkileri(2009) Güney, İbrahim; Altıntepe, Lütfullah; Okudan, Nilsel; Tonbul, H. Zeki; Türk, Süleyman; Yeksan, MehdiAmaç: Malnütrisyon periton diyaliz hastalarında ciddi bir problemdir ve morbitide-mortalitenin önemli nedenlerindendir. Amino asit içeren peritoneal diyaliz solüsyonları (nutrineal) ile diyaliz yapılan malnütrisyonlu hastalarda nutrisyonel durum ve diğer laboratuar parametrelerindeki değişiklikleri incelemeyi amaçladık. Yöntem: Serum albumin düzeyi 3.5 g/dl olan 19 SAPD hastası çalışmaya alındı. Hastaların bir yıllık takiplerinde; 5 hastanın exitus, 2 hastanın hemodiyalize ve bir hastanın ise APD’ye transfer olması, 2 hastada karın ağrısı, 1 hastada ise bulantı-kusma gelişmesi nedeni ile çalışmadan çıkarıldı. Çalışmayı tamamlayan 8 hastanın (6E/2K), yaş ortalaması 49.511.1 yıl idi. Başlangıç ve 1. yılda serum üre, kreatinin, total protein, albumin, ürik asid, fosfor, total kolesterol, trigliserid, hemoglobin düzeyleri, triseps deri kıvrım kalınlığı (TST), vücut yağ oranı ve vücut kitle indeksi (VKİ) belirlendi. Bulgular: Bir yıllık takip sonrasında ise başlangıç değerlerine göre serum albumin (p0.035), üre (p0.002) değerlerinde ve VKİ’de (p0.011) anlamlı artış saptanırken, ürik asit (p0.009) ve trigliserid (p0.004) değerlerinde anlamlı bir düşüş saptandı; diğer parametrelerde ise anlamlı bir fark saptanmadı. Sonuç: Amino asitli diyaliz solüsyonlarının malnütrisyonu bulunan SAPD hastalarında malnütrisyonu düzeltmek için kullanılabileceği kanaatindeyiz.Öğe Antifibrotic Effects of Aldosterone Receptor Blocker (Spironolactone) in Patients with Chronic Kidney Disease(TAYLOR & FRANCIS LTD, 2009) Güney, İbrahim; Selçuk, N. Yılmaz; Altıntepe, Lütfullah; Atalay, Hüseyin; Başarali, M. Kemal; Büyükbaş, SadıkAims. Proteinuria and transforming growth factor beta (TGF-beta) are parameters that can lead to glomerulosclerosis and tubulointerstitial fibrosis. All components of the renin-angiotensin-aldosterone system (RAAS) activate the TGF-beta. Aldosterone may not be inhibited with angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers (ARBs) due to aldosterone escape. We aimed to evaluate the effect of spironolactone on parameters leading to fibrosis. Methods. This prospective study included 30 non-diabetic chronic kidney disease (CKD) patients treated with ACEIs and/or ARBs. The patients were divided into two groups that are similar in terms of demographic parameters. 25 mg of spironolactone was added to group 1 (n = 15) for six months, though it was not administered to group 2 (n = 15). Creatinine (U-Cr), protein (U-Prot), and TGF-beta 1 (U-TGF-beta 1) were measured in spot urine sample in the beginning of study and six months later. Results. Twenty-four patients completed the study. There were no significant changes in mean blood pressure, glomerular filtration rate, creatinine, albumin, and plasma aldosterone concentrations during the observation period in either group. U-Prot/U-Cr (mg/mg Cr) was reduced from 2.43 +/- 4.85 at baseline to 1.66 +/- 3.51 at sixth month (p = 0.003) in group 1. In addition, U-TGF-beta 1/U-Cr (ng/mg Cr) was also reduced from 22.50 +/- 6.65 at baseline to 17.78 +/- 10.94 at sixth month (p = 0.041) in the same group. U-TGF-beta 1/U-Cr and U-Prot/U-Cr ratios after the sixth month were not found significant compared with baseline values in group 2. Conclusion. Spironolactone reduced both proteinuria and urinary TGF-beta 1 excretion in CKD patients. We consider that spironolactone would be beneficial to prevent progression of renal fibrosis in CKD.