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Öğe Akut gastrik dilatasyon(2014) Ermiş, Fatih; Koç, Alper; Büyükkaya, Ramazan; Kutlucan, Ali; Aydın, Yusuf…Öğe Application of ATC/DDD methodology to eveluate of antibiotic use in a general hospital in Turkey(Bmc, 2013) Sözen, Hamdi; Gönen, İbak; Sözen, Ayşe; Kutlucan, Ali; Kalemci, Serdar; Şahan, MuratBackground: The aim of this study is to evaluate in-house antibiotic use in a state hospital in Turkey with its cost, using the ATC/DDD index, which is an accepted standard method. Methods: This study was performed as a point prevalence study in a state hospital with 372 beds. All in-house patients using antibiotics on July 19, 2011 were included in the study. Indications for antibiotic use and information about the patients were recorded on special forms. Antibiotic use and cost analysis were evaluated using the ATC/DDD index, which is also suggested by the WHO to be used in similar studies. Findings: 147 patients out of 308 patients who were in-house were identified to use antibiotics with appropriate indications for prophylaxis or treatment in 61% of the patients. The rate of appropriate antibiotic use was identified to be in 78%, while this rate was 38.9% in surgical clinics. The daily cost of the antibiotics consumed on the date of the study was calculated as 4104.79 TL (=2476.80 USD). Discussion: The rate of inappropriate use of antibiotics seems to be high in our hospital. This will result in both increased costs and also increased nosocomial infection rates with resistant species. Infectious disease specialists should take more active roles in the in-house antibiotic use, hospitals should prepare and implement their own principles of antibiotic use, and microbiology laboratories should be used more effectively. These measures would decrease the conspicuous shortcomings in the antibiotic use.Öğe Association of "Controlling Nutritional Status Index'' and "Prognostic Nutritional Index'' with intensive care unit survival in elderly patients(Springer, 2016) Köş, Mehmet; Titiz, Hafize; Öneç, Birgül; Soysal, Tuba; Kutlucan, Ali; Emen, S. Şahiner; Kutlucan, LeylaObjectives: Providing proper nutritional support for the intensive care unit (ICU) patients is only possible with assessment of malnutrition. In this study, we aimed to evaluate associations between nutritional indexes which were developed to assess malnutrition using blood parameters, and survival among elderly patients in the ICU. Patients and methods: Patients older than 65 years of age and monitored in the ICU, were retrospectively screened with nutritional indexes in order to assess the nutritional status. Each patient was evaluated with both "Controlling Nutritional Status Index'' (CONUT) which includes albumin, total cholesterol, total lymphocyte counts, and "Prognostic Nutritional Index'' (PNI) which includes only albumin beside total lymphocyte count. Results: Two hundred twenty five patients were enrolled in this study. Median age was 79 (range: 65100). One hundred and eleven (49.3%) patients died during intensive care follow-up. CONUT and PNI scores displayed significant differences between patients who died and who were discharged (P = 0.02 and P = 0.03, respectively). Kaplan-Meier analysis revealed that high CONUT (>= 5) and low PNI (<40) scores were associated with intensive care unit survival but statistical significance was not provided for PNI (P = 0.04 and P = 0.06, respectively). Conclusion: Both CONUT and PNI indexes seems associated with survival but only CONUT score provides statistically significant prognostic information and may serve as a cost-effective nutritional assessment tool in elderly patients. Because this association did not retain its significance on multivariate analysis, the validity of this index in elderly patients should be further evaluated by prospective studies including larger samples. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.