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Öğe Does the inhibition of renin-angiotensin system decrease inter-dialytic weight gain in anuric hemodialysis patients?(VERDUCI PUBLISHER, 2015) Kutlucan, Ali; Demir, Murat; Türker, Y.; Sezer, Mehmet Tuğrul; Kutlucan, Leyla; Tunç, Neşe; Altuntaş, A.; Ugan, YunusOBJECTIVE: Knowledge about the inhibition of centrally located angiotensin-I (AT-I) receptors by highly lipophilic AT-I receptor blockers and its' effect are limited with experimental studies. Thus, we aimed to investigate the effect of Telmisartan on Inter-dialytic weight gain (IDWG) % and echocardiographic measurements in anuric hemodialysis (HD) patients. PATIENTS AND METHODS: A total of forty-one anuric HD patients with >= 6 months maintenance on HD were included in this prospective, randomized and self-controlled study. Four weeks prior the study, angiotensin converting enzyme blockers and AT-I receptor blocker drugs were stopped. Patients were assessed three times during the study protocol. These are baseline, three months later (without Telmisartan period) and three months after Telmisartan therapy. RESULTS: IDWG % was significantly decreased in the period of with Telmisartan compared to period without Telmisartan (5.6 +/- 1.0% vs 5.3 +/- 1.0%, p = 0.03). After the administration of Telmisartan left ventricule end-diastolic diameter (LVEDD) (p = 0.001) and inferior vena cava diameter (IVCD) (19.1 +/- 3.8 mm vs 17.3 +/- 4.2 mm, p = 0.001) were significantly decreased compared to the period of without Telmisartan. Despite of significantly changes observed in IVCD and LVEDD measurements in a period without Telmisartan, there was no significantly difference in left ventricular mass index (LVMI) measurements in this period. However, LVMI was significantly regressed after the administration of Telmisartan (269.3 +/- 82.7 g vs 256.3 +/- 70.3 g, p = 0.003 respectively). CONCLUSIONS: Treatment of anuric HD patients with Telmisartan at a dose of 40 mg a day reduces IDWG%, LVEDD and IVCD measurements. Further studies investigating the long-term effect of these beneficial effects on clinical outcomes are necessary.Öğe THE EFFECTS OF ANEMIA AND RED CELL TRANSFUSION ON THE RISK OF MORTALITY AMONG GERIATRIC AND NON-GERIATRIC PATIENTS WITH HOSPITAL-ACQUIRED INFECTIONS IN AN INTENSIVE CARE UNIT(GUNES KITABEVI LTD STI, 2015) Kutlucan, Leyla; Kutlucan, Ali; Basturk, Abdulkadir; Kandis, Hayati; Titiz, Hafize; Senocak, Elif; Dagli, MehmetIntroduction: This study aimed to investigate the effects of anemia and red blood cell transfusion on the risk of mortality in geriatric and non-geriatric Intensive Care Unit patients with Hospital-Acquired Infection. Materials and Method: This study included 546 patients aged >= 18 years; from these, 112 patients had Hospital-Acquired Infection. Results: Among the patients aged >= 65 years with Hospital-Acquired Infection who were treated in the medical Intensive Care Unit, the risk of mortality was significantly increased in patients with anemia or history of diabetes; in patients who were intubated or in patients with neurological disorders or respiratory failure. Although the abovementioned factors increased the risk of mortality in the elderly, the same relationship was not observed in patients aged<65 years. In addition, blood transfusion did not increase the risk of mortality in patients belonging to both the age groups. Conclusion: We conclude that in geriatric Intensive Care Unit patients with Hospital-Acquired Infection, anemia increases the risk of mortality but red cell transfusion does not affect the risk of mortality.