Hakan Buyukhatipoglu | University of Gaziantep (original) (raw)

Papers by Hakan Buyukhatipoglu

Research paper thumbnail of Intravenous immunoglobulin therapy in pregnant patients affected with systemic lupus erythematosus and recurrent spontaneous abortion

Rheumatology, 2008

Objectives. We aimed to test the maternal and fetal outcome of SLE patients who suffered from rec... more Objectives. We aimed to test the maternal and fetal outcome of SLE patients who suffered from recurrent spontaneous abortion (RSA) treated with intravenous immunoglobulin (IVIg) alone during pregnancy and whether the clinical response to IVIg treatment is accompanied by modifications of SLE-associated antibodies and of complement levels. Methods. Twelve SLE-RSA pregnant patients were treated with high-dose IVIg and compared with 12 SLE-RSA pregnant patients treated with prednisolone and NSAIDs. They were evaluated for the clinical response [lupus activity index-pregnancy (LAI-P) scale] and for ANA, anti-dsDNA, anti Ro/SS-A or La/SS-B, aCL, LAC, C4, C3 before and during pregnancy, and before and after each treatment course. Pregnancy outcome in the two groups was also evaluated. Results. The groups characteristics were homogeneous at the beginning of pregnancy. A beneficial clinical response following IVIg treatment was noted in all patients and mean LAI-P decreased from 0.72 AE 0.43 at the beginning of pregnancy to 0.13 AE 0.19 at the end of pregnancy (P < 0.0001). Antibodies and complement levels tended to normalize in most of the patients. These clinical and laboratory improvements were significant with respect to the control group. Pregnancy was successfully carried out in 12/12 (100%) SLE-RSA patients with a mean Apgar score of 8.92. Three patients in the control group got aborted (25%). Conclusions. IVIg has a high response rate among SLE-RSA pregnant patients and may be considered safe and effective.

Research paper thumbnail of N-acetylcysteine fails to prevent renal dysfunction and oxidative stress after noniodine contrast media administration during percutaneous coronary interventions

Polish Archives of Internal Medicine, 2010

INTROduCTION Oxidative stress is believed to have a role in contrast-induced nephropathy. Based o... more INTROduCTION Oxidative stress is believed to have a role in contrast-induced nephropathy. Based on this assumption, several known antioxidants have been studied to assess their effect on nephropathy, especially N-acetylcysteine (NAC). However, its usefulness has yet to be confirmed. ObjECTIvEs We aimed to assess whether NAC has any protective effect on contrast-induced renal dysfunction, and whether NAC affects the para meters of oxidative stress in serum and urine.

Research paper thumbnail of The effect of day and night shifts on oxidative stress and anxiety symptoms of the nurses

European review for medical and pharmacological sciences, 2012

Oxidative stress is believed to have a role in the development of chronic diseases. It is also kn... more Oxidative stress is believed to have a role in the development of chronic diseases. It is also known that long-term night and shift work in nurses might be associated with many health-related problems like fatigue, sleep problems, anxiety and difficulties in maintaining regular lifestyles. In this study, we aimed to evaluate the changes of oxidative stress parameters and anxiety indexes of the nurses on day and night shifts. One hundred and twenty nurses in ordinary service and intensive care unit (ICU) were enrolled to the study. Subjects were divided into 2 groups; group 1 (n = 60) consisted of nurses working in a day shift and group 2 (n = 60) as working in the night shift. Further, both groups were divided in to 2 groups again; group la and 2a (both n = 30) who working in the ICU, group 1b and 2b (both n = 30) in the ordinary service. Just before and the end of the shifts, blood samples were obtained to measure total antioxidant status (TAS) and total oxidant status (TOS). Oxida...

Research paper thumbnail of Serum prolidase activity in idiopathic and ischemic cardiomyopathy patients

Journal of Clinical Laboratory Analysis, 2010

Idiopathic and ischemic dilated cardiomyopathies (DCM) are the most common types of DCM, and both... more Idiopathic and ischemic dilated cardiomyopathies (DCM) are the most common types of DCM, and both exhibit the same histopathological feature of fibrosis. Prolidase is an enzyme that serves a rate-limiting function in collagen turnover. Several studies have shown increased prolidase activity in fibrosis, though controversy persists. In this study, we measured prolidase enzyme activity in patients with idiopathic or ischemic DCM and in healthy controls, making this, to our knowledge, the first study to do so. What we found is that serumprolidase activity was significantly lower in both DCM groups relative to healthy volunteers and lower in ischemic DCM than idiopathic. These intriguing results could be attributed either to decreased collagen turnover in the heart tissues in which DCM develops, a result of diminished functional heart tissue, or to decreased physical activity levels among DCM patients stemming from their heart failure. Either way, further studies are needed to verify and clarify our results.

