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Öğe Alendronat kullanımına bağlı oral ülserler(2008) Cinemre, Hakan; Gökosmanoğlu, Feyzi; Aytuğ, Necip Ö.Bifosfonatlar kemik rezorpsiyonunu ve turnoverını azaltarak etki eden, bu nedenle postmenopozal osteoporoz, multipl myeloma ve maligniteye bağlı osteolizis gibi birçok kemik hastalığında kullanılan ajanlardır. Son yıllarda yaygın kullanımları ile nadir olan komplikasyonlarının görülme sıklığı artmıfltır. En sık gastrointestinal sisteme ait yan etkileri görülmekte olup özafajit, gastrik ülserler, dispepsi, retrosternal yanma nadiren de oral ülserler, çenede osteonekroz ve özafagial daralma bildirilen yan etkileridir. (Romatizma 2008; 23: 35-7)Öğe Anti-Saccharomyces cerevisiae antibodies in acute myocardial infarction(Bmj Publishing Group, 2007) Cinemre, Hakan; Bilir, Cemil; Gökosmanoğlu, Feyzi; Kadakal, FigenBackground: Elevated anti-Saccharomyces cerevisiae antibody (ASCA) immunoglobulin (IgG) and IgA levels were first described in the serum of Crohn disease patients and have increasingly been reported in other inflammatory diseases. The role of in situ and remote inflammation in atherosclerosis is a major area of interest. In this study, we compared ASCA IgG and IgA levels in acute myocardial infarction (AMI) and controls to investigate the possible role of ASCA in AMI. Methods: Serum samples were obtained from 140 consecutive patients who presented to the emergency department with acute chest pain. AMI was diagnosed by electrocardiography and serial enzymes. Patients ruled out for acute coronary event were grouped as controls. ASCA IgA and IgG levels were determined using enzyme-linked immunosorbent assay. Groups were compared for statistically significant difference. Results:ASCA IgG titers ranged between 0.1 and 31.0 RIU/mL (mean 4.92) in the AMI group and 0.1 and 6.0 (mean 0.84) in the controls. The groups were found to differ very significantly (p = .001). ASCA IgA titers ranged between 2.0 and 200.0 RIU/mL (mean 13.73) in the AMI group and 2.0 and 11.5 RIU/mL, (mean 4.25) in controls. The groups differed significantly (p = .32). AMI and controls were also analyzed for ASCA IgA and IgG positivity. Both groups differed significantly from controls (p = .013). Conclusion: Elevated ASCA IgA and IgG levels as well as ASCA positivity in the AMI might suggest use of ASCA as a marker for atherosclerotic plaque instability. It might also provide a link between inflammatory processes and increased cardiovascular risk. Further studies are needed on a Saccharomyces cerevisiae-based diet, related intestinal colonization, and associated inflammation, autoimmune disorders, and cardiovascular events.Öğe Aplastic crisis due to Parvovirus B19 in an adult hereditary spherocytosis patient: Case report(Ortadogu Ad Pres & Publ Co, 2008) Güngör, Adem; Bilir, Cemil; Önder, Elif; Korkmaz, Uğur; Alçelik, Aytekin; Cinemre, HakanParvovirus B19 may cause transient aplastic crises in hereditary hemolytic anemia patients. A 29-year-old male presenting with fatigue, fever and diffuse joint and Muscle pain was admitted to the internal medicine service. He later developed leukopenia, thrombocytopenia and marked anemia with 0.8% reticulocytes. The bone marrow biopsy proved normocellular with increased proetrithroblasts and decreased mature erythroblasts. On day 6 of admission, his complete blood count (CBC) started to return to normal and the aplastic crisis was attributed to parvovirus B19 infection. Anti-IgM B19 antibody positivity supported the diagnosis and the clinical picture. This is the first reported Parvovirus B19-induced aplastic crisis in an adult hereditary spherocytosis patient in Turkey.