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İstanbul, Turkey

Belen E.,Okmeydani Training and Research Hospital | Canbolat I.P.,Kagithane State Hospital | Bayyigit A.,Okmeydani Training and Research Hospital | Helvaci A.,Okmeydani Training and Research Hospital | And 2 more authors.
Blood Coagulation and Fibrinolysis | Year: 2015

After long years of using warfarin for atrial fibrillation, new oral anticoagulants (NOACs) became available for decreasing the risk of ischemic stroke. Our aim was to observe the physicians prescribing patterns of NOACs. This prospective observational study included patients using NOACs applying consecutively to our outpatient clinic. Physical examination was performed, and patient history, electrocardiogram, transthoracic echocardiography, and biochemical results were collected. Bleeding and ischemic stroke risk scores (HAS-BLED and CHA 2 DS 2-VASc scores) were calculated. We evaluated patients' characteristics, risk factors, concomitant drug usage, and physicians' choices. The study consisted of 174 patients using NOACs (dabigatran 113 patients, rivaroxaban 61 patients), with a mean age of 70.7 ± 8.8 years. The mean HAS-BLED score was 1.74 ± 0.9 and the mean CHA 2 DS 2-VASc score was 3.7 ± 1.2. Fifty-three (30.4%) patients were prescribed low-dose NOAC according to the optimal dose, and 12 (6.8%) patients were prescribed high-dose NOAC according to the optimal dose. We compared optimal dose and undertreatment groups to find out if there was any predicting factor for physicians to use low dose of NOACs, but there was no significant difference between the two groups for age, sex, concomitant chronic disease, and CHA 2 DS 2-VASc and HAS-BLED scores. NOACs were prescribed to patients mostly with high CHA 2 DS 2-VASc score and low HAS-BLED score. Low-dose NOAC usage according to the optimal dose was frequent. Frequent coagulation monitoring and drug incompliance are big deficiencies at atrial fibrillation in use of warfarin. NOACs overcome these difficulties; however, physicians' hesitation to use NOACs with the optimal dosage may be another limitation in real-world practice. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Inal B.B.,Istanbul Education and Research Hospital | Oguz O.,Kagithane State Hospital | Emre T.,Istanbul Education and Research Hospital | Usta M.,Giresun University | And 3 more authors.
Clinical Laboratory | Year: 2014

Background: The aim of this study was to compare the use of the ideal weight with the use of the patient's actual weight in the C-G (Cockcroft-Gault) formula for the measurement of the GFR (Glomerular Filtration Rate). We also aimed to compare the results of the calculations explained above with the results of the MDRD (Modification of Diet in Renal Disease) formula and CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) results of the classical 24-hour creatinine clearance method.Methods: Creatinine clearance values, which were obtained from 24-hour urine collection, were compared with the values from the C-G formula in which each patient's ideal weight was used, with the values from the C-G formula in which each patient's actual body weight was used, and with the MDRD Formula and CKD-EPI. Results: The correlation analysis between 24-hour creatinine clearance and the GFR obtained from the C-G formula with adjusted ideal weight in the Control group, Group I (patients with diabetes mellitus) and Group II resulted in values of r = 0.526,0.S76, and 0.850 (p < 0.0001), respectively. The correlation analysis between 24-hour creatinine clearance and the MDRD formula among the same groups resulted in r = 0.814, 0.682, and 0.861 (p < 0.0001), respectively. The correlation analysis between creatinine clearance and the CKD-EPI formula among the same groups resulted in r = 0.821,0.679, and 0.871 (p < 0.0001), respectively.Conclusions: The results of the CKD-EPI formula were the most compatible with the results of 24-hour urine creatinine clearance which is used in clinical practice, especially in the control and diabetic group.


