Hasan Cetin Ekerbicer

Effect of tamsulosin on the number and intensity of ureteral colic in patients with lower ureteral calculus.

Abstract Background: We aimed to objectively determine whether tamsulosin as an α1‐blocker was effective in patients who had ureterolithiasis located in the lower part of the ureter.

Oxidative Stress in Migraine with and Without Aura

Migraine is the most common neurological disorder, but the molecular basis is still not completely understood. An impairment of mitochondrial oxidative metabolism might play a role in the pathophysiology. The goal of this study was to investigate the differences in oxidative stress status with the measurement of erythrocyte superoxide dismutase (SOD), catalase activity, and malondialdehyde (MDA) levels in the migraine patients with or without aura and attack. There were 56 patients (46 female, 10 male) in the migraine group and 25 matched healthy subjects in the control group. The patients comprised 37 with migraine without aura (MWoA], 19 with migraine with aura (MWA), and 22 with headache attack. The MDA levels of patients in the migraine group were significantly higher than that in the control group. The SOD activity was significantly higher in the MWA as compared to MWoA. There was no significant correlation between these levels and headache attack period. Conclusively, in this preliminary study, we had found increased oxidative stress in the migraine patients especially the patients with MWA. Further knowledge about this issue may contribute the cause and complications of migraine and may be essential for development of treatment approaches.

Evaluation of the Effects of Relationships Between Main Spatial Lower Pole Calyceal Anatomic Factors on the Success of Shock-Wave Lithotripsy in Patients with Lower Pole Kidney Stones

OBJECTIVES To evaluate the effects of lower pole calyceal anatomy on lower pole stone clearance after shock-wave lithotripsy (SWL). METHODS A total of 133 patients who had single lower pole radio-opaque stones treated with SWL alone and who became stone-free or had clinically insignificant residual fragments (CIRF) were included in the study. Pre-shock-wave lithotripsy intravenous urograms were used to determine the lower pole infundibular width and length, lower pole infundibulopelvic (LPIP) angle, caliceal pelvic height (CPH), and lower infundibular length-to-width ratio. In addition, to evaluate the relationship between LPIP and CPH, a more simple alternative measurement instead of LPIP angle, called the parenchyma-to-ureter distance (PUD), was suggested. The correlation between LPIP and PUD was then examined, and a good correlation was found between these values (P <0.000, r = 0.64). The PUD/CPH ratio was also calculated. RESULTS The stone-free rate was 62%. According to the cutoff points, the lower infundibular length-to-width ratio and PUD/CPH ratio were different in the stone-free and CIRF groups by univariate analysis but not by multivariate analysis. CONCLUSIONS None of the anatomic factors had a statistically significant effect in predicting the success of SWL in patients with lower pole stones. Nevertheless, evaluation of relationships between lower pole anatomic factors may offer some help in reaching a more accurate interpretation of lower pole stone clearance after SWL.

Plasma homocysteine and lipoprotein (a) levels in Turkish patients with metabolic syndrome

High serum total homocysteine (tHcy) and lipoprotein (a) [Lp(a)] levels are independent risk factors for cardiovascular disease. In this study, we examined the relationship of tHcy and Lp(a) levels with the components of metabolic syndrome. Fifty-one patients diagnosed with metabolic syndrome (median age: 38 [range 25–48] years) and 50 healthy subjects (median age: 35 [26–48] years) were included in the study. We used the National Cholesterol Education Program criteria to define metabolic syndrome. Total tHcy concentrations were measured by using an IMX (Abbott Diagnostics, Abbott Park, IL, USA). Lipoprotein (a) was measured by immunonephelometry using Behring nephrometer method (Behring BN 100, Behring, Germany). Total homocysteine and Lp(a) levels were found to be higher in the metabolic syndrome group than in the control group (tHcy: 24.2 vs 13.4 µmol/l, P < 0.01 and Lp(a): 34.9 vs 15.8 mg/dl, P < 0.01). Vitamin B12 levels were lower in the metabolic syndrome group than in the control group (214 pg/ml vs 247 pg/ml, P < 0.01). In partial correlation, tHcy and Lp(a) concentrations were unrelated to metabolic syndrome or to the components of metabolic syndrome, including fasting serum triglycerides, HDL-cholesterol, fasting glucose, blood pressure, or body mass index. tHcy levels were strongly related only to the vitamin B12 concentration. The risk of cardiovascular disease is higher in patients with metabolic syndrome compared with the normal population. High tHcy and Lp(a) levels should be evaluated in this group of patients in addition to the evaluation of the parameters of metabolic syndrome.

