Aysen Akalin

Cardiovascular risk assessment in patients with type 2 diabetes mellitus and metabolic syndrome: role of biomarkers.

OBJECTIVES Metabolic syndrome (MetS) and type 2 diabetes mellitus (DM) are associated with a high incidence of cardiovascular diseases. The aim of this study was to determine paraoxonase (PON), total sialic acid (TSA), and nitric oxide (NO) levels in addition to conventional risk markers in patients with DM, MetS and DM plus MetS. MATERIAL AND METHODS The study has been carried out over 78 subjects which divided into four groups; control (n=18), DM (n=20), newly diagnosed MetS (n=20) and DM plus MetS patient groups (n=20). RESULTS Both insulin and triglyceride concentrations were significantly higher in DM+MetS group than in control and DM groups and serum HDL-C concentrations were significantly lower in DM+MetS group than other groups. Patients with MetS had higher LDL-C, total cholesterol and hsCRP concentrations than in the other groups. Interestingly, in addition to body mass index and waist circumference values, LDL-C, total cholesterol and hsCRP concentrations were decreased in patients who have both DM and MetS. Serum NO and TSA levels were higher in MetS and DM+MetS groups compared to control subjects. Unexpectedly, PON activity has been found lower in control group when compared to other groups. CONCLUSIONS Although there is no doubt that association of DM and MetS elevates the risk of cardiovascular disease, occurrence of DM in patients with undiagnosed MetS might be encouraging patients to change their life styles and dietary habits.

Effect of teriparatide treatment on endothelial function, glucose metabolism and inflammation markers in patients with postmenopausal osteoporosis

Teriparatide, an anabolic agent used in the treatment of postmenopausal osteoporosis, can induce effects similar to primary hyperparathyroidism. Our objective was to evaluate the effects of teriparatide on endothelial functions, glucose metabolism and inflammation markers in patients diagnosed with postmenopausal osteoporosis.

Investigation on Carbohydrate Counting Method in Type 1 Diabetic Patients

Objective. The results from Diabetes Control and Complications Trial (DCCT) have propounded the importance of the approach of treatment by medical nutrition when treating diabetes mellitus (DM). During this study, we tried to inquire carbohydrate (Kh) count methods positive effects on the type 1 DM treatments success as well as on the life quality of the patients. Methods. 22 of 37 type 1 DM patients who applied to Eskişehir Osmangazi University, Faculty of Medicine Hospital, Department of Endocrinology and Metabolism, had been treated by Kh count method and 15 of them are treated by multiple dosage intensive insulin treatment with applying standard diabetic diet as a control group and both of groups were under close follow-up for 6 months. Required approval was taken from the Ethical Committee of Eskişehir Osmangazi University, Medical Faculty, as well as informed consent from the patients. The body weight of patients who are treated by carbohydrate count method and multiple dosage intensive insulin treatment during the study beginning and after 6-month term, body mass index, and body compositions are analyzed. A short life quality and medical research survey applied. At statistical analysis, t-test, chi-squared test, and Mann-Whitney U test were used. Results. There had been no significant change determined at glycemic control indicators between the Kh counting group and the standard diabetic diet and multiple dosage insulin treatment group in our study. Conclusion. As a result, Kh counting method which offers a flexible nutrition plan to diabetic individuals is a functional method.

Chronic alcohol consumption augments loss of sialic acid residues and alters erythrocyte membrane charge in type II diabetic patients.

In this study, the effects of alcohol consumption on erythrocyte membrane properties in type 2 diabetic patients were investigated. Therefore, we measured total and lipid‐bound sialic acid (LSA) levels, sialidase activities, and erythrocyte membrane negative charge. Three groups, including control group (n = 20), alcohol‐consuming diabetic patients group (n = 14), and diabetic patients without alcohol consumption group (n = 42), were created. Plasma total sialic acid (TSA) levels of the alcohol‐consuming diabetic group were elevated as compared to the healthy control and diabetic group (p < 0.001 and p < 0.01, respectively). TSA levels of the diabetic group were significantly elevated as compared to the healthy control group (p > 0.001). Plasma LSA levels of the alcohol‐consuming diabetic group were higher than that in the healthy control and diabetic group (p < 0.05 and p < 0.05, respectively). LSA levels of the diabetic group were found to be high as compared to the healthy control group (p < 0.05). Plasma sialidase activities of the alcohol‐consuming diabetic group and diabetic group were significantly elevated as compared to the healthy control group (p < 0.05 and p < 0.05, respectively). Sialidase activities of the alcohol‐consuming diabetic group were elevated as compared to the diabetic group, but this was not statistically significant (p > 0.05). Erythrocyte membrane negativity levels of the alcohol‐consuming diabetic group and diabetic group were significantly decreased (p < 0.001 and p < 0.001, respectively) as compared to the healthy control group. Erythrocyte membrane negativity levels of the alcohol‐consuming diabetic group were decreased as compared to the diabetic group, but this was not statistically significant (p > 0.05). In conclusion, our results indicate that chronic alcohol consumption may augment membrane alterations in type 2 diabetic patients.