Öğe Association of vitamin D insufficiency/deficiency with thyroid artery Doppler ultrasonography in patients with Hashimoto thyroiditis(Professional Medical Publications, 2017) Nalbant, Ahmet; Aydın, Ayhan; Karacan, Alper; Önmez, Attila; Tamer, Ali; Cinemre, HakanBackground (sic) Objective: During the course of the autoimmune thyroid diseases, ultrasonography change parallel to histopathology. Vitamin D is associated with autoimmune diseases and thus can affect thyroid blood flow. Our aim was to investigate the relationship between vitamin D insufficiency/deficiency and thyroid hemodynamic indices in patients with Hashimoto thyroiditis. Methods: A total of 93 patients who presented to Sakarya University Endocrinology outpatient clinic from April to September 2016 and diagnosed with Hashimoto thyroiditis were included in this study. Clinical and serologic data, thyroid antibodies and 25(OH)D3 were evaluated. Mean peak systolic velocity(mPSV), mean end-diastolic velocity (EDV), mean resistive index (RI) flows of superior and inferior thyroid arteries were measured with B-mode Doppler ultrasonography. Results: Vitamin D insufficiency/deficiency was detected in 59 (63.4%). TPO Ab and TgAb levels were found higher in patients with vitamin D insufficiency/deficiency. In the normal vitamin D group, superior thyroid artery mPSV (32.21 +/- 6.73cm/s) and EDV(13.27 +/- 2.80 cm/s) were higher than in the low vitamin D group [mPSV (28.32 +/- 8.99cm/s) and EDV(10.67 +/- 3.68 cm/s)] (P=0.034, P=0.001, respectively). Inferior thyroid artery EDV value was higher in the normal compared to the low vitamin D group (0.032). RI measured in all arteries were higher in the vitamin D insufficient/deficient group compared to the Vitamin D normal group (p=0.001). Conclusion: Vitamin-D insufficiency/deficiency has led to reduced parenchymal blood supply and increased micro-vascular resistance in Hashimoto thyroiditis patients.Öğe Carotis intima media thickness in female patiens with subclinical hypothyroidism [Subklinik hipotiroidili kadin hastalarda karotis intima media kalinli?i](Turkiye Klinikleri, 2010) Önder, Elif; Aydın, Yusuf; Güngör, Adem; Celbek, Gökhan; Kır, Seher; Yıldırım, Hayriye Ak; Cinemre, HakanObjective: Recent studies have shown that subclinical hypothyroidism (SCH) has similar cardiovascular risks with clinical hypothyroidism (CH). We evaluated carotis intima media thickness (CIMT)-indicator of early changes in atherosclerotic process- in female patients, who have either CH or SCH, with similar age and demographic features. Materials and Methods: In this study, we included 81 female patients admitted to internal medicine and endocrinology outpatient clinic, diagnosed with CH (30) or SCH (51) according to their laboratory findings and who have not previously received treatment and 38 healthy women. BMI (body mass index), sistolic and diastolic blood pressure, triglycerides (TG), total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), vitamin B-12, folate, homocysteine, high-sensitive C-reactive protein (Hs CRP), and CIMT were measured in all participants. Results: There was not a statistical difference between the groups in TG, TC, HDL-C, LDL-C, vitamin B-12, and folate levels (p>0.05). On the other hand, SCH and CH groups differed statistically significantly from the control group for Hs CRP (p=0.011), homocysteine (p<0.001), and CIMT values. Additionally, age was found to be the most important factor for increase in CIMT when multiple linear regression analysis was performed. Conclusions: Lack of difference between CH patients and SCH patients in respect to Hs CRP, homocystein, and CIMT shows that inflammation and increase in CIMT starts during SCH period. Hence, we think that the increase in CIMT in SCH patients when TSH levels are higher than the normal range is a clinically important sign of early cardiovascular diseases.