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Öğe Effect of ethinyl estradiol-cyproterone acetate treatment on asymmetric dimethyl-arginine levels in women with polycystic ovary syndrome(Springer Heidelberg, 2014) Karakurt, Feridun; Carlioglu, Ayse; Kaygusuz, Ikbal; Gumus, Ilknur Inegol; Uz, Burak; Akdeniz, DeryaOur study was undertaken to evaluate the levels of asymmetric dimethyl-arginine (ADMA) in a group of patients affected with polycystic ovary syndrome (PCOS)-under ethinyl estradiol-cyproterone acetate treatment or not-as compared with a group of healthy controls. Fifty-eight women with PCOS and 45 patients as control group were included in the study. The 58 women with PCOS were separated into two groups: Group A (n = 29) were treated with an oral contraceptive pill containing 0.035 mg of ethinyl estradiol (EE) and 2 mg of cyproterone acetate (CA) (Diane-35) for 6 months. Group B (n = 29) did not take any drug. Group C (n = 45) was healthy women as control group. Serum levels of ADMA, lipid and glucose metabolism parameters, hormone profile were measured on the sixth month of treatment. ADMA levels were similar in women with PCOS and controls, whereas ADMA levels significantly decreased after a period of 6 months treatment with EE + CA in women with PCOS. ADMA levels and insulin resistance were decreased with treatment. However, patients with PCOS had significantly higher total cholesterol and Low-density lipoprotein cholesterol (LDL-C) compared to controls, treatment with EE + CA did not provide any improvement on lipid parameters. Serum ADMA levels and insulin resistance were lower in PCOS group treated with EE + CA than control group.Öğe Higher thrombin activatable fibrinolysis inhibitor levels are associated with inflammation in attack-free familial Mediterranean fever patients(Informa Healthcare, 2014) Bavbek, Nuket; Ceri, Mevlut; Akdeniz, Derya; Kargili, Ayse; Duranay, Murat; Erdemli, Kemal; Akcay, AliBackground: Coagulation abnormalities have been reported in familial Mediterranean fever (FMF) patients with amyloidosis and nephrotic syndrome; but there is not enough data about the continuity of the thrombogenic activity in FMF patients in clinical remission. The purpose of this study was to assess thrombin activatable fibrinolysis inhibitor (TAFI) levels and its relationship with fibrinolytic activity and also evaluate relationships between mutations and clinical signs in attack-free patients without amyloidosis. Methods: Seventy-nine FMF patients and 40 healthy adults were included. The study group was divided into five groups as follows: first group, homozygote M694V; second group, homozygote M680I; third group, M694V in one allele, the other allele have other mutations or not; fourth group, other mutations; and fifth group, no mutation. Results: Serum TAFI levels were significantly increased in patients compared with healthy individuals (116.64 +/- 21.8 vs. 78.48 +/- 19.7 mu g/mL, p<0.001) and a positive correlation was detected between TAFI antigen level and erythrocyte sedimentation rate and C-reactive protein levels (r = 0.247, p = 0.029 and r = 0.252, p = 0.032, respectively). Mean fibrinogen and TAFI levels were significantly higher in Group 1 than the other groups (p = 0.04 and p = 0.001, respectively) and in Group 3 it was higher than Groups 2, 4 and 5 (p = 0.04 and p = 0.001, respectively). Conclusions: High level of TAFI antigen in attack-free period of FMF disease shows ongoing subclinical inflammation and hypercoagulability. Clinicians should be careful about thrombosis even in patients at clinical remission. Also, genetic tests must be considered to predict clinical outcome and to reduce complications of FMF disease.