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Öğe ACCURACY OF URINARY SPOT PROTEIN TO CREATININE RATIO IN PRE-POST TREATMENT OF NEPHRITIS(Oxford Univ Press, 2013) Ozmen, Sehmus; Akin, Davut; Danis, Ramazan; Yilmaz, Mehmet[Abstract Not Available]Öğe Adipocyte volumes and levels of adipokines in diabetes and obesity(Elsevier Sci Ltd, 2008) Gokalp, Deniz; Bahceci, Mithat; Ozmen, Sehmus; Arikan, Senay; Tuzcu, Alpaslan; Danis, RamazanAim: Obesity is a major risk factor for insulin resistance, type 2 diabetes, heart disease, and many other chronic diseases. The factors regulating cytokine production seem to have a role on the determination of adipocyte volume. We aimed to investigate the association of plasma adiponectin and resistin concentrations with adipocyte volumes in obese, diabetic, obese-diabetic and control groups. Methods: Plasma adiponectin, resistin and lipid levels and adipocyte volumes were investigated in obese, non-diabetic, non-obese diabetic, obese diabetic and control groups consisting 100 subjects who planned to undergo elective surgery. Differences in clinical or laboratory parameters among groups were compared by using one-way ANOVA test. Chi-square test was used for comparing the frequencies. Results: The lipid values in all three groups were higher than the control group. A negative correlation was found between adiponectine levels and adipocyte volumes. When adipocyte volumes were compared with other groups, adipocyte volumes were significantly higher in the obese diabetic group (p = 0.000). The adipocyte volumes in the obese group were determined to be higher than the control group. Conclusions: Although a positive correlation was found between adipocyte volumes and adiponectin in literature, adiponectin concentrations in our study were lower. These conditions can be explained by the effect of insulin resistance on the adiponectin levels in obese diabetic groups. Moreover, adiponectin levels are mostly associated with subcutaneous adipose tissue which may have been less. Resistin levels may play an important role in the development of obesity, insulin resistance and diabetes. (C) 2008 Diabetes India. Published by Elsevier Ltd. All rights reserved.Öğe Analysis of 152 Patients with Nephrotic Syndrome in the Period between 2001 and 2007(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2008) Akin, Davut; Ozmen, Sehmus; Danis, RamazanThe frequency of glomerulonephritis (GN) may vary depending on developmental areas and geographic location. The characteristics of 152 patients with nephrotic syndrome (NS) admitted to Dicle University School of Medicine between 2001 and 2007 were retrospectively analyzed. Of 152 patients 76 (50%) was female and 76 (50%) was male. The mean age of patients was 36.30 +/- 16.5 years. 106 patients (69.7%) had a histologic diagnosis. The frequencies of primary glomerulonephritis were as followed: membranous GN (MGN) 28%, membranoproliferative GN (MPGN) 24% and focal segmental glomerulosclerosis (FSGS) 22.7%. In conclusion MGN was the most common primer GN type in biopsies performed with an NS indication in our region. In our study, MPGN, a decreasing GN type in developed countries, is still common in our region but has a trend to decrease.Öğe Analysis of Our Cases With End Stage Renal Disease in a Period Between 2001 and 2007(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2007) Danis, Ramazan; Ozmen, Sehmus; Akin, Davut; Bestas, Remzi; Atayan, Yahya; Zulfuogullari, Abbas; Yalcin, SuatThe etiology of end stage rectal disease (ESRD) varies with the country, ethnicity, and sex. Climate conditions, socioeconomic status, cultural and environmental factors may play an important role in etiologic distribution of ESRD. We retrospectively analyzed 535 patients in Dicle University School of Medicine, Department of Nephrology. The patients had a creetinine clearance below 15 ml/min per and did not take any type of renal replacement therapy. Hypertension: diabetes mellitus, and urologic disorders were the most common causes of ESRD. It was striking that urologic disorders constituted 11.1% of ESRD cases as the third must common cause, and 42.3% of these subjects had urolithiasis. No difference regarding sex, hemoglobin. parathyroid hormon, erythrupoietin calcium, phosphorus between subjects within different etiologies. In conclusion, hypertension and diabetes mellitus account for half of the ESRD etiology as expected. But urologic disorders, may be preventable when diagnosed early, are more common than world and Turkey registries. More attention must he provided in diagnosis and treatment of urologic disorders. Comprehensive and efficient schedules targeted to early diagnose and treatment of renal stone disease must be initiated.