Öğe Association of depressive symptoms with 25(OH) vitamin D in hemodialysis patients and effect of gender(SPRINGER, 2020) Yavuz, Yasemin Coşkun; Bıyık, Zeynep; Özkul, Durmuş; Abuşoğlu, Sedat; Eryavuz, Duygu; Dağ, Mikail; Körez, Muslu Kazım; Güney, İbrahim; Altıntepe, LütfullahBackground Depression is common in chronic kidney disease ( CKD) patients and associated with significant increase in morbidity and mortality. In recent years, a relationship between vitamin D deficiency and depression has been shown. The aim of this study is to investigate the relationship between 25-hydroxy (OH) vitamin D and depression in hemodialysis patients. Methods A total of 140 patients were included in the study. Hamilton depression scale (HAM-D) was completed by all patients. 25(OH) vitamin D levels were compared between patients with and without depressive symptoms. Results Patients who had depressive symptoms had significantly lower 25(OH) vitamin D levels (13.70 [24.3-8.25] vs. 18.20 [29.2-11.7] ng/mL, p = 0.016). HAM-D score showed significant association with gender (p = 0.011) and 25(OH) vitamin D level (p = 0.011). Univariate logistic regression analysis showed that males had lower risk of depression by a ratio of 61.1% (OR 0.389, p = 0.012) and vitamin D-deficient patients had 2.88 times greater risk of depression compared to non-deficient patients (OR 2.885, p = 0.013). Multivariate logistic regression analysis showed that males had 53.7% less risk of depression (OR 0.463, p = 0.046) and vitamin D-deficient patients had 2.39 times greater risk of depression (OR 2.397, p = 0.047). When evaluated by gender, univariate logistic regression analysis showed that 25(OH) vitamin D and other variables were not associated with depression in females (p > 0.05), while only vitamin D level had a significant effect on depression in males (OR 8.207, p = 0.008). Conclusions We found a significant association between vitamin D level and depressive symptoms in hemodialysis patients. When analyzed according to gender, this association was found to stand independent of other variables only in males.Öğe Cinsel Farklılaşma Bozukluğu Olan Bir Olguda 17\beta Hidroksisteroid Dehidrogenaz Yetersizliğine Bağlanan Klinik ve Biokimyasal Bulguların Değerlendirilmesi(2001) Gönen, M. Sait; Sağmanlıgil, Ş. Nur; Güney, İbrahim; Mil, SibelMale psödohermafroditizme neden olan 17?-Hidroksisteroid dehidrogenaz-3 (17?HSD-3) enzim yetersizliği otozomal resessif geçiş gösterir ve halen tespit edilmiş 14 mutantı vardır. Testislerde Androstenedion'un Testosterona çevrilmesi azalmıştır. Dış genital organlar doğumda female özellikte veya tam farklılaşmamış olabilir. Wolffian kanal yapıları hipoplastik olarak gözlenir ve Müllerian kanal yapıları oluşmamıştır. Pubertede virilizasyonun başlaması diğer izoenzimler tarafından Androstenedion'un periferde Testosterona çevrilmesinin artmasına bağlanmaktadır. Yüzde ve vücutta aşırı kıllanma nedeniyle kliniğimize başvuran 35 yaşında bayan hastanın klinik ve labaratuvar bulguları 17?-HSD-3 enzim eksikliği ile uyumlu idi ve olgu sunumu olarak yayınlanmasına karar verildi.Öğe Comparison of Effects of Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis on Health-Related Quality of Life, Sleep Quality, and Depression(Wiley-Blackwell, 2010) Güney, İbrahim; Solak, Yalçın; Atalay, Hüseyin; Yazıcı, Raziye; Altıntepe, Lütfullah; Kara, Fatih; Yeksan, Mehdi; Türk, SüleymanFew studies investigating the effects of automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) on health-related quality of life (HRQoL), depression, and sleep quality exist in the literature. We aimed to determine differences between APD and CAPD modalities with respect to these parameters. Twenty APD and 48 CAPD patients were included in this crosssectional study. Biochemical values were measured at outpatient evaluation. A modified postsleep inventory was