Öğe A case of infective endocarditis presented with a giant free wall vegetation [Serbest duvarda büyük hareketli vejetasyon ile kendisini belli eden infektif endokardit olgusu](2010) Sözen, Serhat Bahadır; Kaya, Ahmet; Cinemre, Hakan; Albayrak, Enver Sinan; Özhan, Hakan; Yazıcı, Mehmet[No abstract available]Öğe Diyaliz uygulanan hastalarda yaşam kalitesi ve psikiyatrik belirti dağılımı(2009) Özçetin, Adnan; Bahçebaşı, Bicik Zerrin; Bahçebaşı, Talat; Cinemre, Hakan; Ataoğlu, AhmetAmaç: Son dönem böbrek yetmezliği (SDBY), hastalarda birçok psikososyal sorunlara neden olmakta ve yaşam kalitesini düşürmektedir. Biz çalışmamızda diyaliz hastalarının yaşam kalitesi ve psikiyatrik belirti dağılımını belir-lemeyi amaçladık. Yöntem: Çalışmamıza nefroloji ünitesi tarafından izlenen 54 hemodiyaliz (HD) ve 13 sürekli ayaktan periton diyalizi (SAPD) uygulanan toplam 67 hastayı aldık. Hastalara sosyodemografik bilgi formu, Short Form-36 (SF-36) Yaşam Kalitesi Ölçeği, Hastane Anksiyete ve Depresyon Ölçeği (HAD), Kısa Semptom Envante-ri (KSE) uygulandı. İstatistiksel analizde nonparametrik testlerden Mann Whitney-U uygulandı. Sonuçlar: Hasta-ların 31’i erkek, 36’sı kadındı. HD hastalarının yaş ortalaması 53.5517.26 yıl, SAPD grubunun ise 47.8313.76 idi. SF-36 alt ölçeklerinden hiçbirisinde HD ve SAPD grupları arasında fark yoktu. Psikiyatrik belirti dağılımını ölçen KSE alt ölçeklerinden ise, HD grubunda daha kötü olmak üzere somatizasyon (p0.027) ve depresyonda (p0.045) istatistiksel olarak anlamlı fark vardı. HAD anksiyete ve depresyon puanı eşik üstü olan hastaların yaşam kalitesi (SF-36) alt ölçeklerinin (anksiyete grubunda emosyonel rol alt ölçeği hariç p0.186) tümü ve KSE alt ölçek puanları daha kötüydü ve istatistiksel olarak anlamlı fark vardı. Tartışma: Diyaliz uygulanan SDBY’li hastaların biyolojik değerlendirilmesine koşut olarak psikiyatrik yönden de değerlendirilmesi önemli görülmektedir. Hem yaşam kalitesi, hem de psikiyatrik belirti dağılımı yönünden kötüleşmeye neden olabilen depresyon ve/veya anksiyete kısa sürede ve kolayca uygulanabilen ölçeklerle tanınabilir. Bu sayede hastalara gerekli psikiyatrik destek sağlanarak yaşam kalitelerinin artırılabilmesinin yanı sıra, psikiyatrik belirtiler de daha kolay tanınıp gerekli önlemler alınabilir. Bu grup hastalarda psikiyatrik değerlendirme ve destek ihmal edilmeyecek kadar önemli görülmektedir. Bu sayede bakım verenlerin de tükenme sendromuna girmesi engellenebilir.Öğe The effect of COVID-19 lockdown on glycemic control in patients with type 2 diabetes mellitus in Turkey(Elsevier Sci Ltd, 2020) Onmez, Attila; Gamsizkan, Zerrin; Ozdemir, Seyma; Kesikbas, Enis; Gokosmanoglu, Feyzi; Torun, Serkan; Cinemre, HakanBackground and aims: A national lockdown to prevent the spread of coronavirus disease (COVID-19) in Turkey was introduced in March 2020. We think that lockdowns may lead to weight gain and worsening of glycemic parameters in patients with type 2 diabetes mellitus (DM). The purpose of this study was to investigate how type 2 DM patients were affected by the lockdown. Method: Type 2 DM patients unable to attend regular follow-ups due to lockdown over a 75-day period between March and June 2020 and who again attended polyclinic follow-up when the lockdown was lifted were included in the study. These patients' glycemic control and weight status were compared with the pre-lockdown period. In addition, patients' general habits, and adherence to diet and exercise were evaluated, while their general health was assessed using the Short-Form 36-item survey. Result: The research involved 101 type 2 DM patients, 57 men (56.5%) and 44 women (44.5%), with a mean age of 55 +/- 13. Patients' mean pre-lockdown weight was 84.7 +/- 16.4 kg, rising to 85.5 +/- 16.8 kg post-lockdown, although the increase was not statistically significant (p = 0.781). In terms of glycemic parameters, Hba1c rose from 7.67 +/- 1.76 to 8.11 +/- 2.48, and fasting glucose from 157.9 (83-645) mg/dl to 163.2 (84-550) mg/dl, none of which were statistically significant (p = 0.253, p = 0.079, respectively). Conclusion: In addition to weight gain among type 2 DM patients during the Covid 19 lockdown, statistically insignificant increases were also observed in such glycemic parameters. This was a small sample and further studies with larger sample are needed. (C) 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.