Öğe A Case of Sheehan's Syndrome Admitting With Severe Hyponatremia(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2005) Danis, Ramazan; Ozmen, Sehmus; Parmaksiz, Ergun; Ozmen, Cihan Akgul; Yazanel, OrhanPostpartum necrosis of pituitary gland is one of the most common reasons of hypopituitarism. It is most commonly due to massive bleeding before or during delivery. Nonspecific symptoms like fatigue and weakness may confuse and delay the diagnosis. Patients with Sheehan's syndrome may rarely present with hyponatremia signs. A 55-year-old woman admitted to our nephrology department with stupor, severe hyponatremia (100 mEq/L), and hypoglycemia (56 mg/L). The diagnosis of Sheehan's syndrome was based on medical history, laboratory and radiological imaging findings. The patient's clinical picture improved dramatically after hormone and sodium replacement therapy. Sheehan's syndrome must be in differential diagnosis of old women with hyponatremia and it must be known that hyponatremia in those patients may be severe.Öğe Hyaluronic Acid as a New Biomarker to Differentiate Acute Kidney Injury From Chronic Kidney Disease(Iranian Soc Nephrolgy, 2017) Akin, Davut; Ozmen, Sehmus; Yilmaz, Mehmet EminIntroduction. It may be difficult to differentiate acute kidney injury from chronic kidney disease in patients with no past medical reports of kidney function. This study aimed to investigate the role of serum hyaluronic acid (HA), which is known as a marker of fibrosis, in differential diagnosis of kidney failure. Materials and Methods. A total of 90 patients (52 women and 38 mne) admitted to our renal unit with uremia for the first time were included. Serum HA level was measured. The diagnostic role of the test was investigated using the receiver operator curve curves. Results. The mean age of the patients was 54.6 +/- 17.9 years. The diagnosis was chronic kidney disease (CKD) in 41.1%, acute kidney injury (AKI) in 48.9%, AKI on CKD in 6.7% (3 died without a diagnosis). The mean serum HA was significantly higher in the CKD group (146.1 +/- 119.3 ng/mL) than the AKI group (68.9 +/- 69.1 ng/mL; P < .001). Serum HA significantly correlated with proteinuria (r = 0.717, P < .001) and serum albumin level (r = -0.599, P < .001) in the CKD group only. Serum HA cutoff level of 61 ng/dL had a sensitivity of 82% and specificity of 67% for differential diagnosis of AKI and CKD. Conclusions. Serum HA level may be used as tool to differentiate AKI from CKD. Further larger studies are warranted to clarify the definite the role of this marker.Öğe MICROCHIMERISM, A DILEMMA IN CURRENT MEDICINE(Nobel Ilac, 2006) Ozmen, Sehmus; Danis, Ramazan; Altintas, Abdullah; Bayan, Kadim; Yilmaz, SerifMicrochimerism refers to presence of a small number of cells or DNA of one individual harbored in another individual. Many studies indicate that cell trafficking occurs between the fetus and mother during pregnancy and between others after organ transplantation or blood transfusions. These cells or DNA can persist in recipient?s blood or tissues for decades, creating a state of physiologic microchimerism. In several recent studies, microchimerism has been shown to have potential roles in pathogenesis of different diseases. However, due to the fact that microchimerism has also been found in healthy individuals and in organs affected by non-autoimmune conditions, an alternative hypothesis has been suggested in which microchimeric cells are associated with the healing process of a tissue injury as opposed to causing disease. As a conclusion of this review of recent studies, we can say that microchimerism studies yielded more questions than answers.