Öğe Is Kidney Injury Molecule 1 a Valuable Tool for the Early Diagnosis of Contrast-Induced Nephropathy?(Bmj Publishing Group, 2015) Akdeniz, Derya; Celik, Huseyin Tugrul; Kazanci, Fatmanur; Yilmaz, Hakki; Yalcin, Serkan; Bilgic, Mukadder Ayse; Ruzgaresen, NuketAim/Scope Contrast-induced nephropathy (CIN) is a common complication of diagnostic/therapeutic procedures. Serum creatinine levels are sensitive but often lead to diagnostic delays in acute kidney injury and potential misclassification of actual injury status. Kidney injury molecule (KIM-1) is a novel early marker of acute kidney injury. The aim of our study was to evaluate the KIM-1 levels in patients with CIN. We performed a single-center, nested case-control study. Materials and Methods Three thousand two hundred patients who had undergone coronary angiography were included in the study. Thirty-two patients were diagnosed with CIN. Twenty patients who had undergone coronary angiography but did not have CIN were evaluated as a control group (n = 20). The diagnosis of CIN was performed according to the KDIGO 2012 Acute Kidney Injury Guideline criteria. Urinary KIM-1 levels were measured by enzyme-linked immunosorbent assay before as well as on the 6th and 48th hours of contrast exposure. Serum creatinine levels were measured before as well as on the 24th and 48th hours after angiographic procedure. Results We demonstrated that KIM-1 levels increased in the patients with CIN significantly on the sixth hour when compared with the baseline (P < 0.01; median levels, 0.27 and 0.70 mg/dL) but not in the controls (P = 0.107). The precontrast and 48th-hour KIM-1 levels were median ones and were also significantly different (P = 0.001, the median levels were 0.27 and 0.60 mg/dL, respectively). Conclusions Because creatinine is a sensitive but a late marker of CIN, KIM-1 may be used for early diagnosis and early initiation of treatment and may reduce risk for morbidity.Öğe Kontrast madde nefropatisinde erken marker olarak kidney injury molecule-1 (KIM-1) kullanımı(Turgut Özal Üniversitesi, 2014) Akdeniz, Derya; Akçay, AliAmaç: Bu çalışmada, Kontrast Madde Nefropatisi (KMN) tanısında serum kreatinin değerinin yanısıra erken böbrek hasarı belirteçlerinden biri olan Kidney Injury Molecule 1'in (KIM-1) kullanılabilirliği araştırıldı. Gereç ve Yöntem: Turgut Özal Üniversitesi Tıp Fakültesi Kardiyoloji Kliniğinde angiografi uygulanan olan hastalar çalışmaya alındı. 3200 hasta takip edilerek AKIN 2007 ve KDIGO 2012 Akut Böbrek Hasarı Kılavuzları baz alınarak KMN tanısı alan 32 hasta KMN grubu ve 20 kontrast alan ancak KMN gelişmeyen hasta kontrol grubu olarak alındı. Çalışma prospektif olarak planlandı. Hasta ve kontrol gruplarından kontrast maruziyeti öncesi (0. saat), KM verildikten sonra 6. ve 48. saatlerde idrar örnekleri alındı. Ayrıca her iki gruptan sabah açlık kanı alınarak lipid paneli, tam kan sayımı ve böbrek fonksiyon testleri incelendi. Hasta ve kontrol grubu idrar örneklerinde KIM-1 molekülü düzeyi bakıldı. Anlık idrar örnekleri olduğu için spot idrar kreatinin düzeyi ile oranlanarak düzeltilmiş KIM-1 düzeyleri gruplar arasında kıyaslandı. Bulgular: Hasta ve kontrol grupları arasında lipid paneli, demografik özellikler ve tam kan sayımı parametreleri arasında anlamlı fark yoktur (P>0,05). Hasta ve kontrol gruplarını belirlerken kreatinin düzeyi baz alınarak fark oluşturulmuştu. Kontrast madde nefropatisi gelişen hastalarda üre ve kreatinin değerlerinde anlamlı yükseklik görüldü (p=0,001, p=0,004). KIM-1 