Research paper thumbnail of The association between silicone implants and both antibodies and autoimmune diseases

Clinical Rheumatology, 2008

Silicones are widely used materials in many fields of medicine and largely are believed to be bio... more Silicones are widely used materials in many fields of medicine and largely are believed to be biologically inert. However, some investigators have reported that silicone implants are associated with an increased incidence of autoimmune disorders. In this study, we evaluated the capsular tissue of silicone implants and the sera of implant patients and controls for antisilicone antibodies and nonspecific immunoglobulins

Research paper thumbnail of Propylthiouracil-Related Hemorrhagic Diathesis: A Case Report and Review of the Literature

We present an unusual case of a drug-related hemorrhagic diathesis. One month prior to admission,... more We present an unusual case of a drug-related hemorrhagic diathesis. One month prior to admission, the patient was diagnosed at another medical center as having Graves&amp;amp;#39; disease and propylthiouracil therapy (PTU) was initiated. Since clinical recovery was not achieved, the PTU was quickly increased to an unconventional daily dose of 1,000 mg. The patient was referred to our hospital because of spontaneous epistaxis, multiple ecchymoses and prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), which developed soon after the increase in PTU dose. Drug-related hemorrhagic diathesis was considered, after other possible causes had been eliminated. To the best of our knowledge, this is the first reported case of spontaneous hemorrhage due to PTU use.

Research paper thumbnail of The Value of Urine Specific Gravity in Detecting Diabetes Insipidus in a Patient with Uncontrolled Diabetes Mellitus: Urine Specific Gravity in Differential Diagnosis

Journal of General Internal Medicine, 2006

When a patient with diabetes mellitus presents with worsening polyuria and polydipsia, what is a ... more When a patient with diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 diabetes mellitus and diabetes insipidus. A 46-year-old woman with poorly controlled type 2 diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, diabetes insipidus was confirmed when urine specific gravity and urine osmolality normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in patients with polyuria and diabetes mellitus to detect diabetes insipidus.

Research paper thumbnail of Acute renal failure with the combined use of rosuvastatin and fenofibrate

Renal Failure, 2010

Among the lipid-lowering drugs, the statins and fibrates are the most commonly used agents. Eithe... more Among the lipid-lowering drugs, the statins and fibrates are the most commonly used agents. Either class of drug is considered relatively safe. Though a variety of albeit uncommon adverse side effects have been observed with both classes, most of these therapeutic complications can be managed without discontinuation of the offending drug. Sometimes, especially in patients with extremely high cholesterol and/or triglyceride levels, a combination regimen is deemed necessary. However, the combined use of lipid-lowering drugs increases the incidence and severity of adverse events. In this article, we report an unusual case of acute renal failure (ARF) in a patient who had been prescribed both a statin (rosuvastatin) and a fibrate (fenofibrate).

Research paper thumbnail of The value of urine specific gravity in detecting diabetes insipidus in a patient with uncontrolled diabetes mellitus

Journal of General Internal Medicine, 2006

When a patient with diabetes mellitus presents with worsening polyuria and polydipsia, what is a ... more When a patient with diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 diabetes mellitus and diabetes insipidus. A 46-year-old woman with poorly controlled type 2 diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, diabetes insipidus was confirmed when urine specific gravity and urine osmolaity normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in patients with polyuria and diabetes mellitus to detect diabetes insipidus.

Research paper thumbnail of Rapidly improving, severe, acute myocarditis after a scorpion bite: an extremely rare complication and successful management

American Journal of Emergency Medicine, 2010

Rapidly improving, severe, acute myocarditis after a scorpion bite: an extremely rare complicatio... more Rapidly improving, severe, acute myocarditis after a scorpion bite: an extremely rare complication and successful management

Research paper thumbnail of Erratum to: Cardiovascular involvement in Behçet’s disease

Clinical Rheumatology, 2010

Erratum to: Clin Rheumatol DOI: 10.1007/s10067-009-1302-0There was an error in the authors name o... more Erratum to: Clin Rheumatol DOI: 10.1007/s10067-009-1302-0There was an error in the authors name of the article.The correct name is:Hakan Buyukhatipoglu

Research paper thumbnail of Serum prolidase activity in idiopathic and ischemic cardiomyopathy patients

