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    Colchicine Toxicity in End-Stage Renal Disease Patients: A Case-Control Study
    (Lippincott Williams & Wilkins, 2014) Solak, Yalcin; Atalay, Huseyin; Biyik, Zeynep; Alibasic, Hayrudin; Gaipov, Abduzhappar; Guney, Figen; Kucuk, Adem
    Colchicine has been used in a number of disorders. Because colchicine is partially excreted from the kidney, there is a need for dose reduction in case of renal functional impairment. There are no data with regards to safe dosing schedule of colchicine in hemodialysis patients. We aimed to evaluate adverse effects of colchicine use in a hemodialysis cohort. We screened hemodialysis patients who were using colchicine for any reason. All patients were interviewed regarding possible toxicities of colchicine use and were examined with a special focus on neuromuscular system. Creatine kinase and myoglobin were used to detect any subclinical muscle injury or rhabdomyolysis, respectively. Twenty-two maintenance hemodialysis patients who were on colchicine for more than 6 months and 20 control hemodialysis patients not using colchicine were included in the study. Four of 22 patients were using 0.5 mg/day, 4 patients were using 1.5 mg/day, and 14 patients were using 1 mg/day colchicine. Mean duration for colchicine use was 8.9 +/- 8.2 years. There was no difference between the groups in terms of myoneuropathic signs and symptoms and blood counts except for white blood cell count, which was significantly higher in patients on colchicine. Serum creatine kinase (56.3 +/- 39.5 and 52.1 +/- 36.1 for colchicine and control groups, respectively, P = 0.72) and myoglobin (191.4 +/- 108.8 and 214.6+/-83.5 for colchicine and control groups, respectively, P = 0.44) levels were not different between the groups. We conclude that in a small number of haemodialysis patients who were apparently tolerating colchicine, detailed assessment revealed no evidence of sublinical toxicity when compared with controls.
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    Effciency of Silver Coated Urinary Catheter in Catheter-Associated Urinary Tract Infection in Critical Care Unit
    (Aves, 2010) Teke, Turgut; Yavuz, Zuhal; Atalay, Huseyin; Maden, Emin; Solak, Yalcin; Uzun, Kursat
    with an incidence of 40%. The incidence of urosepsis occurs in approximately 16% of the ICU patient populations. The purpose of this study was to determine the efficacy of a silver coated urinary catheter in prevention of catheter-associated UTI. Material and Methods: We investigated 21 patients (mean age with 71.4 +/- 9.0 year and 14 M, 7 F) foley silicon urinary catheter and 20 patients (mean age with 67.6 +/- 8.7 year and 15 M, 5 F) with silver coated urinary catheter. In all patients, foley urinary catheters were changed with silver coated catheter in critical care unit. Results: The most common cause of infection was Klebsiella (33%). The susceptibility of gram negative microorganisms against antimicrobial agents were amicacin, piperacillin-tazobactam and carbapenem. The cost of antibiotic was higher in foley catheter group than silver coated group (p<0.001). Conclusion: Silver coated urinary catheter is expensive, it is cost effect according to urinary infection and antibiotic cost.
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    Glomerulonephritis associated with tuberculosis: A case report and literature review
    (Wiley, 2013) Solak, Yalcin; Gaipov, Abduzhappar; Anil, Melih; Atalay, Huseyin; Ozbek, Orhan; Turkmen, Kultigin; Polat, Ilker
    Rapidly progressive glomerulonephritis caused mycobacterium tuberculosis is rare; however, three case have been reported to date. Crescentic glomerulonephritis is a life-threatening disease and together with the presence of tuberculous infection is associated with a poor outcome if treatment is inadequate and delayed. We describe the case of a 31-year-old female patient with nephrotic syndrome and progressive renal failure secondary to pulmonary tuberculosis. Renal biopsy showed crescent formation in 14 out of 27 glomeruli, and there was diffuse linear staining of immunoglobulin G deposits. Treatment included corticosteroids in combination with antituberculosis drugs for 2 months, and resulted in a significant improvement in renal function, the disappearance of proteinuria and pulmonary symptoms. We also present a review of the pertinent literature and discuss the pathophysiology of tuberculosis-related acute postinfectious glomerulonephritis. Copyright (C) 2012, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.
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    Influenza A/H1N1 Infection in a Renal Transplant Recipient: Early Recognition Prevented Unfavorable Results
    (Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2011) Solak, Yalcin; Selcuk, Nedim Yilmaz; Atalay, Huseyin; Ozbek, Orhan; Genc, Nejdet
    Influenza A/H1N1 2009 rapidly created a pandemic after it was first reported in April 2009. This virus caused a wave of panic around the world because of the rapidity of transmission and the characteristics of the dying victims, which were apparently healthy young adults. The pandemic caused thousands of laboratory-confirmed cases and many deaths. Despite this high prevalence, few reports of infection and clinical results in renal transplant recipients have been described in the literature. Early recognition and prompt administration of oseltamivir may prevent severe respiratory disease. Here we describe a renal transplant recipient who presented early after symptom onset who was successfully treated with oseltamivir and broad spectrum antibiotics without dire clinical consequences.
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    Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: A prospective, crossover study
    (Wiley, 2012) Solak, Yalcin; Biyik, Zeynep; Atalay, Huseyin; Gaipov, Abduzhappar; Guney, Figen; Turk, Suleyman; Covic, Adrian
    Aim: Pruritus is common in dialysis patients. Peripheral neuropathy is also prevalent in this patient population. However, the role of neuropathy in the genesis of uraemic itch has not been adequately studied to date. Therefore, we aimed to investigate the effects of gabapentin and pregabalin on uraemic pruritus along with neuropathic pain in patients receiving haemodialysis. Methods: This is a 14 week long randomized, prospective, cross-over trial. Haemodialysis patients with established neuropathy and/or neuropathic pain were included. Fifty patients were randomly assigned to gabapentin 300 mg after each haemodialysis session and pregabalin 75 mg daily. After 6 weeks of treatment, cross-over was performed and patients received the other drug for another 6 weeks. Short Form of McGill Pain Questionnaire and Visual Analogue Scale were used to evaluate pain and pruritus, respectively. At each week's visit, patients were interrogated in terms of adverse effects of study drugs. Baseline laboratory data and demographic characteristics were recorded from patient charts. Results: Forty (12 males, 28 females) out of 50 patients completed the study. Mean age was 58.2 +/- 13.7. Overall, 29 out of 40 patients (72.5%) had pruritus symptoms at baseline evaluation. Fifteen patients (37.5%) were diabetic. Thirty-one out of 40 patients (77.5%) had electromyography (EMG)-proven peripheral neuropathy. Twenty three patients (57.5%) had both EMG-proven neuropathy and pruritus. Gabapentin and pregabalin improved both neuropathic pain and pruritus significantly. There was no difference between the study drugs in terms of efficacy against pain and pruritus. Conclusion: Treatment of neuropathic pain with either pregabalin or gabapentin effectively ameliorates uraemic itch.