Öğe Geriatrik yaşta amoksisilin kullanımı sonucu gelişen ve hayatı tehtid eden, ağır stevens johnson sendromu(2010) Önder, Arif; Güngör, Adem; Celbek, Gökhan; Çeçen, Faruk; Yıldırım, Ümran; Gürlevik, Zehra; Cinemre, HakanStevens Johnson Sendromu (SJS) genellikle ilaçlara ve enfeksiyonlara karşı oluşan, ateş, stomatit ve konjonktivit ile karakterize ağır bir cilt reaksiyonudur. Her yaş ve cinsiyette ortaya çıkabilmekle birlikle genellikle 2.-4. dekatta görülür, ileri yaşlarda nadir olarak görülmektedir. Litaretürde ilaca bağlı SJS ile ilgili pek çok vaka sunumu yapılmakla birlikte amoksisiline bağlı SJS vakaları nadirdir. Bu yazıda pnömoni nedeniyle amoksisilin başlanmasının ardından gelişen, geriatrik yaş grubunda ortaya çıkan SJS olgusu sunulmuştur. Yetmiş dört yaşında erkek hasta pnömoni nedeniyle amoksisilin tedavisi başlanmasından 2 gün sonra başlayan tüm vücudunda yaygın döküntü, göz kapağında şişlik, gözde kızarıklık ve nefes darlığı şikayeti ile acil servisimize başvurdu. Hasta prerenal akut böbrek yetmezliği, pnömoni, ilaç reaksiyonu (SJS) öntanısıyla servisimize yatırıldı. Hastaya klinik ve histopatolojik olarak SJS tanısı konularak IV steroid tedavisi başlandı. Hastanın verilen steroid tedavisi ile cilt döküntülerinde belirgin düzelme izlendi. Hastanın steroid tedavisi azaltılarak kesildi. Günümüzde betalaktam antibiyotikler özellikle amoksisilin güvenli bir ilaç olarak sıklıkla kullanılmaktadır. Ancak nadirde olsa ileri yaşlarda amoksisiline bağlı SJS gibi yaşamı tehdit eden yan etkilerin görülebileceği akılda tutulmalıdır.Öğe Hematologic Effects of Levothyroxine in Iron-Deficient Subclinical Hypothyroid Patients: A Randomized, Double-Blind, Controlled Study(Endocrine Soc, 2009) Cinemre, Hakan; Bilir, Cemil; Gökosmanoğlu, Feyzi; Bahçebaşı, TalatContext: In patients with coexisting iron-deficiency anemia and subclinical hypothyroidism, anemia does not adequately respond to oral iron therapy. Objective: We studied whether iron-deficiency anemia might indicate treatment of subclinical hypothyroidism. Design: Patients were assigned to a control or experimental group: 240 mg/d oral iron alone (iron group) or 240 mg/d oral iron plus 75 mu g/d levothyroxine (iron/levothyroxine group). Levels of hemoglobin, hematocrit, red blood cell count, serum iron levels, ferritin, total iron-binding capacity, TSH, and free T-4 were measured before and after treatment. Setting: The study was conducted at a university hospital outpatient clinic. Patients: Fifty-one patients with coexisting iron-deficiency anemia and subclinical hypothyroidism participated in the study. Intervention: Patients were treated as described above in either the iron group or the iron/levothyroxine group. Main Outcome Measure: A clinically satisfactory increase in hemoglobin was regarded as successful. Results: Mean hemoglobin levels increased by 0.4 g/dl in the iron group [95% confidence interval (CI) 0.2-0.7, P = 0.001], whereas it increased by a mean of 1.9 g/dl in the iron/levothyroxine group (95% CI 1.5-2.3, P < 0.0001). The increase in serum iron was greater in the iron/levothyroxine group by a mean of 47.6 mu g/dl (95% CI 34.5-60.6, P < 0.0001). Increases in hemoglobin, red blood cells, hematocrit, and serum ferritin levels after treatment were statistically significantly greater in the iron/levothyroxine group (P < 0.0001). Starting hemoglobin and increase in hemoglobin were negatively correlated in the iron/levothyroxine group (r = -0.531, P = 0.006). Conclusions: Subclinical hypothyroidism should be treated in iron-deficiency anemia patients when both conditions coexist. This would provide a desired therapeutic response to oral iron replacement and prevent ineffective iron therapy. (J