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Acute Pancreatitis and Splenic Vein Thrombosis due to Hypertriglyceridemia
(Hindawi Ltd, 2015) Gunduz, Ercan; Dursun, Recep; Icer, Mustafa; Zengin, Yilmaz; Guloglu, Cahfer
Acute pancreatitis (AP) is a condition characterised by the activation of the normally inactive digestive enzymes due to an etiological factor and digestion of the pancreatic tissues, resulting in extensive inflammation and leading to local, regional, and systemic complications in the organism. It may vary from the mild edematous to the hemorrhagic and severely necrotising form. The most common causes are biliary stones and alcohol abuse. In this case study, we would like to present a patient with AP due to hypertriglyceridemia (HPTG), which is a rare cause of pancreatitis, and splenic vein thrombosis, which is a rare complication of pancreatitis.
Adult-Onset Still's Disease: Case Report
(Aves, 2014) Gunduz, Ercan; Gullu, Mehmet Nezir; Zengin, Yilmaz; Dursun, Recep; Icer, Mustafa; Ozhasenekler, Ayhan; Karakoc, Yenal
Introduction: Adult-onset Still's disease (ASD) is a systemic inflammatory disease of unknown etiology and pathogenesis. ASD, one of the most important causes of fever of unknown origin, is diagnosed after ruling out infection, malignancy, and rheumatologic diseases. It may also present with fever alone, without typical skin rash and articular manifestations. Case Report: There are no pathognomonic laboratory findings in ASD. In this paper, we report a case that presented to the emergency department with fever, malaise, and joint pain for 5 days and was subsequently diagnosed with ASD. Conclusion: In patients with prolonged fever combined with musculoskeletal symptoms and macular rash, the differential diagnosis should include ASD. Timely diagnosis and treatment of the disease can prevent complications and lead to a favorable prognosis
AFFECTING FACTORS ON EARLY MORTALITY IN ELDERLY PATIENTS DIAGNOSED WITH PULMONARY EMBOLISM IN EMERGENCY DEPARTMENT
(Gunes Kitabevi Ltd Sti, 2015) Zengin, Yilmaz; Gunduz, Ercan; Dursun, Recep; Icer, Mustafa; Durgun, Hasan Mansur; Taylan, Mahsuk; Guloglu, Cahfer
Introduction: The ratio of elderly people in Turkey is rapidly growing. It is known that pulmonary embolism and venous thrombolysis incidence increases with age. Despite the major advances in pulmonary embolism diagnosis and treatment, pulmonary embolism leads to higher mortality rates in the elderly. In the present study, evaluation of socio-demographic and clinical characteristics of elderly patients diagnosed with pulmonary embolism in the emergency department and determination of factors that affect early mortality have been targeted in order to decrease mortality. Materials and Method: Between January 1, 2009, and September 30, 2014, patients who were 65 years of age and older who had been admitted through the emergency department with suspected pulmonary embolism and whose pulmonary embolism diagnosis was finalized via computerized tomographic pulmonary angiography. Results: In the study, 87 (61.8%) were female and 52 (38.2%) were male. Thirteen patients (9.4%) died during the follow-up period. The analysis of the relationship between pulmonary embolism in elderly patients and early mortality revealed that there is a statistical correlation among immobility, syncope, tachycardia, hypotension, elevated Troponin-T, coronary arterial disease, cerebrovascular disease, pulmonary embolism with massive dimension, bilateral pulmonary embolism, Wells-likely pulmonary embolism, and modified Geneva-likely pulmonary embolism were statistically related factors(p values, respectively, were 0.002; 0.033; 0.000; 0.000; 0.000; 0.037; 0.011; 0.000; 0.030; 0.023; 0.018). Conclusion: Immobility, syncope, tachycardia, hypotension, elevated Troponin T, coronary arterial disease, cerebrovascular disease, pulmonary embolism with massive dimension, bilateral pulmonary embolism, Wells-likely pulmonary embolism, and modified Geneva-likely pulmonary embolism were determined as effective risk factors affecting the early mortality of elderly patients with pulmonary embolism.