Öğe Association of mean Platelet volume with DSM-IV major depression in a large community-based population: The MELEN study(Pergamon-Elsevier Science Ltd, 2012) Canan, Fatih; Dikici, Süber; Kutlucan, Ali; Celbek, Gökhan; Coşkun, Hülya; Güngör, Adem; Kocaman, GülşenThe relationship between major depression and increased platelet activity has been previously stated by several studies. This study sought to test the relationship between mean platelet volume (MPV) - an indicator of platelet activity - and major depression, in an adult Turkish population sample. Respondents were 2286 participants interviewed in a regional survey. The diagnosis of current (one month) major depression was made according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. MPV was measured along with total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, BMI, and waist circumference. Two hundred eighty-nine participants (12.5%) were diagnosed as having major depression. Patients with major depression were found to have increased MPV levels in comparison with participants without depression (p = 0.001). After excluding the subjects with risk factors capable of influencing platelet activity. MPV was still found to be elevated in patients with major depression compared with non-depressed individuals (p < 0.01). Linear regression analysis revealed a significant independent association of major depression with MPV levels (r = 0.123: p = 0.001). According to the findings of this study, increased MPV (or platelet activation) is associated with current (one month) diagnosis of major depression. Future research should investigate the effect of depression treatment on MPV. (C) 2011 Elsevier Ltd. All rights reserved.Öğe Association of vitamin B12 with obesity, overweight, insulin resistance and metabolic syndrome, and body fat composition; primary care-based study(2013) Baltacı, Davut; Kutlucan, Ali; Türker, Yasemin; Yılmaz, Aylin; Karaçam, Mehmet Serkan; Deler, Harun; Kara, İsmail HamdiAim To investigate correlation of vitamin B12 with obesity insulin resistance, metabolic syndrome. Methods The cross-sectional and primary care-based study was carried out. Anthropometric, blood pressure measurements and bioelectric impedance analysis (BIA) were recorded. Vitamin B12, folic acid, hemogram, insulin, ferritin, iron, total iron binding capacity and other biochemical tests were assayed. The subjects were grouped as obesity, overweight, control, metabolic syndrome (MetS) and insulin resistance (IR). Correlation of vitamin B12 with body mass index (BMI), IR, age, and BIA was evaluated. Results The study enrolled 976 patients (obesity: 414, overweight: 212, and control: 351). The mean age in groups of obesity, overweight and control were 35.9 ± 8.7, 28.9 ± 6.3 and 33.1 ± 8.7, respectively (p = 0.142). Vitamin B12 level was significantly lower in patients with obesity and overweight than healthy individuals (178.9 ± 25.2; 219.8 ± 78.5, and 328.5 ± 120.5, p < 0.001, respectively). Vitamin B12 level was lower in patients with MetS (+/-) and IR (+/-), but insignificant (p = 0.075 and 0.058, respectively). Significant and negative correlation was observed between vitamin B12 and BMI (r =-0.221, p=0.001). No significant difference was observed between obese male and female patients (247.8 ± 89.1 versus 235.5 ± 89.3 pg/mL, respectively, p=0.090). Conclusion Low Vitamin B12 level was associated with obesity and overweight, but not with insulin resistance, metabolic syndrome and gender. Vitamin B12 was negatively correlated only with body mass index.Öğe An Atypical Femoral Fracture in a Patient on Long-term Alendronate Therapy(Informa Healthcare, 2014) Celbek, Gökhan; Özşahin, Mustafa; Uslu, Mustafa; Önder, Elif; Kutlucan, Ali; Beşir, Fahri Halit; Aydın, YusufBackground: Biphosphonates, especially alendronate, are used extensively and successfully for the treatment of osteoporosis. However, there are numerous recent studies that indicate low-energy subtrochanteric femoral fractures can be associated with long-term alendronate therapy. Findings: We present a 76-year-old female patient who has taken 70 mg alendronate per week for 7 years, and who presented with pain in the left thigh. Conclusions: The patient was diagnosed as atypical femoral fracture resulting from long-term alendronate use. The diagnosis and the treatment will be discussed with a review of the literature.Öğe Bilateral Fifth-Finger Camptodactyly(Lippincott Williams & Wilkins, 2012) Özşahin, Mustafa; Uslu, Mustafa; Kutlucan, Ali; Baki, Ali Erdem; Ataoğlu, Safinaz…Öğe Can influenza H1N1 vaccination lead to the membranous glomerulonephritis?