used to evaluate sleep quality. Health-related quality of life and depression were evaluated by the Short Form of Medical Outcomes Study and Beck Depression Inventory, respectively. Automated peritoneal dialysis and CAPD patients were compared in terms of sleep quality, HRQoL, and depression. Our results showed that there were no significant differences between APD and CAPD in any of the studied parameters. Moderate or severe sleep problems were found in 60% and 69% of the APD and CAPD patients, respectively. Mean HRQoL scores for any of the 8 Short Form of Medical Outcomes Study-36 domains were similar in the 2 groups. The mean physical component score was 51.1 +/- 21.2 and 48.9 +/- 18.2 in APD and CAPD patients, respectively (P=0.672). The mean mental component score was 47.5 +/- 20.1 in APD patients, whereas it was 42.4 +/- 19.5 in CAPD patients (P=0.291). Depression was detected in 70% of APD and 62.5% of the CAPD patients. The mean Beck Depression Inventory scores were also similar in the 2 groups. This study showed that HRQoL, sleep quality, and depression were similar in APD and CAPD patients.Öğe Depression and Quality of Life in Continuous Ambulatory Peritoneal Dialysis Patients(Oxford Univ Press, 2006) Yeksan, Mehdi; Güney, İbrahim; Yazıcı, Raziye; Atalay, Hüseyin; Altıntepe, Lütfullah; Türk, Süleyman; Tonbul, H. Zeki[Abstract not Available]Öğe Early and intensive fluid replacement prevents acute renal failure in the crush cases associated with spontaneous collapse of an apartment in Konya(TAYLOR & FRANCIS LTD, 2007) Altıntepe, Lütfullah; Güney, İbrahim; Tonbul, Zeki; Türk, Süleyman; Mazı, Mehmet; Ağca, Erhan; Yeksan, MehdiBackground. Crush syndrome developing as a result of earthquake and other natural disasters has been investigated from many angles to date. Data are scarce, however, on cases associated with the spontaneous crash of buildings. This study presents the results on seven rhabdomyolysis patients treated in our clinics out of nine casualties who were rescued from the rubble of Zumrut apartment after the building collapsed suddenly and spontaneously. Methods. As a result of the sudden, spontaneous collapse of the 10-floor Zumrut apartment in Konya at 20:15 hours on February 2, 2004, 92 out of a total of 121 persons who were inside the building lost their lives, and 29 casualties were rescued from the rubble. Nine hospitalized patients had crush syndrome, and a prophylactic mannitol-bicarbonate cocktail was started in all at admission. Results. The time they remained entrapped under the rubble was 11.1 +/- 7.3 (5-24 hours) on average. The highest CPK level of the patients was 79049 +/- 75374 u/L (17478-223600 u/L), observed on the median day 1.7 +/- 1.1 (days 1-4) following the incident. ARF developed in only two cases (28.6%) owing to the prophylactic mannitol-bicarbonate cocktail administered to prevent ARF, and because of hyperpotassemia, hemodialysis (HD) treatment was administered to these patients. One patient required two sessions of HD, and another required four. In both patients who received HD treatment, the level of potassium was in excess of 7 mEq/L. A total of eight fasciotomies were performed on five (71.4%) of the seven patients with crush syndrome. Five of the fasciotomies (62.5%) were performed on two of our patients who required HD treatment. None of our patients with crush syndrome developed permanent kidney damage, and no mortality occurred. Conclusion. It was deduced that rapid fluid therapy accompanied by the prophylactic administration of mannitol-bicarbonate are largely effective in preventing the development of ARF in cases with crush syndrome resulting from disasters.