Clin Endocrinol Metab 94: 151-156, 2009)Öğe Increased P wave dispersion in hypothyroidism: a sign of risk of atrial fibrillation(Tubitak Scientific & Technical Research Council Turkey, 2009) Akdemir, Ramazan; Eryaşar, Neslihan Ebru; Çelik, Kudret; Güngüneş, Aşkın; Cinemre, Hakan; Bilir, Cemil; Kılıç, HarunAim: As in hyperthyroidism, cardiac arrhythmias can be seen in hypothyroidism. In this study, we measured P wave dispersion among hypothyroid patients to evaluate atrial fibrillation risk. Methods: 75 patients who received first time diagnosis of hypothyroidism and 40 normal control patients were included in this study. Each patient had echocardiographic and electrocardiographic studies were carried out. Groups were compared for statistically significant difference in P wave dispersion, minimum P wave duration and maximum P wave duration. Results: The groups were similar in echocardiographic and electrocardiograpic features. P wave dispersion was significantly higher in the hypothyroid group compared to normal controls (31.9 +/- 9.3 ms vs. 26.5 +/- 9.4 ms, p = 0.003). Minimum P wave duration was significantly shorter in the hypothyroid group compared to controls (63.8 +/- 9.2 ms vs 68 +/- 9.2ms, p = 0.026). Maximum P wave duration was not significantly different between groups (95.4 +/- 12.3 ms vs. 94.7 +/- 8.7 ms, p.0, 74). Conclusion: P wave dispersion was increased in the first time diagnosed clinical hypothyroid patients. This is the first study to evaluate P wave dispersion in clinical hypothyroid patients. We believe that our findings have clinically important implications and provide insight into possible mechanisms of this morbid condition.Öğe Increased Serum Asymmetric Dimethylarginine Levels in Primary Dysmenorrhea(Karger, 2010) Akdemir, Nermin; Cinemre, Hakan; Bilir, Cemil; Akın, Okhan; Akdemir, RamazanBackground: Primary dysmenorrhea is a common disorder among young women, and uterine ischemia plays an important role in pelvic pain. Asymmetric dimethylarginine (ADMA) is accepted as a strong marker of endothelial dysfunction. Objective: To investigate the role of ADMA in primary dysmenorrhea. Methods: Thirty-three patients with primary dysmenorrhea and 29 healthy controls were evaluated in a hospital outpatient clinic-based study. Secondary causes of dysmenorrhea had been ruled out in each patient. LDL cholesterol, triglycerides measured and body mass index were also calculated. Blood samples for determination of ADMA concentration were drawn on the 3rd day of menses in each woman. Groups were compared for statistically significant difference by Mann-Whitney U test. Results: Groups did not differ in age or hormone levels. ADMA level was higher in women with dysmenorrhea compared to healthy controls (Mann-Whitney U test, Z = -2.24, p = 0.025). ADMA levels showed positive correlation with age and erythrocyte sedimentation rate in the first group (Spearman's rho = 0.360, p = 0.040, and r = 0.379, p = 0.029, respectively). Although erythrocyte sedimentation rate and C-reactive protein (CRP) were positively correlated, no significant correlations were found between high-sensitivity CRP and ADMA level in the first group (Spearman's rho = 0.048, p = 0.749). Conclusion: ADMA concentrations are elevated in primary dysmenorrhea compared to healthy controls. This suggests that endothelial dysfunction plays a role in primary dysmenorrhea. Copyright (C) 2009 S. Karger AG, BaselÖğe Isolated Renal Vein Thrombosis Associated With MTHFR-1298 and PAI-1 4G Gene Mutations(Sage Publications Inc, 2010) Cinemre, Hakan; Bilir, Cemil; Akdemir, NerminIsolated renal vein thrombosis is very rare without the presence of nephrotic syndrome. It is more common in the newborns and infants. Whereas major risk factors in adults are the procoagulant states such as protein C or S deficiency, factor V Leiden mutation, primary or secondary antiphospholipid syndrome, severe hypothyroidism, and trauma. Here, we report a case of isolated renal vein thrombosis associated with MTHFR-1298 and PAI-1 4G gene mutations. It should be noted that the presence of MTHFR-1298 and PAI-1 4G gene mutations together might be one of the examples of genetic mutation combinations that increase the likelihood of a thrombotic event.