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Öğe Co-existing proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis with immunoglobulin A nephropathy(Korean Assoc Internal Medicine, 2016) Kucuk, Adem; Solak, Yalcin; Gaipov, Abduzhappar; Bagcaci, Sinan; Esen, Hasan; Turk, Suleyman; Tunc, Recep[Abstract Not Availabe]Öğe 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, AdemColchicine 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.Öğe Drug Dose Adjustment in Dialysis Patients Admitted in Clinics Other Than Internal Medicine(Lippincott Williams & Wilkins, 2016) Solak, Yalcin; Biyik, Zeynep; Gaipov, Abduzhappar; Kayrak, Mehmet; Ciray, Hilal; Cizmecioglu, Ahmet; Tonbul, Halil ZekiMany drugs that are administered during hospitalization are metabolized or excreted through kidneys, consequently require dosage adjustment. We aimed to investigate inappropriate prescription of drugs requiring renal dose adjustment (RDA) in various surgical and medical inpatient clinics. We retrospectively determined dialysis patients hospitalized between January 2007 and December 2010. Inpatient clinics, including cardiology, pulmonary medicine, neurology, infectious diseases (medical clinics) and cardiovascular surgery, orthopedics, general surgery, obstetrics and gynecology, and neurosurgery (surgical clinics), were screened via electronic database. Total and RDA medications were determined. RDA drugs correctly adjusted to creatinine clearance were labeled as RDA-A (appropriate), otherwise as RDA-I (inappropriate). Renal doses of RDA medications were based on the American College of Physicians Drug Prescribing in Renal Failure, fifth Edition. Two hundred seventeen hospitalization records of 172 dialysis patients (92 men and 80 women) were included in the analysis. Mean age of patients was 59.4 +/- 14.6 years, and the mean hospitalization duration was 8.5 +/- 7.8 days. In total, 247 (84.3%, percentage in drugs requiring dose adjustment) and 175 (46.2%) drugs have been inadequately dosed in surgical and medical clinics, respectively. The percentage of patients to whom at least 1 RDA-I drug was ordered was 92% and 91.4% for surgical and medical clinics, respectively (P > 0.05). Nephrology consultation numbers were 8 (7.1%) in surgical and 32 (30.4%) in medical clinics. The most common RDA-I drugs were aspirin and famotidine. A significant portion of RDA drugs was ordered inappropriately both in surgical and medical clinics. Nephrology consultation rate was very low. Measures to increase physician awareness are required to improve results.Öğe 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, Kursatwith 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.Öğe Epicardial Adipose Tissue and Atherosclerosis In Patients With Familial Mediterranean Fever(Wiley-Blackwell, 2013) Kucuk, Adem; Solak, Yalcin; Akilli, Hakan; Yildirim, Oguzhan; Guler, Ibrahim; Ucar, Ramazan; Aribas, Alpay[Abstract Not Availabe]Öğe 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, IlkerRapidly 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.Öğe Heparin-induced thrombocytopenia in a hemodialysis patient treated with fondaparinux: Nephrologists between two fires(Wiley-Blackwell, 2013) Solak, Yalcin; Demircioglu, Sinan; Polat, Ilker; Biyik, Zeynep; Gaipov, Abduzhappar; Acar, Kadir; Turk, SuleymanHeparin-induced thrombocytopenia (HIT) is caused by heparin exposure and presents with reduced platelet count. Patients undergoing hemodialysis (HD) treatment have increased risk of developing HIT due to prolonged exposure to unfractionated heparin or low-molecular weight heparin. We report a 79-year-old male patient with end-stage renal disease who developed type-II HIT during maintenance HD. Platelet count of the patient decreased gradually and antiplatelet factor IV antibody was found to be positive. The patient was treated with fondaparinux and continued heparin-free HD. Unfortunately, despite favorable initial response without any thrombotic episodes, the patient died due to severe sepsis complicated by gastrointestinal hemorrhage.