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Öğe Blood neutrophil-to-lymphocyte ratio independently predicts survival in patients with liver cirrhosis(LIPPINCOTT WILLIAMS & WILKINS, 2013) Biyik, Murat; Ucar, Ramazan; Solak, Yalcin; Gungor, Gokhan; Polat, Ilker; Gaipov, Abduzhappar; Cakir, Ozlem O.Objectives Neutrophil-to-lymphocyte ratio (NLR) is a novel inflammation index that has been shown to independently predict poor clinical outcomes. We aimed to evaluate the role of NLR in the prediction of long-term mortality in patients with stable liver cirrhosis. Materials and methods This is a retrospective observational cohort study in which 145 stable cirrhotic patients without infection, hepatocellular carcinoma, and ongoing steroid therapy were enrolled between January 2009 and December 2011. The primary end point was survival during follow-up. NLR along with Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD) scores, and Charlson comorbidity index were assessed for the prediction of mortality. Results There were 86 men and 59 women, mean age 58.9 +/- 13.4 years. The etiologies of liver cirrhosis included viral hepatitis (n = 73), cryptogenic (50), alcoholic (12), and other (10). The mean follow-up duration was 27.8 +/- 6.8 months, during which 40 patients died. The mean NLRs were 2.08 +/- 0.99 and 4.39 +/- 3.0 in surviving and nonsurviving patients, respectively (P < 0.001). Kaplan-Meier survival analysis was carried out according to the median NLR above and below 2.72. Patients with NLR of at least 2.72 had a significantly lower survival (log rank, P < 0.001). NLR was found to be an independent predictor of mortality in all Cox Regression models (odds ratio 1.2; 95% confidence interval 1.2-1.3; P < 0.001). Receiver operating characteristic analysis showed that cut-off values of 4.22, 3.07, and 2.96 for NLR predicted 12, 24, and 36-month mortality, respectively (AUC: 0.806, P = 0.0029; 0.841, P < 0.0001 and 0.783, P < 0.0001, respectively). Conclusion NLR is a predictor of mortality independent of CTP and MELD scores in patients with liver cirrhosis. NLR could predict mortality in the subgroup of patients with low MELD scores as well. Eur J Gastroenterol Hepatol 25:435-441 (C) 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. European Journal of Gastroenterology & Hepatology 2013, 25:435-441Öğe BRUCELLA PERITONITIS IN PERITONEAL DIALYSIS: A CASE REPORT AND REVIEW OF THE LITERATURE(MULTIMED INC, 2012) Solak, Yalcin; Biyik, Zeynep; Demircioglu, Sinan; Polat, Ilker; Genc, Nejdet; Turkmen, Kultigin; Turk, SuleymanBrucellosis is a zoonotic infection that humans contract usually by ingestion of unpasteurized milk and milk products or by direct contact with raw infected animal products. Infection is endemic in many countries, including Turkey. Being a systemic disease, brucellosis may affect almost any part of the body. The peritoneum is a site rarely involved in brucellosis. Most peritonitis episodes involving Brucella species have been spontaneous cases reported in cirrhotic patients with ascites. To our knowledge, the literature contains only 5 cases of Brucella peritonitis related to continuous ambulatory peritoneal dialysis. Here, we report Brucella peritonitis in a continuous ambulatory peritoneal dialysis patient, and we discuss the relevant literature.