Journal of Clinical Laboratory Analysis, 2010

Idiopathic and ischemic dilated cardiomyopathies (DCM) are the most common types of DCM, and both... more Idiopathic and ischemic dilated cardiomyopathies (DCM) are the most common types of DCM, and both exhibit the same histopathological feature of fibrosis. Prolidase is an enzyme that serves a rate-limiting function in collagen turnover. Several studies have shown increased prolidase activity in fibrosis, though controversy persists. In this study, we measured prolidase enzyme activity in patients with idiopathic or ischemic DCM and in healthy controls, making this, to our knowledge, the first study to do so. What we found is that serumprolidase activity was significantly lower in both DCM groups relative to healthy volunteers and lower in ischemic DCM than idiopathic. These intriguing results could be attributed either to decreased collagen turnover in the heart tissues in which DCM develops, a result of diminished functional heart tissue, or to decreased physical activity levels among DCM patients stemming from their heart failure. Either way, further studies are needed to verify and clarify our results. J. Clin. Lab. Anal. 24:213–218, 2010. © 2010 Wiley-Liss, Inc.

Research paper thumbnail of Unusual presentation of triple A syndrome mimicking Sjögren’s syndrome

Clinical Rheumatology, 2007

Clin Rheumatol DOI: 10.1007/s10067-006-0498-5The surname of the fourth author was inadvertently o... more Clin Rheumatol DOI: 10.1007/s10067-006-0498-5The surname of the fourth author was inadvertently omitted. The author’s full name is Yusuf Ziya Igci.

Research paper thumbnail of Immunoglobulin E: a new diagnostic clue for Behçet’s disease

Clinical Rheumatology, 2007

Behçet’s disease (BD) is a multisystemic inflammatory disorder of unknown etiology. Hyperimmunogl... more Behçet’s disease (BD) is a multisystemic inflammatory disorder of unknown etiology. Hyperimmunoglobulinemia has been demonstrated in BD; however, its clinical importance has not yet been discovered. In a few reports, an association between BD and plasma immunoglobulin E (IgE) has been noted. In this study, we had three objectives: (1) to investigate plasma levels of IgE and their association with levels of acute phase reactants, (2) to determine whether treatment has any effect upon IgE levels, and (3) to assess whether higher serum levels of IgE provide a clue for the diagnosis of BD. Fifty-two patients with BD, without any accompanying disease or condition that might lead to a rise in IgE, were compared with 51 age-matched healthy controls. Plasma levels of IgE, IgA, IgG, and IgM were analyzed by means of nephelometric analysis. Results showed that among the 52 patients, 23 (44%) had IgE levels that were higher than the upper limits of normal. IgE was not correlated with age, erythrocyte sedimentation rate, or C-reactive protein (p=0.59, p=0.57, and p=0.757, respectively). These relationships remained nonsignificant when multiple regression analysis was performed, with R 2 of 0.187 and p=0.057. Moreover, treatment of patients with elevated IgE did not produce any predictable IgE response. We conclude that Behçet’s patients commonly exhibit elevated plasma IgE levels. However, elevated IgE levels are not correlated with levels of acute phase reactants or disease activity. We suggest that IgE levels might be an independent diagnostic clue in Behçet’s patients.

Research paper thumbnail of The Effects of Exogenous Melatonin on Peripheral Nerve Regeneration and Collagen Formation in Rats

Journal of Surgical Research, 2011

Background. Peripheral nerve damage that requires surgical repair does not result in complete rec... more Background. Peripheral nerve damage that requires surgical repair does not result in complete recovery because of collagen scar formation, ischemia, free oxygen radical damage, and other factors. To date, the best treatment method has not yet been determined. In this study, we designed an experimental peripheral nerve injury model, and researched the possible effects of melatonin hormone, based on evidence of its strong antioxidant and cell-protective effects via mimicking the effects of calcium channel blockers.

Research paper thumbnail of Systemic lupus erythematosus complicated by dilated cardiomyopathy and severe heart failure

Clinical Rheumatology, 2007

Systemic lupus erythematosus (SLE) is the prototype autoimmune disorder, one that is known for it... more Systemic lupus erythematosus (SLE) is the prototype autoimmune disorder, one that is known for its many, diverse modes of presentation. In this paper, we present a further unusual presentation of SLE, that of acute onset, severe heart failure secondary to dilated cardiomyopathy. Only a few similar cases have been reported in the literature.

