Y. Sertdemir - Academia.edu (original) (raw)

Papers by Y. Sertdemir

Research paper thumbnail of Comparing the Performance of Logistic Regression and Different Classification Models

TEZ11114Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 2018.Kaynakça (s. 125-129) var.xvii,... more TEZ11114Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 2018.Kaynakça (s. 125-129) var.xvii, 130 s. : tablo ; 29 cm.Sağlık alanında sınıflama modelleri hastalıkların seyrinin tahmin edilmesinde ve tanı koymada sık kullanılan modellerdir. Bu modeller arasında en sık kullanılan ve en iyi bilineni Lojistik regresyon(LR) dur ancak son yıllarda kullanımı artan sınıflama modellerinin performansları konusunda henüz yeterli bilgiye sahip değiliz. Bu tezde kullanılan Karar Ağacı(KA), Random Forest(RF), Destek Vektör Makineleri(DVM) ve Naive Bayes(NB) sınıflama modelleri yanıt değişkenin iki değerli ve açıklayıcı değişkenlerin kategorik ve/veya sürekli olabildiği modellerden seçilmiştir. Bu tezde, LR yöntemi ile diğer yöntemlerin farklı örnek büyüklüğü, prevelans, açıklayıcı değişken tipi ve tanımlayıcılık katsayısı durumunda, etkileşim terimlerini bulunduran ve etkileşim terimlerini bulundurmayan 2 farklı model ile veri setleri üretilerek sınıflama modellerinin performanslarının karşıla...

Research paper thumbnail of Prevention of new sensitizations by specific immunotherapy in children with rhinitis and/or asthma monosensitized to house dust mite

Journal of investigational allergology & clinical immunology, 2007

Previous studies have suggested that single-allergen-specific immunotherapy (SIT) may prevent sen... more Previous studies have suggested that single-allergen-specific immunotherapy (SIT) may prevent sensitization to other airborne allergens in monosensitized children. We aimed to assess the prevention of new sensitizations in monosensitized children treated with single-allergen SIT injections in comparison with monosensitized patients given appropriate pharmacologic treatment for their disease. A total of 147 children with rhinitis and/or asthma monosensitized to house dust mite were studied; 45 patients underwent SIT with adsorbed extracts and 40 patients underwent SIT with aqueous extracts for 5 years. The control group was comprised of 62 patients given only pharmacologic treatment for at least 5 years. Skin prick tests, medication scores for rhinitis and asthma, and atopy scores according to skin prick tests were evaluated at the beginning and after 5 years of treatment. All groups were comparable in terms of age, sex, and disease characteristics. At the end of 5 years, 64 out of 8...

Research paper thumbnail of Clinical Evaluation of Behçet's Disease: A Five Year Follow-Up Study

The Journal of Dermatology, 2005

The frequencies of clinical features of Behçet's disease vary in different studies according to t... more The frequencies of clinical features of Behçet's disease vary in different studies according to the diagnostic criteria used in the study, the department where the study is done, and the ethnic origin of patients included in the study. In this study, we aimed to evaluate the influence of the length of the follow-up period of patients on the frequencies of clinical features of Behçet's disease. Out of 231 patients who applied to our dermatology clinic from June of 1991 to October of 1996, only 52 patients that were followed up for at least five years were included in this retrospective study. The baseline characteristics of these 52 patients were almost the same as those of the 179 patients who dropped out. Almost all of the frequencies of clinical features at the end of the follow-up period of five years were higher than those at the time of presentation. The most prominent increases were observed for erythema nodosum (59.6% to 75.0%), papulopustular lesions (84.6% to 94.2%), and large vessel involvement (23.1% to 30.8%). According to our results, it is most likely that studies mainly including mostly patients with long-standing disease will report higher figures for the frequencies of these clinical features of Behçet's disease.