Öğe Plasma resistin and leptin levels in overweight and lean patients with rheumatoid arthritis(Tubitak Scientific & Technological Research Council Turkey, 2009) Canoruc, Naime; Kale, Ebru; Turhanoglu, Ayse Dicle; Ozmen, Sehmus; Ogun, Ceyla; Kaplan, AbdurahmanAim: Adipocytokines; are now considered important players in the etiopathogenesis of numerous metabolic and inflammatory disorders. However, plasma leptin and resistin levels in rheumatoid arthritis (RA) are still unclear. We aimed to investigate the plasma levels of leptin and resistin in patients with rheumatoid arthritis and to compare them with controls. Materials and Methods: Consecutive 52 patients with RA were compared with 52 control subjects in terms of mean leptin and resistin levels. Results: Patients with RA showed considerably higher plasma levels of leptin (34.3 +/- 27.9 vs. 11.1 +/- 4.1) and resistin (4.8 +/- 0.7 vs. 4.0 +/- 1.3) than healthy controls (P < 0.0001). There was no significant difference regarding age, duration of disease, sex, CRP, and leptin and resistin levels between overweight and lean RA Subjects. Plasma leptin level was significantly correlated with ESR (Erythrocyte Sedimentation Rate) (r = 0.287, P = 0.039) and swollen and tender joint count (r = 0.563, P < 0.0001) but not with resistin in subjects with RA. Measuring the plasma leptin level may be a potential marker of disease activity in RA. Conclusions: Studies including more RA patients might be needed to define the role of leptin and resistin in RA subjects.Öğe Predictive value of serum NT-proBNP levels in type 2 diabetic people with diabetic nephropathy(Elsevier Ireland Ltd, 2012) Danis, Ramazan; Ozmen, Sehmus; Arikan, Senay; Gokalp, Deniz; Alyan, OmerObjective: The serum N-terminal fragment of pro brain natriuretic peptide (NT-proBNP) level in type 2 diabetic subjects with or without diabetic nephropathy (DN) is still unclear. We aimed to evaluate the relationship between serum NT-proBNP levels and different stages of diabetic nephropathy, and identify probable factors predicting serum NT-proBNP level. Subjects and methods: This cross-sectional study included 20 normoalbuminuric (Group-I), 28 microalbuminuric (Group-II), 20 macroalbuminuric type 2 diabetic patients (Group-III), and 20 healthy volunteers (Group-IV). Serum NT-proBNP levels were measured with highly sensitive and specific immunoassay. Results: Mean NT-proBNP levels were 32 +/- 55, 91 +/- 95, 331 +/- 297, 42 +/- 34 pg/ml for Groups I-IV, respectively. When patients with LVH were excluded, mean logNT-proBNP was still significantly higher in Group-III than all other groups. The three diabetic groups were similar in age, BMI, HbA1c, fasting serum glucose, and GFR. In a multivariate linear regression model, adjusting for factors significantly correlated with NT-proBNP levels, the patient group, presence of LVH, and hemoglobin remained as an independent predictor of serum NT-proBNP. These variables explained 68% of the variability of NT-proBNP (adjusted R-2 = 0.683). Conclusions: Mean serum NT-proBNP level of macroalbuminuric diabetic patients was higher than normoalbuminuric and microalbuminuric diabetic patients, and healthy control subjects even after exclusion of LVH. NT-proBNP may be a useful and predictive marker of diabetic nephropathy. (C) 2011 Elsevier Ireland Ltd. All rights reserved.Öğe The Retrospective Analysis of 84 Patients With Nephrotic Sydrome(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2005) Danis, Ramazan; Ozmen, Sehmus; Parmaksiz, Ergun; Yazanel, OrhanThe frequency of histologic types of glomerulonephritis vary depending on ethnicity and geographic location. Characteristics of 84 patients with nephrotic syndrome admitted to Dicle University Faculty of Medicine were retrospectively analysed. The mean age of 41 female and 43 male patients was 35.0 years. Forty-seven patients (78.3%) had primary glomerulonephritis and the remaining 13 patients (21.7%) had secondary glomerulonephritis. The basal mean values of patients with NS were as follows: serum creatinine 1.68 mg/dl, serum urea 64.5 mg/dl, renal protein loss 5.7 gr/day, and creatinine clearence 65 ml/min. MPGN and MGN were the most common GN types in biopsies performed with a NS indication. In our study, MPGN, a decreasing type in developed countries, and MGN, the most common type worldwide were at top. Although MPGN is decreasing in western countries it is still common in different regions of our country and is the most common GN type in our region.