Cikrikcioglu M.A.,Bezmialem Foundation University | Halac G.,Kagithane State Hospital | Hursitoglu M.,Sisli Etfal Training and Research Hospital | Erkal H.,Private Yesiltepe Clinic | And 6 more authors.
Acta Neurologica Belgica | Year: 2011

The prevalence of restless legs syndrome (RLS) is increased in gluten sensitive enteropathy (GSE); but prevalence of GSE is not known in RLS. 96 RLS patients and 97 healthy controls, both with or without iron deficiency were enrolled. All secondary RLS patients except iron deficiency were excluded. Subjects underwent a thorough biochemistry and routine blood analyses, and tissue transglutaminase antibodies (TTGA), endomysium antibodies (EMA) and gliadin antibodies (AGA) were also tested. In RLS patients positivity rates of all GSE anti - bodies were similar to those in controls. The rate of iron deficiency anaemia in RLS patients with at least one positive GSE antibody was significantly higher than that of RLS patients whose GSE antibodies were all negative. The prevalence of GSE antibodies in RLS patients is not increased. GSE might have a role in the aetiology of RLS in association with iron deficiency anaemia. Since the prevalence of GSE antibodies is not increased in RLS, it seems unlikely that GSE is involved in the aetiology of RLS through different mechanisms (e.g. immunological mechanisms) other than iron deficiency as proposed in some published papers.


Oguz O.,Kagithane State Hospital | Inal B.B.,Kagithane State Hospital | Emre T.,Istanbul Education and Research Hospital | Ozcan O.,Corum State Hospital | And 4 more authors.
Clinical Laboratory | Year: 2014

Background: Advanced oxidation protein product (AOPP) was first described as an oxidative protein marker in chronic uremic patients and measured with a semi-automatic end-point method. Subsequently, the kinetic method was introduced for AOPP assay. We aimed to compare these two methods by adapting them to a chemistry analyzer and to investigate the correlation between AOPP and fibrinogen, the key molecule responsible for human plasma AOPP reactivity, microalbumin, and HbA1c in patients with type II diabetes mellitus (DM II). The effects of EDTA and citrate-anticogulated tubes on these two methods were incorporated into the study. Methods: This study included 93 DM II patients (36 women, 57 men) with HbA1c levels ≥7%, who were admitted to the diabetes and nephrology clinics. The samples were collected in EDTA and in citrate-anticoagulated tubes. Both methods were adapted to a chemistry analyzer and the samples were studied in parallel. Results: In both types of samples, we found a moderate correlation between the kinetic and the endpoint methods (r = 0.611 for citrate-anticoagulated, r = 0.636 for EDTA-anticoagulated, p = 0.0001 for both). We found a moderate correlation between fibrinogen-AOPP and microalbumin-AOPP levels only in the kinetic method (r = 0.644 and 0.520 for citrate-anticoagulated; r = 0.581 and 0.490 for EDTA-anticoagulated, p = 0.0001). Conclusions: We conclude that adaptation of the end-point method to automation is more difficult and it has higher between-run CV% while application of the kinetic method is easier and it may be used in oxidative stress studies.


Arslan G.,Selahattin Cizrelioglu State Hospital Emek Caddesi | Gemici A.A.,Kagithane State Hospital | Yirgin I.K.,Bakirkoy Dr Sadi Konuk Training Research Hospital | Gulsen E.,Van Ipekyolu State Hospital | Inci E.,Bakirkoy Dr Sadi Konuk Training Research Hospital
Emergency Radiology | Year: 2013

Among solid organ blunt traumas, the liver and spleen are mostly subject to injury. In addition, the liver is also commonly injured in penetrating traumas because of its size, location, and the ease of injury to the "Glisson Capsule". Several enzymes are known to be elevated following trauma. In our study, we evaluated the correlation between the levels of serum aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and gamma-glutamyl transpeptidase in 57 patients with blunt trauma to the liver and compared these values to the American Association for the Surgery of Trauma trauma grading system. Additionally, we compared the enzyme level elevations in these patients to the enzyme levels of 29 healthy subjects. As expected, we found significant elevations in enzyme levels of trauma patients compared to the control group. The calculated point estimates were not significantly different between grades 1 and 2 trauma. However, grade 3 trauma group showed a significant increase in enzyme levels. © 2013 Am Soc Emergency Radiol.

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