Öğe Kimura Disease's: A Case Report(Deri Zuhrevi Hastaliklar Dernegi, 2009) Cinemre, Hakan; Gökosmanoğlu, Feyzi; Bilir, CemilKimura is a chronic inflammatory disease at oral mucosa which presents as large subcutaneous nodules or masses on the head or neck of adulthood males The lesions characteristics are eosinophilia in lymphocytic infiltration, fibrosis and diffuse vascularity. Eosinophilia and elevated blood IgE can be present. A 62 years old female with inguinal mass and itching was presented (Turkderm 2009, 43 171-3)Öğe Kimura disease's: A case report(2009) Cinemre, Hakan; Gökosmanoğlu, Feyzi; Bilir, CemilKimura is a chronic inflamatuary disease at oral mucosa which presents as large subcutaneous nodules or masses on the head or neck of adulthood males. The lesions characteristics are eosinophilia in lymphocytic infiltration, fibrosis and diffuse vascularity. Eosinophilia and elevated blood IgE can be peresent. A 62 years old female with inguinal mass and itching was presented.Öğe Kimura hastalığı: Olgu sunumu(2009) Cinemre, Hakan; Gökosmanoğlu, Hakan; Bilir, CemilKimura hastalığı; subkutan dokuda nodül veya kitleler şeklinde, özellikle genç ve orta yaşlı erkeklerde baş-boyun bölgesi, oral mukozada görülen kronik inflamatuvar bir hastalıktır. Lezyonlar, lenfositik infiltrasyonların içinde yer alan eozinofiller, fibrozis ve zengin vasküler ağ yapısının varlığıyla karakterizedir. Periferik kanda eozinofili ve serum Ig E artışı olabilir. Olgumuz 62 yaşında kadın olup inguinal bölgede şişlik ve bütün vucudda yaygın kaşıntı yakınması ile başvurdu.Öğe Lifestyle modification decreases the mean platelet volume in prehypertensive patients(Taylor & Francis Inc, 2009) Yazıcı, Mehmet; Kaya, Ahmet; Kaya, Yasemin; Albayrak, Sinan; Cinemre, Hakan; Özhan, HakanMean platelet volume (MPV) is an indicator of platelet activation. The present study was designed to investigate platelet function by measuring MPV, platelet count (PLC) and platelet mass (PLM) in prehypertensive (PHT) subjects. Additionally, we also evaluated the effects of lifestyle modification on platelet functions by measuring MPV, PLC and PLM. We selected 36 newly diagnosed PHT patients and 21 control subjects (BP 120/80 mmHg) matched for age and sex. Lifestyle modifications (weight loss, reduced sodium intake, increased physical activity, limited alcohol consumption and the Dietary Approaches to Stop Hypertension (DASH) diet) were recommended to PHT individuals for 20 weeks. At entry into the study, although PLM and PLC values were similar between study groups, MPV values were significantly higher in the PHT group than in the control group (respectively, 10.41 0.93 fl vs. 9.56 1.04 fl, p 0.01). Additionally, MPV was positively correlated with the systolic blood pressure (BP), body mass index (BMI) and insulin resistance (IR) in the PHT group (r: 0.41; p 0.02, r: 0.37; p 0.04, r: 0.35; p 0.05, respectively). Only age and PHT were found to be independent predictors of MPV after regression analysis. The program substantially lowered BP (net reductions in systolic and diastolic BPs of 16.2 and 8.7 mmHg, p 0.001, p 0.001, respectively). In addition, BMI, waist circumference (WC) and IR were significantly reduced in the PHT group (p 0.01, p 0.01, p 0.05, respectively). At the end of study, although PLM, PLC values were reduced in the PHT group, only the decrease in MPV reached statistical significance (respectively, 10.41 0.93 fl vs. 9.67 1.2 fl, p 0.01). In closing, to our best notice, our study is the first to display a significant increase in MPV in PHT subjects and to show a decrease in MPV by lifestyle modification after 20 weeks. As a result, we consider that decreased platelet activation with multi-aspect effects of lifestyle modification therapy might play an important role in reducing thrombotic risk in PHT patients.