Research paper thumbnail of Thyroid Hormone Levels and their Relationship to Survival in Children with Bacterial Sepsis and Septic Shock

Journal of Pediatric Endocrinology and Metabolism, 2004

Reported studies have showed alternations of thyroid hormones in critical illness mostly in adult... more Reported studies have showed alternations of thyroid hormones in critical illness mostly in adults and some in children. In this study, we aimed to measure thyroid hormone levels in children with sepsis and septic shock and investigate the relationship of these hormones with clinical state and survival. Thyroid hormone levels of children with sepsis and septic shock, and age- and sex-matched controls were measured. There were 51 children in sepsis (group S), 21 children in septic shock (group SS) and 30 in the control (group C) group. Total triiodothyronine (TT3) levels were (nmol/l): 0.91 +/- 0.22, 0.64 +/- 0.23, 2.11 +/- 0.59; free triiodothyronine (FT3) (pmol/l): 0.027 +/- 0.006, 0.018 +/- 0.007, 0.049 +/- 0.010; total thyroxine (TT4) (nmol/l): 100.62 +/- 21.93, 65.79 +/- 19.35, 109.65 +/- 19.35; free thyroxine (FT4) (pmol/l): 18.06 +/- 3.87, 10.32 +/- 1.29, 19.35 +/- 3.87; and thyroid stimulating hormone (TSH) (mIU/ml): 5.0 +/- 2.0, 4.8 +/- 2.4, 5.2 +/- 3.0, in children with sepsis, septic shock, and controls, respectively. The TT3, FT3, TT4, and FT4 levels of group SS were significantly lower than those of groups S and C. The TT3 and FT3 levels of group S were lower than in group C, but there was no significant difference between TT4, and FT4 levels of groups S and C. TSH levels were slightly decreased in both sepsis and septic shock, but the difference was not significant. Eleven (21.6%) children with sepsis and 15 (71.4%) children with septic shock died (p < 0.001). The levels of TT3, FT3, TT4 and FT4 were markedly lower in non-survivors of groups S and SS compared to survivors (p < 0.001). These changes in the hypothalamo-pituitary-thyroidal axis may suggest a possible prognostic value of thyroid hormone levels in children with sepsis and septic shock. To the best of our knowledge, this report is the first study to compare thyroid hormone levels in a large number of patients with sepsis and septic shock with those in healthy controls in childhood.

Research paper thumbnail of Effect of Botulinum Toxin-A in Myofascial Pain Patients With or Without Functional Disc Displacement

Journal of Oral and Maxillofacial Surgery, 2008

To evaluate the effects of botulinum toxin-A in the treatment of patients who have myofascial pai... more To evaluate the effects of botulinum toxin-A in the treatment of patients who have myofascial pain with or without functional disc displacement. Twenty-four participants were randomly assigned to the study by using Research Diagnostic Criteria for Temporomandibular Disorders. All patients were informed about botulinum toxin-A, and were required to give informed consent. Before the injections, patients were asked to fill out a Biobehavioral Questionnaire to evaluate their pain and psychological status, and afterward, electromyography of the right and left masseter and anterior temporal muscles was recorded. Saline was injected into the masseter and anterior temporal muscles in the placebo group, and botulinum toxin-A was used in the study group. On days 14 and 28, patients were asked to fill out a Biobehavioral Questionnaire again, and electromyography of the right and left masseter and anterior temporal muscles was recorded again. The study group showed improvement in pain and psychological status. Although a decrease in the action potentials of the masseter muscles on day 14 was followed by an increase on day 28, the reduction of pain scores and improvement in psychological status continued on day 28. The injection of botulinum toxin-A decreases the muscle action potential in 14 days. The patients also show improvement in pain and psychological status.

Research paper thumbnail of Analysis of peripheral blood T-cell subsets, natural killer cells and serum levels of cytokines in children with Down syndrome