Status of pandemic influenza vaccination and factors affecting it in pregnant women in Kahramanmaras, an eastern Mediterranean city of Turkey.

Background Pregnant women are a target group for receipt of influenza vaccine because there appears to be an elevated mortality and morbidity rate associated with influenza virus infection in pregnant women. The goal of this study is to determine the factors affecting the decisions of pregnant women in Turkey to be vaccinated or not for 2009 H1N1 influenza. Methodology We enrolled 314 of 522 (60.2%) pregnant women who attended to the antenatal clinics of the Medical Faculty of Kahramanmaras Sutcuimam Universitys Department of Gynecology and Obstetrics between December 23, 2009, and February 1, 2010. We developed a 48-question survey which was completed in a face-to-face interview at the clinic with each pregnant woman. Principal Findings Of the 314 pregnant women, 27.4% were in the first trimester, 33.8% were in the second trimester, and 38.8% were in the third trimester. Twenty-eight pregnant women (8.9%) got vaccinated. Of all the women interviewed, 68.5% stated that they were comfortable with their decisions about the vaccine, 7.3% stated they were not comfortable, and 24.2% stated that they were hesitant about their decisions. The probability of receiving the 2009 H1N1 vaccine was 3.46 times higher among working women than housewives, 1.85 times higher among women who have a child than those who do not, and 1.29 times higher among women with a high-school education or higher than those with only a secondary-school education and below. Correct knowledge about the minimal risks associated with receipt of influenza vaccine were associated with a significant increase in the probability of receiving the 2009 H1N1 vaccine. Conclusions/Significance The number of pregnant women in the study group who received the 2009 H1N1 vaccine was very low (8.9%) and two-thirds of them stated that they were comfortable with their decisions concerning the vaccine. Our results may have implications for public health measures to increase the currently low vaccination rate among pregnant women. Further studies are required to confirm whether our findings generalize to other influenza seasons and other settings.

Plasma selenium levels in Turkish women with polycystic ovary syndrome

OBJECTIVE(S) To evaluate selenium (Se) levels in serum and their relation with hyperandrogenism and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS) and in control subjects. STUDY DESIGN Women with any gynecological problem who presented to the Kahramanmaras Sutcuimam University Medical Faculty Gynecology and Obstetric Outpatient Clinic were invited to participate. Group 1 consisted of 36 cases with a diagnosis of PCOS according to the 2003 Rotterdam Consensus Criteria, and Group 2 (control group) consisted of 33 age- and BMI-matched healthy women. In all cases, serum total testosterone (tT), dihydroepiandrostenedione-sulfate (DHEAS), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), insulin, glucose (mg/dL), total cholesterol (TC) (mg/dL), high density lipoprotein-cholesterol (HDL-C) (mg/dL), low density lipoprotein-cholesterol (LDL-C) (mg/dL), triglyceride (TG) (mg/dL) and Se levels were measured. RESULTS The level of FSH was significantly lower, and the levels of LH, E2, tT, and DHEAS were significantly higher in group 1 than in group 2 (p<0.05). The hirsutism score was significantly higher among PCOS women compared to the control group (p<0.05). Although insulin levels and HOMA-IR were markedly increased in the PCOS group compared to the control group, the differences were not significant (p>0.05). The plasma Se level was significantly lower in PCOS women compared to the control group (p<0.05). When we combined the all women in two groups, regarding them as one group (combined group, n=69), a negative correlation between Se and LH and tT was present (p<0.05). CONCLUSION(S) Our results show decreased plasma concentrations of Se and a negative correlation between Se and LH, tT in women with PCOS. These results indicate that Se may play a role in the pathogenesis of PCOS related with hyperandrogenism.