A Case of Uncorrected Tetralogy of Fallot Undiagnosed Until Adulthood and Presenting With Polycythemia
(Elmer Press Inc, 2014) Gunduz, Ercan; Gorgel, Ahmet; Dursun, Recep; Durgun, Hasan Mansur; Cil, Habip; Icer, Mustafa; Zengin, Yilmaz
Congenital heart defects with right-to-left shunt are one of the hypoxia-related causes of acquired secondary polycythemia (SP). Tetralogy of Fallot (ToF) is the most common congenital cyanotic heart disease in children. Cases of uncorrected ToF in adult ages are rare. This paper reports a woman detected with elevated hemoglobin level during routine tests performed for infertility therapy and subsequently diagnosed SP with related ToF.
Clopidogrel resistance in patients with type 2 Diabetes Mellitus: A comparison between oral antidiabetic agents and insulin
(Drunpp-Sarajevo, 2012) Ariturk, Zuhal; Cil, Habib; Gunduz, Ercan; Yavuz, Celal; Kaya, Hasan; Ertas, Faruk; Oylumlu, Mustafa
Background: Clopidogrel resistance has been found in certain patient populations, including patients with acute coronary syndrome, ischemic stroke, patients undergoing percutaneous coronary intervention with a drug-eluting stent, diabetes mellitus, ischemic stroke and stent restenosis. The aim of this study was to assess clopidogrel resistance in diabetic patients taking oral antidiabetic drugs and insulin. Methods and Results: Platelet aggregation was measured after clopidogrel treatment in 101 diabetic patients undergoing percutaneous coronary intervention. Two diabetic patient subpopulations were compared: patients who used insulin (group 1) and patients who used oral antidiabetic agents (group 2). Clopidogrel nonresponders and responders were defined by a relative inhibition of adenosine diphosphate (20 mol/L) induced platelet aggregation of < 10% and >= 30%, respectively. Among group 1 patients, 12.5% were clopidogrel nonresponders and Among group 2 patients, 9.4% were clopidogrel nonresponders. There were no statistical differences found between the two groups (P=0.618). Conclusions: This study demonstrates that there was no significant difference in the clopidogrel resistance between type 2 diabetes mellitus patients taking insulin or oral antidiabetes medication. The clinical implications of this finding are unknown and need to be evaluated in large-scale clinical trials.
DEMOGRAPHIC PROPERTIES AND CLINICAL OUTCOMES OF ACUTE PANCREATITIS IN PREGNANCY: OUR EXPERIENCE OF 33 PATIENTS
(Carbone Editore, 2014) Gunduz, Ercan; Zengin, Yilmaz; Ulger, BurakVeli; Icer, Mustafa; Dursun, Recep; Gullu, Mehmet Nezir
Objective: In this study We aimed to examine the clinical, demographic properties, and outcome of acute pancreatitis in pregnancy. Materials and method: Our study included 33 patients with acute pancreatitis in pregnancy (APP) who were followed at the departments of Obstetrics and Gynecology and Internal Medicine at Dicle University Faculty of Medicine between January 2004 and June 2013. Patient information were obtained from the hospital records:. Age, gestational age, etiology, complications, laboratory results, diagnostic tests, treatment modalities, mode of delivery,(normal vaginal delivery or caesarean section (C/S)), duration of hospital stay, and maternal mortality and morbidity rates were recorded. Hypertriglyceridemia was recorded as the etiological factor when triglyceride level was more than 11.3 mmol/L (1000 mg/dl)and biliary pathology was recorded when there were biliary stones or bile mud. Patients who did not have a history of alcohol abuse or any condition responsible from pancreatitis were classified as idiopathic pancreatitis and grouped accordingly. Results: This study included a total of 33 patients with APP among a total of 85542 deliveries. Mean age of the study population was 34.8 +/- 7.15 (2346) years and mean gestational age was 25.75 +/- 7.49 weeks. The etiology of acute pancreatitis was a biliary pathology in 18 (545%) patients, hypertriglyceridemia in 11 (33.3%), and idiopathic APP in 4 (12.2%). Four (12.1%) maternal deaths occurred. Sixteen (48.5%) patients suffered from a maternal complication while 10 (33.3%) patients died. Twenty-nine patients were discharged With cure. All maternal deaths and 50% of maternal complications occurred in second trimester. Conclusion: In our study APP was most commonly observed in second trimester and it had a more complicated and fatal course during this period. Biliary pathologies were the most fatal etiological group.
