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Dogan A.,Erciyes University | Yarlioglues M.,Erciyes University | Kaya M.G.,Erciyes University | Karadag Z.,Rize Training and Research Hospital | And 9 more authors.
Blood Pressure | Year: 2011

Objectives. Endothelial dysfunction is a well known risk factor for atherosclerosis. Uric acid levels are associated with endothelial dysfunction and atherosclerosis even if in physiological range. Xanthine oxidase inhibition with allopurinol decreases uric acid levels and oxidative stress and improves endothelial function. We have investigated the effect of high-dose and long-term allopurinol therapy on endothelial function in diabetic normotensive patients. Methods. This study is a randomized, single-blind, placebo-controlled trial. Both treatment and placebo groups consisted of 50 patients. In the treatment group, daily oral 900 mg allopurinol was started after randomization and maintained for 12 weeks. Brachial artery flow-mediated dilatation (FMD) and nitrate-induced dilatation (NID) were measured at baseline and after the allopurinol therapy to evaluate endothelial function. Results. HbA1c and uric acid levels decreased after allopurinol therapy (6.1 ± 2.1 vs 5.5 ± 1.0%, 5.0 ± 0.8 vs 3.3 ± 0.5 mg/dl, respectively, p = 0.01) but no change was observed in the placebo group (7.7 ± 1.9% vs 7.6 ± 2.0%, 5.3±2.1 vs 5.6 ± 0.8 mg/dl, respectively, p > 0.05). FMD and NID increased significantly in the treatment group (5.6 ± 2.1% vs 8.5 ± 1.2%, 10 ± 7.4% vs 14 ± 4.0%, 10 ± 7.4% vs 14 ± 4.0%, respectively, p = 0.01), whereas no change was observed in the placebo group (5.8 ± 1.8% vs 6.1 ± 0.8%, 12 ± 9.5 vs 10 ± 3.8%, respectively, p > 0.05). Conclusion. Long-term and high-dose allopurinol therapy significantly improved endothelial function in diabetic normotensive patients. In addition, allopurinol therapy contributes to the lower HbA1c levels. © 2011 Scandinavian Foundation for Cardiovascular Research. Source


Karahan S.C.,Karadeniz Technical University | Sit D.,Trabzon Fatih Public Hospital | Akdag I.,Rize Training and Research Hospital | Topal C.,Trabzon Training and Research Hospital | And 4 more authors.
Artificial Organs | Year: 2013

Hemodialysis (HD) adequacy requires monitoring in line with standards and at appropriate intervals. However, the use of inappropriate or incorrectly applied techniques in the determination of HD adequacy can lead to highly unfortunate results. This study was intended to identify the path to a solution by determining how far HD adequacy in HD centers in our region reflects reality. Three hundred and thirty HD patients from eight centers were included. On the first visit, predialysis and postdialysis blood collection with the centers' own methods being used were observed and errors were recorded. Kt/V1 was calculated from pre- and postdialysis blood specimens taken by the units themselves. On the second visit, one session later, pre- and postdialysis blood samples were collected in line with guidelines by ourselves, the authors, and Kt/V2 was calculated from these samples. The eight units' total Kt/V2 value was significantly lower compared with Kt/V1 (<0.0001). The level of patients in all centers with Kt/V1<1.2 was 13.5%, and that of patients with Kt/V2<1.2 was 22.1%. No center, apart from one unit, managed to complete the collection of blood specimens as recommended by the guidelines. With one exception, blood collection for HD adequacy was not performed using proper technique in any center. This simple but easily overlooked situation, HD being regarded as adequate though in fact it is not, may lead to patients not being treated effectively and accurately and to a rise in mortality and morbidity in the long term. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc. Source


Kurt E.E.,Rize Training and Research Hospital | Unsal Delialioglu S.,Ankara Physical Medicine and Rehabilitation Training and Research Hospital | Ozel S.,Ankara Physical Medicine and Rehabilitation Training and Research Hospital | Culha C.,Ankara Physical Medicine and Rehabilitation Training and Research Hospital
Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi | Year: 2013