Öğe The Effects of Initial Cortisol Levels and Vitamin D on Mortality and Hospital Infection Development in Geriatric Patients at Intensive Care Unit(2016) Kutlucan, Leyla; Kutlucan, AliIntroduction: Vitamin D deficiency is a common problem throughout the world. Also vitamin D deficiency has been reported in up to 82% of patients in intensive care unit (ICU). In addition, corticosteroid insufficiency is a common problem in ICU patients. In this study, we investigated the effects of initial cortisol and vitamin D levels on mortality, hospital infection development and intubation status in geriatric ICU patients. Methods: This study was conducted in a tertiary ICU. In a one-year period, 117 consecutive ICU patients older than 65 years of age were evaluated retrospectively. Looking at the first with Vitamin D and cortisol levels of the patients were collected in the first 24 hours of hospitalization. At follow up period, relationship between these data's and mortality, hospital infection, and intubation conditions were evaluated.Results: Initial Vitamin D, the morning cortisol, and albumin levels were found to be significantly lower (respectively; p <0.001, p <0.001 and p <0.001), and lactate levels were found to be significantly higher (p <0.001) in patients who died in ICU than alive patients. Development rate of hospital-acquired infection was found to be significantly higher (p 0.025) in patients with low vitamin D levels than alive patients. Vitamin D and cortisol levels were found to be lower and lactate levels were found to be higher (respectively: p <0.001, p 0.004, p 0.035) in intubated patients than alive patients.Conclusion: In geriatric patients, relationship between initial vitamin D and cortisol levels and mortality, hospital infection and intubation conditions were evaluated in our study for the first time. The low level of vitamin D is seen as an important risk factor for the mortality, development of hospital-acquired infections and intubation. Also it is determined that the low cortisol creates a negative situation in terms of mortality and intubation.Öğe Enfeksiyon tanılı yoğun bakım hastalarında kısa ve uzun dönem mortaliteye etkili faktörler(2015) Kutlucan, Ali; Erdoğan, Murat; Kutlucan, Leyla; Ankaralı, Handan; Ermiş, Fatih; Gür, Mücahit; Şenocak, ElifAmaç: Yoğun Bakım Ünitesindeki (YBÜ) enfeksiyöz hastalarda mortalite üzerinde etkili olabilecek risk faktörleri olan yaş, eşlik eden hastalıklar, prokalsitonin (PCT), C-reaktif protein (CRP), 25 -OH vitamin D düzeyi ve APACHE II skoru ile; bu parametrelerin yoğun bakımda ve hastane sonrası otuz ile doksan günlük mortalite arasındaki ilişkisini değerlendirmeyi amaçladık. Yöntem : Düzce Üniversitesi Tıp Fakültesi İç Hastalıları YBÜye 1 Eylül 2011 30 Ağustos 2012 tarihleri arasında enfeksiyon tanısı ile kabul e dilen 52 hasta prospektif olarak değerlendirilmiştir. Bulgular: Sepsis, YBÜde mortaliteyi belirgin artırmıştır. Eşlik eden hastalıklardan; hipertansiyon dışındakilerin taburculuk durumuna, 30 ve 90 günlük yaşam süresine ulaşmayla ilişkisi saptanmadı. Yatı ş laboratuar değerlerinde; CRP ve PCT yüksek, 25 -OH vitamin D ise düşük saptanmıştır. YBÜden taburculukta; yaş, 25 -OH vitamin D, PCT, APACHE IInin etkili olmadıkları, CRP artışının ölüm riski ile ilişkili olduğu görüldü. APACHE II skoru, otuz günlük yaşa mla; yaş ise, otuz ve doksan günlük yaşamla ilişkili bulunmuştur. YBÜ sonrası devredilen serviste yatış süresi uzun olanlarda, hastane sonrası yaşam süresinin yüksek olduğu saptanmıştır Sonuç : Sepsis, YBÜ mortalitesini, sepsisle beraber ileri yaş ta taburculuk sonrası 30 ve 90 günlük mortaliteyi artırabilir. APACHE II skoru, taburculuk sonrası uzun dönem sağkalım tahmininde kullanılabilir. PCT, CRP ve 25 - OH vitamin Dnin, YBÜ hastalarının takibi ve prognozunu belirlemede tek başl arına ideal yöntemler olarak kullanılmasının uygun olmadığı düşünülmektedir.Öğe Evaluation of bone mineral density (BMD) and indicators of bone turnover in patients with hemophilia(ASSOC BASIC MEDICAL SCI FEDERATION BOSNIA & HERZEGOVINA SARAJEVO, 2018) Dağlı, Mehmet; Kutlucan, Ali; Abuşoğlu, Sedat; Baştürk, Abdulkadir; Sözen, Mehmet; Kutlucan, Leyla; Ünlü, Ali; Yılmaz, FariseA decrease in bone mass is observed in hemophilic patients. The aim of this study was to evaluate bone mineral density (BMD), parathyroid hormone (PTH), 25-hydroxy vitamin D (vitamin D), and a bone formation and resorption marker, procollagen type I N-terminal propeptide (PINP) and urinary N-terminal telopeptide (uNTX) respectively, in hemophilic patients and healthy controls. Laboratory parameters related to the pathogenesis of bone loss such as neutrophil- lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were also evaluated. Thirty-five men over 18 years of