International Journal of Immunogenetics, 2010

The objective of this study was to evaluate the relationship between humoral and cell-mediated im... more The objective of this study was to evaluate the relationship between humoral and cell-mediated immune response parameters and impairment of immune functions in children with Down syndrome (DS). The patient group was consisted of cytogenetically documented 32 children with DS. Lymphocyte subsets and natural killer cells were counted by flow-cytometry system. Levels of interleukin (IL)-1b, IL-2, IL-4, IL-6, IL-8, IL-10 and tumour necrosis factor-alpha (TNF-a) were detected by enzyme-linked immunosorbent assay method. Serum IgG, IgM, IgA levels were measured by turbidimetric methods. The percentage of CD8+ lymphocytes and CD56+ cells of patients with DS were significantly higher, whereas CD20+ lymphocytes were lower than that of controls (P < 0.05). The percentage of CD2 and CD4 levels and CD4 ⁄ CD8 ratio of patients with DS and normal controls were similar (P > 0.05). Levels of IL-4 and IL-10 were significantly increased, but IL-6 and TNF-a levels were decreased in children with DS (P < 0.05). Levels of other studied cytokines between patients with DS and controls were not statistically different (P > 0.05, for all). Serum IgG, IgM and IgA levels were found to be similar between the groups (P > 0.05). It has been known that IL-4 and IL-10 are anti-inflammatory molecules which inhibit the synthesis of proinflammatory cytokines such as IL-6 and TNF-a. In this study, levels of IL-4 and IL-10 were significantly increased, but IL-6 and TNF-a levels were decreased in children with DS. These results may suggest that continuing anti-inflammatory state in DS and this process may explain the cause of recurrent infection of the disease. On the other hand, in contrast to the low percentage of CD20+ cells, high percentage of CD8+ and CD56+ cells were found. Our findings may demonstrate that the cell-mediated and humoral immune system parameters in children with DS were altered according to healthy children.

Research paper thumbnail of Correlation of simultaneously obtained capillary, venous, and arterial blood gases of patients in a paediatric intensive care unit

Archives of Disease in Childhood, 2004

To investigate the correlation of pH, partial pressure of oxygen (PO 2), partial pressure of carb... more To investigate the correlation of pH, partial pressure of oxygen (PO 2), partial pressure of carbon dioxide (PCO 2), base excess (BE), and bicarbonate (HCO 3) between arterial (ABG), venous (VBG), and capillary (CBG) blood gases. Methods: Patients admitted to the paediatric intensive care unit (PICU) in Ç ukurova University between August 2000 and February 2002 were enrolled. Results: A total of 116 simultaneous venous, arterial, and capillary blood samples were obtained from 116 patients (mean age 56.91 months, range 15 days to 160 months). Eight (7%) were neonates. Sixty six (57%) were males. pH, PCO 2 , BE, and HCO 3 were all significantly correlated in ABG, VBG, and CBG. Correlation in PO 2 was also significant, but less so. Correlation between pH, PCO 2 , PO 2 , BE, and HCO 3 was similar in the presence of hypothermia, hyperthermia, and prolonged capillary refilling time. In hypotension, correlation in PO 2 between VBG and CBG was similar but disappeared in ABG-VBG and ABG-CBG. Conclusions: There is a significant correlation in pH, PCO 2 , PO 2 , BE, and HCO 3 among ABG, VBG, and CBG values, except for a poor correlation in PO 2 in the presence of hypotension. Capillary and venous blood gas measurements may be useful alternatives to arterial samples for patients who do not require regular continuous blood pressure recordings and close monitoring of PaO 2. We do not recommend CBG and VBG for determining PO 2 of ABG.

Research paper thumbnail of 39: A Randomized Clinical Trial: Oral Ondansetron for Reducing Vomiting Secondary to Acute Gastroenteritis in Children

Annals of Emergency Medicine, 2008

Research paper thumbnail of Clinical trial: oral ondansetron for reducing vomiting secondary to acute gastroenteritis in children – a double-blind randomized study

Alimentary Pharmacology & Therapeutics, 2010

Vomiting as a consequence of gastroenteritis frequently occurs in children. It is still debatable... more Vomiting as a consequence of gastroenteritis frequently occurs in children. It is still debatable whether vomiting should be treated with antiemetic drugs. To investigate potential beneficial effects of ondansetron in treating vomiting during acute gastroenteritis. A randomized, double blind, placebo-controlled trial was performed in our emergency departments. Children, aged 5 months to 8 years, were randomized to receive either ondansetron 0.2 mg/kg or placebo at 8h intervals. The primary outcome measure was the frequency of emesis during an 8-h-period after enrollment. A hundred and nine patients were enrolled; 54 received placebo and 55 received ondansetron. As compared with the children who received placebo, children who received ondansetron were less likely to vomit both during the first 8-h follow-up in the emergency department [relative risk (RR): 0.33, 95% CI: 0.19-0.56, NNT: 2, 95% CI: 1.6-3.5], and during the next 24-h follow-up (RR: 0.15, 95% CI: 0.07-0.33, NNT: 2, 95% CI: 1.3-2.1). Ondansetron may be an effective and efficient treatment that reduces the incidence of vomiting from gastroenteritis during both the first 8 h and the next 24 h, and is probably a useful adjunct to oral rehydration.