(Medknow Publications, 2012) Kutlucan, Ali; Gönen, İbak; Yıldızhan, Esra; Aydın, Yusuf; Sav, Tansu; Yıldırım, ÜmranIn 2009 winter, Influenza A (H1N1) monovalent split virus vaccine was used prevalently in the whole world as a result of the pandemic caused by Influenza (H1N1) virus. The vaccine's adverse effects were observed closely and vaccination has been found as safe in most studies. But some reports about immune response related diseases after influenza vaccinations are remarkable. The close relationship between membranous glomerulonephritis and antigens is known, particularly in seconder forms which occur after viral infections and vaccinations. So this case report is about a 56-year-old man, who developed membranous glomerulonephritis 23 days after the vaccination against Influenza A (H1N1) virus.Öğe CAN LEUKOCYTE SUBGROUPS OF CRITICAL PATIENTS BE AN INDICATOR FOR MORTALITY, DURATION OF HOSPITALISATION AND DEVELOPMENT OF HOSPITAL INFECTION?(Pergamon-Elsevier Science Ltd, 2015) Kutlucan, Leyla; Kutlucan, Ali; Baştürk, Abdulkadir; Başaran, Betül; Kozanhan, Betül; Gür, M.; Köş, Mehmet…Öğe COINCIDENCE OF AUTUIMMUNE HEMOLYTIC ANEMIA AND AUTOIMMUNE HEPATITIS(Pergamon-Elsevier Science Ltd, 2015) Kutlucan, Ali; Dağlı, M.; Kutlucan, L.; Ermiş, F.; Baştürk, A.; Uğurluoğlu, C.; Sözen, M.…Öğe Destroyed lung secondary to multiple myeloma in a previously treated tuberculosis patient(TIP ARASTIRMALARI DERNEGI, 2014) Kutlucan, Ali; Aydın, Leyla Yılmaz; Gönen, İbak; Erdem, Havva; Özşahin, Mustafa; Aydın, Yusuf; Büyükkaya, RamazanThis case is presented with a pulmonary parenchymal destruction due to acquired multiple myeloma who has a history of pulmonary tuberculosis. A 55 year old male patient attempted to emergency department with complaints of shortness of breath. The final diagnose with the existing clinical and laboratory outputs were right pulmonary parenchymal destruction and pleural involvements secondary to multiple myeloma. Our prediagnose was confirmed by the overt plasma cell increase and Russell bodies in cytopathologic examination of the pleural fluid. Even though multiple myeloma leads to destruction in the pulmonary parenchyma rarely, patients should be scrutinized enough to elicit true diagnose.Öğe Diklofenak ve parasetamolun intihar amaçlı kullanımına bağlı subkonjonktival kanama gelişen iki olgu(2011) Yıldızhan, Esra; Kutlucan, Ali; Güngör, Adem; Kılıç, Cağrı; Kandiş, HayatiParasetamol ve diklofenak çok sık kullanılan ve güvenli kabul edilen ilaçlar olmasına rağmen terapötik ve aşırı dozlarında gelişen komplikasyonlarla sıkça karşılaşılır. Her iki ilaç da trombosit fonksiyon bozukluğu yaparak kanama bozukluklarına sebep olabilir ve subkonjunktival hemoraji gibi atipik bir klinikle kendini gösterebilir. Sunulan olgularda intihar amacı ile primer olarak toksik dozda parasetamol ve ilk olguda ek olarak yüksek dozda diklofenak alımı sonrasında gelişen subkonjunktival kanama, ilaç yan etkisi ile ilişkili kanama bozukluğuna bağlandı. Bilinen komorbiditesi olmayan hastalar için subkonjunktival kanamaya neden olabilecek ilaç kullanımı dışındaki; travma, enfeksiyonlar, trombositopeni, malign kan hastalıkları, septisemi, hipertansiyon, siddetli öksürük gibi nedenler dışlandı. Karaciğer ve böbrek toksisitesi yaygın olarak bilinen bu ilaçların yüksek dozlarda alımı söz konusu olmasına rağmen kompanse metabolik asidoz dışında karaciğer ve böbrek fonksiyon testlerinde bozukluk görülmedi. Yazıda parasetamol ve diklofenak’ın kanama bozuklukları ile ilişkisi subkonjunktival kanama ile ortaya çıkan iki olgu üzerinden tartışılmıştır.Öğe Disseminated Tuberculosis During the Course of Behçet's Disease: A Case Report(2012) Gönen, İbak; Özşahin, Mustafa; Yıldırım, Mustafa; Özdemir, Davut; Aydın, Leyla Yılmaz; Kutlucan, Ali; Büyükkaya, RamazanBu yazıda, ateş, baş ağrısı ve yorgunluk şikayetiyle başvuran, Behçet hastalığı seyrinde dissemine tüberküloz olan, 22 yaşında bir erkek hasta sunuldu. Başlangıç tanısı nöro-Behçet sendromuydu. Romatizmal hastalıkların seyrinde görülen tüberküloz, genellikle TNF-alfa blokerlerinin kullanımıyla ilişkilendirilmektedir. Olgumuzda, hasta TNF-alfa blokeri kullanmamış olmasına rağmen, dissemine tüberküloz gelişti. Mevcut bilgilerimiz doğrultusunda, bu olgu, konvansiyonel immünosüpresif tedavi alan bir Behçet hastasında gelişen bu denli yaygın seyreden ilk tüberküloz olgusudurÖğe Disseminated Tuberculosis During the Course of Behcet's Disease: A Case Report(Turkish League Against Rheumatism, 2012) Gönen, İbak; Özşahin, Mustafa; Yıldırım, Mustafa; Özdemir, Davut; Aydın, Leyla Yılmaz; Kutlucan, Ali; Büyükkaya, RamazanIn this article, a 22 year-old male with disseminated tuberculosis during the course of Behcet's disease who was admitted with the complaints of fever, headache and fatigue was presented. The initial diagnosis was neuro-Behcet's syndrome. Tuberculosis during the course of rheumatic diseases are often associated with the use of TNF-alpha blockers. In our case, the patient experienced severe disseminated tuberculosis, despite being TNF-alpha blocker-naive. To the best of our knowledge, this is the first case of tuberculosis with such a disseminated course developed in a patient with Behcet's disease who received conventional immunosuppressive treatment.