The effect of isoniazide on myocardial tissue: protective role of cape
(Drunpp-Sarajevo, 2012) Cil, Habib; Yavuz, Celal; Atilgan, Zuhal Ariturk; Demirtas, Sinan; Caliskan, Ahmet; Gunduz, Ercan
Aim: To investigate a toxic effect of Isoniazide on the myocardial tissue and protective role of the caffeic acid phenyl ester (CAPE). Material and methods: Animals: Male Sprague-Dawley rats were divided into four experimental groups, with ten animals in each group; Control, INH-treated group, CAPE treated group and INH plus CAPE-treated group. Biochemical analyses: Superoxide dismutase activity was measured according to the method described by Fridovich. Lipid peroxidation level in the myocardium was expressed as malondy-aldehyde (MDA). It was measured according to procedure of Ohkawa et al. The total antioxidant capacity of supernatant fractions was evaluated by using a novel automated and colorimetric measurement method developed by Erel (13). Histopathological analyses: Myocardial tissue specimens were fixed in 10% formaldehyde, dehydrated in alcohol solution and were embedded in paraffin for 24 hours and used for histopathological examination. Four micrometer (mu m) thick sections were cut, deparaffinized, hydrated and stained with hematoxyline and eosin (H&E) under a light microscope (Nikon Eclipse 80i, JAPAN). Results: In the INH group, malondialdehyde and total oxidant status levels were significantly higher than those of the control group in the myocardial tissues (p<0.05). In the INH group myocardial TAC levels, activities of SOD and PON-1 decreased compared with control group (p<0.05). CAPE plus INH treatment caused a significant decrease in MDA and TOS generation in the myocardium (p<0.05). Also, CAPE plus INH caused a significant an increase in TAC levels, SOD and PON-1 activities (p<0.05). Conclusion: We have shown that experimental administration of INH is accompanied by in-creased lipid peroxidation and oxidants in myocardial tissues of rats. Therefore, we suggest that oxidative stress is a cause of INH induced cardiotoxicity. Simultaneously, CAPE is a protective agent in this toxicity by overcoming the inactivation of antioxidant enzyme systems by INH. Thereby CAPE may play a role in preventing INH induced cardiotoxicity.
EFFECTS OF SLEEP QUALITY, INCOME LEVEL AND COMORBID CONDITIONS ON QUALITY OF LIFE IN A TURKISH ELDERLY POPULATION: A MULTICENTRE STUDY
(Gunes Kitabevi Ltd Sti, 2015) Gunduz, Ercan; Eskin, Fatih; Gunduz, Mehmet; Bentli, Recep; Selcuk, Engin Burak; Zengin, Yilmaz; Icer, Mustafa
Introduction: Our aim is to investigate the effects of sleep quality, income level and comorbid conditions on Quality of Life in a Turkish elderly population. Materials and Method: This multicentric study was performed in seven districts. A total of 1030 patients older than 65 years of age who applied to the internal medicine and geriatrics outpatient clinics of study centres between January and December 2014 were included. All patients underwent the Pittsburgh Sleep Quality Index and Quality of Life Assessment (Short Form 36) tests viaface to face interview method. The demographic properties of patients were also recorded during this interview. Results: The mean Quality of Life subscale scores, except for vitality, were significantly lower (p < 0.001) in patients with poor sleep quality. When analysing the relationship between Quality of Life and multiple chronic diseases, it was observed that patients having multiple chronic diseases had significantly lowered scores in three subscales (physical functioning, mental health and bodily pain; p=0.04, p=0.04, p=0.01, respectively). There were significant differences between patients with high versus low income level with respect to the mean physical functioning, mental health and bodily pain subscales (p=0.01). Conclusion: Our study demonstrated an adverse effect of low sleep quality, multiple chronic disorders and low income level on Quality of Life.
