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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 Neutropenia Due to Acute Exposure with Aluminium Phosphide(MODESTUM LTD, 2015) Kutlucan, Ali; Dagli, Mehmet; Kutlucan, Leyla; Basturk, Abdulkadir[Abstract not Available]