Öğe Hypomagnesemia Among Outpatient Long-Term Proton Pump Inhibitor Users(Lippincott Williams & Wilkins, 2017) Biyik, Murat; Solak, Yalcin; Ucar, Ramazan; Cifci, Sami; Tekis, Dilek; Polat, Ilker; Goktepe, Mevluet HakanProton pump inhibitors (PPIs) are extensively prescribed drugs usually used for a long period. Recent reports linked PPI use with development of hypomagnesemia. However, there is still uncertainty regarding risk of hypomagnesemia in outpatients who were on long-term PPI use. Thus, we aimed to evaluate frequency of hypomagnesemia among a well-defined outpatient patient cohort with no other possible risk factors affecting serum magnesium levels. This was a case-control study carried out at the outpatient gastroenterology clinic of a University hospital. Patients who were on PPI therapy for at least 6 months without diuretic use and chronic kidney disease were included. Patients who were subjected to the same inclusion and exclusion criteria and not using PPI were included as control subjects. One hundred fifty-four patients and 84 control subjects were included. The mean duration of PPI use was 27.5 +/- 2.5 months. Mean serum magnesium levels of PPI users and nonusers were 2.17 +/- 0.20 mg/dL and 2.19 +/- 0.15 mg/dL, respectively. None of the patient had a serum magnesium level below laboratory lower range of 1.7 mg/dL. Our results showed that for typical gastroenterology outpatient clinic patients with no other risk factors affecting serum magnesium levels, long-term PPI use did not affect serum magnesium levels.Öğe IMPACT OF ON-PUMP CIRCULATION ON HEMOTOLOGIC PARAMETERS OF PATIENTS WITH ACUTE KIDNEY INJURY AFTER OPEN HEART SURGERY(Oxford Univ Press, 2015) Gaipov, Abduzhappar; Solak, Yalcin; Kilicaslan, Alper; Pektas, Fatih; Ucar, Ramazan; Dossov, Mukhit; Kayrak, Mehmet[Abstract Not Availabe]Öğe 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, NejdetInfluenza 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.Öğe IRRITABLE BOWEL SYNDROME PREVALENCE IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER(Carbone Editore, 2015) Kucuk, Adem; Biyik, Murat; Solak, Yalcin; Ucar, Ramazan; Polat, Ilker; Pektas, Fatih; Gungor, GokhanIntroduction: Patients with Familial Mediterranean Fever (FMF) and Irritable bowel syndrome (IBS) share some clinical features including abdominal pain, constipation and diarrhea. Furthermore, some patients with FMF do not have typical abdominal pain and fever attacks rather they have nonspecific symptoms. This makes the diagnosis of FMF harder and lead to a delay in starting the colchicine treatment. Both diseases lack specific diagnostic tests. We aimed to determine the prevalence of IBS in patients with established diagnosis of FMF. Materials and methods: FMF patients who had been diagnosed according to Tel-Hashomer criteria in Rheumatology clinic of a university hospital were included in the study between January 2011 and December 2011. 10 point IBS questionnaire according to Rome III criteria was used to determine the presence of IBS. Patients with recent FMF attack and abdominal pain from other reasons were excluded. Results: One-hundred and thirteen patients (67 females and 46 males) with an established diagnosis of FMF were included in the study. The mean duration of FMF was 6.4 +/- 6.7 years. IBS prevalence based on Roma III criteria was 40.7% (n=46). IBS prevalence was 30.4% (n=14) in male patients and 47.8 % (n=32) in female patients (p=0.06). In female patients IBS subtypes were as follows; IBS mixed type (IBS-M) 37% (n=12), IBS diarrhea predominant (IBS-D) 22% (n=7), IBS unsubtyped (MS-U) 22% (n=7), and IBS constipation predominant (IBS-C) 19% (n=6), whereas in male patients, IBS-M 57% (n=8), IBS-C 29% (n=4), IBS-D 7% (n=1) and IBS-U 7% (n=1). The most common subtype of IBS was IBS-M in both sexes. Conclusion: IBS is frequent in FMF patients when Rome HI criteria are used for diagnosis. The question to be answered is whether increased frequency or merely the failure of Rome III criteria to differentiate IBS in such patient groups with abdominal discomfort.