Research paper thumbnail of Alterations of ghrelin with weights and correlation among ghrelin, cytokine and survival in patients receiving chemoradiotherapy for gastrointestinal cancers

International journal of clinical and experimental medicine, 2015

This study involved 30 patients (16 had gastric, 9 pancreatic and 5 gall bladder cancer) who had ... more This study involved 30 patients (16 had gastric, 9 pancreatic and 5 gall bladder cancer) who had received concomitant chemoradiotherapy (CRT). Blood ghrelin and IL-6 values were compared before, in the last week of, and 3 months after CRT. Meanwhile, changes in body weight of patients were also investigated with changes in ghrelin and IL-6 levels before, in the last week of, and after radiotherapy (RT). Informed consent of the patients and the ethical committee approval from Cukurova University Medical Faculty were taken. Blood ghrelin and IL-6 levels were measured by using the ELISA method. Survival analysis was performed by the Kaplan Maier method, and data were evaluated by using the SPSS 19.0 package. Categorical measurements were calculated as numbers and percentages, whereas numerical data were summarized as mean and standard deviation. The correlation between ghrelin and IL-6 values at the baseline of RT and overall survival rates at the end of the 30-month follow up was anal...

Research paper thumbnail of Health care–associated infections in the neonatal intensive care unit

American Journal of Infection Control, 2005

Research paper thumbnail of Gastric lavage with normal saline: effects on serum electrolytes

Bratislavské lekárske listy, 2010

The aim of this study is to determine the intensity of changes in serum calcium, ionized calcium,... more The aim of this study is to determine the intensity of changes in serum calcium, ionized calcium, and magnesium levels after gastric lavage with normal saline in patients with amitriptyline intoxication. In this study, thirty patients older than 16 years with the history of intoxication with amitriptyline were included. After the baseline serum calcium, ionized calcium, and magnesium levels had been measured, gastric lavage with normal saline was performed. Serum levels of calcium, ionized calcium, and magnesium were monitored at 15 minutes, 6 hours, and 12 hours. Serum calcium levels decreased significantly from 9.32 +/- 0.47 mg/dL to 8.40 +/- 0.61 mg/dL (15 minutes, p < 0.001), 8.92 +/- 0.54 mg/dL (6 hours, p < 0.001), and 8.93 +/- 0.54 mg/dL (12 hours, p < 0.001). Serum ionized calcium levels decreased significantly from 1.26 +/- 0.10 mmol/L to 1.20 +/- 0.07 mmol/L (15 minutes, p = 0.004), 1.21 +/- 0.08 mmol/L (6 hours, p = 0.024), and 1.21 +/- 0.08 mmol/L (12 hours, p =...

Research paper thumbnail of Effects of Pentoxifylline on the Cytokines That May Play a Role in Rejection and Resistive Index in Renal Transplant Recipients