Factors affecting mortality in patients with organophosphate poisoning
(Pakistan Medical Assoc, 2015) Gunduz, Ercan; Dursun, Recep; Icer, Mustafa; Zengin, Yilmaz; Gullu, Mehmet Nezir; Durgun, Hasan Mansur; Gokalp, Osman
Objective: To investigate the relationship between clinical and demographic characteristics and mortality in patients with organophosphate poisoning. Methods: The retrospective study was conducted at Dicle University, Diyarbakir, Turkey, and comprised data of patients who presented with organophosphate poisoning between April 2004 and April 2013. The records were assessed in two groups, with Group 1 having data related to recovery, and Group 2 having data related to mortality. SPSS 16 was used for statistical analysis. Results: Of the 296 patients, 219(74%) were women. Mortality was the outcome in 41(13.9%) cases. In Group 2, mean age, marital status, rural origin, presence of psychiatric disease, being illiterate, presence of nicotinic symptoms, and late admission were significantly higher than Group 1 (p<0.05 each). Logistic regression analysis indicated bradycardia as the most prominent independent predictor of mortality (p<0.001). Other independent predictors were age, glucose level, lactate dehydrogenase, coma and acidosis (p<0.05 each). Conclusion: Independent predictors of mortality in patients with organophosphate poisoning as bradycardia, age, glucose, lactate dehydrogenase level and acidosis.
Factors affecting mortality in patients with splenic injuries
(Edizioni Luigi Pozzi, 2018) Uslukaya, Omer; Bozdag, Zubeyir; Gumus, Metehan; Turkoglu, Ahmet; Boyuk, Abdullah; Yilmaz, Edip Erdal; Gunduz, Ercan
AIM: Mortality in splenic injuries can create medico-legal problems. Though many studies exist regarding splenic injuries, there are not a sufficient number investigating the factors in splenic injuries influencing mortality. In this study, we aimed to investigate the factors affecting mortality in splenic injuries. MATERIALS AND METHODS: All 237 patients with splenic injury between 2005 to 2014 were retrospectively analyzed. The patients were divided into two groups, survivors and non-survivors. Age, gender, mechanism of injury, grade of splenic injury, pulse, respiratory rate, systolic blood pressure, hemoglobin levels, number of transfusions, surgical procedure, ISS, RTS and hospitalization period were recorded. Univariate and multivariate analysis were used to compare survivors and non-survivors. RESULTS: The average age of the patients was 32 and most (82.7%) were male. Mortality was observed in 18 patients (7.6%). Mortality was found significantly lower in patients who had isolated splenic injury (p=0.048). In univariate analyses, decreased RTS (p<0.001), increased number of blood transfusion (p<0.001), decreased hemoglobin level (p=0, 025) and increased ISS (p<0.001) were found significant in non-survivors. In multivariate analysis; number of transfusions, ISS and RTS were found as independent risk factors for mortality. CONCLUSIONS: We found high number of transfusions, high ISS and low RTS as independent risk factors for mortality in patients with splenic injury.