düzeyleri kontrast madde nedropatisi gelişen hastalarda 0. Saate göre 6. ve 48. Saat örneklerinde anlamlı yüksek olarak izlenirken (p<0,001) kontrol grubu olan hastalarda bazal, 6. ve 48. saat KIM-1 düzeyleri benzerdi (p=0,107). Sonuç: Kontrast madde nefropatisi mortaliteyi önemli ölçüde arttıran, çoğu hastada kalıcı böbrek hasarına yol açabilen bir akut böbrek yetmezliği tipidir. Kreatinin yükselmesinin glomerüler filtrasyon oranındaki düşüşe geç eşlik etmesi nedeniyle çoğu hasta akut böbrek hasarı tanısını geç almakta, bu da koruyucu önlemlerin gecikmesine neden olmaktadır. KIM-1 bu konudaki problemin çözülmesine, KMN taısının erken konulup önlemlerin erken alınmasına ve kalıcı böbrek hasarı gelişmesinin önlenmesine yardımcı olabilecek umut verici bir markerdır.Öğe Kontrast madde nefropatisinde erken marker olarak kidney injury molecule-1 (KIM-1) kullanımı(Turgut Özal Üniversitesi, 2014) Akdeniz, Derya; Akçay, AliAmaç: Bu çalışmada, Kontrast Madde Nefropatisi (KMN) tanısında serum kreatinin değerinin yanısıra erken böbrek hasarı belirteçlerinden biri olan Kidney Injury Molecule 1'in (KIM-1) kullanılabilirliği araştırıldı. Gereç ve Yöntem: Turgut Özal Üniversitesi Tıp Fakültesi Kardiyoloji Kliniğinde angiografi uygulanan olan hastalar çalışmaya alındı. 3200 hasta takip edilerek AKIN 2007 ve KDIGO 2012 Akut Böbrek Hasarı Kılavuzları baz alınarak KMN tanısı alan 32 hasta KMN grubu ve 20 kontrast alan ancak KMN gelişmeyen hasta kontrol grubu olarak alındı. Çalışma prospektif olarak planlandı. Hasta ve kontrol gruplarından kontrast maruziyeti öncesi (0. saat), KM verildikten sonra 6. ve 48. saatlerde idrar örnekleri alındı. Ayrıca her iki gruptan sabah açlık kanı alınarak lipid paneli, tam kan sayımı ve böbrek fonksiyon testleri incelendi. Hasta ve kontrol grubu idrar örneklerinde KIM-1 molekülü düzeyi bakıldı. Anlık idrar örnekleri olduğu için spot idrar kreatinin düzeyi ile oranlanarak düzeltilmiş KIM-1 düzeyleri gruplar arasında kıyaslandı. Bulgular: Hasta ve kontrol grupları arasında lipid paneli, demografik özellikler ve tam kan sayımı parametreleri arasında anlamlı fark yoktur (P>0,05). Hasta ve kontrol gruplarını belirlerken kreatinin düzeyi baz alınarak fark oluşturulmuştu. Kontrast madde nefropatisi gelişen hastalarda üre ve kreatinin değerlerinde anlamlı yükseklik görüldü (p=0,001, p=0,004). KIM-1 düzeyleri kontrast madde nedropatisi gelişen hastalarda 0. Saate göre 6. ve 48. Saat örneklerinde anlamlı yüksek olarak izlenirken (p<0,001) kontrol grubu olan hastalarda bazal, 6. ve 48. saat KIM-1 düzeyleri benzerdi (p=0,107). Sonuç: Kontrast madde nefropatisi mortaliteyi önemli ölçüde arttıran, çoğu hastada kalıcı böbrek hasarına yol açabilen bir akut böbrek yetmezliği tipidir. Kreatinin yükselmesinin glomerüler filtrasyon oranındaki düşüşe geç eşlik etmesi nedeniyle çoğu hasta akut böbrek hasarı tanısını geç almakta, bu da koruyucu önlemlerin gecikmesine neden olmaktadır. KIM-1 bu konudaki problemin çözülmesine, KMN taısının erken konulup önlemlerin erken alınmasına ve kalıcı böbrek hasarı gelişmesinin önlenmesine yardımcı olabilecek umut verici bir markerdır.