Öğe MALNUTRITION, INFLAMMATION, AND ATHEROSCLEROSIS SYNDROME COMPONENTS PREDICTS POOR CARDIOVASCULAR OUTCOMES IN PATIENTS WITH STAGE 3-5 CHRONIC KIDNEY DISEASE(Oxford Univ Press, 2012) Solak, Yalcin; Yilmaz, Mahmut Ilker; Caglar, Kayser; Saglam, Mutlu; Yaman, Halil; Sonmez, Alper; Unal, Hilmi Umut[Abstract Not Availabe]Öğe Masked hypertension in renal transplant recipients(Taylor & Francis Ltd, 2014) Kayrak, Mehmet; Gul, Enes Elvin; Kaya, Coskun; Solak, Yalcin; Turkmen, Kultigin; Yazici, Raziye; Guney, IbrahimPurpose: Arterial hypertension is a risk factor affecting graft function in renal transplant recipients (RTRs). In pediatric RTRs, high prevalence of masked and nocturnal hypertension was reported. Most of the RTRs had a history of hypertension and some of them were normotensive at outpatient visits whereas home blood pressure (BP) levels were higher. Masked hypertension (MHT) is defined as a normal office BP but an elevated ambulatory BP. Previous reports have demonstrated the detrimental role of MHT in clinical outcomes in hypertensive patients. However, the true prevalence of MHT in RTRs is yet to be defined. Methods: A total of 113 RTRs (mean age 44 +/- 16 years, 72 males, 41 females) with normal office BP (< 140/90 mmHg) were enrolled to the study from the outpatient renal transplantation clinic. Ambulatory BP monitoring (ABPM) was performed in all participants for a 24-h period. Average daytime BP values above 135 mmHg systolic and 85 mmHg diastolic were defined as MHT. Results: The prevalence of MHT in our cohort was 39% (n = 45). Fasting glucose and C-reactive protein levels were higher in patients with MHT compared with normal BP group (p = 0.02 and p = 0.04, respectively). RTRs with deceased donor type had higher prevalence of MHT than RTRs with living donor (40% vs 19%, p = 0.003). In multivariate analysis, deceased donor type could predict the MHT independent of age, gender, office systolic BP level, diabetes mellitus, serum creatinine, C-reactive protein, and glucose levels (OR = 3.62, 95% CI 1.16-11.31, p = 0.03). Conclusion: We demonstrated an increased prevalence of MHT in a typical renal transplant cohort. In addition, transplantation from a deceased donor may be a predictor of MHT. The prevalence of MHT may help to explain high rate of cardiovascular events in RTRs. Therefore, routine application of ABPM in RTRs may be plausible, particularly in RTRs with deceased donor type.Öğe Neutrophil gelatinase-associated lipocalin in prediction of mortality in patients with hepatorenal syndrome: a prospective observational study(Wiley, 2014) Gungor, Gokhan; Ataseven, Huseyin; Demir, Ali; Solak, Yalcin; Gaipov, Abduzhappar; Biyik, Murat; Ozturk, BahadirBackground & AimsHepatorenal syndrome (HRS) is a severe complication of cirrhosis which is characterized by renal dysfunction and associated with poor survival. Neutrophil gelatinase-associated lipocalin (NGAL) is a troponin-like biomarker for human acute kidney injury. We aimed to investigate levels of plasma and urine NGAL in HRS and predictive ability of these markers for all-cause mortality, in HRS, stable cirrhosis and control subjects. MethodsA total of 64 patients with cirrhosis (8 patients with type 1 HRS, 22 with type 2 HRS, and 34 without HRS) and 23 control subjects were included in the