Research paper thumbnail of Prevalence of hepatitis B and C viruses in patients with lymphoproliferative disorders

International Journal of Hematology, 2008

The etiology of most lymphoproliferative disorders remains unclear, though several hypotheses hav... more The etiology of most lymphoproliferative disorders remains unclear, though several hypotheses have been proposed. One of the conjectured mechanisms is infection of a tumor clone by an oncologic virus. Recently, evidence has arisen implicating both hepatitis B and, even more so, hepatitis C viruses in the pathogenesis of lymphoproliferative disease. Based on this information, we surveyed the prevalence of hepatitis B and C virus in patients with lymphoproliferative disease. A total of 334 newly-diagnosed lymphoproliferative disease patients (200 males, 134 females) and 1,014 (133 females, 881 males) healthy controls were randomly recruited from the university blood bank. Serologic evaluation for hepatitis B and C viruses was conducted and confirmed using PCR analyses. Those with hepatitis B and/or C, controls, and subgroups of patients with lymphoproliferative disease were compared using Pearson Chi-square analysis. Among patients with lymphoid tumors, the seropositivity of HbsAg and/or anti-HCV was 8.7% (29/334), and among the controls 6.1% (49/802), however this difference did not achieve statistical significance (P = 0.23, OR: 1.36, 95% CI: 0.82–2.26). We found no significant gender- or age-related differences for either hepatitis B or C seropositivity. There were no significant differences between the seropositivity rates of hepatitis B, C, or both in either NHL or Hodgkin’s lymphoma. However, in the diffuse large cell lymphoma and follicular lymphoma subgroups, the HbsAg seropositivity rate was significantly higher than that in the controls (P = 0.017, P = 0.048, respectively), as was the seropositivity rate for hepatitis C in those with diffuse B cell lymphoma versus controls (P = 0.008). We did not identify any significant difference in the combined prevalence of hepatitis B or C seropositivity between patients with lymphoproliferative disorders and controls. However, significant differences were revealed among certain patient subgroups versus the controls. These two viruses could play a role in the development of certain specific lymphoproliferative disorders. Nevertheless, larger epidemiological studies are necessary and should focus, particulary on specific patient subgroups.

Research paper thumbnail of Enterococcus avium Cerebral abscess

Research paper thumbnail of Function of dynamically stimulated endothelium and renin-angiotensin-aldosterone system in normotensive subjects with a family history of hypertension

Nephrology, 2008

Aim: Genetic influences on the acute stimulation of the renin–angiotensin–aldosterone system (RA... more Aim: Genetic influences on the acute stimulation of the renin–angiotensin–aldosterone system (RAAS) and on endothelial activation were studied by examining healthy blood donors with and without hypertensive parents.Methods: Healthy blood donors were assigned to two groups, according to the presence or absence of a parental history of hypertension. Plasma levels of renin, nitric oxide (NO) and plasminogen activator inhibitor 1 (PAI-1) were studied before and after acute alterations in renal perfusion induced by phlebotomy, and the two groups compared. During phlebotomy, 400–500 mL of blood was extracted from each subject, with that volume varying relative to each subject's body surface area (m2).Results: No statistically significant inter-group differences were observed between the baseline mean levels of plasma renin, NO or PAI-1. After phlebotomy, significant increases were detected in mean plasma renin activity (PRA) and NO levels and in PAI-1 activity (P < 0.001). However, the increases in mean PRA (P < 0.05) level and PAI-1 activity (P < 0.05) were more pronounced in those with hypertensive parents than those without; conversely, the increase in NO levels was more pronounced in the latter group. No statistically or clinically significant difference was found between the mean body mass indices of these two groups. Only two subjects were overweight, and none were obese; the remainder had weights that were normal. We found no significant correlation between body mass index and either NO or PAI-1 level.Conclusion: Post-phlebotomy, PRA and PAI-1 responses were more dramatic, but the NO response less in normotensive subjects having a parental history of hypertension, suggesting that these changes may represent familial, possibly genetic influences before overt hypertension occurs.

Research paper thumbnail of Audiovestibular disturbance in patients with systemic lupus erythematosus

Otolaryngology-head and Neck Surgery, 2007

The aim of this study was to evaluate the audiovestibular disturbance in patients with systemic l... more The aim of this study was to evaluate the audiovestibular disturbance in patients with systemic lupus erythematosus (SLE). Twenty-eight patients with SLE and 28 healthy control subjects were included. Pure-tone audiometry, impedance audiometry, and electronystagmography (ENG) were used for baseline evaluation. Laboratory tests were carried out. Cranial and brain stem magnetic resonance imagings (MRI) were undertaken. Nineteen (67%) patients reported audiovestibular symptoms. Sensorineural hearing loss was found in 6 (21%) patients. Abnormal results on ENG were significantly higher (50%) (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). Abnormal laboratory data were available from 26 patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). MRI did not show any pathosis. The audiovestibular disturbances in SLE are more prevalent than previously recognized. Although no cause and effect relationship can be established by this type of study, it appears that a relationship exists. Audiologic research should be directed toward routine, pure tone audiometry, and ENG assessment for patients with SLE to enable crucial treatment.