Öğe Matrix Metalloproteinases 2 and 9 Polymorphism in Patients With Myeloproliferative Diseases A STROBE-Compliant Observational Study(Lippincott Williams & Wilkins, 2015) Maral, Senem; Acar, Muradiye; Balcik, Ozlem Sahin; Uctepe, Eyyup; Hatipoglu, Omer Faruk; Akdeniz, Derya; Altun, Hatice UludagChronic myeloproliferative disorders such as polycythemia vera (PV), essential thrombocytosis (ET), and idiopathic myelofibrosis arise from clonal proliferation of neoplastic stem cells in the bone marrow. Matrix metalloproteinases (MMPs) are a family of zinc-dependent endopeptidases that have potential to degrade all types of extracellular matrix (ECM) and also play a role in remodeling of the ECM. It is known that MMPs play a role in bone marrow remodeling. The primary goal of our study is to explore the relationship between chronic myeloproliferative diseases and some of MMP gene polymorphisms. The demonstration of a relationship will help to understand whether these polymorphisms may be a potential early diagnosis marker of the diseases. Patients were selected from outpatient clinks of Turgut Ozal University Hospital, Ankara, Turkey, between December 2010 and May 2011. Twenty-eight patients that previously diagnosed and followed-up with PV, 17 with secondary polycythemia (SP), and 12 with ET were enrolled in the study, along with a control group of 22 healthy people. DNA was isolated from peripheral blood. Using polymerase chain reaction restriction fragment length polymorphism method, MMP2 and MMP9 gene polymorphisms were analyzed with agarose gel electrophoresis. There was a statistically significant difference between the study groups and the control group in terms of Gin279Arg polymoiphisms rates of MMP9. The highest MMP9 Gln279Arg polymorphism rate was observed in the ET group. But nobody from the control group had polymorphic MMP9. There was no statistically significant difference between the groups in terms of MMP2-735 C > T polymorphism rates. In conclusion, MMP9 gene Gln279Arg polymorphism was associated with ET, SP, and PV diseases. Hence, we believe that these gene polymorphisms may play a role in the mechanism of bone marrow fibrosis and may be a factor that increases the risk of thrombosis. Illumination of the molecular basis of the relationship between MMP-thrombosis and MMP-librosis provides a better understanding of the pathophysiology of PV and ET diseases mid will allow new approaches to diagnosis and treatment.Öğe Plasma nesfatin-1 levels are increased in patients with polycystic ovary syndrome(Springer, 2014) Ademoglu, Esra Nur; Gorar, Suheyla; Carlioglu, Ayse; Yazici, Havva; Dellal, Fatma Dilek; Berberoglu, Zehra; Akdeniz, DeryaBackground Nesfatin-1 is a recently discovered neuropeptide derived from its precursor nucleobindin-2 (NUCB2) and has been implicated in the regulation of feeding and energy metabolism. It is located in the brain and also produced at the periphery and present in the plasma. However, its pathophysiological role in humans remains unknown. Polycystic ovary syndrome (PCOS) is commonly presented with obesity, insulin resistance, hyperandrogenemia and hirsutism. Aim To characterize serum nesfatin-1 levels in PCOS women and determine association of nesfatin-1 with metabolic parameters. Materials and methods It is a cross-sectional study of 55 PCOS and 28 healthy women matched in age, in a university hospital setting. Anthropometric, hormonal, metabolic parameters and nesfatin-1 blood levels were determined. Results Nesfatin-1 levels were significantly higher in PCOS group compared with the controls 371.43 +/- 2.50 versus 275.55 +/- 1.74 pg/mL. Multivariate logistic regression analysis that contains: nesfatin-1, body mass index and homeostasis model assessment index revealed significant correlation of nesfatin-1 with the existence of PCOS (p < 0.05). Conclusions Higher nesfatin-1 levels in PCOS women compared to control group may suggest a possibility that nesfatin-1 may play some role in the PCOS.