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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 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 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 Predictors of Sleep Quality in Hemodialysis Patients(Wichtig Editore, 2010) Güney, İbrahim; Atalay, Hüseyin; Solak, Yalçın; Altıntepe, Lütfullah; Toy, Hasan; Tonbul, H. Zeki; Türk, SüleymanPurpose: Poor sleep quality (SQ) is common in hemodialysis (HD) patients. Factors associated with poor SQ are not well understood. The objectives of the present study were to determine the prevalence of poor SQ in HD patients in our region and to examine the association between SQ and health-related quality of life (HRQoL), depression, and certain clinical and laboratory parameters. Methods: A total of 233 HD patients at 5 centers in the city center of Konya, Turkey were included in this study. Their demographic data and biochemical parameters were analyzed. All patients were instructed to complete Turkish versions of three questionnaires, namely, a modified post-sleep inventory (PSI), Beck Depression Inventory (BDI) and a Short Form of Medical Outcomes Study (SF-36). Results: The mean age of the patients was 52.8+/-15.3 years and the male to female ratio was 1.33:1. The prevalence of poor sleepers, defined as those having a total sleep score (PSI-4 score) >= 4, was 60.9%. Compared with good sleepers, poor sleepers had higher BDI scores and as well as lower PCS and MCS domains of HRQoL. In addition, poor sleepers were older and more likely to be unemployed. There was a significant inverse correlation of PSI-4 score with PCS and MCS, and significant positive correlation of PSI-4 score with BDI and age (p<0.001). The significant independent predictors of PSI-4 score were BDI score, MCS score and employment status. Conclusions: Depression, MCS score and employment status were the most important predictors of sleep quality in HD patients.Öğe A Rare Masquerader of Lung Cancer: Nonsecretory Multiple Myeloma With Plasmacytoma of Bone Presenting as Acute Kidney Injury(Japan Soc Internal Medicine, 2010) Güney, İbrahim; Solak, Yalçın; Atalay, Hüseyin; Altıntepe, Lütfullah; Tonbul, H. ZekiMultiple myeloma (MM) is a neoplasm of B cell lineage characterized by excessive proliferation of abnormal plasma cells which produce immunglobulins. If a monoclonal spike is not found in serum or urine but the patient has clinical findings and bone marrow plasma cell infiltration suggestive of MM, then the patient may have a rare subtype known as nonsecretory multiple myeloma (NSMM). Here, we describe a rare case of NSMM with plasmacytoma of bone who presented with severe hypercalcemia, acute kidney injury and a large thoracal mass on chest X-ray masquerading as lung cancer.Öğe Results of the pregnancies with HELLP syndrome(MARCEL DEKKER INC, 2003) Çelik, Çetin; Gezginç, Kazım; Altıntepe, Lütfullah; Tonbul, H. Zeki; Yaman, S. Tülin; Akyürek, Cemalettin; Türk, SüleymanIn this study, clinical features, developing complications, and results of thirty-six patients, which were followed up in our Obstetrics and Gynecology and Nephrology departments between 1997 and 2001, with the diagnosis of HELLP syndrome were searched retrospectively. The mean age of the cases followed up with diagnosis of HELLP syndrome were 30.2+/-5.9 (17-46) years. HELLP syndrome was diagnosed on average in the 32.6+/-4.8th (23-41) week of gestations. Seventy percent of the cases were with severe preeclampsia and 30% of the cases were with mild preeclampsia. Eleven cases (30%) were nullipara and twenty-five cases (70%) multipara. The average of arterial systolic blood pressure of the cases were 161.6+/-26 mmHg, and that of diastolic blood pressure was 98.5+/-16.8 mmHg. In thirteen cases (36%) acute renal failure (ARF), six cases (17%) placenta detachment, two cases disseminate intravascular coagulation (DIC), one case Adult Respiratory Distress Syndrome (ARDS) were developed. In seven cases (19%) intrauterine dead fetuses were detected. In twenty-three cases by cesarian section (64%), in thirteen cases by induction (36%) the pregnancies were terminated in 72 h after diagnosing HELLP syndrome. Birth weights of eleven babies (30%) were below 1500 g. Five of the eleven babies were dead in the neonatal period. Six of the thirteen patients who had ARF were given hemodialysis. Two patients died because of the development of ARF+DIC and ARDS. No predicting factors for the development of HELLP syndrome could be detected, but severe preeclampsia. Therefore we think that preeclamptic pregnancies must be followed up very closely and if HELLP syndrome develops, termination of the pregnancy would be proper as soon as possible.Öğe Transmission of Hepatitis C Virus Infection to Spouses of Patients Undergoing Chronic Hemodialysis(Karger, 1999) Akarsu, Ersin; Tonbul, H. Zeki; Selçuk, Yılmaz; Kaya, HasanSexual transmission of HCV is relatively rare [1]. However, that anti-HCV measurements were performed with the first-generation tests in previous years may have led to having less evidence HCV transmitted sexually [2]. On the other hand, the prevalence of HCV infection in HD patients is quite high and the transmission of this infection to the patients is generally by way of blood transfusion and nosocomial [3], and the prevalence of HCV infection in HD patients in Turkey is reported as 49.4% in a multicenter study [4]. In this study, we investigated whether anti-HCV-positive HD patients transmitted this infection to their spouses sexually.Öğe Transmission of Hepatitis C Virus Infection to Spouses of Patients Undergoing Chronic Hemodialysis(Karger, 1999) Akarsu, Ersin; Tonbul, H. Zeki; Selçuk, Yılmaz; Kaya, HasanSexual transmission of HCV is relatively rare [1]. However, that anti-HCV measurements were performed with the first-generation tests in previous years may have led to having less evidence HCV transmitted sexually [2]. On the other hand, the prevalence of HCV infection in HD patients is quite high and the transmission of this infection to the patients is generally by way of blood transfusion and nosocomial [3], and the prevalence of HCV infection in HD patients in Turkey is reported as 49.4% in a multicenter study [4]. In this study, we investigated whether anti-HCV-positive HD patients transmitted this infection to their spouses sexually.