Öğe Rhabdomyolysis-Induced Acute Renal Failure Following Fenofibrate Therapy: A Case Report and Literature Review(Hindawi Ltd, 2010) Danis, Ramazan; Akbulut, Sami; Ozmen, Sehmus; Arikan, SenayFenofibrate, a fibric acid derivative, is used to treat diabetic dyslipidemia, hypertriglyceridemia, and combined hyperlipidemia, administered alone or in combination with statins. Rhabdomyolysis is defined as a pathological condition involving skeletalmuscle cell damage leading to the release of toxic intracellular material into circulation. Its major causes include muscle compression or overexertion; trauma; ischemia; toxins; cocaine, alcohol, and drug use; metabolic disorders; infections. However, rhabdomyolysis associated with fenofibrate is extremely rare. Herein we report a 45-year-old female patient who was referred to our department because of generalizedmuscle pain, fatigue, weakness, and oliguria over the preceding 3 weeks. On the basis of the pathogenesis and clinical and laboratory examinations, a diagnosis of acute renal failure secondary to fenofibrate-induced rhabdomyolysis wasmade. Weekly followups for patients who are administered fenofibrate are the most important way to prevent possible complications.Öğe Role of lean body mass for estimation of glomerular filtration rate in patients with chronic kidney disease with various body mass indices(Informa Healthcare, 2009) Ozmen, Sehmus; Kaplan, Mehmet Ali; Kaya, Halil; Akin, Davut; Danis, Ramazan; Kizilkan, Berfin; Yazanel, OrhanObjective. Glomerular filtration rate (GFR) is the main tool used to diagnose, treat and follow up renal diseases. Age, gender, ethnicity and obesity all affect the relationship between serum creatinine, muscle mass/body weight and GFR. This study aimed to investigate the role of lean body mass for GFR estimation in patients with chronic kidney disease (CKD) with various body mass indices. Material and methods. In total, 110 Caucasian adult subjects with CKD referred for GFR measurement by 99mTc-DTPA renography were enrolled in the study. The patients were categorized according to body mass index values: 18.5 kg/m2 (underweight), 18.5-24.9 kg/m2 (normal), 25-29.9 kg/m2 (overweight) and 30 kg/m2 (obese). Lean body mass (LBM) and fat mass were measured by leg-to-leg bioimpedance. Predictive factors were identified by linear regression analysis in each group. Results. GFR measured by DTPA, creatinine clearance, Cockcroft and Gault, and Modification of Diet in Renal Disease (four-variable) equations was 3727, 4230, 4227, and 4935 ml/min/1.73 m2, respectively. The predictive role of 1/SCr, age, serum albumin, amount of proteinuria, LBM and fat mass was investigated all groups. None of the factors was significant in underweight and healthy weight groups except for 1/serum creatinine (SCr). LBM/SCr was an independent predictive factor for both overweight and obese groups. 1/SCr accounted for 96.2% of the variability in measured GFR for underweight subjects but only 58.1% of the variability in GFR of obese subjects. Conclusions. The formulae derived from SCr should be used cautiously in overweight and obese subjects. LBM measured by bioimpedance was an independent predictive factor of GFR in obese/overweight subjects and added clinically important diagnostic value to 1/SCr. It needs to be investigated as a parameter in further studies attempting to develop formulae for estimating GFR in larger obese and overweight populations.