Öğe Mean Platelet Volume is Associated with Glycaemic Control and Retinopathy in Patients with Type 2 Diabetes Mellitus(Univ West Indies Faculty Medical Sciences, 2013) Dindar, S.; Cinemre, Hakan; Şengül, Erkan; Annakkaya, Ali NihatObjectives: To investigate the relationship between mean platelet volume (MPV) and glycometabolic indices, to compare MPV according to HbA1c levels, and to analyse the difference in MPV between patients with and without microvascular complications. Methods: This retrospective study was conducted on 60 Type 2 diabetic patients and 50 age- and sex-matched non-diabetic controls. We obtained demographic, clinical and laboratory data including MPV platelet count, fasting and postprandial blood glucose (FBG and PBG), haemoglobin A1c (HbA1c), lipid profile, creatinine, systolic and diastolic blood pressure (BP) in patient and control groups, and diabetic microvascular complications including nephropathy, neuropathy, and retinopathy in the patient group. All analyses were performed using SPSS version 15.0 for Windows. Results: Mean platelet volume in the diabetic group was higher than in the control group (p = 0.001). Mean platelet volume was positively correlated with FBG and HbA1c levels (p = 0.03 and p < 0.001, respectively). It was also negatively related to platelet count (p < 0.001). Mean platelet volume in patients with HbA1c > 7% was significantly higher than those with HbA1c <= 7% (p < 0.001). Mean platelet volume was significantly increased in patients with retinopathy compared to those without retinopathy (p = 0.04). Conclusion: This study has shown that an increased MPV is closely associated with poor glycaemic control, which may be a risk factor for diabetic retinopathy. Nonetheless, further prospective studies are needed to assess the relationship between MPV, glycaemic indices and microvascular complications.Öğe Multiple myeloma bağlı maksiller tutulum sonrası gelişen akut lösemi(2007) Gökosmanoğlu, Feyzi; Cinemre, Hakan; Bilir, CemilMultiple myelom, immünglobulin sekrete eden plazma hücrelerinin malign bir klonunu meydana getiren, transformasyona uğramış B-lenfoid progenitor hücrelerinin proliferasyonunun neden olduğu, kemik iliğini infiltre eden plazma hücrelerinden kaynaklanan, yaşlı popülasyonun neoplastik bir hastalığıdır. Multiple myelom (MM) tüm kemik tümörlerinin %27'sini oluşturur ve bu oran ile kemiğin en sık görülen malign tümörüdür. Lokalize ya da yaygın iskelet sistemi ağrılarının eşlik ettiği kemik tutulumları karakteristiktir. Multiple myelom, genellikle kafatası, klavikula, vertebra, pelvis gibi yassı kemikleri tutar. MM 'da oral bulguların ortaya çıkması, hastalığın ileri dönemde olduğuna işaret eder. Bu nedenle multiple myelom tanılı olguların dikkatli değerlendirilmesi ve bu olgulara multidisipliner yaklaşılmalıdır. Biz, kliniğimizde multiple myelom tanısı alan 60 yaşında kadın bir hastanın takipleri sırasında ikinci molar diş bölgesi lokalizasyonunda myelomatoz maksiUer tutulum sonrası gelişen akut plazma hücreli lösemili bir olgu rapor ettik.Öğe Oral ulcers caused by alendronate use(2008) Cinemre, Hakan; Bilir, Cemil; Gökosmanoğlu, Feyzi; Aytuğ, Necip Ö.Bisphosphonates are the drugs which modulate bone turnover and reduce bone reabsorbsion. Hence, they are used in postmenopausal osteoporosis, multiple myeloma or osteolisis associated with malign cancer. The rare complications are appearing more often now because of their wide use in treatments. Most important possible adverse effects belong to gastrointestinal systems; esophagitis, gastric ulcers, dyspepsia, heartburn and rarely oral ulcers, osteonecrosis on jaws and esophagial stricturs are illustrated.