Öğe A Case of Familial Mediterranean Fever After Renal Transplantation: From Phenotype II to I(TURKISH LEAGUE AGAINST RHEUMATISM, 2012) Solak, Yalcin; Atalay, Huseyin; Polat, Ilker; Biyik, Zeynep; Gaipov, Abduzhappar; Kucuk, Adem; Turk, SuleymanFamilial Mediterranean fever (FMF) is the prototype of autoinflammatory syndromes. Several factors may trigger the disease including physical and emotional stress, fat-rich diet, and menstruel cycle. Infections and some drugs such as cisplatin may result in a change in cytokine levels and may precipitate attacks. Most cases of FMF presents with typical self-limited attacks including fever and abdominal pain. However, a minority of patients, called as phenotype II, presents with amyloidosis AA-type and/or end-stage renal disease in the absence of clinically recognizable attacks. Immunosupression may precipitate a typical FMF attack, possibly through a change in cytokine balance. Initiation of colchicine treatment in these patients is of utmost importance to prevent amyloidosis involvement of the newly transplanted graft. In this article, we present a rare case of FMF who transformed from phenotype II to phenotype I after renal transplantation, most probably due to the effect of immunosuppressants.Öğe The Effect of Hypothyroidism on Color Contrast Sensitivity: A Prospective Study(KARGER, 2015) Cakir, Mehtap; Ozturk, Banu Turgut; Turan, Elif; Gonulalan, Gulsum; Polat, Ilker; Gunduz, KemalBackground: Thyroid hormone has been shown to control retinal cone opsin expression, the protein of color vision, in adult rodents. Objectives: The aim of this study was to evaluate the effect of hypothyroidism on color contrast sensitivity in adult overt hypothyroid patients. Methods: Thirtyeight overt hypothyroid (31 females, 7 males) subjects and 20 euthyroid (16 females, 4 males) controls were studied prospectively. Color vision examination was performed by Chromatest, a software program analyzing the tritan (blueyellow) color contrast threshold (tritan CCT) and protan (redgreen) color contrast threshold (protan CCT). Color contrast sensitivity analyses of hypothyroid subjects were performed on admission and after L -thyroxine treatment when biochemical euthyroidism was achieved. Results: After a median period of 90 (90-210) days, 24 (19 females, 5 males) patients were euthyroid and eligible for a second color vision examination. Baseline tritan CCT and protan CCT values were significantly higher in the hypothyroid group compared to euthyroid controls, which clinically translates into impaired color contrast sensitivity (p < 0.001 and p < 0.001, respectively). There was a significant decrease in tritan CCT (p = 0.002) and protan CCT (p < 0.001) values in the hypothyroid group after euthyroidism was achieved, which denotes improvement in color contrast sensitivity. Conclusions: It is a novel finding of the current study that color contrast sensitivity is impaired in hypothyroidism and significantly improves after euthyroidism is achieved. (C) 2015 European Thyroid Association Published by S. Karger AG, BaselÖğe SERUM AND URINE NGAL LEVELS IN PATIENTS WITH CIRRHOSIS AND HEPATO-RENAL SYNDROME(OXFORD UNIV PRESS, 2012) Gungor, Gokhan; Ataseven, Huseyin; Demir, Ali; Solak, Yalcin; Biyik, Murat; Ozturk, Bahadir; Polat, Ilker[Abstract not Available]Öğe When urine is no longer beneficial: renal artery embolisation in severe nephrotic syndrome secondary to amyloidosis(INFORMA HEALTHCARE, 2010) Solak, Yalcin; Polat, Ilker; Atalay, Huseyin; Turk, SuleymanRenal artery embolisation (RAE) is an interventional radiology procedure which is used to embolise small branches of renal artery. It is mainly used for urologic purposes, i.e., vascular malformations, angiomyolipomas and renal tumours not amenable to surgical resection. Bilateral RAE can be performed via using absolute ethanol, polyvinyl alcohol or microparticles. After RAE, patients may experience post-embolisation syndrome which is usually self-limited. Use of this procedure for refractory nephrotic syndrome has been rarely defined in the literature to date. Here, we describe a patient who had nephrotic syndrome due to secondary systemic amyloidosis. The patient presented with severe proteinuria (33 g per day), hypoalbuminaemia and anasarca oedema. We applied bilateral RAE with microparticles. We did not observe any complications associated with the procedure. Protein excretion, laboratory values and clinical signs returned to normal.