Research paper thumbnail of Intravenous immunoglobulin therapy in pregnant patients affected with systemic lupus erythematosus and recurrent spontaneous abortion

Rheumatology, 2008

Objectives. We aimed to test the maternal and fetal outcome of SLE patients who suffered from rec... more Objectives. We aimed to test the maternal and fetal outcome of SLE patients who suffered from recurrent spontaneous abortion (RSA) treated with intravenous immunoglobulin (IVIg) alone during pregnancy and whether the clinical response to IVIg treatment is accompanied by modifications of SLE-associated antibodies and of complement levels. Methods. Twelve SLE-RSA pregnant patients were treated with high-dose IVIg and compared with 12 SLE-RSA pregnant patients treated with prednisolone and NSAIDs. They were evaluated for the clinical response [lupus activity index-pregnancy (LAI-P) scale] and for ANA, anti-dsDNA, anti Ro/SS-A or La/SS-B, aCL, LAC, C4, C3 before and during pregnancy, and before and after each treatment course. Pregnancy outcome in the two groups was also evaluated. Results. The groups characteristics were homogeneous at the beginning of pregnancy. A beneficial clinical response following IVIg treatment was noted in all patients and mean LAI-P decreased from 0.72 AE 0.43 at the beginning of pregnancy to 0.13 AE 0.19 at the end of pregnancy (P < 0.0001). Antibodies and complement levels tended to normalize in most of the patients. These clinical and laboratory improvements were significant with respect to the control group. Pregnancy was successfully carried out in 12/12 (100%) SLE-RSA patients with a mean Apgar score of 8.92. Three patients in the control group got aborted (25%). Conclusions. IVIg has a high response rate among SLE-RSA pregnant patients and may be considered safe and effective.

Research paper thumbnail of N-acetylcysteine fails to prevent renal dysfunction and oxidative stress after noniodine contrast media administration during percutaneous coronary interventions

Polish Archives of Internal Medicine, 2010

INTROduCTION Oxidative stress is believed to have a role in contrast-induced nephropathy. Based o... more INTROduCTION Oxidative stress is believed to have a role in contrast-induced nephropathy. Based on this assumption, several known antioxidants have been studied to assess their effect on nephropathy, especially N-acetylcysteine (NAC). However, its usefulness has yet to be confirmed. ObjECTIvEs We aimed to assess whether NAC has any protective effect on contrast-induced renal dysfunction, and whether NAC affects the para meters of oxidative stress in serum and urine.

Research paper thumbnail of The effect of day and night shifts on oxidative stress and anxiety symptoms of the nurses

European review for medical and pharmacological sciences, 2012

Oxidative stress is believed to have a role in the development of chronic diseases. It is also kn... more Oxidative stress is believed to have a role in the development of chronic diseases. It is also known that long-term night and shift work in nurses might be associated with many health-related problems like fatigue, sleep problems, anxiety and difficulties in maintaining regular lifestyles. In this study, we aimed to evaluate the changes of oxidative stress parameters and anxiety indexes of the nurses on day and night shifts. One hundred and twenty nurses in ordinary service and intensive care unit (ICU) were enrolled to the study. Subjects were divided into 2 groups; group 1 (n = 60) consisted of nurses working in a day shift and group 2 (n = 60) as working in the night shift. Further, both groups were divided in to 2 groups again; group la and 2a (both n = 30) who working in the ICU, group 1b and 2b (both n = 30) in the ordinary service. Just before and the end of the shifts, blood samples were obtained to measure total antioxidant status (TAS) and total oxidant status (TOS). Oxida...

Research paper thumbnail of Serum prolidase activity in idiopathic and ischemic cardiomyopathy patients

Journal of Clinical Laboratory Analysis, 2010

Idiopathic and ischemic dilated cardiomyopathies (DCM) are the most common types of DCM, and both... more Idiopathic and ischemic dilated cardiomyopathies (DCM) are the most common types of DCM, and both exhibit the same histopathological feature of fibrosis. Prolidase is an enzyme that serves a rate-limiting function in collagen turnover. Several studies have shown increased prolidase activity in fibrosis, though controversy persists. In this study, we measured prolidase enzyme activity in patients with idiopathic or ischemic DCM and in healthy controls, making this, to our knowledge, the first study to do so. What we found is that serumprolidase activity was significantly lower in both DCM groups relative to healthy volunteers and lower in ischemic DCM than idiopathic. These intriguing results could be attributed either to decreased collagen turnover in the heart tissues in which DCM develops, a result of diminished functional heart tissue, or to decreased physical activity levels among DCM patients stemming from their heart failure. Either way, further studies are needed to verify and clarify our results.