age, with severe hemophilia (A and B) and receiving secondary prophylaxis, were included in the study. The same number of age-, sex-, and ethnicity-matched healthy controls were evaluated. Anthropometric, biochemical, and hormonal parameters were determined in both groups. No significant difference in anthropometric parameters was found between the two groups. The BMD was low in 34% of hemophilic patients. Vitamin D, calcium, and free testosterone levels were significantly lower (p < 0.001, p = 0.011, p < 0.001, respectively), while PTH, PINP, and activated partial thromboplastin time (aPTT) levels were significantly higher (p < 0.014, p = 0.043, p < 0.001, respectively), in hemophilic patients compared to controls. There was no significant difference between the two groups in NLR, PLR, phosphorus, thyroid-stimulating hormone, and uNTX level. The reduction of bone mass in hemophilic patients may be evaluated using the markers of bone formation and resorption, enabling early detection and timely treatment.Öğe Evaluation of Clinical Effectiveness of Self-Monitoring Blood Glucose Level in Patients with Type 2 Diabetes Mellitus Treated with Non-Insulin Regimens in Düzce: Primary Care-Based Study(2015) Baltaci, Davut; Kutlucan, Ali; Turker, Yasemin; Deler, Mehmet Harun; Sariguze, Feyza; Ozcan, Engin; Ankarali, HandanAmaç: Kendi kendine kan şekeri (SMBG) takibi sıklıkla tavsiye edilmesinin yanında, etkinliği tartışmalıdır. Burada, SMBG kullanımının diyabetteki sıklığını ve Türkiyede Düzce ilinde birinci basamakta tip 2 diyabet (T2DM) olan hastalarda etkinliğinin değerlendirilmesi amaçlanmıştır. Yöntem: Kesitsel ve birinci basamak-tabanlı çalışmaya oral anti-diyabetik ajanlar ile tedavi olan T2DM'li toplam 680 hasta alınmıştır. SMBG kullanım durumu kullanmayan, günlük, haftalık ve aylık kullanan seklinde kaydedilmiştir. Metabolik ve glisemik indeksler SMBG kullanım durumuna göre karşılaştırılmıştır. Bulgular: Hastaların 2/3 ten fazlası SMBG uygulamaktadır. Günlük, haftalık ve aylık SMBG kullananların oranı sırası ile 13,2%, 32,1% ve 24,5% idi. Bunların da çoğunluğu düzensiz kullanıyordu (59,4%). Fakat düzenle kullananların oranı 24,3%. SMBG kullanım durum grupları arasında HbA1c, Açlık kan şekeri ve tokluk kan şekeri olan glisemik indeksler için farklılık gözlenmemiştir (Sırası ile p0.655, p0.721 ve p0.389). Sonuç: Yüksek ve düzensiz SMBG kullanımı olsa da, SMBG kullanım durumları arasında hiçbir fark yoktu. Bu nedenle, aile hekimleri kendi kendine kan şekeri izlemini dikkatli ve bilinçli olarak tavsiye etmelidir. Hastalar eğitimle bilgilendirilmiş ve kendi yeterliliklerini kazanmasından sonra SMBG kullanımı önerilmelidir. Türkiye'de SMBG kullanımının klinik etkinliği hakkında genel bir kannat için ileri düzeyde araştırmalar yapılmalıdırÖğe High sensitive CRP and sICAM-1 can predict Major Adverse Cardiovascular Events: MELEN Study: A Large Turkish Population Based Study(DUZCE UNIV, 2016) Turker, Yasin; Kayapinar, Osman; Demirin, Hilmi; Eroz, Recep; Kutlucan, Ali; Turker, Yasemin; Basar, CengizObjective: We aimed to evaluate the predictors of major adverse cardiovascular events (MACE) in a prospective population based study. Methods: This study included 153 participants aged>40 years with high and very high cardiovascular risk, and 50 participants aged>40 years with low cardiovascular risk according to the SCORE risk assessment. All the participants underwent a doppler ultrasound examination of carotid intima media thickness (CIMT), echocardiographic examination, ECG recording and various biochemical analyses. High-sensitivity C-reactive protein (hsCRP) was measured with chemiluminescent immunometric assay, serum amyloid-A (SAA) protein, soluble intercellular adhesion molecule-1 (sICAM), apolipoprotein-B (ApoB) were measured with ELISA method. eNOS single-nucleotide polymorphism was detected using polymerase chain reaction and restriction fragment length polymorphism methods. The follow-up was done 36 months after the baseline admission. MACE was defined as cardiovascular mortality or myocardial infarction or stroke. Results: Frequency of MACE was higher in high and very high risk group according to low risk group. There were no