Fire disaster caused by LPG tanker explosion at Lice in Diyarbakir (Turkey): July 21, 2014
(Elsevier Sci Ltd, 2015) Zengin, Yilmaz; Dursun, Recep; Icer, Mustafa; Gunduz, Ercan; Durgun, Hasan Mansur; Erbatur, Serkan; Damar, Omer
A disaster can be defined as a situation where the affected society cannot overcome its own resources. Our aim was to present the case of a fire disaster caused by a liquefied petroleum gas (LPG) tanker-based explosion on the Diyarbakir-Bingol road in Lice to determine the various kinds of challenges and patient groups that an emergency department faces and to discuss more effective interventions for similar disasters. This is a retrospective cross-sectional study. To find out the factors that affected mortality, we investigated the patient conditions presented at the time of admission. Among 69 patients included in the study, 62 were male (89.9%) and seven were female (10.1%). The average age of patients was 32.10 +/- 14.01 years, and the burn percentage was 51.1 +/- 32.2. One patient died during the first response, and a total of 34 patients (49.3%) died during the patient follow-up. Factors statistically related to mortality were determined to be inclusion in the severe burn group, presence of inhalation injuries, use of central venous catheter on patients, application of fasciotomy, presence of a tracheostomy opening, use of endotracheal intubation and sedoanalgesia, and transfer to centers outside the city (p-values <0.001, <0.001, <0.001, <0.001, <0.001, <0.001, 0.001, and 0.003, respectively). In conclusion, although fire disasters caused by LPG tanker explosions are rare, the frequency of such disasters will increase with the increase in LPG use. The factors affecting mortality should be determined to decrease mortality. We recommend that all personnel members who engage in work related to LPG from production to use, in addition to rescue and first-response personnel, be trained comprehensively and that advanced technological fire equipment be used to prevent such disasters. (C) 2015 Elsevier Ltd and ISBI. All rights reserved.
How was Felt Van Earthquake by a Neighbor University Hospital?
(Elsevier Science Bv, 2015) Zengin, Yilmaz; Icer, Mustafa; Gunduz, Ercan; Dursun, Recep; Durgun, Hasan Mansur; Gullu, Mehmet Nezir; Orak, Murat
Objectives Natural disasters, which are defined as events causing great damage or loss of life, are events of natural origin unpreventable by human beings that occur in a short period of time and lead to loss of life and property. The aim of the study is to analyze which patient groups and problems at a university hospital after the earthquakes in Van. Methods For the purposes of this study, 169 patients who presented to our emergency room following the earthquakes that occurred on the 23rd of October, 2011 and the 9th of November, 2011 in Van and were treated as an outpatient or inpatient were enrolled. Patients were divided into two groups. Patient data including the clinical and demographic characteristics were analyzed. Results Among the 169 patients included in our study, 97 (57.4%) were male and 72 (42.6%) were female. The mean age was 26.95 +/- 16.44 years in Group 1 and 39.80 +/- 23.08 years in Group 2. In our study, the majority of the patients in Group 1 had orthopedic injuries, while internal problems were more common in Group 2. The need for intensive care was greater among the patients in Group 1 compared to Group 2 (p<0.05). The leading cause of death in Group 1 was multi-systemic trauma in 7 out of the 10 patients (70%) and internal problems in Group 2 with 5 out of 12 patients (41.5%). Conclusions Our country is in a geographical location where earthquakes are responsible for great losses of life and property. An efficient disaster relief plan may help to minimize the possible damage of earthquakes.
Hypokalemic Periodic Paralysis Due To Distal Renal Tubular Acidosis
(Modestum Ltd, 2015) Gunduz, Ercan; Zengin, Yilmaz; Dursun, Recep; Icer, Mustafa; Gullu, Mehmet Nezir; Durgun, Hasan Mansur
Hypokalemic periodic paralysis (HPP) is a disorder that characterized by attacks of skeletal muscle paralysis depending on the changes in serum potassium levels, and can occur due to primary and secondary causes. One of the secondary causes of HPP is distal renal tubular acidosis (DRTA). DRTA is a disorder that characterized by hypokalemia or hyperkalemia hypercalciuria, metabolic acidosis and alkaline urine. DRTA's clinical symptoms are listed as constipation, nausea, vomiting, kidney and skeletal muscle complications, nephrocalcinosis, urolithiasis and severe hypokalemia crisis. In this case report, we reported a patient who admitted to emergency department with complains of nausea, vomiting, and periodic muscle weakness and was diagnosed with hypokalemic periodic paralysis due to DRTA was presented.
