Istinye State Hospital

İstanbul, Turkey

Istinye State Hospital

İstanbul, Turkey
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Urganci N.,Sisli Etfal Training and Research Hospital | Kalyoncu D.,Sisli Etfal Training and Research Hospital | Kalyoncu D.,Istinye State Hospital
Minerva Pediatrica | Year: 2017

BACKGROUND: The aim of the study was to determine tuberculin skin test reactivity and associated factors in pediatric patients with celiac disease (CD). METHODS: Tuberculin skin test (TST) was performed on 28 patients with CD aged from 1 year to 15 years (mean, 6.64±4.8) and 28 healthy age and sex-matched children. The association between TST reactivity and parameters such as age, gender, malnutrition, clinical presentation, compliance to gluten free diet and response to hepatitis A and B vaccinations were determined. RESULTS: No difference was observed in TST reactivity (induration size) between the patients with CD and healthy controls. Thirty-two percent (9/28) of the patients were anergic, and one-third of these nine patients had malnutrition. No significant difference was observed between TST-positive and TST-negative patients in terms of age, gender, malnutrition, compliance to gluten-free diet and response to hepatitis A and B vaccinations (P>0.05). One of 11 patients with positive TST had tuberculosis disease and 10 had latent tuberculosis infection (LTBI), whereas none of the controls had LTBI or tuberculosis disease (P=0.0007). CONCLUSIONS: Although based on a small number of cases, it seems that children with CD are more susceptible to tuberculosis than healthy children. TST can be used to identify BCG-vaccinated children with CD who are probably infected with M. tuberculosis, similarly to healthy children. © 2015 Edizioni Minerva Medica.


Yalcn M.,Istanbul Science University | Tellioglu E.,Istinye State Hospital | Gunduz A.,Istanbul University | Ozmen M.,Istanbul University | And 3 more authors.
Neurophysiologie Clinique | Year: 2017

Objective Psychogenic nonepileptic seizures (PNES) are abrupt, paroxysmal changes in behavior or consciousness that may phenomenologically resemble epileptic seizures. Given the known association between anxiety and PNES, we hypothesized that in these subjects there may be evidence that the nervous system is hypersensitive to external stimuli. We aimed to test our hypothesis by means of the auditory startle reaction (ASR). By investigating ASR, we also had the opportunity to test presence of orienting reaction, which is generally defined as the second phase of response after the auditory stimulus, with longer latency. Methods We included 22 patients diagnosed as PNES and 25 age- and gender-matched healthy subjects. Clinical assessments and ASR recordings were performed. Electrophysiological findings were compared between patients with PNES and healthy subjects, including the presence of an orienting reaction. Orienting reaction was defined as a late response with latency between 100–1000 ms. Results The mean ages of patients with PNES and healthy subjects were 34.9 ± 12.3 years and 33.3 ± 10.9 years, respectively (P = 0.709). All patients were diagnosed as having conversion disorder. Additionally, 19 patients had depressive disorder and four had anxiety. The recruitment pattern of muscles and probability were similar between patients with PNES and healthy subjects. Orienting reaction was solely observed in patients with PNES (n = 13, 59.1% of the patients vs. no healthy subject). The sequence and contribution of muscles in the orienting reaction changed almost in all patients. The duration of these responses was long, sometimes more than 200 ms. Conclusion PNES is associated with orienting reaction. This provides a possible electrophysiological marker of altered nervous system function in patients with PNES and may also reflect the distorted emotional processing in these patients. © 2017 Elsevier Masson SAS


Kalyoncu D.,Sisli Etfal Training and Research Hospital | Kalyoncu D.,Istinye State Hospital
European Journal of Ophthalmology | Year: 2015

Purpose: To determine the prevalence of eye disorders in children with celiac disease (CD). Methods: A total of 67 patients with CD aged from 1 to 16 years and 38 age- and sex-matched healthy children were screened for decreased visual acuity, cataract, uveitis, and diabetic retinopathy at diagnosis and during follow‐up. Results: None of the patients had eye disorders at diagnosis. Only 2 of the patients had accommodative dysfunction and the others had no change in visual function during the follow-up. One of the controls had accommodative dysfunction. Conclusions: No significant association was found between CD and eye disorders such as visual acuity, cataract, and uveitis among children. © 2015 The Authors.