Öğe Snakebite-induced acute kidney injury: Data from Southeast Anatolia(Taylor & Francis Inc, 2008) Danis, Ramazan; Ozmen, Sehmus; Celen, Mustafa Kemal; Akin, Davut; Ayaz, Celal; Yazanel, OrhanRenal failure is an important complication of snakebite and a major cause of mortality. We aimed to study the clinical profile of snake envenomation in Southeast Anatolia, Turkey, in an adult population. We retrospectively analyzed the records of 200 snakebite victims from 1998 to 2006 at the Dicle University School of Medicine, Diyarbakir, Turkey. Sixteen patients (8%) developed AKI (acute kidney injury). Of those, 25% required dialysis and 18% died. There was no difference between groups in age, arrival time to hospital, and hospital stay time. Both groups received similar hydration and therapy at admission. Disseminated intravascular coagulation (DIC) was observed in 25% of the AKI group and was significantly higher than the non-AKI group (7.1%; p = 0.014). There was no significant difference regarding hemoglobin, platelet levels, and prothrombin time at admission. The prevalence of thrombocytopenia (<150,000 K/UL ) was 60% in the AKI group and 40% in the non-AKI group (p > 0.05). WBC count was significantly higher in the AKI group than in those without AKI (p = 0.001); serum albumin was significantly lower in the AKI group than in those without AKI (p = 0.013). AKI is an important complication of snakebite that may lead to mortality. Despite some troublesome aspects due to its retrospective design, this is a large series from Southeast Anatolia of Turkey in an adult population. Subjects with high WBC, low albumin, and DIC should be closely followed up for the development of AKI.Öğe Socio-cultural features and sex profile of the individuals with serious suicide attempts in southeastern Turkey: A one-year survey(Wiley, 2008) Yasan, Aziz; Danis, Raimazan; Tamam, Lut; Ozmen, Sehmus; Ozkan, MustafaOur objective was to elucidate potential causes of higher rates of suicide attempts in females compared to males in southeastern Turkey through a I-year survey. Gender-related differences observed in 96 subjects who attempted suicide by poisoning for the first time were as follows: in comparison to male, females were predominantly within the age interval of 15-24 years, experienced more stressful events in the previous week before suicide attempt, had lower education level, and had a lower rate of employment. One year after the suicide attempt, unfavorable attitude of family, lack of support, persisting unfavorable lifestyle comparable with that prior to the first attempt, and higher rates of domestic violence were more pronounced in females compared to males. These findings might be contributing factors to the higher suicide attempt rates observed in females compared to the males.Öğe Spontaneous bacterial peritonitis: pathogenesis, diagnosis, and management(Univ Catholique Louvain-Ucl, 2006) Ozmen, Sehmus; Dursun, Mehmet; Yilmaz, SerifSpontaneous bacterial peritonitis (SBP) is a bacterial infection of ascitic fluid which arises in the absence of any other intraabdominal infection source. SBP may develop in all cirrhotic patients with ascites. Gram-negative aerobic bacteria and non-enterococcal Streptococcus spp. are the most common organisms isolated from ascites. Diagnosis necessarily relies on paracentesis and requires a high index of suspicion. The incidence of mortality of the first episode varies between 10% and 46%. Early antibiotic treatment is warranted. Renal impairment develops in approximately one-third of patients with spontaneous bacterial peritonitis and is postulated to arise as a result of a further reduction in effective arterial blood volume. Cefotaxime has been the most extensively studied antibiotic for this infection. It is considered to be one of the first choice antibiotics because of low toxicity and excellent efficacy. Although parenteral antibiotics are generally used, studies evaluated the efficacy of several oral antibiotics in patients with relatively good clinical conditions. The reported probability of spontaneous bacterial peritonitis recurrence one year after the first attack averaged 40 to 69%. Selective intestinal decontamination with 400 mg norfloxacin per day decreased the overall probability of recurrence from 68% to 20% in 1 year of follow-up.