Research paper thumbnail of The association between silicone implants and both antibodies and autoimmune diseases

Clinical Rheumatology, 2008

Silicones are widely used materials in many fields of medicine and largely are believed to be bio... more Silicones are widely used materials in many fields of medicine and largely are believed to be biologically inert. However, some investigators have reported that silicone implants are associated with an increased incidence of autoimmune disorders. In this study, we evaluated the capsular tissue of silicone implants and the sera of implant patients and controls for antisilicone antibodies and nonspecific immunoglobulins

Research paper thumbnail of Propylthiouracil-Related Hemorrhagic Diathesis: A Case Report and Review of the Literature

We present an unusual case of a drug-related hemorrhagic diathesis. One month prior to admission,... more We present an unusual case of a drug-related hemorrhagic diathesis. One month prior to admission, the patient was diagnosed at another medical center as having Graves&amp;amp;#39; disease and propylthiouracil therapy (PTU) was initiated. Since clinical recovery was not achieved, the PTU was quickly increased to an unconventional daily dose of 1,000 mg. The patient was referred to our hospital because of spontaneous epistaxis, multiple ecchymoses and prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), which developed soon after the increase in PTU dose. Drug-related hemorrhagic diathesis was considered, after other possible causes had been eliminated. To the best of our knowledge, this is the first reported case of spontaneous hemorrhage due to PTU use.

Research paper thumbnail of The Value of Urine Specific Gravity in Detecting Diabetes Insipidus in a Patient with Uncontrolled Diabetes Mellitus: Urine Specific Gravity in Differential Diagnosis

Journal of General Internal Medicine, 2006

When a patient with diabetes mellitus presents with worsening polyuria and polydipsia, what is a ... more When a patient with diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 diabetes mellitus and diabetes insipidus. A 46-year-old woman with poorly controlled type 2 diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, diabetes insipidus was confirmed when urine specific gravity and urine osmolality normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in patients with polyuria and diabetes mellitus to detect diabetes insipidus.

Research paper thumbnail of Acute renal failure with the combined use of rosuvastatin and fenofibrate

Renal Failure, 2010

Among the lipid-lowering drugs, the statins and fibrates are the most commonly used agents. Eithe... more Among the lipid-lowering drugs, the statins and fibrates are the most commonly used agents. Either class of drug is considered relatively safe. Though a variety of albeit uncommon adverse side effects have been observed with both classes, most of these therapeutic complications can be managed without discontinuation of the offending drug. Sometimes, especially in patients with extremely high cholesterol and/or triglyceride levels, a combination regimen is deemed necessary. However, the combined use of lipid-lowering drugs increases the incidence and severity of adverse events. In this article, we report an unusual case of acute renal failure (ARF) in a patient who had been prescribed both a statin (rosuvastatin) and a fibrate (fenofibrate).

Research paper thumbnail of The value of urine specific gravity in detecting diabetes insipidus in a patient with uncontrolled diabetes mellitus

Journal of General Internal Medicine, 2006

When a patient with diabetes mellitus presents with worsening polyuria and polydipsia, what is a ... more When a patient with diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 diabetes mellitus and diabetes insipidus. A 46-year-old woman with poorly controlled type 2 diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, diabetes insipidus was confirmed when urine specific gravity and urine osmolaity normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in patients with polyuria and diabetes mellitus to detect diabetes insipidus.

Research paper thumbnail of Rapidly improving, severe, acute myocarditis after a scorpion bite: an extremely rare complication and successful management

American Journal of Emergency Medicine, 2010

Rapidly improving, severe, acute myocarditis after a scorpion bite: an extremely rare complicatio... more Rapidly improving, severe, acute myocarditis after a scorpion bite: an extremely rare complication and successful management

Research paper thumbnail of Erratum to: Cardiovascular involvement in Behçet’s disease

Clinical Rheumatology, 2010

Erratum to: Clin Rheumatol DOI: 10.1007/s10067-009-1302-0There was an error in the authors name o... more Erratum to: Clin Rheumatol DOI: 10.1007/s10067-009-1302-0There was an error in the authors name of the article.The correct name is:Hakan Buyukhatipoglu

Research paper thumbnail of Serum prolidase activity in idiopathic and ischemic cardiomyopathy patients

