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Akboga M.K.,Ministry of Health Etimesgut State Hospital | Akyel A.,Diskapi Yildirim Beyazit Education and Research Hospital | Sahinarslan A.,Gazi University | Demirtas C.Y.,Gazi University | And 3 more authors.

Objective: Coronary collaterals play a crucial role during an acute ischemic attack. Angiogenesis has an important role in the formation of coronary collateral vessels. Previously, it was shown that apelin is a potential angiogenetic factor. Thus, we aimed to investigate relationship between plasma apelin levels and coronary collateral circulation in patients with stable coronary artery disease. Methods: Among patients who underwent coronary angiography with stable angina pectoris, patients with a stenosis of ≥90% were included in our study. Collateral degree was graded according to Rentrop-Cohen classification. Patients with grade 2 or 3 collateral degree were included in good collateral group and patients with grade 0 or 1 collateral degree were included in poor collateral group. Results: Plasma apelin level was significantly higher in good collateral group (0.69±0.2 vs 0.59±0.2ng/dl, p<0.001). Serum nitric oxide levels were similar between two groups. In multivariate regression analysis apelin [6.95 (1.46-33.15), p=0.015] and presence of total occlusion [4.40 (1.04-18.62), p=0.044] remained as independent predictors for good coronary collateral development. Conclusions: Higher plasma apelin level was related to better coronary collateral development. Demonstration of favorable affects of apelin on good collateral development may lead to consider apelin in antiischemic treatment strategies in order to increase collateral development. © 2014 Elsevier Ireland Ltd. Source

Civelek G.M.,Diskapi Yildirim Beyazit Education and Research Hospital | Pekyavas N.O.,Baskent University | Cetin N.,Baskent University | Cosar S.N.,Baskent University | Karatas M.,Baskent University

Aim The aim of this study was to analyze the effect of vitamin D deficiency on muscle strength and quality of life in postmenopausal women. Methods Self-sufficient, community-dwelling, postmenopausal women over 55 years old attending the Physical Medicine and Rehabilitation outpatient clinic were included in the study. 25-Hydroxyvitamin D levels below 20 ng/ml were accepted as indicative of vitamin D deficiency. A computerized isokinetic dynamometer (Cybex 770 Norm, Lumex Inc., Ronkonkoma, NY, USA) was used for testing knee extensor muscle strength. Results Forty-nine postmenopausal women with median age 64.3 years (interquartile range 59.0-69.5 years) were included in the study. Vitamin D deficiency was detected in 49% of the participants. There was no relation between vitamin D deficiency and knee muscle strength in both right and left legs. Vitamin D deficiency was found not to be associated with any of the domains of SF-36. Conclusions Vitamin D deficiency is not related to decreased muscle strength and lowered quality of life in postmenopausal women. Other factors rather than vitamin D deficiency should be investigated for illuminating the causalities of these two common clinical conditions. © 2014 International Menopause Society. Source

Gurer B.,Fatih Sultan Mehmet Education and Research Hospital | Kahveci R.,Ministry of Health | Gokce E.C.,Ankara University | Ozevren H.,Ministry of Health | And 2 more authors.
Spine Journal

Background context Epidural fibrosis is a major challenge in spine surgery, with some patients having recurrent symptoms secondary to excessive formation of scar tissue resulting in neurologic compression. One of the most important factors initiating the epidural fibrosis is assumed to be the transforming growth factor-1β (TGF-1β). Rosuvastatin (ROS) has shown to demonstrate preventive effects over fibrosis via inhibiting the TGF-1β. Purpose We hypothesized that ROS might have preventive effects over epidural fibrosis through the inhibition of TGF-1β pathways. Study design Experimental animal study. Methods Forty-eight adult male Wistar Albino rats were equally and randomly divided into four groups (laminectomy, spongostan, topical ROS, and systemic ROS). Laminectomy was performed at the L3 level in all rats. Four weeks later, the extent of epidural fibrosis was assessed both macroscopically and histopathologically. Results Our data revealed that topical application and systemic administration of ROS both were effective in reducing epidural fibrosis formation. Furthermore, the systemic administration of ROS yielded better results than topical application. Conclusions Both topical application and systemic administration of ROS show meaningful preventive effects over epidural fibrosis through multiple mechanisms. The results of our study provide the first experimental evidence of the preventive effects of ROS over epidural fibrosis. © 2015 Elsevier Inc. Source

Duru S.,Diskapi Yildirim Beyazit Education and Research Hospital | Bilgin E.,Dr. Ali Menekse Chest Diseases Hospital | Ardic S.,Diskapi Yildirim Beyazit Education and Research Hospital
Annals of Thoracic Medicine

Purpose: This study was designed to evaluate the levels of hepcidin in the serum of patients with chronic obstructive pulmonary disease (COPD). Methods: In the study, 74 male patients (ages 45-75) in a stable period for COPD were grouped as Group I: Mild COPD (n:25), Group II: Moderate COPD (n:24), and Group III: Severe COPD (n:25). Healthy non-smoker males were included in Group IV (n:35) as a control group. The differences of hepcidin level among all the groups were examined. Also, in the patient groups with COPD, hepcidin level was compared with age, body mass index, cigarette (package/year), blood parameters (iron, total iron binding capacity, ferritin, hemoglobin, hematocrit [hct]), respiratory function tests, and arterial blood gas results. Results: Although there was no difference between the healthy control group and the mild COPD patient group (P=0.781) in terms of hepcidin level, there was a difference between the moderate (P=0.004) and the severe COPD patient groups (P=0.002). The hepcidin level of the control group was found to be higher than the moderate and severe COPD patient groups. In the severe COPD patients, hepcidin level increased with the increase in serum iron (P=0.000), hct (P=0.009), ferritin levels (P=0.012), and arterial oxygen saturation (SaO 2, P=0.000). Conclusion: The serum hepcidin level that is decreased in severe COPD brings into mind that it may play a role in the mechanism to prevent hypoxemia. The results suggest that serum hepcidin level may be a useful marker in COPD. Larger prospective studies are needed to confirm our findings between hepcidin and COPD. Source

Gencler B.,Diskapi Yildirim Beyazit Education and Research Hospital | Gonul M.,Diskapi Yildirim Beyazit Education and Research Hospital
Dermatology Research and Practice

The incidence of melanoma has recently been increasing. BRAF mutations have been found in 40-60% of melanomas. The increased activity of BRAF V600E leads to the activation of downstream signaling through the mitogen-activated protein kinase (MAPK) pathway, which plays a key role as a regulator of cell growth, differentiation, and survival. The use of BRAF inhibitors in metastatic melanoma with BRAF mutation ensures clinical improvement of the disease. Vemurafenib and dabrafenib are two selective BRAF inhibitors approved by the Food and Drug Administration (FDA). Both drugs are well tolerated and successfully used in clinical practice. However, some adverse reactions have been reported in patients in the course of treatment. Cutaneous side effects are the most common adverse events among them with a broad spectrum. Both the case reports and several original clinical trials reported cutaneous reactions during the treatment with BRAF inhibitors. In this review, the common cutaneous side effects of BRAF inhibitors in the treatment of metastatic melanoma with BRAF V600E mutation were reviewed. © 2016 Bilgen Gençler and Müzeyyen Gönül. Source

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