Öğe Thrombophilias and arteriovenous fistula dysfunction in maintenance hemodialysis(Springer, 2009) Danis, Ramazan; Ozmen, Sehmus; Akin, Davut; Batun, Sabri; Kahvecioglu, Serdar; Altintas, Abdullah; Yilmaz, Mehmet E.Most episodes of fistula thrombosis are consequences of underlying physioanatomic abnormalities. However, some dialysis access thrombosis develops independent from any obvious anatomic cause. We aimed to clarify the role of thrombophilias in primary and secondary AVF failure. One hundred eighty nine arteriovenous fistulas in 116 adults on maintenance hemodialysis were analyzed. All subjects were evaluated for many thrombotic factors. Fistula information was obtained both from the patients' self reports, and from their medical records. Twenty-seven AVFs in 18 cases (14.3%) had pAVFF. The percentage of subjects with a BMI < 20 kg/m(2) was significantly lower than no-pAVFF group (P = 0.03). ATIII levels and albumin values were significantly lower in patients with sAVFF compared to those with no sAVFF. Other parameters were similar. There was no statistically significant difference between pAFFF versus No-pAFFF and sAFFF versus No-sAFFF groups with respect to all mutant alleles count. Routine extended analyses of all thrombophillic factors are not recommended in AVFF.Öğe Thrombosis of temporal artery and renal vein in Kimura disease related nephrotic syndrome(Springer, 2009) Danis, Ramazan; Ozmen, Sehmus; Akin, Davut; Ozekinci, Selver; Altintas, Abdullah; Cil, Timucin; Pasa, SemirKimura disease (KD) is an angiolymphoid proliferative disorder of unknown etiology, occurs mainly in Asian patients, presenting with subcutaneous slowly growing masses, with a predilection for preauricular and submandibular regions. The clinical course of the disease is thought to be benign. Concomitant peripheral blood eosinophilia and elevated serum immunoglobulin E levels are often observed. Main systemic manifestation of the KD is renal involvement. Renal abnormalities, notably proteinuria and nephrotic syndrome have been found to be associated with KD. We report a 42-year-old man with KD and a steroid-sensitive membraneous nephrotic syndrome with bilaterally temporal artery and renal vein thrombosis. This is the first reported case of KD associated nephrotic syndrome complicated with wide arterial and venous thrombosis from Anatolia.Öğe Type 4 Renal Tubular Acidosis in a Patient With Lupus Nephritis(Iranian Soc Nephrolgy, 2014) Akin, Davut; Ozmen, SehmusAlthough renal tubular acidosis (RTA) is a rare complication of systemic lupus erythematosus (SLE), type 4 RTA associated with lupus nephritis is extremely rare. A 20-year-old woman presented with malaise and edema in the lower extremities and face. She had multiple lymphadenopathies. There were 20% eosinophil in blood smear and 32% in bone marrow aspiration. Serology revealed positive antinuclear antibody at 1:1000 titer, positive double-stranded DNA antibodies, and low complements C3 and C4 levels. Urinary sediment was active and urinary protein excretion was 4.8 g/d. The SLE Disease Activity Index score was 23. A high SLE Disease Activity Index scores was proposed as a potential risk factor for type 4 RTA. Type 4 RTA may complicate SLE, and specifically, patients with high SLEDAI scores and lymphadenopathy may pose a high risk. Our patient responded successfully to immunomodulatory therapy.Öğe Ureterosygmoidostomy-associated quadriparesis, non-traumatic rhabdomyolysis, and tetany in an adult(Springer, 2008) Ozmen, Sehmus; Danis, Ramazan; Akin, Davut; Gullu, Nezir; Ozmen, Cihan Akgul; Yazanel, OrhanWe report an adult case of ureterosigmoidostomy-associated quadriparesis, rhabdomyolysis, and tetany which may be the first such case in the literature. A 32-year-old female patient was brought to the emergency room of our hospital, having been unable to walk or use her arms for 24 h. Neurological examination revealed quadriparesis. She had severe hypokalemia (1.27 mmol/l) and metabolic acidosis (pH = 7.05). Creatine kinase value was 2,590 U/l on the third day. She received intensive therapy to correct the hypokalemia and acidosis. On the third day of hospitalization tetany was detected in her upper extremities. The patient regained full muscle power after intravenous potassium chloride, bicarbonate, and calcium replacement therapy.