Öğe The effect of vardenafil on erectile dysfunction, quality of life and depression in cases with renal failure(OXFORD UNIV PRESS, 2007) Türk, Süleyman; Kan, Seyfullah; Atalay, Hüseyin; Güney, İbrahim; Altıntepe, Lütfullah; Küçür, Rahim; Kılıç, Mehmet[Abstract not Available]Öğe The Effects of Gabapentin Therapy on Pruritus, Quality of Life, Depression and Sleep Quality in Pruritic Hemodialysis Patients(AVES YAYINCILIK, IBRAHIM KARA, 2010) Tol, Hüseyin; Atalay, Hüseyin; Güney, İbrahim; Gökbel, Hakkı; Altıntepe, Lütfullah; Büyükbaş, Sadık; Bodur, SaidObjectives: We aimed to determine possible changes in pruritus, quality of life, depression and sleep quality in pruritic hemodialysis (HD) patients with gabapentin therapy. Patients and Methods: Fourteen adult HD patients (7 men, 7 women; mean age 59.7 +/- 17.2 years; range 41 to 88 years) with history of pruritus of more than eight weeks were assigned to receive 8-week gabapentin (300 mg per day) therapy. The daily pruritus were recorded using visual analogue scale for each period of the study during one week preceding the trial, the active treatment phase, the placebo phase and the intervening 1-week washout period. Sleep quality was determined with a modified post-sleep inventory, quality of life with a short form of Medical Outcomes Study (SF-36), depression using the Beck Depression Inventory. Results: The mean pruritus score and total of post-sleep inventory were decreased significantly with gabapentin therapy (p=0.01 and p=0.002 respectively). Physical and mental component scales of SF-36 increased, whereas cognitive and somatic depression index decreased with gabapentin. Conclusion: We concluded that beneficial effects of gabapentin therapy on pruritus, quality of life, depression and sleep quality are clinically important in HD patients with pruritus. Gabapentin therapy should be taken into account as an important choice of therapy in pruritic HD patients.Öğe Etiology and Prognosis in 36 Acute Renal Failure Cases Related to Pregnancy in Central Anatolia(2005) Altıntepe, Lütfullah; Gezginç, Kazım; Tonbul, H. Zeki; Çelik, Çetin; Güney, İbrahim; Gezginç, S. Tülin; Türk, SüleymanAim: In this study, the reason of the acute renal failure (ARF) clinic features and results of it has examined as retrospectively. Methods: In this study, the etiology, clinical features and outcome of acute renal failure (ARF) evaluted retrospectively in the Anatolian region of Turkey. Above mentioned features were examined retrospectively in 36 ARF cases (mean age 31.6±6.8, range 17-46), related to pregnancy between 1997 and 2001. Results: The ARF has developed approximately on the 30th gestational week. The reasons of ARF were; HELLP Syndrome and preclampsia (44%) in 16 cases, postpartum hemorrhage in 7 cases (19%), placenta detachment in 5 cases (14%), septic or spontaneous abortion in 5 cases (14%), and eclampsia in 3 cases. The 5 cases related to the abortion were seen (14%) in the first trimester and others were developed (86%) in the third trimester or postpartum period. In 9 cases (25%) there were intrauterine dead. In 24 of the ARF cases (67%) had hypertension at the time of the diagnosis whereas six cases (17%) had hypotension related to the vaginal bleeding. All cases had oliguria and the avarage duration was 4.8±8.7 (2-27) days. The avarage of the staying period in the hospital was 11.7±7.6 ( 4-28 )days. Hemodialysis was applied to 17 cases (47%), and not needed for 19 cases (53%). Conclusion: ARF related to the pregnancy was seen commonly in the third or the later pregnancies and the most common reasons were HELLP Syndrome, placenta detachment, and postpartum hemorrhage and resulted in a high risk condition for fetal and maternal mortality therefore, we think that the number of the pregnancies should be limited and especially multipar pregnancies must be closely controlled for ARF.