Imaging features of cerebral and spinal cystic echinococcosis
(Springer-Verlag Italia Srl, 2015) Teke, Memik; Gocmez, Cuneyt; Hamidi, Cihad; Gunduz, Ercan; Goya, Cemil; Cetincakmak, Mehmet Guli; Hattapoglu, Salih
The main objective of this study was to describe the characteristic imaging features of cerebral and spinal hydatid disease (HD) in magnetic resonance imaging (MRI) and computed tomography (CT) in order to provide more effective differential diagnoses in endemic regions. We also aimed to use MRI and CT to evaluate whether the World Health Organization's (WHO) new classification of hepatic cystic echinococcosis (CE) could be used in the classification of cerebral HD. We retrospectively reviewed the CT and MR images of 30 patients who were diagnosed with cerebral and spinal HD between 1990 and 2014. The imaging findings were noted. All hydatid cysts were classified according to the WHO classification of hepatic CE, consisting of six types. The study group consisted of 49 CEs in 27 patients with cerebral HD and 12 CEs in three patients with spinal HD. Of the cysts, 14 were type CL (cystic lesion), 29 were type CE1, 11 were type CE2 and seven were type CE3. In other words, 54 cysts were in the active group and seven were in the transition group. Most of the cysts were type CL and CE1. Even though characteristic imaging features could be used in the differential diagnosis of HD, sometimes the differentiation of HD from other cystic lesions may be difficult. The use of WHO classification will provide standardisation of uniform treatment modality, as the treatment of HD, according to the stage of the disease, may be surgical or medical.
Is montelukast as effective as N-acetylcysteine in hepatic injury due to acetaminophen intoxication in rats?
(Elsevier Gmbh, 2016) Icer, Mustafa; Zengin, Yilmaz; Gunduz, Ercan; Dursun, Recep; Durgun, Hasan Mansur; Turkcu, Gul; Yuksel, Hatice
This study aims to investigate the acute protective effect of montelukast sodium in hepatic injury secondary to acetaminophen (APAP) intoxication. This study used 60 rats. The rats were grouped into 6 groups. The control group was administered oral distilled water 10 ml/kg, the APAP group oral APAP 1 g/kg, the montelukast sodium (MM) group oral MK 30 mg/kg, the acetaminophen + N-acetylcysteine (APAP + NAC) group oral APAP 1 g/kg, followed by a single dose of intraperitoneal NAC 1.5 g/kg three hours later, the acetaminophen + montelukast sodium (APAP+MK) group oral APAP 1 g/kg, followed by oral MK 30 mg/kg 3 h later, the acetaminophen + Nacetylcysteine + montelukast sodium (APAP + NAC + MM) group oral APAP 1 g/kg, followed by a single intraperitoneal NAC 1.5 g/kg plus oral MK 30 mg/kg 3 h later. Blood and liver tissue samples were taken 24 h after drug administration. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin were studied from the blood samples. Liver tissue samples were used for histopathological examination. Compared with the control group, serum AST and ALT activities were higher in the APAP and APAP + NAC groups. APAP + NAC, APAP + MK, and APAP + NAC + MM groups had reduced serum ALT and AST activities than the group administered APAP alone. APAP + MM and APAP + NAC + MK groups had a lower serum ALP activity than the control group. Histopathologically, there was a difference between the group administered APAP alone and the APAP + MK and APAP + NAC + MK groups. MK is as protective as NAC in liver tissue in APAP intoxication in rats. (C) 2015 Elsevier GmbH. All rights reserved.