Öğe THE EFFECT OF ANEMIA AND RED CELL TRANSFUSIONS ON MORTALITY IN YOUNG AND ELDERLY INTENSIVE CARE PATIENTS WITH NOSOCOMIAL INFECTION(Pergamon-Elsevier Science Ltd, 2014) Kutlucan, Leyla; Kutlucan, Ali; Kandiş, Hayati; Titiz, Hafize; Şenocak, Elif; Baştürk, Abdulkadir; Geyik, M.…Öğe Effectiveness for self-monitoring of blood sugar on blood glucose control in Turkish patients with type 2 diabetes mellitus(Medical Assoc Zenicadoboj Canton, 2012) Baltacı, Davut; Kutlucan, Ali; Öztürk, Serkan; Sarıtaş, Ayhan; Çeler, Ahmet; Celbek, Gökhan; Ankaralı, HandanAim Diabetes mellitus (DM) is a chronic disease requiring continuous monitoring and treatment. Self-monitoring of blood glucose (SMBG) is frequently recommended. The purpose of the study was to evaluate effectiveness of SMBG on metabolic control in Turkish patients with type 2 DM. Methods The cross-sectional study enrolled type 2 diabetic patients without insulin regimen. The participants were assigned to three groups according to status of SMBG: group 1- regular, group 2 - irregular and group 3 - never SMBG implementation. Results A total of 349 patients were enrolled. There was no significant difference in mean fasting and post-prandial blood glucose, lipid profile values between the groups. The number of patients with high education level in group 1 was higher than groups 2 and 3 (p = 0.001). HbA1c level was higher in groups 2 and 3 than group I, but not significantly (p = 0.285). Mean spot urinary albumin-creatinine ratio (ACR) in group I is significantly lower than in groups 2 and 3 (p = 0.008 and p = 0.044, respectively), but no significant difference was observed between group 2 and 3 (p = 0.473). Conclusion The study indicated that regular use of SMBG was not superior to irregular/never use of SMBG on glycemic control, but it seemed to be good intervention for prevention of diabetic nephropathy. We suggestively offered that SMBG should be recommended for patients with a high education level to meet the goal of its use, and it should be incorporated into self-management with effective educational intervention.Öğe THE EFFECTS OF ANEMIA AND RED CELL TRANSFUSION ON THE RISK OF MORTALITY AMONG GERIATRIC AND NON-GERIATRIC PATIENTS WITH HOSPITAL-ACQUIRED INFECTIONS IN AN INTENSIVE CARE UNIT(Gunes Kitabevi Ltd Sti, 2015) Kutlucan, Leyla; Kutlucan, Ali; Baştürk, Abdulkadir; Kandiş, Hayati; Titiz, Hafize; Şenocak, Elif; Ankaralı, HandanIntroduction: This study aimed to investigate the effects of anemia and red blood cell transfusion on the risk of mortality in geriatric and non-geriatric Intensive Care Unit patients with Hospital-Acquired Infection. Materials and Method: This study included 546 patients aged >= 18 years; from these, 112 patients had Hospital-Acquired Infection. Results: Among the patients aged >= 65 years with Hospital-Acquired Infection who were treated in the medical Intensive Care Unit, the risk of mortality was significantly increased in patients with anemia or history of diabetes; in patients who were intubated or in patients with neurological disorders or respiratory failure. Although the abovementioned factors increased the risk of mortality in the elderly, the same relationship was not observed in patients aged<65 years. In addition, blood transfusion did not increase the risk of mortality in patients belonging to both the age groups. Conclusion: We conclude that in geriatric Intensive Care Unit patients with Hospital-Acquired Infection, anemia increases the risk of mortality but red cell transfusion does not affect the risk of mortality.