Öğe Female sexual dysfunction in end stage renal disease and relation with quality of life and depression(OXFORD UNIV PRESS, 2007) Yazıcı, Raziye; Altıntepe, Lütfullah; Güney, İbrahim; Yeksan, Mehdi; Atalay, Hüseyin; Türk, Süleyman; Tonbul, Halil Zeki[Abstract not Available]Öğe Female Sexual Dysfunction in Peritoneal Dialysis and Hemodialysis Patients(TAYLOR & FRANCIS LTD, 2009) Yazıcı, Raziye; Altıntepe, Lütfullah; Güney, İbrahim; Yeksan, Mehdi; Atalay, Hüseyin; Türk, Süleyman; Tonbul, Halil ZekiBackground. Sexual dysfunction (SD) is a common problem in end-stage renal disease (ESRD). In contrast to basic and clinical research in the field of male SD, the sexual problems of women have received relatively little attention and are often under-treated. We evaluated sexual function in female ESRD patients using the validated Female Sexual Function Index (FSFI) and relation with QOL, depression, and some laboratory parameters. Methods. 117 ESRD patients (85 peritoneal dialysis [PD], 32 hemodialysis [HD], mean age 48.5 +/- 13.9 years) were enrolled. All patients had been dialyzed (PD or HD) for more than three months. In addition, an age-matched married control group of 48 subjects (mean age 47.1 +/- 12.7 years) were enrolled in the study. All patients were asked to complete three questionnaires of the FSFI, Beck Depression Index (BDI) and SF-36. Results. Female sexual dysfunction was found in 80 of the 85 peritoneal dialysis patients (94.1%) and all of the HD patients (100%), but in only 22 subjects of the control group (45.8%). A significant negative correlation was found between total FSFI score and age (r = -0.288, p = 0.002), BDI score (r = -0.471, p < 0.001), mental-physical component score of QOL (r = -0.463, p < 0.001 and r = -0.491, p < 0.001, respectively) in PD and HD patients. The rates of depression were 75.3, 43.8, and 4.2% in the PD and HD patients and control subjects, respectively. Conclusion. Female sexual dysfunction is common problem ESRD. This problem especially related with depression and QOL. Thus, sexual function should be evaluated in female subjects to determine its impact on quality of life.Öğe Health-Related Guality of Life, Sleep Guality, and Depression in Peritoneal Dialysis and Hemodialysis Patients(Wiley-Blackwell, 2012) Türkmen, Kültigin; Yazıcı, Raziye; Solak, Yalçın; Güney, İbrahim; Altıntepe, Lutfullah; Yeksan, Mehdi; Tonbul, Halil ZekiHealth-related quality of life (HRQoL) and sleep quality (SQ) were impaired in patients with end-stage renal disease (ESRD). The impairment of both HRQoL and SQ and being in a depressive mood were found to be associated with increased morbidity and mortality in dialysis patients. We aimed to investigate the association between SQ, HRQoL, and depression, and to define independent predictors of SQ and depression in peritoneal dialysis (PD) and hemodialysis (HD) patients. Ninety HD patients (41 females, 49 males with mean age 50 +/- 15.7 years) and 64 PD patients (27 females, 37 males with mean age 52.4 +/- 15.3 years) receiving renal replacement therapy for at least 3 months were screened for the assessment of SQ, HRQoL, and depression in this cross-sectional study. A modified postsleep inventory, Short Form of Medical Outcomes Study (SF-36) and Beck depression inventory (BDI) were applied to all patients for evaluating SQ, HRQoL, and depression, respectively. HD and PD patients had similar total SQ scores. Physical and mental component scale of HRQoL were found to be significantly higher in HD patients (p?