Journal of Clinical Laboratory Analysis, 2010

Idiopathic and ischemic dilated cardiomyopathies (DCM) are the most common types of DCM, and both... more Idiopathic and ischemic dilated cardiomyopathies (DCM) are the most common types of DCM, and both exhibit the same histopathological feature of fibrosis. Prolidase is an enzyme that serves a rate-limiting function in collagen turnover. Several studies have shown increased prolidase activity in fibrosis, though controversy persists. In this study, we measured prolidase enzyme activity in patients with idiopathic or ischemic DCM and in healthy controls, making this, to our knowledge, the first study to do so. What we found is that serumprolidase activity was significantly lower in both DCM groups relative to healthy volunteers and lower in ischemic DCM than idiopathic. These intriguing results could be attributed either to decreased collagen turnover in the heart tissues in which DCM develops, a result of diminished functional heart tissue, or to decreased physical activity levels among DCM patients stemming from their heart failure. Either way, further studies are needed to verify and clarify our results. J. Clin. Lab. Anal. 24:213–218, 2010. © 2010 Wiley-Liss, Inc.

Research paper thumbnail of Unusual presentation of triple A syndrome mimicking Sjögren’s syndrome

Clinical Rheumatology, 2007

Clin Rheumatol DOI: 10.1007/s10067-006-0498-5The surname of the fourth author was inadvertently o... more Clin Rheumatol DOI: 10.1007/s10067-006-0498-5The surname of the fourth author was inadvertently omitted. The author’s full name is Yusuf Ziya Igci.

Research paper thumbnail of Immunoglobulin E: a new diagnostic clue for Behçet’s disease

Clinical Rheumatology, 2007

Behçet’s disease (BD) is a multisystemic inflammatory disorder of unknown etiology. Hyperimmunogl... more Behçet’s disease (BD) is a multisystemic inflammatory disorder of unknown etiology. Hyperimmunoglobulinemia has been demonstrated in BD; however, its clinical importance has not yet been discovered. In a few reports, an association between BD and plasma immunoglobulin E (IgE) has been noted. In this study, we had three objectives: (1) to investigate plasma levels of IgE and their association with levels of acute phase reactants, (2) to determine whether treatment has any effect upon IgE levels, and (3) to assess whether higher serum levels of IgE provide a clue for the diagnosis of BD. Fifty-two patients with BD, without any accompanying disease or condition that might lead to a rise in IgE, were compared with 51 age-matched healthy controls. Plasma levels of IgE, IgA, IgG, and IgM were analyzed by means of nephelometric analysis. Results showed that among the 52 patients, 23 (44%) had IgE levels that were higher than the upper limits of normal. IgE was not correlated with age, erythrocyte sedimentation rate, or C-reactive protein (p=0.59, p=0.57, and p=0.757, respectively). These relationships remained nonsignificant when multiple regression analysis was performed, with R 2 of 0.187 and p=0.057. Moreover, treatment of patients with elevated IgE did not produce any predictable IgE response. We conclude that Behçet’s patients commonly exhibit elevated plasma IgE levels. However, elevated IgE levels are not correlated with levels of acute phase reactants or disease activity. We suggest that IgE levels might be an independent diagnostic clue in Behçet’s patients.

Research paper thumbnail of The Effects of Exogenous Melatonin on Peripheral Nerve Regeneration and Collagen Formation in Rats

Journal of Surgical Research, 2011

Background. Peripheral nerve damage that requires surgical repair does not result in complete rec... more Background. Peripheral nerve damage that requires surgical repair does not result in complete recovery because of collagen scar formation, ischemia, free oxygen radical damage, and other factors. To date, the best treatment method has not yet been determined. In this study, we designed an experimental peripheral nerve injury model, and researched the possible effects of melatonin hormone, based on evidence of its strong antioxidant and cell-protective effects via mimicking the effects of calcium channel blockers.

Research paper thumbnail of Systemic lupus erythematosus complicated by dilated cardiomyopathy and severe heart failure

Clinical Rheumatology, 2007

Systemic lupus erythematosus (SLE) is the prototype autoimmune disorder, one that is known for it... more Systemic lupus erythematosus (SLE) is the prototype autoimmune disorder, one that is known for its many, diverse modes of presentation. In this paper, we present a further unusual presentation of SLE, that of acute onset, severe heart failure secondary to dilated cardiomyopathy. Only a few similar cases have been reported in the literature.