Anaemia and iron-deficiency anaemia in south-east Anatolia

Abstract: Purpose : To determine the prevalence of anaemia and iron‐deficiency anaemia (IDA) in Kahramanmaras, a province in the south‐eastern Anatolia. Methods : The study was performed on 1491 persons of both sexes aged 2–69. All were volunteers. Haematological parameters were determined and haemoglobin (Hb) electrophoresis was carried out in all subjects, and only for those with haemoglobin levels below normal were subsequent measurements of ferritin and Hb A 2 made to detect iron deficiency and rule out β‐thalassaemia. Results : The means of all the haematological parameters for all age groups and sexes were found to be lower than the reference values given in the literature. Anaemia was found to be present in all age groups, especially in children aged 2–5 yr and women aged 19–40 yr (34.5% and 40.0%, respectively). IDA in the same age groups was 15.5% and 23.8%, respectively. Conclusion : The high rate of IDA raises serious concern about nutritional disease risks in the region. An inexpensive oral iron therapy and education as to the importance of iron for their health would help to provide optimal health for the population concerned, especially for mothers‐to‐be and children.

Hepatitis A seroprevalence and its relationship with environmental factors in children of different age groups in Kahramanmaras, Eastern Mediterranean region of Turkey.

Summary.  Hepatitis A infections are influenced by environmental and socioeconomic factors. Epidemiologic studies regarding hepatitis A virus (HAV) infection in Turkey have not previously examined these factors. We investigated HAV seroprevalence and its association with sociodemographic factors among children of various ages in the Eastern Mediterranean region of Turkey. The study included 1142 children (603 male and 539 female) between ages of 6 months and 18 years. Seropositivity in the whole group was 57.2%. HAV prevalence rates according to age groups were as follows: 35.5% in 6–23 months group, 19.2% in 2–5 years group, 74.3% in 6–10 years group, 83.0% in 11–14 years group, 92.8% in 15–18 years group. Risk factors that influenced seropositivity were; dense population, over‐crowded families, excessive number of siblings, low socioeconomic status and low education of the mother. As HAV seroprevalence in children older than 6 years of age is high, we recommend hepatitis A vaccination in this region after the first year of life.

Evaluation of a new chromogenic medium for isolation and identification of common urinary tract pathogens

In the study presented here, a new chromogenic medium (CPS ID 3; bioMérieux, Marcy l’Etoile, France) was compared to routine media for the isolation, identification and antimicrobial susceptibility testing of bacteria recovered from urine specimens, and a cost analysis was performed. Escherichia coli, Proteeae tribe, Pseudomonas aeruginosa, Enterococcus spp. and Streptococcus agalactiae grew on the chromogenic medium as typical differentiated colonies and were accurately identified even in mixed cultures. Although the similarity of colors produced by isolates belonging to the Klebsiella, Enterobacter, Serratia and Citrobacter (KESC) group prevents differentiation among them, members of KESC were easily identified as coliforms. No substantial difference was observed when comparing the results of antimicrobial susceptibility testing performed on colonies selected from reference media versus CPS ID 3. Use of the new medium was associated with a savings of 75% over the conventional methods and the API system. Furthermore, this medium facilitated a remarkable reduction in the laboratory workload and consequently resulted in additional time and cost savings.

Sonographic Evaluation of Subclinical Entheseal Involvement in Patients With Behçet Disease

OBJECTIVE The aim of the current study was to determine the prevalence of subclinical entheseal involvement in patients with Behçet disease via ultrasound using a newly developed method, the Madrid sonography enthesitis index. SUBJECTS AND METHODS The study was conducted with 36 patients with Behçet disease and 46 healthy sex- and age-matched control subjects. All patients with Behçet disease who had no clinical evidence of arthritis or enthesitis underwent an ultrasound examination. All sonographic findings were identified according to the Madrid sonography enthesitis index. Madrid sonography enthesitis index values of patients and control subjects were compared by Student t test and Mann-Whitney U test. Validity was analyzed by receiver operating characteristic curve. RESULTS Total enthesitis score was 12.16 ± 6.16 among patients with Behçet disease and 2.06 ± 2.18 among healthy control subjects (p < 0.001). The receiver operating characteristic curve established an ultrasound score greater than 4.5 in the Behçet disease group as the best cut-off point differentiating case subjects from control subjects. This cutoff was exceeded by 88.8% of the patients with Behçet disease. When the Madrid sonography enthesitis index score in each affected enthesis was evaluated, patients with Behçet disease had significantly higher scores than did control subjects when all entheseal sites were compared (all p values < 0.05). CONCLUSION This is the first study to our knowledge to show significant subclinical enthesopathy of the triceps tendon enthesis in patients with Behçet disease who had no arthritic involvement. These data suggest that the Madrid sonography enthesitis index scoring system for sonographic detection of enthesopathy should be incorporated into the clinical protocol for evaluating patients with Behçet disease in routine clinical practice.