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Borazan A.,Mustafa Kemal University | Binici D.N.,Erzurum Education and Research Hospital
Renal Failure | Year: 2010

Objective. The prevalence and risk factors of cardiovascular disease (CVD) are increasing in end stage renal disease (ESRD) patients. In this study, we sought to research the relationship between the insulin resistance, which is one of the risk factors for CVD, and the inflammation markers, especially C-reactive protein, fibrinogen, uric acid, and homocysteine levels in our patients who were recently diagnosed with ESRD and started hemodialysis. Materials and methods. 64 HOMA-IR-positive and 114 HOMA-IR-negative patients were enrolled in this study. Blood samples were obtained from the patients for fasting plasma glucose, insulin, CRP, fibrinogen, uric acid, total homocysteine, urea, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, total protein, and albumin analysis after physical examinations and anamnesis were completed. Results. Fibrinogen and CRP levels of HOMA-IR-positive HD patients were significantly increased compared to non-insulin resistants. Furthermore, there is significant positive relationship between insulin resistance and serum CRP and fibrinogen levels in these HOMA-IR-positive HD patients (r 0.258, p < 0.001). Conclusion. We found out that the fibrinogen and CRP levels are significantly high in HOMA-IR positive HD patients, according to determine the risk ratio for coronary artery disease in HD patients, and think that an assessment of insulin resistance is necessary. © Informa UK, Ltd.


Binici D.N.,Erzurum Education and Research Hospital | Gunes N.,Kafkas University
Renal Failure | Year: 2010

Although metabolic syndrome (MS) is associated with low bone mineral density (BMD) in the general population, it is unknown whether similar associations exist in patients with chronic kidney disease. We investigated risk factors that can lead to low BMD values in hemodialysis patients with MS according to the diagnostic criteria set by International Diabetes Federation (IDF) in this study. A total of 64 patients with MS undergoing hemodialysis and 60 hemodialysis patients who were matched in terms of age, gender, and hemodialysis duration without MS were enrolled in the study. BMD was measured at lumbar vertebra (LV) and femur neck (FN) by performing dual-energy X-ray absorptiometry (DEXA). LV andor FN-BMD results revealed that, of the hemodialysis patients with MS, 45% had osteoporosis and 48% had osteopenia. On the other hand, of the hemodialysis patients without MS, 42% had osteoporosis and 52% had osteopenia. Low BMD values were observed to be correlated negatively with age, hemodialysis period, and parathormone (PTH) both in the group with MS and in the group without MS. Height, weight, BMI, calcium, phosphorus, alkaline phosphatase, heparin, and vitamin D therapy and urea reduction ratio were not established to be correlated with BMD. © 2010 Informa UK Ltd.


Fidan V.,Erzurum Education and Research Hospital | Aksakal E.,Ataturk University
Journal of Craniofacial Surgery | Year: 2011

AIM: The nasal septal deviation (NSD) increases upper airway obstruction. This study aimed to measure the mean pulmonary arterial pressure (mPAP) of the patients with markedly deviated nasal septum and to determine the effect of septoplasty on the pulmonary arterial pressure. METHODS: Fifty-one patients with NSD (mean age, 37.1 [SD, 8.6] years; 27 men and 24 women) were included in the study. Thirty-five of the patients (22 men, 13 women) aged between 21 and 55 years (mean, 35.1 [SD, 8.9] years) comprised the control group. Mean pulmonary arterial pressure was measured in the preoperative period and postoperative third month. RESULTS: The mean preoperative mPAP value (25.4 [SD, 5.3]) of the study group was statistically significantly higher than that of the control group (20.5 [SD, 2.8]) (P = 0.000). There was a significant decrease in mPAP after the operation (20.6 [SD, 3.8]) (P = 0.000). Twenty-two of 51 patients had pulmonary arterial hypertension. CONCLUSION: Markedly deviated nasal septum significantly affected mPAP. Septoplasty was efficient in the treatment of patients with NSD. Copyright © 2011 Mutaz B. Habal, MD.