Research paper thumbnail of Prevalence of hepatitis B and C viruses in patients with lymphoproliferative disorders

International Journal of Hematology, 2008

The etiology of most lymphoproliferative disorders remains unclear, though several hypotheses hav... more The etiology of most lymphoproliferative disorders remains unclear, though several hypotheses have been proposed. One of the conjectured mechanisms is infection of a tumor clone by an oncologic virus. Recently, evidence has arisen implicating both hepatitis B and, even more so, hepatitis C viruses in the pathogenesis of lymphoproliferative disease. Based on this information, we surveyed the prevalence of hepatitis B and C virus in patients with lymphoproliferative disease. A total of 334 newly-diagnosed lymphoproliferative disease patients (200 males, 134 females) and 1,014 (133 females, 881 males) healthy controls were randomly recruited from the university blood bank. Serologic evaluation for hepatitis B and C viruses was conducted and confirmed using PCR analyses. Those with hepatitis B and/or C, controls, and subgroups of patients with lymphoproliferative disease were compared using Pearson Chi-square analysis. Among patients with lymphoid tumors, the seropositivity of HbsAg and/or anti-HCV was 8.7% (29/334), and among the controls 6.1% (49/802), however this difference did not achieve statistical significance (P = 0.23, OR: 1.36, 95% CI: 0.82–2.26). We found no significant gender- or age-related differences for either hepatitis B or C seropositivity. There were no significant differences between the seropositivity rates of hepatitis B, C, or both in either NHL or Hodgkin’s lymphoma. However, in the diffuse large cell lymphoma and follicular lymphoma subgroups, the HbsAg seropositivity rate was significantly higher than that in the controls (P = 0.017, P = 0.048, respectively), as was the seropositivity rate for hepatitis C in those with diffuse B cell lymphoma versus controls (P = 0.008). We did not identify any significant difference in the combined prevalence of hepatitis B or C seropositivity between patients with lymphoproliferative disorders and controls. However, significant differences were revealed among certain patient subgroups versus the controls. These two viruses could play a role in the development of certain specific lymphoproliferative disorders. Nevertheless, larger epidemiological studies are necessary and should focus, particulary on specific patient subgroups.

Research paper thumbnail of Enterococcus avium Cerebral abscess

Research paper thumbnail of Function of dynamically stimulated endothelium and renin-angiotensin-aldosterone system in normotensive subjects with a family history of hypertension

Nephrology, 2008

Aim: Genetic influences on the acute stimulation of the renin–angiotensin–aldosterone system (RA... more Aim: Genetic influences on the acute stimulation of the renin–angiotensin–aldosterone system (RAAS) and on endothelial activation were studied by examining healthy blood donors with and without hypertensive parents.Methods: Healthy blood donors were assigned to two groups, according to the presence or absence of a parental history of hypertension. Plasma levels of renin, nitric oxide (NO) and plasminogen activator inhibitor 1 (PAI-1) were studied before and after acute alterations in renal perfusion induced by phlebotomy, and the two groups compared. During phlebotomy, 400–500 mL of blood was extracted from each subject, with that volume varying relative to each subject's body surface area (m2).Results: No statistically significant inter-group differences were observed between the baseline mean levels of plasma renin, NO or PAI-1. After phlebotomy, significant increases were detected in mean plasma renin activity (PRA) and NO levels and in PAI-1 activity (P < 0.001). However, the increases in mean PRA (P < 0.05) level and PAI-1 activity (P < 0.05) were more pronounced in those with hypertensive parents than those without; conversely, the increase in NO levels was more pronounced in the latter group. No statistically or clinically significant difference was found between the mean body mass indices of these two groups. Only two subjects were overweight, and none were obese; the remainder had weights that were normal. We found no significant correlation between body mass index and either NO or PAI-1 level.Conclusion: Post-phlebotomy, PRA and PAI-1 responses were more dramatic, but the NO response less in normotensive subjects having a parental history of hypertension, suggesting that these changes may represent familial, possibly genetic influences before overt hypertension occurs.

Research paper thumbnail of Audiovestibular disturbance in patients with systemic lupus erythematosus

Otolaryngology-head and Neck Surgery, 2007

The aim of this study was to evaluate the audiovestibular disturbance in patients with systemic l... more The aim of this study was to evaluate the audiovestibular disturbance in patients with systemic lupus erythematosus (SLE). Twenty-eight patients with SLE and 28 healthy control subjects were included. Pure-tone audiometry, impedance audiometry, and electronystagmography (ENG) were used for baseline evaluation. Laboratory tests were carried out. Cranial and brain stem magnetic resonance imagings (MRI) were undertaken. Nineteen (67%) patients reported audiovestibular symptoms. Sensorineural hearing loss was found in 6 (21%) patients. Abnormal results on ENG were significantly higher (50%) (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). Abnormal laboratory data were available from 26 patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). MRI did not show any pathosis. The audiovestibular disturbances in SLE are more prevalent than previously recognized. Although no cause and effect relationship can be established by this type of study, it appears that a relationship exists. Audiologic research should be directed toward routine, pure tone audiometry, and ENG assessment for patients with SLE to enable crucial treatment.