study. Blood and urine samples were measured with Human NGAL sandwich ELISA. Patients were followed up prospectively. ResultsPatients with type 1 and type 2 HRS had significantly higher plasma and urine NGAL levels compared with stable cirrhosis and control subjects. Cox regression analysis showed that plasma NGAL and MELD-Na scores were independent predictors of mortality. ROC-curve analysis showed that the plot of the plasma NGAL, urine NGAL, MELD-Na and Child-Turcot-Pugh score could predict all-cause mortality in cirrhotic patients' area under the curve (AUC 0.819, 0.686, 0.807 and 0.795 respectively). ConclusionsNGAL could predict mortality in patients with HRS independent of other commonly used risk factors.Öğe Plasma BNP, a useful marker of fluid overload in hospitalized hemodialysis patients(Wiley-Blackwell, 2012) Solak, Yalcin; Gaipov, Abduzhappar[Abstract Not Availabe]Öğe PLATELET TO LYMPHOCYTE RATIO INDEPENDENTLY PREDICTS CARDIOVASCULAR EVENTS IN PATIENTS WITH CHRONIC KIDNEY DISEASE(Oxford Univ Press, 2012) Yilmaz, Mahmut Ilker; Solak, Yalcin; Saglam, Mutlu; Yaman, Halil; Unal, Hilmi Umut; Gok, Mahmut; Cetinkaya, Hakki[Abstract Not Availabe]Öğe Predictive Value of Increased Ankle-Brachial Index in Contrast Nephropathy Development Due to Coronary Angiography(Elsevier Science Inc, 2013) Yildirim, Serkan; Kayrak, Mehmet; Eris, Mehmet Doguscan; Akilli, Hakan; Solak, Yalcin; Sertdemir, Ahmet Lutfi[Abstract Not Availabe]Öğe 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, AdrianAim: 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.Öğe Prognostic Value of Neutrophil to Lymphocyte Ratio in Patients with Acute Pulmonary Embolism: A Restrospective Study(Elsevier Science Inc, 2014) Kayrak, Mehmet; Erdogan, Halil Ibrahim; Solak, Yalcin; Akll, Hakan; Gul, Enes Elvin; Yldrm, Oguzhan; Erer, MuratBackground Acute pulmonary embolism (PE) is a serious clinical condition characterised by a high mortality rate. Previous studies showed that leukocytosis was associated with recurrences of venous thromboemboli, major bleeding and increased mortality. The aim of the present study was to investigate the prognostic value of neutrophil to lymphocyte ratio (NLR) in patients with acute PE during short term follow-up. Method A total of 640 patients were screened by 126 code of ICD-9 and 359 patients were included as cases of confirmed acute PE. Admission blood counts and clinical data were obtained from medical charts. The predictors of 30-day mortality were examined. Results Fifty-one out of 359 patients (14.2%) included in the study died during 30 days follow-up. In multivariate Cox regression analysis systolic blood pressure (HR:0.97 (0.94-0.99 CI95%), p = 0.019), diabetes mellitus (HR:3.3 (1.30-8.39 CI95%), p = 0.012), CK-MB(HR:1.03 (1.01-1.06 CI95%), p = 0.024) and NLR (HR:1.03 (1.01-1.06 CI95%), p = 0.008) were predictors of 30-day mortality. An optimal cut-off value of NLR was determined as 9.2 by using ROC curve. Hazards ratio of NLR > 9.2 was found to be 3.60 (1.44-9.18 CI95%, p = 0.006). NLR > 9.2 had a sensitivity, specificity, negative predictive value, and positive predictive value of 68.6%, 80.5%, 93.9% and 36.5%, respectively. Conclusion NLR on hospital admission may be a predictor of 30-day mortality in acute PE. Since complete blood count is a part of the routine laboratory investigation in the most hospitalised patients use and preliminary promising results of this study, NLR should be investigated in future prospective randomised trials regarding prognostic value in acute PE.Öğe RED CELL DISTRIBUTION WIDTH INDEPENDENTLY PREDICTS CARDIOVASCULAR EVENTS IN PATIENTS WITH CHRONIC KIDNEY DISEASE(Oxford Univ Press, 2012) Solak, Yalcin; Yilmaz, Mahmut Ilker; Caglar, Kayser; Saglam, Mutlu; Yaman, Halil; Unal, Hilmi Umut; Gok, Mahmut[Abstract Not Availabe]