Öğe Hemodiyaliz hastalarında yaşam kalitesinin mortalite üzerine etkisi(Selçuk Üniversitesi Tıp Fakültesi, 2007) Güney, İbrahim; Türk, SüleymanHemodiyaliz hastalarının 5 yıl sonraki mortalite durumlarını ve baslangıçtaki klinik, sosyodemografik özellikler, laboratuar bulguları ve yasam kalitesi ile mortalite arasındaki iliskiyi inceledik. 2001 yılında inceledigimiz toplam 511 HD hastasından 5 yıl sonra yalnızca 293'ünün HD'e devam ettigi ve 127'sinin öldügü tespit edildi. En sık ölüm sebebinin kardiyavasküler olaylar oldugu görüldü (% 47.2). Ölen hastaların daha yaslı ve diabetik oldukları ve serum albumin ve kreatinin düzeylerinin daha düsük oldukları görüldü. Ayrıca haftada 2 defa HD olanların ve HD seans süresi < 4 saat olanların daha çok ölen hastalar oldukları tespit edildi. Bunlara ilaveten; ölen hastaların yasam kalitelerinin de daha kötü oldugu belirlendi. Yapılan regresyon analizinde; mortaliteyi etkileyen faktörlerin yas, komorbidite, HD seansının kısa tutulması, malnutrisyon (hipoalbuminemi ve düsük BMI) ve kötü yasam kalitesi oldugu tespit edildi. Hemodiyaliz hastalarında mortalite ile iliskili olan yasam kalitesi belli aralıklarla degerlendirilmeli ve daha iyi yasam kalitesini saglamak için çaba gösterilmelidir.Öğe Hemoperfusion treatment of digital intoxication in chronic hemodialysis patient(2008) Atalay, Hüseyin; Selçuk, N. Yılmaz; Altıntepe, Lütfullah; Güney, İbrahimDiagnosis of Digitalis intoxication depends on good history taking, clinical signs and symptoms, and digoxin level. Sixty one years old female with diabetes mellitus (DM), coronary artery disease (CAD) and end-stage renal failure administered to emergency department with complaints of dyspnea and chest pain. Digoxin 0.50 mg once a day was prescribed by an internal medicine physician and she has been taking the drug for 7 days. In our case digoxin level was decreased to valuable level after hemoperfusion. In conclusion it was observed that hemoperfusion therapy of digitalis intoxication in chronic hemodialysis patient is effective.Öğe Hodgkin Lenfomalı Olgularımızın Klinik Özellikleri. 73 Olgunun Sonuçları(2002) Ecirli, Şamil; Borazan, Ali; Güney, İbrahim; Tek, Banu; Polat, HakkıBu çalışmada; Selçuk Üniversitesi Tıp Fakültesi Ic Hastalıkları Anabilim Dah'nda Ocak 1993-Arahk 2000 tarihleri arasında teşhis ve tedavi edilen 73 Hodgkin hastalığı olgusunun dosyalan retrospektif olarak incelendi. Hastalann yaş ortalaması 39.9 16 (18-80) yıl idi. Erkek/kadın oram 1.5 bulundu. En sık başlangıç bölgesi. baş-boyun bölgesindeki lenf nodları idi (%80.8) Histolojik subtiplendirmede en sık karışık hücreli (%45.2) görülürken, nodüler sklerozis tip (%37.0) onu takip etti. B semptomları hastaların %78.1'inde vardı. Hastalann %84.9'u ileri evrelerde görüldü (evre 3 %26, evre 4 %58.9). Primer tedavi seçeneği olarak hastaların %76.7'sine sistemik kemoterapi uygulanırken, %12.3'üne radyoterapi ile birlikte kemoterapi ve %11'ine radyoterapi uygulandığı belirlendi. iki yıllık yaşam süresi 60 hastada %93 iken, 5yıllık yaşam süresi 27 hastada %74 olarak bulundu. Teşhis esnasında hastalığın evresinin yaşam süresi için önemli prognostik faktör olduğu görüldü.Öğe Kronik Idyopatik Ürtikerli Hastalarda Helikobakter Pilori(2003) Polat, Hakkı; Balevi, Şükrü; Güney, İbrahim; Hidayetoğlu, Taha; Kayaçetin, ErtuğrulAmaç: Kronik ürtiker sık görülen bir deri hastalığıdır ve prevalansı % 15-25'dir. Helikobakter pilori (Hp)'ye bağlı gastointestinal inflamasyonun kronik ürtiker etyolojisinde önemli rolü olabileceği çeşitli çalışmalarda öne sürülmüştür. Kronik idyopatik ürtikerli hastalarda helikobakter pilori sıklığını ve arasındaki ilişkiyi araştırmak amaçlanmıştır. Yöntem: Etyolojik nedeni belirlenemeyen 31 kronik ürtikerli hasta çalışma