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Öğe Cancer and thrombotic thrombocytopenic purpura(Ortadogu Ad Pres & Publ Co, 2008) Altintas, Abdullah; Cil, Timucin; Atay, A. Engin; Kaplan, M. Ali; Isikdogan, Abdurrahman; Ayyildiz, OrhanThrombotic thrombocytopenic purpura (TTP) is a rare and fatal disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurologic disorder, renal function deterioration and fever. TTP may be idiopathic or secondary to autoimmune diseases, drugs, cancer and infections. Clinical findings of TTP are also present in cancer patients with disseminated intravascular coagulation and sepsis. TTP must be considered in the differential diagnosis in the case of concurrent microangiopathic hemolytic anemia and thrombocytopenia with or without leukoerythroblastic blood smear in cancer patients. Here we presented two patients who were followed up in our clinic with TTP secondary to metastatic breast cancer.Öğe The evaluation of effects of demographic features, biochemical parameters, and cytokines on clinical outcomes in patients with acute renal failure(Taylor & Francis Ltd, 2007) Kadiroglu, Ali Kemal; Sit, Dede; Atay, A. Engin; Kayabasi, Hasan; Altintas, Abdullah; Yilmaz, M. EminAim. To evaluate the effects of cytokines, biochemical parameters and demographic features on clinical outcomes of acute renal failure (ARF). Patients and Methods. 59 patients with acute renal failure (28 men, 31 women) were enrolled to the study. Cytokines, biochemical parameters, and complete blood count were measured. Patients were divided into two groups: as survivors (group 1, n = 46) and nonsurvivors (group 2, n = 13). Results. Mean age of patients were 52.3 +/- 17.9 years. 46 patients survived (77.9%) and 13 patients died (22. 1 %). There was a statistically significant relationship between IL-2R, IL-6, and TNF-oc levels and mortality rates (p = 0.004, p = 0.016, p = 0.020, respectively) and between TC levels and mortality rates (p = 0.041). In multivariable logistic regression analysis, the effects of proinflammatory cytokines (IL- I beta, IL-2R, IL-6, TNF alpha, CRP, and ESR) on the clinical outcomes in ARF was observed to be statistically significant (r = 0.341, p = 0.005). Conclusion. We realized that in totally demographic features (male gender, advanced age, poor nutritional status), biochemical parameters (TC, albumin, and hemoglobin) and cytokine levels (IL-2R, IL-6, TNF-oc), CRP and ESR may be predictive factors for mortality in patients with ARF.Öğe GPR, King's Score and S-Index are superior to other non-invasive fibrosis markers in predicting the liver fibrosis in chronic Hepatitis B patients(Univ Catholique Louvain-Uclclin Univ Saint Luc, 2022) Ekin, N.; Uçmak, F.; Ebik, B.; Tuncel, E. Tuğba; Kaçmaz, H.; Arpa, M.; Atay, A. EnginBackground and study aims: In this study, we investigated the efficacy of nine non-invasive fibrosis markers in the assessment of the degree of fibrosis in patients with chronic Hepatitis B (CHB) in comparison with liver biopsy. Patients and methods: A total of 1454 untreated CHB patients from two different centers who underwent liver biopsy were included in the study. Laboratory results of patients were reviewed retrospectively and the pathology slides were re-evaluated in accordance with the Ishak score. Degree of fibrosis >_ 3 was accepted as "significant fibrosis", >_ 4 as "advanced fibrosis", and >_ 5 as cirrhosis. The diagnostic performance of the markers Aspartate aminotransferase to Platelet Ratio Index (APRI), Fibrosis-4 score (FIB-4), Aspartate aminotransferase to Alanine aminotransferase Ratio (AAR), AAR to Platelet Ratio Index (AAPRI), Gamma-glutamyl transpeptidase to Platelet Ratio (GPR), King's Score, Fibro quotient (Fibro-Q), S Index and Platelet to Lymphocyte Ratio (PLR) were evaluated with ROC analysis. Results: In detecting