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Öğe COMPARISON OF CARDIAC ARRHYTHMIA TYPES BETWEEN HYPERTHYROID PATIENTS WITH GRAVES' DISEASE AND TOXIC NODULAR GOITER(Editura Acad Romane, 2018) Turan, E.; Can, I.; Turan, Y.; Uyar, M.; Cakir, M.Purpose. Previous studies have demonstrated the relationship between hyperthyroidism and increased risk of cardiac arrhythmias. The most common causes of hyperthyroidism are Graves' disease (GD) and toxic nodular goiter (TNG). The aim of our study was to demonstrate if the underlying mechanism of hyperthyroidism, in other words autoimmunity, has an impact on the type of cardiac arrhythmias accompanying hyperthyroidism. Method. Twenty patients with TNG and 16 patients with GD who had overt hyperthyroidism were included in the study. Age, sex, thyroid hormone levels, thyroid autoantibody positivity, thyroid ultrasonography and scintigraphy results were recorded. 24-hour Holter ECG monitoring was performed in all patients. Results. Mean age was significantly higher in the TNG group compared to the GD group (62.9 +/- 11.5 vs. 48.9 +/- 8.6 years, p=0.001). Free T3 was significantly higher (7.87 +/- 3.90 vs. 5.21 +/- 1.53 pg/mL, p=0.033) in the GD group while free T4 and TSH levels were similar between the two groups. In 24-hour Holter ECG recordings nonsustained ventricular tachycardia (VT) rates were significantly higher in the GD group than in TNG group [18.75% (n=3/16) vs. 0% (n=0/20), respectively, (p=0.043)] Paroxysmal atrial fibrillation (AF) rates were significantly higher in the TNG group compared to GD group [(30% (n=6/20) vs. 0% (n=0/16), respectively, (p=0.016)]. Conclusion. Although free T3 levels were lower, paroxysmal AF rates were found significantly higher in the TNG group which may be associated with significantly higher age of this group. On the other hand, higher rate of nonsustained VT in the GD group may be related to either significantly higher free T3 levels or autoimmunity.Öğe The efficacy and results of medical treatment in postoperative ileus(Wolters Kluwer Medknow Publications, 2023) Alkan, S.; Cakir, M.; Senturk, M.; Varman, A.; Duyan, A. G.Background: Postoperative paralytic ileus refers to the disruption of the normal coordinated propulsive motor activity of the gastrointestinal system following surgery. Surgery causes inflammation in the muscle walls of organs with an intestinal lumen that, in turn, leads to a decrease in intestinal motility. Aim: The aim of this study was to investigate the efficacy of gastrografin, neostigmine, and their combined administration in patients diagnosed with paralytic ileus in the postoperative period. Patients and Methods: One-hundred twelve patients were included from January 2017 and November 2019. The retrospective study is involving prolonged postoperative ileus cases following colorectal surgery. The effect of gastrografin, neostigmine, and gastrografin neostigmine combination was compared retrospectively in the treatment of prolonged ileus after surgery. Results: The study covered 112 patients. Gastrografin was administered to 63 patients; neostigmine was administered to 29, while 20 patients received the combination of the two. Data pertaining to the comparison of the two groups revealed that patients in the gastrografin group were discharged earlier than those in the neostigmine group. Further, patients in the combined group had earlier gas and/or stool discharge and were also discharged from the hospital earlier than those in the neostigmine group. Conclusion: Gastrografin and combined use of gastrografin and neostigmine are effective and viable methods for postoperative ileus cases. Gastrografin can safely be used in patients with anastomoses.Öğe Investigation of telomerase activity in ulcerative colitis and colorectal cancer patients(Nature Publishing Group, 2019) Duman, T. Akin; Yildirim, M. S.; Cakir, M.; Ataseven, H.; Zamani, A. G.[Abstract Not Availabe]Öğe NORMOCORTISOLEMIA AFTER TEN DAYS OCTREOTIDE TREATMENT IN A PATIENT WITH ECTOPIC CUSHING'S SYNDROME DUE TO BRONCHIAL CARCINOID(Editura Acad Romane, 2013) Kaya, A.; Cakir, M.; Turan, E.; Kulaksizoglu, M.; Tastekin, G.; Altinok, T.Contex. We report the use of subcutaneous somatostatin injection three times a day to decrease hypercortisolism in a patient who had Cushing's syndrome induced by bronchial carcinoid tumour progressive pneumonia due to immune suppression. Subject and Method. A 46-year-old man with 7-month history of DM type-2, hypertension and cerebrovascular-disease, vertebral compression-fracture was admitted to our clinic. Physical examination was consistent with Cushing's syndrome. Laboratory results revealed hyperglycemia (143 mg/dL; reference range, <100 mg/dL) and hypokalemia (2.29 mEq/L; reference range, 3.5-5.1 mEq/L). His morning serum cortisol was 40 mu g/dL (reference range 6.7-22.6 mu g/dL), urine cortisol-excretion was 2245 mu g/24 hours (reference range 58-403 mu g/24 hours), after 1 mg dexamethasone-suppression test serum cortisol was 28 mu g/dL (6.7-22.6 mu g/dL) and ACTH 354 pg/mL (reference range 7.9-66 pg/mL). Adrenal CT and hypophyseal MRI were normal. An ectopic source was searched for Cushing's syndrome. Chest CT scan of the right lung showed 12x9 mm nodule. High fever cough occurred on the follow-up. Chest radiograph revealed diffuse pneumonic infiltration. Despite 3-drug antibiotic combination therapy, infection did not improve. Subcutaneous injection of octreotide 3x100 mu g was initiated to decrease hypercortisolism. The infection improved rapidly after the therapy. The morning serum cortisol, urine cortisol-excretion, ACTH was at the upper normal range (77.1 pg/mL, reference range 7.9-66 pg/mL) on 10th day of treatment. The patient was a consulted for surgery and the nodule was excised. The pathology was consistent carcinoid tumor. Conclusion. Subcutaneous octreotide treatment may be helpful to gain time for exploring the focus in ectopic cushing's syndrome and to control the serious infections due to hypercortisolism.Öğe Protective effects of grape seed proanthocyanidin extract in experimental obstructive jaundice(Wiley-Blackwell, 2013) Vatansev, H.; Savda, M.; Akyurek, F.; Cakir, M.; Ozturk, B.; Unlu, A.[Abstract Not Availabe]Öğe Radiotherapy-induced Hypopituitarism in Nasopharyngeal Carcinoma: the Tip of an Iceberg(Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh, 2015) Ipekci, S. H.; Cakir, M.; Kiyici, A.; Koc, O.; Artac, M.Background: Radiation-induced hypopituitarism is an important late complication of cranial radiotherapy in children and adults. The purpose of this cross-sectional study was to evaluate the effects of radiotherapy on pituitary function in adult nasopharyngeal carcinoma patients. Methods: Pituitary function was evaluated in 30 patients after cranial radiotherapy for nasopharyngeal carcinoma. Somatotroph and corticotroph axes were assessed by insulin tolerance test while gonadotroph and thyroid axes were evaluated by basal pituitary and end organ hormone levels at 10-133 months after radiotherapy. Results: At least one hormonal disorder was observed in 28 (93%) patients after radiotherapy. 26 (87%) patients had one or more anterior pituitary hormone deficiencies. The rates of pituitary hormone deficiencies were 77% for growth hormone, followed by adrenocorticotropic hormone (73%), thyroid-stimulating hormone (27%) and gonadotropins (7%). Hyperprolactinemia was present in 13 (43%) patients. Conclusions: Radiation-induced hypopituitarism is more common than expected in patients with nasopharyngeal carcinoma.