grubu, dispeptik şikâyetleri olan, ancak endoskopik görünümleri normal bulunan yaş ve cinsiyet bakımından uygun 24 hasta kontrol grubu olarak alındı. Endoskopik yöntem ile mide antrumundan alınan 2 adet biyopsiden birine üreaz (CLO) testi uygulandı, diğeri histopatolojik değerlendirmeye alındı. Hp ()'liği histolojik ve/veya üreaz () olanlar kabul edildi. Bulgular: Histopatolojik ve/veya üreaz testi ile ele alınan 31 hastanın 20'sinde Hp (), 11 'inde Hp (-) idi. 24 kişilik kontrol grubunda altı hastada Hp (), 18'inde Hp (-) bulundu. Sonuç: Kronik idyopatik ürtikerli hastalarda Hp sıklığı normal bireylere göre yüksektir.Öğe Malnutrition-inflammation-atherosclerosis (MIA) syndrome components in hemodialysis and peritoneal dialysis patients(TAYLOR & FRANCIS LTD, 2006) Tonbul, Halil Zeki; Demir, Murat; Altıntepe, Lütfullah; Güney, İbrahim; Yeter, Ekrem; Türk, Süleyman; Yeksan, MehdiBackground. Malnutrition, inflammation, and atherosclerosis (MIA syndrome) are common in end-stage renal disease (ESRD) patients. Each component of MIA syndrome is the predictor of outcomes in ESRD patients. In this cross-sectional study, we aimed to compare both dialysis modalities for MIA syndrome components. Material and Methods. Thirty hemodialysis (HD) (mean age 44 +/- 11 years, 14 male and 16 female, mean time on dialysis: 31.0 +/- 19.0 months) and 30 continuous ambulatory peritoneal dialysis (CAPD) patients (41 +/- 9 years, 12 male and 18 female, mean time on dialysis: 25.5 +/- 21.5 months) were included. In order to determine malnutrition in ESRD patients, serum albumin level and anthropometric measurements were used. For inflammation, serum C-reactive protein level, erythrocyte sedimentation rate, and fibrinogen levels were measured. Mean-carotid artery intima media thickness (m-CIMT), presence of carotid plaque and serum homocysteine level were used to determine atherosclerosis. Results. Five CAPD patients (16%) and one HD patient (3%) was hypoalbuminemic. HD and CAPD groups were similar for inflammation. Mean-CIMT and serum homocysteine level were higher in HD patients than CAPD patients. There was a positive correlation between homocysteine and m-CIMT. Conclusion. Before choosing renal replacement therapy, malnutrition, inflammation, and atherosclerosis parameters must be investigated in ESRD patients. Hemodialysis seems to be more advantageous for malnutrition components than CAPD. Both dialysis modalities seem to be similar for inflammation, and CAPD modality has superiority for atherosclerosis. Before choosing the type of renal replacement therapy, assessment of MIA syndrome components could be useful for individualization of the decision on which dialytic modality is appropriate in ESRD patients.Öğe Mantar zehirlenmesinde hemoperfüzyon ve plazmaferezin birlikte kullanımı (olgu sunumu)(2009) Atalay, Hüseyin; Güney, İbrahim; Altıntepe, Lütfullah; Çiftçi, Elif; Tonbul, Halil ZekiAmaç: Ülkemizde zehirli mantarların yenmesi sonucu ölüm oranı çok yüksektir. Tedavide hemoperfüzyon ve plazmaferezin birlikte kullanımı konusunda yeterli veri yoktur. Olgu sunumu: Yirmidört yaşında, geçmişinde her hangi bir rahatsızlığı olmayan ve ilaç kullanmayan hasta, yedi gün önce mantar yeme hikayesi ve bulantı, kusma, tüm vücutta ve gözlerinde sararma, bilinç bulanıklığı şikayetleriyle acil servisimize başvurdu. Hasta mantar zehirlenmesine bağlı akut böbrek yetmezliği ve karaciğer yetmezliği olarak değerlendirildi. Hastaya bir kez hemoperfüzyon ve beş kez plazmaferez, taze donmuş plazma desteği ile yapıldı. Sonuç: Mantar zehirlenmesi yüksek mortalitesinden dolayı, hemoperfüzyon ve plazmaferez tedavisi şansının, bu hastalar için göz ardı edilmemesi gerektiği düşüncesindeyiz.