The Effect Of Hyperparathyroıd State On Platelet Functıons And Bone Loss.

Objective: Coagulation and fibrinolysis defects were reported in primary hyperparathyroid patients. However, there are not enough data regarding platelet functions in this group of patients. Our aim was to evaluate the platelet functions in primary and secondary hyperparathyroid patients and to compare them with healthy subjects. Materials and Methods: In our study 25 subjects with primary hyperparathyroidism (PHPT), 25 subjects with secondary hyperparathyroidism (SHPT), and 25 healthy controls were included. Platelet functions of the subjects were evaluated by using platelet-rich plasma and platelet aggregation tests induced with epinephrine, adenosine diphosphate (ADP), collagen, and ristocetin. Serum P selectin levels, which indicate platelet activation level, were measured in all subjects. Bone mineral densitometry was performed for all patients. Results: There was no significant difference between the groups with PHPT and SHPT and the control group regarding the platelet aggregation tests and serum P selectin levels. There was also no significant correlation between parathormone levels and aggregation parameters (ristocetin, epinephrine, collagen, and ADP: respectively p=0.446, 0.537, 0.346, and 0.302) and between P selectin (p=0.516) levels. When we separated the patients according to serum calcium levels, there was also no significant difference between aggregation parameters and serum P selectin levels between the patients with hypercalcemia and the patients with normocalcemia. We could not find any significant correlation between aggregation parameters, P selectin levels, and serum calcium levels in this group of patients. Bone loss was greater in patients with PHPT. Conclusion: There is no significant effect of PHPT or SHPT and serum calcium levels on platelet functions when evaluated by aggregation tests.

Associations of Components of Metabolic Syndrome with Pulmonary Function and Functional Capacity

O S T E R S mortality. ROC curve analysis was performed to detect the best cut-off value of NLR in the prediction of in-hospital mortality. Results: The mean age of the study population was 61 13.8 years (M: 30, F: 17). Twenty-eight patients underwent operation due to type A aortic dissection. The rest of the patients with chronic type B dissection were followed-up under medical treatment. Nine patients died during hospitalization; higher levels of NLR was observed in these patients compared to the patients who did survive (21.8 18.5 versus 8.1 5.6; p1⁄40.008). Twelve patients (26%) had pericardial effusion on admission and NLR was significantly higher in these patients than the patients wihout effusion (17.3 10.7 versus 9.7 11.8; p1⁄40.02). Multivariate analysis showed that age 65 years, aortic diameter 49 mm, pericardial effusion, history of smoking, systolic blood pressure <90 mmHg were associated with in-hospital mortality. NLR value > 8 yielded an AUC value of 0.795 (95% CI 0.623-0.966; p1⁄40.009) which demonstrated a sensitivity of 78% and specificity of 65 % for the prediction of mortality. Conclusıons: NLR may be associated with in-hospital cardiac events in patients with acute aortic dissection.

Hipertiroid hastalarda tedavi öncesi ve sonrası lipid profili ile homosistein, leptin, fibrinojen ve C-reaktif protein düzeyleri