significant differences in eNOS gene polymorphisms between the risk groups and control subjects, and no significant association between eNOS gene polymorphisms and MACE was detected. Age, ejection fraction (EF), CIMT, hsCRP, ApoB, sICAM-1, and SAA protein levels were all significantly associated with MACE in univariate logistic regression analyses. Multivariate analyses revealed that age (OR: 1.08, CI: 1.02-1.15, p=0.013), EF (OR: 0.94, CI: 0.89-0.99, p=0.016), hsCRP (OR: 1.36, CI: 1.12-1.67, p=0.003) and sICAM-1 (OR: 81.0, CI: 1.04-6320, p=0.048) levels were the only independent predictors of MACE. Conclusion: Higher age, hsCRP and sICAM-1 levels and lower EF were independent predictors of MACE.Öğe Neutropenia Due to Acute Exposure with Aluminium Phosphide(MODESTUM LTD, 2015) Kutlucan, Ali; Dagli, Mehmet; Kutlucan, Leyla; Basturk, Abdulkadir[Abstract not Available]Öğe PROTECTIVE EFFECTS OF CAFFEIC ACID PHENETHYL ESTER (CAPE) ON CYCLOPHOSPHAMIDE INDUCED HEMORRHAGIC CYSTITIS IN RATS(BMJ PUBLISHING GROUP, 2015) Uysal, Ersin; Yılmaz, H. Ramazan; Ugan, Yunus; Altuntaş, Atila; Doğru, Atalay; Kutlucan, Ali; Tunç, Şevket Ercan[Abstract not Available]Öğe Protective Effects of Caffeic Acid Phenethyl Ester on Cyclophosphamide-Induced Hemorrhagic Cystitis in Rats(WILEY-BLACKWELL, 2015) Uysal, Ersin; Yılmaz, H. Ramazan; Ugan, Yunus; Altuntaş, Atila; Doğru, Atalay; Kutlucan, Ali; Tunç, Şevket ErcanWe investigated the protective effect of caffeic acid phenethyl ester (CAPE) on cyclophosphamide-induced hemorrhagic cystitis in rats in comparison with 2-mercaptoethane sulfonate (MESNA). Forty male rats were randomized into four groups: group 1 (control), group 2 (cyclophosphamide), group 3 (cyclophosphamide + MESNA), group 4 (cyclophosphamide + CAPE). Cyclophosphamide injection increased malondialdehyde levels indicating oxidative stress, whereas CAPE and MESNA ameliorated malondialdehyde levels in the bladder (p < 0.05). Only catalase activities were decreased significantly in both groups (cyclophosphamide + MESNA and cyclophosphamide + CAPE, p < 0.05). Pretreatment with CAPE (p < 0.01) resulted in a significant decrease in nitric oxide levels when compared with the cyclophosphamide group. When we consider the studies that show the critical importance of increased nitric oxide levels in pathogenesis of cyclophosphamide-induced hemorrhagic cystitis, we suggest that it would be more beneficial to use MESNA with CAPE to prevent histological damage. (C) 2015 Wiley Periodicals, Inc.Öğe The Relationship Between Mean Platelet Volume with Metabolic Syndrome in Obese Individuals(LIPPINCOTT WILLIAMS & WILKINS, 2012) Kutlucan, Ali; Bulur, Serkan; Kır, Seher; Bulur, Şule; Önder, Elif; Aslantaş, Yusuf; Ekinözu, İsmail; Aydın, Yusuf; Özhan, HakanThe metabolic syndrome is closely associated with atherosclerotic risk factors and increased mortality. Mean platelet volume (MPV) is an indicator of platelet activation which also shows a close relationship with cardiovascular risk factors, such as diabetes mellitus, hypertension, hypercholesterolemia, obesity, metabolic syndrome. The aim of this study was to investigate the correlates of metabolic syndrome, its components and MPV adjusted for obesity in a large population study. A total of 2298 individuals with a mean age of 50 (age range 18-92) were interviewed. Nine hundred and twenty obese participants, who had BMI 30 kg/m(2) or more, further evaluated for the presence of metabolic syndrome. Five hundred and thirteen [396 women (70.2%)] had metabolic syndrome and the rest 407 individuals [324 women (79.6%)] served as the control group. The BMI, SBP, DBP, waist circumference, fasting plasma glucose, visceral fat, total cholesterol, high-density lipoprotein-cholesterol, and triglyceride was higher significantly in metabolic syndrome group (P=0.002 for BMI and P<0.001 for the others). No significant difference was observed between groups regarding low-density lipoprotein cholesterol, white blood cells, platelet counts, MPV, hematocrit and hemoglobin (P>0.05 for all). The presence of metabolic syndrome and its components do not constitute a difference in MPV values in obese patients with a BMI 30 kg/m(2) or more.