Objective: Several scales had been developed to evaluate upper extremity function in patients with cerebral palsy (CP). One of these scales is the Manual Ability Classification System (MACS) which evaluates the manual ability of children with CP in daily activities. MACS aims to assess the level of the child's usual performance, not to classify best capacitiy. Likewise, the Bimanual Fine Motor Function (BFMF) scale determines both hand functions together. In this study, we aimed to determine the relationship between CP severity and hand functions in children with CP. Materials and Methods: We included a total of 87 children with CP patients hospitalized in our CP unit. Hand functions were assessed with the MACS and the BFMF scales, whereas the CP severity was evaluated with the Gross Motor Function Classification System (GMFCS). Results: The mean of age of the patients was 6.93±1.93 (4 to 13) years. 40 children (46.0%) were diplegic, 3 (3.4%) - hemiplegic, 9 (10.3%) - tetraplegic, 9 - (10.3) ataxic - 5 (5.7%) - dyskinetic and 21patients (24.1%) were with mixed-type CP. A positive strong correlation was found between the BFMF ile the MACS. The patients were divided into two groups: group 1 consisted of patients with diplegic, hemiplegic and mixed CP, while group 2 included ataxic, dyskinetic and mixed CP. In both groups, a positive correlation was found either between the GMFCS and the MACS or between the GMFCS and the BFMF scales The patients were divided into two groups: group 1 consisted of patients with diplegic, hemiplegic and mixed CP, while group 2 included ataxic, dyskinetic and mixed CP. In both groups, a positive correlation was found either between the GMFCS and the MACS or between the GMFCS and the BFMF scales. On the other hand, in group 2 both the correlation between GMFCS and MACS and the correlation between GMFCS and BFMF were found to be stronger than that of Group 1. Conclusion: Based on the results of this study, in assessing the manual functions of CP children, the MACS and the BFMF are compatible scales with each other and with GMFCS as well. © Turkish Journal of Physical Medicine and Rehabilitation, Published by Galenos Publishing. Source


Sacarcelik G.,Afsin State Hospital | Turkcan A.,Bakyrkoy Research and Training Hospital for Psychiatry | Guveli H.,Rize Training and Research Hospital | Yesilbas D.,Bakyrkoy Research and Training Hospital for Psychiatry
Dusunen Adam | Year: 2011

Object: In this study, the prevalence of deliberate self-harm behavior and its association with sociodemographic features in patients referred to secondary care psychiatric clinic of adolescents and young adults was researched. Methods: Overall 300 patients, who successively referred to the secondary care clinic for adolescents and young adults in Bakirköy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery throughout a month were evaluated by using a sociodemographic form, a deliberate self-harm and intent screening form, and those who were found to perform a deliberative self-harm, were assessed with a deliberative self-harm inventory. Results: The ratio of deliberate self-harm in all patients participated in the study was 50% (n=150). Behavior of deliberate self-harm was found to be 56.8% (n=129) in girls and 28.8% (n=21) in boys, and the difference was significant. The most frequent deliberate self-harm type was taking high dose pill (73.3%) in girls and body cutting in boys (66.7%). Discussion: In our study, in one of the two adolescents treated in psychiatry clinic, a deliberate self-harm behavior was observed and this was higher among girls than boys. Source


Turkyilmaz A.K.,Rize Training and Research Hospital | Kurt E.E.,Rize Training and Research Hospital | Capkin E.,Karadeniz Technical University | Karkucak M.,Karadeniz Technical University
Journal of Musculoskeletal Pain | Year: 2012

Objective To evaluate the widespread pain of patients with fibromyalgia syndrome [FMS] with neuropathic pain and to investigate the correlation between widespread pain and the functional status of patients.Methods The study comprised 173 female patients with FMS [mean age, 39.35±7.7 years; range: 2050 years]. The demographic data, widespread pain index [WPI], symptom severity scale [SSS], and complaint durations of the patients were recorded. Current pain intensity was determined using a visual analog scale for pain [VASp], functional status using the Fibromyalgia Impact Questionnaire [FIQ], and pain characteristics using the McGill Pain Questionnaire [MPQ]. Neuropathic and nociceptive pains were differentiated using Leeds Assessment of Neuropathic Symptoms and Signs [LANSS].Results The patients reported different types of neuropathic pain: knife-stabbing pain 20.8 percent, burning pain 19.7 percent, and stinging pain 16.8 percent. 52.6 percent of patients showed a LANSS score of ≥12, while 47.4 percent showed <12. The former reported knife-stabbing pain most frequently [22 percent], whereas the latter reported burning pain most frequently [26.8 percent]. The FIQ and VASp scores showed a significant correlation [r0.557, P<0.05]. In contrast, the correlation between the LANSS and VASp scores was poor but significant [r0.266, P<0.05] and that between the FIQ and LANSS scores was very poor, but significant [r0.175, P<0.05].Conclusion Patients with FMS had high LANSS scores and diffuse neuropathic pain complaints. Their functional status was associated with pain severity. Their assessment for neuropathic pain could guide in the explanation of FMS aetiopathogenesis and in clinical practice. © 2012 Informa Healthcare USA, Inc. Source

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