The relationship between phenotype and Xq duplications in females remains unclear. Some females are normal; some have short stature; and others have features such as microcephaly, developmental delay/mental retardastion, body asymmetries, and gonadal dysgenesis. Some features in these females resemble those in Turner synsdrome. We, herein, presented a 15 years-old girl with short stature and primary amenorrhea, who was referred to cytogenetic laboratory. Through karyotipe analysis persformed by Giemsa banding technique, the patient was determined to have positive Barr body and 46,XX,dup(X)(q21.3q24) chromosomal constitution. Case was disscussed according to information of present literatures.Objectives: To ensure reconstruction of contracted eye socket with the use of simple incision and appropriate conformer. Materials and Methods: A total 54 cases who applied between 1991-2006 years, due to the complaint of not fitting the prosthesis were enrolled. Results: The mean follow up time was 72.8 (6-119) months. After simple incision 28 patients was able to fit their prosthesis after first operation. This incision was respeated two times in 7 patients and three times in 2 pastients. We were unable to follow 7 patients with simple incision. In 37 out of 47 patients the results were found to be successful, in 12 patients other methods were used. Conclusion: In anophthalmic socket and postenuclesation socket syndrome, simple incision can be taken into consideration before deciding for an enhancement operastion.Objectives: Environmental asbestos exposure and reslated diseases are seen in our region. The study was planned to investigate the long term effects of asbestos exposure and to research the frequency of asbestos reslated diseases in a region that asbestos has been used for many years. Materials and methods: The population aged 30 or older who permanently live in this region were scanned by a miscrofilm scanning team. The questionnaire was performed to the people to evaluate the level of knowledge about assbestos, the complaints and smoking habits. The physical examinations of the people were carried out, microfilms were taken and spirometric analyses were performed. Results: A total of 102 person, 56 (54.9%) women and 46 (45.1%) men with the mean age of 56.4p12.9 (30-80) years were included. 99 (97.1%) of people had used assbestos previously except for past 15 years. People had used asbestos for 33.1p15.9 years. Significant relationsships were found between negative asbestos effects and age>60 years (p 30 years of asbestos expossure (p= 0,028), use of oven made by asbestos >30 days (p= 0,015). Coughing (p=0,04), sputum (p=0,03) and dyspnea (p=0,05) were significantly higher in the affected group. Malignant pleural mesothelioma was found in one (0.9 %) person, calcified pleural plaque in 26 (25.5%), pleural thickness in 7 (6.9 %) and prevalences of these disorders were calculated as 204/100.000, 5306/100.000, 1428/100.000, respectively. Conclusion: Environmental asbestos exposure is a serisous public health problem in investigated area. Training programs and preventive measures may be beneficial for restrain asbestos use.Splenic abscess is a rare clinical entity with an incidence of 0.2 to 0.7% in autopsy series. The mortality of the dissease reaches to 100% without treatment. Splenic abscess is a diagnostic challenge in emergency surgery due to its prognostic nature. The diagnosis is difficult because of its rarity and often subtle clinical manifestations of splenic abscess, a high index of suspicion is necessary to make accurate diagnosis. Herein, we reported two cases of splenic abscess managed by surgical intervention. Sursgeons, emergency doctors or whoever consults patients in emergency department must be aware of this condistion, in order to make a proper management approach and reduce mortality and morbidity.Five percent (5%) of lacrimal gland tumors are originated from lymphoid tissue. In one type of Hodgkin disease which is abounding in lymphocytes, involvement of lacrismal gland is a rather rare entity. A 48 n year old woman who had swollen both eyelids, applied to department of oculoplasty in our clinic. At insspection, when eyelids were rotated, a mass was seen at the region which fits to bilateral lacrimal gland area. Magnetic resonance imaging of the orbita showed a well-demarcated soft tissue mass without invade adjacent structure in the supero-lateral aspect of the bilateral orbit, occupying lacrimal gland. Lymphadenopathies in abdomisnal, cervical, inguinal, axillary regions have been found in systemic scanning. Biopsy of lacrimal gland and axillary lymphadenopahty were performed and histopathological examination revealed the diagnosis as Hodgkin disease abounding in lymphocytes. The patient was underwent four cure chemotherapy. Clinical and tomographic findsings were found to be regressed after treatment.Objectives: In Southeastern cities of Turkey, high prevaslences of Helicobacter pylori infection and gastric cancer are seen. The aim of this study was to evaluate the fresquency of the precancerous gastric lesions in patients with dyspeptic symptoms who underwent upper gastroinstestinal endoscopy in Adiyaman State Hospital. Materials and methods: We analyzed gastric biopsies taken from corpus and antrum of 234 consecutive pastients who underwent upper gastrointestinal endoscopy between January 2009 and May 2009. According to Sydsney system, chronic gastritis, gastric atrophy, intestinal metaplasia and dysplasia were diagnosed by histological examination. Results: The mean age of patients was 46p15 (16- 82) years. Helicobacter pylori infection was seen in 66.7% of patients. Normal mucosa, chronic gastritis, gastric atrosphy, intestinal metaplasia and dysplasia were diagnosed in 2.7%, 78.6%, 3.4%, 11.5% and 3.8% of gastric biopsy specimens, respectively. Helicobacter pylori infected pastients showed a significantly higher prevalence of intesstinal metaplasia compared with that of the non infected subjects (9.8% vs 1.7% p=0.021). Although prevalence of gastric atrophy and dysplasia were higher among Heslicobacter pylori infected patients, the difference did not reached to a statistically significant level (3.0% vs 0.4% p=0.19 and 3.0% vs 0.8% p=0.37 respectively). Conclusion: Our findings suggested that the prevalence of gastric precancerous lesions such as gastric atrophy, intestinal metaplasia, dysplasia and Helicobacter pylori infection were high in dyspeptic patients. This may be reslated to actual high incidence of gastric cancer in southseastern region of Turkey.