PubMed | Istinye State Hospital, Erzincan University, Erzurum Region Education and Research Hospital, Family Physician and 3 more.
Type: | Journal: Life sciences | Year: 2015

This study investigates the effect of a new combination of glucosamine hydrochloride, chondroitin sulfate, methylsulfonylmethane, Harpagophytum procumbens root extract (standardized to 3% harpagoside) and bromelain extract (GCMHB) on formalin-induced damage to cartilage tissue in the rat knee joint and evaluates this combination in comparison with another combination of glucosamine hydrochloride, chondroitin sulfate and methylsulfonylmethane (GKM).Animals in the control group were injected with formalin into the knee joint (FCG). Animals in the GCMHB-500 group were given 500mg/kg GCMHB+formalin, and those in the GKM-500 group were given 500mg/kg GKM+formalin. Finally, a healthy group (HG) was also used. GCMHB and GKM were administered to rats orally once a day for 30days. At the end of this period, the rats were sacrificed and the levels of MDA, NO, 8-OH/Gua, and tGSH in the knee joint tissue were measured. Analysis of IL-1 and TNF- gene expression was done and the tissue was evaluated histopathologically.MDA, NO and 8-OH/Gua levels and IL-1 and TNF- gene expression were significantly lower in the GCMHB-500 group compared to the FCG group, whereas tGSH was significantly higher in the GCMHB-500 group than in the FCG group. No significant difference was found for the IL-1, TNF- and oxidant/antioxidant parameters between the GKM and FCG groups. The histopathological analysis showed that GCMHB could prevent damage to the cartilage joint, whereas GKM could not.GCMHB may be used clinically by comparing with GKM in the treatment of osteoarthritis.


PubMed | Istinye State Hospital, Cerrahpasa Medical Faculty and Bakrkoy Dr Sadi Konuk Education and Research Hospital
Type: Journal Article | Journal: Angiology | Year: 2016

We compared Turkish patients with cardiac syndrome X (CSX) and controls with respect to serum pro- and anti-inflammatory cytokine levels, as well as the single-nucleotide polymorphisms located in the promoter regions of their related genes. This study included 111 consecutive patients angiographically diagnosed with CSX and 111 healthy controls with similar demographic characteristics. Serum interleukin (IL) 6, tumor necrosis factor (TNF-), and IL-10 levels were measured, and the genotypes of the patients and controls were determined using standard methods. Serum IL-6 and IL-10 levels were significantly higher in the CSX group than in the control group (P < .01, respectively). Serum TNF- level was lower in the CSX group than in the control group (P < .001). On the other hand, participants with CSX and healthy controls were not significantly different with respect to the genotype distributions of IL-6, TNF-, and IL-10 genes. As a result of our study, both pro-inflammatory and anti-inflammatory cytokines may play a role in the pathogenesis of CSX. In contrast, the studied gene polymorphisms did not influence CSX pathogenesis.


PubMed | Istinye State Hospital, Trakya University Medical Faculty, Bezmialem Foundation University, Dicle University and Kilis State Hospital
Type: | Journal: BioMed research international | Year: 2015

Obesity has a significant effect on the cephalic spread of a spinal block (SB) due to a reduction in cerebrospinal fluid (CSF). SB is controlled by the tissue blood flow in addition to the CSF. Some positions and techniques of surgery used can cause changes in hemodynamics. We investigated effects of hemodynamic changes that may occur during Transurethral prostate resection (TUR-P) and lithotomy position (LP) at the SB level in obese versus nonobese individuals. Sixty patients who had undergone TUR-P operation under spinal anesthesia were divided into a nonobese (BMI < 25kg/m(2), Group N) or obese (BMI 30kg/m(2), Group O) group. SB assessments were recorded afterthe LP. SB at 6 and 120min and the peak SB level were compared between two groups. Hemodynamics were recorded after LP. Peak and 6 min SB levels were similar between the groups, while 120min SB levels were significantly higher for Group O (P < 0.05). Blood pressure (BP) after the LP was significantly higher for Group N (P < 0.05). LP and TUR-P increased the BP in Group N when compared to Group O. The increase in hemodynamics enhances the blood flow in the spinal cord and may form similar SB levels in nonobese patients to those in obese patients. However, SB time may be longer in obese patients.


Sahin I.,Bagcilar Research and Education Hospital | Gungor B.,Siyami Ersek Cardiovascular and Thoracic Surgery Center | Can M.M.,Bagcilar Research and Education Hospital | Avci I.I.,Bagcilar Research and Education Hospital | And 7 more authors.
Canadian Journal of Cardiology | Year: 2014

Background: Vitamin D deficiency may be associated with an increased risk of renovascular disease. We assessed the correlation between vitamin D levels and contrast-induced nephropathy (CIN) in patients undergoing coronary angiography (CAG). Methods: Vitamin D and parathyroid hormone (PTH) levels were assessed before CAG in 403 patients. Estimated glomerular filtration rate (eGFR) was calculated using the Cockcroft-Gault equation. Patients with eGFR < 60 mL/min/1.73 m2 were hydrated with 0.9%-saline at 1 mL/kg/h for 12 hours before and after CAG. CIN was defined as serum creatinine increase of > 0.5 mg/dL or > 25% within 48-72 hours after CAG. Results: CIN developed in 74 participants. Baseline eGFR, blood urea and creatinine in CIN (+) and (-) groups were not significantly different (P= 0.14, P= 0.07, and P= 0.61, respectively). Total volume of contrast medium (CM) was higher in the CIN (+) group (132 ± 64 mL vs 90 ± 41 mL; P= 0.01). Vitamin D levels were lower (median 8.5 [range, 0.5-26.6] ng/mL vs 14.9 [range, 1.9-93.5] ng/mL; P= 0.01) and PTH levels were higher (median 73.9 [range, 22-530] pg/mL vs 44.2 [range, 5-361] pg/mL; P= 0.01) in the CIN (+) group. Multivariate logistic regression analysis revealed that lower vitamin D levels (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.11-1.26; P=0.01) and increased CM volume (OR, 1.01; 95% CI, 1.008-1.017; P=0.01) were independently correlated with CIN. In patients who had undergone percutaneous coronary intervention, lower levels of vitamin D were independently associated with CIN development. Conclusions: Lower vitamin D levels, implying possible vitamin D deficiency, are associated with a higher incidence of CIN. © 2014 Canadian Cardiovascular Society.