Öğe The effects of anemia and red cell transfusion on the risk of mortality among geriatric and non-geriatric patients with hospital-acquired infections in an intensive care unit(Geriatrics Society, 2015) Kutlucan, Leyla; Kutlucan, Ali; Baştürk, Abdulkadir; Kandiş, Hayati; Titiz, Hafize; Şenocak, Elif; Ankaralı, HandanIntroduction: This study aimed to investigate the effects of anemia and red blood cell transfusion on the risk of mortality in geriatric and non-geriatric Intensive Care Unit patients with Hospital- Acquired Infection. Materials and Method: This study included 546 patients aged ?18 years, from these, 112 patients had Hospital-Acquired Infection. Results: Among the patients aged ?65 years with Hospital-Acquired Infection who were treated in the medical Intensive Care Unit, the risk of mortality was significantly increased in patients with anemia or history of diabetes, in patients who were intubated or in patients with neurological disorders or respiratory failure. Although the abovementioned factors increased the risk of mortality in the elderly, the same relationship was not observed in patients aged<65 years. In addition, blood transfusion did not increase the risk of mortality in patients belonging to both the age groups. Conclusion: We conclude that in geriatric Intensive Care Unit patients with Hospital-Acquired Infection, anemia increases the risk of mortality but red cell transfusion does not affect the risk of mortality. © 2015, Geriatrics Society. All rights reserved.Öğe Effects of the Degree of Obesity on Achieving Target Blood Pressure and Metabolic Deterioration in Obese Individuals: A Population-Based Study(Karger, 2013) Öztürk, Serkan; Baltacı, Davut; Türker, Yasemin; Kutlucan, Ali; Yengil, Erhan; Deler, Mehmet Harun; Ankaralı, HandanBackground/Aims: This study aimed to evaluate the severity of obesity and its impact on achieving target blood pressure and metabolic derangement in obese individuals. Methods: This cross-sectional and population-based study was conducted between January and December 2012. A total of 1837 consecutive obese patients admitted to our outpatient clinic were enrolled. The anthropometric and blood pressure measurements, bioelectrical impedance fat analysis, blood sample analysis, impaired glucose status, metabolic syndrome, and insulin resistance of 1265 obese patients were compared between groups of patients separated by severity of obesity. Results: Only approximately one-third of patients with previous hypertension achieved normal blood pressure. In addition, the majority of patients without previous hypertension had higher blood pressure at the end of the study compared with baseline. The percent of patients with an impaired fasting blood glucose >= 100 mg/dL was 38.5%. The frequency of impaired glucose tolerance was 39.1% in the patients who underwent OGTT. Body mass index (BMI) was associated with impaired blood glucose, hypertension, insulin resistance, and the development of metabolic syndrome. The incidences of metabolic syndrome, insulin resistance, impaired glucose tolerance, and uncontrolled blood pressure were significantly different between groups of differing obesity severity (p<0.001, p<0.001, p=0.041, and p<0.001, respectively). Conclusion: The severity of obesity was associated with the failure to achieve target blood pressure and metabolic syndrome. Based on our data, blood pressure and metabolic parameters in obese patients should be monitored frequently and treated with caution. Copyright (C) 2013 S. Karger AG, BaselÖğe Enerji içecekleri hakkında neler biliyoruz?(2012) Dikici, Süber; Yılmaz, Leyla Aydın; Kutlucan, Ali; Ercan, NurtenGenç erişkinler arasında popüler olan enerji içecekleri, özellikle 21-35 yaş arası üniversite öğrencilerine, atletlere ve aktif kişilere pazarlanmaktadır. Enerji içeceklerinin kullanımı başlangıçta fiziksel ve mental performansı belirgin olarak artırabilir. Enerji içeceklerinin ana bileşenlerini ginkgo ve gingsengin oluşturduğu bitkisel ürünler oluşturmuş olup, kafein ve guarana içeren gibi bileşenler karışımını içerir Ne yazık ki enerji içeceklerinin vücut üzerine etkileri ile ilgili literatür sınırlıdır ve bu iyileşmenin kafein veya diğer bitkisel içeriklere bağlı olup olmadığı bilinmemektedir. Alkol ile enerji içeceklerinin beraber kullanımı sonrası ciddi klinik tablolar ortaya çıkabilir. Bu makalenin amacı; enerji içeceklerinin içerikleri ve kullanımı sonrasın da oluşabilecek klinik tablolarla ilgili farkındalığı artırma ve bilgileri güncellemektir.
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