Lycium barbarum extract provides effective protection against paracetamol-induced acute hepatotoxicity in rats
(E-Century Publishing Corp, 2015) Gunduz, Ercan; Dursun, Recep; Zengin, Yilmaz; Icer, Mustafa; Durgun, Hasan Mansur; Kanici, Ayse; Kaplan, Ibrahim
The aim of the present study was to investigate the hepatoprotective and antioxidant effects of Lycium barbarum (LB) extract against paracetamol-induced acute oxidative stress and hepatotoxicity in rats. The subjects were divided into 6 groups of 8 rats each. The rats in the LB group were administered a dose of 100 mg/kg LB extract dissolved in saline via the intraperitoneal route for 7 days. Subsequently, after last dose of LB, PCT was given in a single dose of 1 g/kg diluted in saline via the oral route. Twenty-four hours later, blood samples were drawn from all of the subjects for serum Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Total antioxidant status (TAS) and Total oxidant status (TOS) tests, and liver tissue samples were obtained for histopathological evaluation. The mean TAS level of the group that was subjected to PCT intoxication was significantly lower than those of the other groups. Additionally, the mean TOS, Oxidative stress index (OSI), ALT and AST values were significantly higher in this group. Though the mean TAS level in the PCT + LB group was significantly higher than that of the PCT group, the TOS, OSI, ALT, and AST levels were significantly lower. When the PCT + LB group and the PCT only group were compared in terms of liver damage during the histopathological evaluation, a statistically significant difference was observed in Grade I and Grade III damage (P = 0.013 and P = 0.038, respectively). We conclude that Lycium barbarum extract leads to a significant improvement in PCT-induced acute hepatotoxicity in terms of the histopathological results, serum oxidative stress parameters, and serum liver function marker enzymes.
Malnutrition in Community-Dwelling Elderly in Turkey: A Multicenter, Cross-Sectional Study
(Int Scientific Information, Inc, 2015) Gunduz, Ercan; Eskin, Fatih; Gunduz, Mehmet; Bentli, Recep; Zengin, Yilmaz; Dursun, Recep; Icer, Mustafa
Background: This study aimed to investigate the prevalence of malnutrition and explore the somatic, psychological, functional, and social or lifestyle characteristics linked to malnutrition in elderly people at a hospital in Turkey. Material/Methods: This study included 1030 patients older than 65 years of age who were seen at the internal medicine and geriatrics outpatient clinics of the study centers in Istanbul, Ankara, Duzce, Corum, Mardin, Malatya, and Diyarbakir provinces between January and December 2014. All patients underwent Mini Nutritional Assessment (MNA) and Geriatric Depression Scale (GDS) tests via one-on-one interview method. The demographic properties of the patients were also recorded during this interview. Results: Among 1030 patients included in this study, 196 (19%) had malnutrition and 300 (29.1%) had malnutrition risk. The malnutrition group and the other groups were significantly different with respect to mean GDS score, income status, educational status, the number of children, functional status (ADL, IADL), the number of patients with depression, and the number of comorbid disorders. According to the results of the logistic regression analysis, age (OR=95% CI: 1.007-1.056; p=0.012), BMI (OR= 95% CI: 0.702-0.796; p<0.001), educational status (OR= 95% CI: 0.359-0.897; p=0.015), comorbidity (OR= 95% CI: 2.296-5.448; p<0.001), and depression score (OR= 95% CI: 1.104-3.051; p=0.02) were independently associated with malnutrition. Conclusions: Our study demonstrates that age, depression, BMI, comorbidity, and the educational status were independently associated with malnutrition in an elderly population.