significant fibrosis, APRI, GPR, King's Score and S Index had AUROC values over 0.70. For advanced fibrosis, all of the models except AAPRI; and for cirrhosis, all of the models had AUROC values over 0.70. In accordance with the chosen staging system, GPR, King's Score and S Index had high diagnostic efficacy whereas APRI, FIB-4, FibroQ and PLR had moderate diagnostic efficacy, AAR and AAPRI had low diagnostic efficacy. Conclusions: GPR, King's Score and S Index had moderate diagnostic performance in detecting significant fibrosis and advanced fibrosis, and high diagnostic performance in detecting cirrhosis. (Acta gastroenterol. belg., 2022, 85, 62-68).Öğe Hodgkin lenfoma olgularımız: Klinik ve patolojik değerlendirme(2006) Atay, A. Engin; Müftüoğlu, Ekrem; Altıntaş, Abdullah; Işıkdoğan, Abdurrahman; Ayyıldız, M. Orhan; Çil, Timuçin; Kaplan, M.AliHodgkin Hastalığı tüm lenfomaların yaklaşık %25’ini ve tüm kanserlerin %1’ini oluşturmaktadır. Bu çalışmada kliniğimizde takip ve tedavi edilen Hodgkin lenfomalı hastalar retrospektif olarak incelendi. Histopatolojik tanısı ve düzenli kayıtları olan 150 olgu; yaş, cins, histopatolojik alt tipleri ve evreleri bakımından değerlendirildi. Olguların 102’si (%68) erkek, 48’i (%32) kadındı. Medyan yaş 41 (16-73) yıl olarak bulundu. Histolojik alt tiplerine göre; Miks sellüler, nodüler sklerozan, lenfositten zengin ve lenfositten yoksun tip sırasıyla 63 (%42), 37 (%24.6), 25 (%16.6) ve 21 (%14) hastada saptandı. Histolojik alt tipin 4 (%2.7) hastada belirlenemediği görüldü. Evrelere göre hasta dağılımı sırasıyla: Evre I’de 18 (%12) hasta, evre II’de 35 (%23.3) hasta, evre III’de 52 (%34.7) hasta ve evre IV’de 43 (%28.7) hasta mevcuttu. İki hastada ise yeterli evreleme işlemleri yapılamamıştı. SPSS 11.0 istatistik analiz programı kullanılarak değerlendirme yapıldı: 40 yaş altı ve üstü olmak üzere hastalar gruplandırıldığında yaş grupları arasında anlamlı bir fark bulunmadı. Ayrıca yaş grupları ile histolojik alt tipler arasında anlamlı bir ilişki saptanmadı. Sonuç ve yorum: Hodgkin lenfoma erkeklerde daha sık rastlandı (E/K: 2.1). En sık histolojik alt tip mikst sellüler tip olduğu görüldü. Hastaların çoğunluğunun (%63.7) ileri evre (evre III ve IV) olduğu saptandı.Öğe Parameters of oxidative stress and echocardiographic indexes in patients on dialysis therapy(Taylor & Francis Ltd, 2010) Kayabasi, Hasan; Sit, Dede; Atay, A. Engin; Yilmaz, Zulfukar; Kadiroglu, Ali Kemal; Yilmaz, M. EminAim: Quantity of oxidative stress (OS) is enhanced in every stage of chronic renal failure (CRF). OS and its effects on echocardiographic indexes in patients on hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) were evaluated. Materials and methods: Thirty-nine patients on CAPD, 32 patients on HD, and 30 healthy individuals with similar demographic features were included. Patients with diabetes mellitus and chronic inflammatory diseases were excluded. Blood samples were collected to examine hematological and biochemical parameters and levels of malonyldialdehyde (MDA), glutathione peroxidase (GSH-px), and superoxide dismutase (SOD) after a 12-hour fasting period in the middle of dialysis week. OS parameters were compared with ejection fraction (EF), interventricular septum diameter (IVSd), left ventricular posterior wall diameter (LVPWd), and left atrium diameter (LAd) determined in M-mod echocardiographic examination. Results: No significant difference was observed between MDA and GSH-px levels of patients and control group; however, SOD levels of patients group were significantly lower (p < 0.0001). SOD levels of patients on HD were lower than that of patients on CAPD (p = 0.039). Negative correlation was detected between MDA and EF (r = -0.380, p = 0.001); SOD has negative correlation with systolic blood pressure (r = -0.265, p = 0.011), diastolic blood pressure (r = -0.230, p = 0.028), phosphorus (r = -0.327, p = 0.001), intact parathyroid hormone (iPTH) (r = -0.259, p = 0.013), C-reactive protein (CRP) (r = -0.235, p = 0.024), fibrinogen (r = -0.342, p = 0.001), and total cholesterol (r = -0.249, p = 0.017); and positive correlation with hemoglobin (r = 0.414, p < 0.001) and albumin (r = 0.367, p < 0.001). MDA was independently related with age (beta = -0.258, p = 0.035), male gender (beta = -0.312, p = 0.004), and EF (beta = -0.461, p < 0.001). No correlation was determined between antioxidants and cardiac indexes. Conclusion: SOD levels decreased significantly especially in patients on HD, and it was observed that lower levels of SOD would lead to OS in patients on HD and CAPD when compared to healthy individuals; MDA levels were independently influenced from EF.Öğe Relationship between bone mineral density and biochemical markers of bone turnover in Hemodialysis patients(Springer, 2007) Sit, Dede; Kadiroglu, Ali Kemal; Kayabasi, Hasan; Atay, A. Engin; Yilmaz, Zulfukar; Yilmaz, M. EminEnd-stage renal disease is closely associated with changes in bone and mineral metabolism. In recent times, osteoporosis has become important among hemodialysis (HD) patients. In this study, the investigators sought to evaluate the relationship between bone mineral density (BMD) and biochemical markers of bone turnover among HID patients. A total of 70 uremic patients on a maintenance HD program for at least 1 y were enrolled in the study. All patients were treated with conventional bicarbonated HD for 5 h through the use of low-flux hollow-fiber dialyzers. Bone densitometry was measured by dual energy x-ray absorptiometry in the lumbar spine (LS) and the femoral neck (FN). BMD was classified according to World Health Organization criteria on the basis of BMD T scores. Biochemical bone turnover markers such as calcium, phosphorus, ionized calcium, intact parathyroid hormone, alkaline phosphatase, plasma bicarbonate, blood pH, serum albumin, and hematocrit levels were measured before the HD session in the morning. Male patients (n=37; 52.9%; mean age, 46.2 +/- 17.0 y) were assigned to a single study group, and female patients (n=33; 47.1%; mean age, 44.0 +/- 13.1 y) to another. Mean duration of HD treatment was 33.7 +/- 28.5 mo in females and 33.0 +/- 26.0 mo in males. Among all patients, BMD T scores in the osteopenia/crsteoporosis range were observed at the LS in 58 patients (82.8%) and at the FN in 45 patients (64.3%). According to BMD measurements in FN T score, 10% of patients (n=7) were osteoporotic, 54.3% (n=38), osteopenic, and 35.7% (n=25), normal. On the other hand, in LS T score, the results were 47.1% (n=33) osteoporotic, 35.7% (n=25), osteopenic, and 17.1% (n=12), normal. No statistically significant association was found in osteopenia/osteoporosis between sexes according to FN and LS T score (P=.542, P=.267, respectively). No significant relationship was noted between BMD and biochemical markers of bone turnover. A positive correlation was found between FN T scores of BMD and age (r=. 413, P=.000). BMD T scores within the range of scores for osteopenia/osteoporosis were observed in 78.5% of patients at the LS and in 58.5% of patients at the FN. The investigators concluded that no correlation could be found between markers of bone turnover and bone mass measurements in both skeletal regions. LS T score results were worse than FN T score results. Elevated alkaline phosphastase levels combined with high intact parathyroid hormone levels are predictive of renal osteodystrophy but not of adynamic bone disease/osteoporosis.Öğe Thalidomide-associated arterial thrombosis: Two case reports(Acad Medicine Singapore, 2007) Altintas, Abdullah; Ayyildiz, Orhan; Atay, A. Engin; Cil, Timucin; Isikdogan, Abdurrahman; Muftuoglu, Ekrem[Abstract Not Available]