Öğe Pregnancy with Congenital Adrenal Hyperplasia: A Case Report(Gazi Univ, Fac Med, 2015) Akdeniz, Derya; Demirci, Huseyin; Ceydilek, Bilge; Yavuz, Halise CinarCongenital adrenal hyperplasia is a group of autosomal recessive disorders characterized by impaired cortisol synthesis. Dysregulation of corticotropin synthesis often leads to increased synthesis of adrenal androgens. Low fertility is often and troublesome condition in patients with congenital adrenal hyperplasia. In this report, we presented a case report which is a woman with non-classical hyperplasia who were pregnant and followed until delivery in our clinic.Öğe The Comparison of Standard and Salvage Chemotherapy Regimens Regarding to CD34(+) Peripheric Stem Cell Harvesting Success(Akad Doktorlar Yayinevi, 2013) Balcik, Ozlem S.; Aksoy, Cafer; Akdeniz, Derya; Akkaya, Cigdem; Guvenc, Birol; Dincer, SuleymanAlthough regimens of harvesting peripheric stem cell vary from one center to another, the most common ones are chemotherapy plus growth factor or growth factor alone. We aimed to determine which variables of harvesting peripheral stem cells are effective on the number of harvested CD34+ cells and successfull mobilisation defined as the collection of >2.0 x 106 CD34+ cells/kg b.w. with a maximum of three leukaphereres. From August 2008 to January 2011, the documents of 56 patients included in the autologous peripheral stem cell harvesting program were retrieved retrospectively. Regarding harvesting regimens, 28 patients (50.0%) were administered filgrastim 10 mu g/kg/day (filgrastim group), 18 patients (32.1%) were administered a standard regime with ifosphamide + etoposide + epirubicin + filgrastim 5 mu g/kg/day or cyclophosphamide + etoposide + filgrastim 5 mu g/kg/day (standard group), and 10 patients (17.9%) were administered a salvage regime + filgrastim 5 mu g/kg/day (salvage group). Rituximab was added if the disease was CD20 positive. The median number of CD34+ cells and the number of inadequate collection did not differ between these 3 groups. Transplantation before mobilization was found to have a negative effect on the harvesting success. The transplantated patients had a lower number of harvested CD34+ cells than the patients without transplantation history. But no clear relationship was seen between harvest success and the diagnosis of the patients, pretransplant response, radiotherapy history before mobilization, or mobilization with a standard regimen. Finally, the number of standard CT cycles before mobilization were found to have a borderline negative effect on the harvested CD34+ cells.Öğe The Effect of Zofenopril on Pancreas, Kidney and Liver of Diabetic Rats(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2014) Carlioglu, Ayse; Akdeniz, Derya; Alkan, Rabia; Uz, Ebru; Haltas, Hacer; Turgut, Faruk; Uysal, SemaOBJECTIVE: Oxidative stress is responsible for some important complications of diabetes mellitus. Zofenopril, which has an antioxidant effect, may decrease the oxidative stress of the diabetic microenvironment. The aim of our study was to evaluate the effect of zofenopril in the liver, pancreas and kidney of alloxan- induced diabetic rats. MATERIAL and METHODS: Rats were divided into five groups: control group (n=6), rats treated with zonenopril (50 mg/kg/day, orally four weeks; n=6), rats exposed to alloxane (120 mg/kg single dose intraperitoneal injection, n=6), rats administered alloxan+ zofenopril (n=6) and rats administered insulin plus alloxan. RESULTS: After one month, we observed histological improvement in the kidneys but not in the pancreas and liver. CONCLUSION: In conclusion, zofenopril may be effective on the renal complications of diabetes mellitus.