Neuroleptic Malignant Syndrome Associated with Quetiapine Treatment in a Patient with Ventriculoperitoneal Shunt
(Aves, 2014) Zengin, Yilmaz; Icer, Mustafa; Gunduz, Ercan; Ozhasenekler, Ayhan; Dursun, Recep; Orak, Murat; Guloglu, Cahfer
Introduction: Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening idiosyncratic reaction during the use of antipsychotic drugs, usually beginning in the first 2 weeks of the treatment. NMS is generally manifested by muscle rigidity, hyperthermia, autonomic instability, altered mental status, tremors, elevated serum creatinine phosphokinase, and leukocytosis. Case Report: A 26-year-old male patient who had a ventriculoperitoneal (V-P) shunt was admitted to the emergency department with complaints of loss of consciousness, fever, respiratory distress, and palpitations. In his history, we learned that treatment of quetiapine 25 mg/day was initiated 6 months ago. After physical examination and laboratory results, the patient, who had a V-P shunt, was primarily considered shunt dysfunction or infection. But, with laboratory parameters and radiographic examinations, we moved away from this diagnosis. He was evaluated as NMS due to the history of antipsychotic drug using, fever, rigidity, tachycardia, tachypnea, confusion, and increase of creatine phosphokinase for the preliminary diagnosis. Since there was no any etiological factor that could explain the clinical process, he was admitted to the medical intensive care with a diagnosis of NMS. Conclusion: NMS is a disorder that can be life-threatening and must be recognized by clinicians.
Paraoxonase and Arylesterase Activities in Dipper and Non-Dipper Prehypertensive Subjects
(Lippincott Williams & Wilkins, 2015) Yuksel, Murat; Yildiz, Abdulkadir; Tekbas, Ebru; Gunduz, Ercan; Ekinci, Aysun; Bilik, Mehmet Zihni; Ozaydogdu, Necdet
Paraoxonase-1, a high-density lipoprotein linked enzyme complex, was shown to be decreased in several cardiovascular diseases. We aimed to explore whether serum paraoxonase and arylesterase activities differ in dipper and non-dipper prehypertensive subjects compared to healthy controls. Sixty prehypertensive subjects and 30 controls were enrolled. All subjects underwent echocardiographic assessment and 24-hour ambulatory blood pressure monitoring (ABPM). According to the blood pressure (BP) course on ABPM, prehypertensive subjects were categorized into two: non-dipper prehypertensive (NDPH) and dipper prehypertensive (DPH) groups. Serum paraoxonase and arylesterase activities were detected spectrophotometrically. Paraoxonase and arylesterase activities were significantly lower in patients with NDPH compared to both DPH and control groups. Both paraoxonase and arylesterase activities showed significant negative correlations with BP and left ventricular mass index. We have demonstrated that NDPH subjects have lower paraoxonase and arylesterase activities compared to DPH subjects and normotensives. Further prospective studies are needed to clarify the role of paraoxonase and arylesterase activities in the development of overt hypertension in prehypertensive subjects.
Platelet Count and Mean Platelet Volume in Patients With In-Hospital Deep Venous Thrombosis
(Sage Publications Inc, 2012) Cil, Habib; Yavuz, Celal; Islamoglu, Yahya; Tekbas, Ebru Onturk; Demirtas, Sinan; Atilgan, Zuhal Ariturk; Gunduz, Ercan
Aim: To investigate the relationship between mean platelet volume (MPV) and in-hospital deep venous thrombosis (DVT). Material and methods: 147 patients with the diagnosis of DVT and 149 control participants were included in the study. For all participants, clinical risk factors, smoking status, and other demographic data were recorded from hospital registries. The data of patients with DVT were compared with the control participants. Results: Mean MPV was significantly higher in patients with DVT than the control group (8.91 +/- 1.86 vs 7.86 +/- 0.9; P < .001). Body mass index, smoking frequency, hematocrit, and platelet count were significantly correlated with MPV. Independent predictors of in-hospital DVT were MPV (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.2-1.87; P <= .001), body mass index (OR = 1.17; 95% CI = 1.04-1.34; P = .012), and smoking (OR = 1.83; 95% CI = 1.09-3.08; P = .023). Conclusion: Mean platelet volume was significantly higher in patients with DVT, and it is an independent predictor of in-hospital DVT.

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