Bilen E.,Ataturk Education and Research Hospital | Akcay M.,Ataturk Education and Research Hospital | Bayram N.A.,Ataturk Education and Research Hospital | Kocak U.,Ataturk Education and Research Hospital | And 3 more authors.
Journal of Heart Valve Disease | Year: 2012

Background and aim of the study: Bicuspid aortic valve (BAV) is one of the most common congenital heart defects. BAV disease is not only a disorder of valvulogenesis, but also represents a genetic disorder of aorta and cardiac development. Recent studies have shown that BAV is associated with abnormal aortic elasticity, and that a reduced distensibility of the aortic root may have a negative impact on left ventricular function. Hence, the study aim was to investigate left ventricular diastolic function and its relationship to aortic elasticity in this patient group. Methods: Thirty-nine patients with isolated BAV with a normal left ventricular ejection fraction, and 29 age- and gender-matched healthy (control) subjects, were studied prospectively. In none of the patients with BAV was the aortic velocity >2m/s, and no aortic regurgitation (other than mild) was present. Parameters of aortic elasticity (aortic strain, distensibility index, stiffness index and elastic modulus), left ventricular diastolic parameters (E, A, E/a, deceleration time, E′, ratio of E/E′, left atrial volume index) and valvulo-arterial impedance were calculated in all patients. Results: Aortic strain and distensibility were lower, and aortic stiffness index and aortic modulus higher, in patients with BAV than in controls. Compared to controls, the E/E′ ratio and left atrial volume index were significantly higher in BAV patients (E/E′ ratio 8.26 ± 2.56 versus 6.85 ± 1.45, p = 0.01; left atrium volume index 24.23 ± 5.78 versus 21.68 ± 4.11 ml/m2, p = 0.04). However, no significant correlations were identified between the aortic elasticity parameters, valvulo-arterial impedance, and left ventricular diastolic parameters. Conclusion: These findings indicated that BAV is associated with an increased left atrial volume and a decreased E/E′ ratio. In addition, these parameters did not correlate with any parameters of aortic elasticity, nor valvulo-arterial impedance. These data suggest that BAV disease might have subclinical cardiac dysfunction, and further studies are required to confirm these findings and any causal relationship. © Copyright by ICR Publishers 2012.


Binici D.N.,Erzurum Education and Research Hospital | Gunes N.,Kafkas University | Kayatas K.,Haydarpasa Education and Research Hospital | Piskinpasa N.,Uskudar Government Hospital
European Journal of Inflammation | Year: 2011

Peritonitis is an important cause of the mortality and morbidity of peritoneal dialysis patients. The present study aims to investigate the effects of ynterferon (IFN)-α2b on intestinal flora in peritoneal fibrosis. Twenty-four Wistar albino rats were divided into three groups. The control group received 0.9% saline (3 ml/d) intraperitoneally; the chlorhexidine gluconate (CH) group received 3 ml daily injections of 0.1% CH intraperitoneally; the CH+IFN group received 3 ml daily injections of 0.1% CH intraperitoneally and pegylated IFN-α2b 1.5 μg/kg per week subcutaneously on days 0, 7, 14. On the twenty-first day rats were sacrificed and visserai peritoneum samples were obtained from the liver. Blood samples were obtained from the abdominal aorta and intestinal flora samples were obtained from distal small intestine and transverse colon. Histopathologic control of CH, CH+IFN groups peritoneal thickness were 6.04±2.32, 135.4±22.24, and 42.56±11.6 μm, respectively. The decrease in thickness of parietal peritoneum in the CH+IFN group was statistically significant when compared to the CH group. Escherechia coli (E. Coli) had grown in cultures of the small intestine and colon samples of all the rats in the control group, whereas Proteus species (spp) had grown in one and Enterobacter spp. in seven cultures of the CH group. E. Coli had grown in four cultures, Proteus spp in three culture and Enterobacter spp. in one culture obtained from small intestine and transverse colon of the control group. The intestinal flora changed as the peritoneal thickness increased. The intestinal flora in the CH group completely changed compared with the control group (p<0.001). There was no correlation between visceral peritoneal thickness and intestinal flora change in the IFN group (p>0.05). IFN-α2b recovers the intestinal flora and the intestinal motility, thus reducing the experimental peritoneal fibrosis. Copyright © by BIOLIFE, s.a.s.

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