Urganci N.,Sisli Etfal Training and Research Hospital | Kalyoncu D.,Sisli Etfal Training and Research Hospital | Kalyoncu D.,Istinye State Hospital | Calis A.B.,Sisli Etfal Training and Research Hospital
European Archives of Oto-Rhino-Laryngology | Year: 2015

Sensorineural hearing loss (SNHL) as an extraintestinal manifestation of celiac disease (CD) has been reported in several studies. The aim of this study was to determine presence of subclinical sensorineural hearing loss associated with CD in pediatric patients. Otoscopy, tympanometry and pure tone audiometry were performed in 44 patients with CD and 20 healthy age and sex-matched controls. Pure tone audiometry did not show significant sensorineural hearing loss over all frequencies in patients with CD compared with controls (P > 0.05). SNHL was detected in only three (6.8 %) patients with CD. In conclusion, subclinical sensorineural hearing loss was demonstrated in adult patients with CD; therefore, we recommend to perform audiometric examinations in pediatric patients for recognizing hearing loss early during the course of the disease. © 2014, Springer-Verlag Berlin Heidelberg.


PubMed | Istinye State Hospital, Okmeydani Training and Research Hospital and Erzurum Region Training and Research Hospital
Type: | Journal: Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences | Year: 2016

Carcinomas of the thyroid follicular epithelium are the most common cancers of the endocrine system. In the diagnosis of thyroid nodules and tumors, the gold standard is histological evaluation. In cases which have morphological overlap, immunohistochemistry is needed for differential diagnosis. The purpose of this study is to investigate the expressions of CD56, HBME-1, cytokeratin 19 (CK19) antibodies in papillary thyroid carcinoma (PTC) and thyroid nodular lesions and their contributions to differential diagnosis.In this study, 47 PTCs (26 follicular variant, 21 classic type) and 26 benign thyroid lesions (15 nodular hyperplasia, 10 follicular adenomas, 1 Hurtle cell adenoma) were analyzed retrospectively. HBME-1, CK19, and CD56 antibodies were performed with immunohistochemical methods. The results were evaluated statistically.+3 staining with HBME-1 and CK19 was observed in 72.3% and 83% of patients with PTC. In 95.7% of PTC cases, loss of CD56 expressions in various degrees was identified. A statistically significant difference was detected in HBME-1, CK19, and CD56 expressions between PTCs and benign lesions (In our study, positive staining of HBME-1, CK19, and loosing expression of CD56 that supports malignancy was found and concluded that CD56 is a helpful antibody for the differential diagnosis of benign and malignant lesions and may increase the diagnostic accuracy when used with HBME-1 and CK19.


PubMed | Istinye State Hospital
Type: Journal Article | Journal: Experimental animals | Year: 2016

Intestinal mucositis is one of the major problems in the patients receiving cancer treatment. Nimesulide is a drug with antioxidant, antiinflammatory and antiulcer features. We aimed to investigate the effect of nimesulide on the small intestine mucositis induced by methotrexate (MTX) in rats. Experimental animals were divided into the control group, MTX group (MTXG) and nimesulide+MTX administered group (NMTXG) with eight rats per group. The control and MTXG groups were given distilled water by gavage and the NMTXG was given nimesulide 100 mg/kg orally. After one hour, the NMTXG and MTXG rat groups were administered oral MTX 5 mg/kg. This procedure was repeated once a day for 15 days and the rats were sacrificed. The duodenum and jejunum of each rat was removed for the assessment of biochemical markers and histopathological evaluation. Malondialdehyde (MDA) and myeloperoxidase (MPO) levels were significantly higher in the duodenal and jejunal tissues of the animals which received MTX, compared to the control and NMTXG (P<0.001). Also, the levels of total glutathione (tGSH), glutathione reductase (GSHRd), glutathione peroxidase (GSHPx), catalase (CAT) and superoxide dismutase (SOD) were significantly lower in the MTXG (P<0.001) compared to other groups. MTX led to villus and crypt epithelial damage and inflammation containing marked PMNL and eosinophils in the intestinal tissues histopathologically. Whereas, there was only mild irregularities in the villus structures of the NMTXG. Nimesulide protected the small intestines against damage by MTX. Intestinal mucositis caused by MTX may be preventable by co-administered nimesulide.

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