Transplantation Proceedings - TRANSPLANT PROC, 2006

Pentoxifylline (PTX) is a nonselective phosphodiesterase inhibitor that inhibits the production o... more Pentoxifylline (PTX) is a nonselective phosphodiesterase inhibitor that inhibits the production of TNFα and IL6 and IL-10 cytokines. In renal rejection TNFα, IL-6, and IL-10 may have important roles. In this study, 22 renal transplant recipients treated with tacrolimus, prednisolone, and mycophenolate mofetil were prescribed PTX (2 × 600 mg/d) for 3 months (GI), and 20 similar patients not receiving PTX were used as controls (GII). Stable subjects whose serum creatinine was lower than 1.8 mg/dL and were more than 6 months posttransplant, were enrolled into this study if the blood pressure was well controlled and there was no diabetes mellitus, infection, or inflammation. At the end of 3 months TNF-α decreased from 4.2 ± 2.1 to 2.4 ± 0.7 (P = .001) and 4.0 ± 2.2 to 3.9 ± 1.7 (P = .718), IL-10 also decreased from 3.90 ± 1.9 to 2.38 ± 0.6 (P = .001) and 4.02 ± 1.6 to 3.82 ± 1.5 (P = .225) in GI and GII, respectively. For IL-10 and TNF-α the alterations between baseline and the last vis...

Research paper thumbnail of Diagnostic value of neuroimaging in patients with primary headaches

The Pain Clinic, 2006

ABSTRACT Emergencies in headache, requiring prompt diagnosis and treatment, are frequently import... more ABSTRACT Emergencies in headache, requiring prompt diagnosis and treatment, are frequently important issues for the physician. Neuroimaging with computed tomography and magnetic resonance in the differential diagnosis of headache emergencies is the major diagnostic tool. To determine the differential diagnostic contribution of the imaging techniques, 275 consecutive patients with migraine with or without aura, tension type headache and other types of headaches were included in this study. The diagnoses were based on the International Headache Society&#39;s (IHS-2004) criteria. Regardless of the clinical diagnosis, CT and/or MRI images were performed in all cases.Abnormal images were encountered in 9.9% (27 of 275) of patients with headache. These findings were serious in 14 cases and led to the diagnosis of lacunar infarct, vascular malformation, mass lesion, calcification, subarachnoidal hemorrhage and leptomeningitis, while they were nonspesific in the other 13 patients (cortical or cerebral artophy and small anatomical alterations). Mean age was significantly higher in the patients with positive radiological findings (p &lt; 0.0001). Radiological findings were more frequent in patients with tension type headache.

Research paper thumbnail of The effect of two different parenteral nutrition regimens on parenteral nutrition-associated cholestasis

Journal of Maternal-Fetal and Neonatal Medicine, 2013

Exposure to parenteral nutrition (PN) is one major factor in the development of cholestasis. The ... more Exposure to parenteral nutrition (PN) is one major factor in the development of cholestasis. The aim of this retrospective study was to compare the effect of these two different PN regimens on PN-associated cholestasis (PNAC). The files of the patients who have received different PN regimens for &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;14 d in 2005 and 2009 were retrospectively reviewed. 133 patients have received PN more than 14 d. 22 (16.5%) patients had PNAC. 90 neonates were in Group low-dose parenteral (LDpn) and 43 neonates in Group high-dose parenteral. Mean gestational age and birth weight were statistically significantly lower in LDpn Group (p = 0.016, p = 0.434). Cholestasis rate was significantly higher in high dose group. (p = 0.023). Although several risk factors for PNAC are unavoidable, research is still needed to define the optimal parenteral amino acid solution for neonatal patients. Individualized PN may be more affective in allowing growth and minimizing side effects.

Research paper thumbnail of The Effect of Human Growth Hormone on Superoxide Dismutase Activity, Glutathione and Malondialdehyde Levels of Hypoxic-Ischemic Newborn Rat Brain

Biology of the Neonate, 2006

We investigated the effect of human growth hormone (GH) on newborn rat brain superoxide dismutase... more We investigated the effect of human growth hormone (GH) on newborn rat brain superoxide dismutase, glutathione and malondialdehyde (MDA) levels in hypoxic-ischemic (H-I) newborn rats. Fourty-eight 7 days old newborn rats were randomized to a healthy (n: 15), H-I (n: 18) and GH administered H-I (GH-H-I, n: 15) group. Permanent, left common carotid ligation was performed in the H-I groups. In the GH-H-I group, 50 mg/kg human GH (Norditropin Simplex, Novo Nordisk A/S) was administered subcutaneously just before carotid artery ligation. Two hours after ligation, rats were subjected to 2 h of hypoxemia and then were decapitated. Right and left cerebral hemispheres (CHs) and cerebellum-brain stem (C-BS) were separated. Glutathione levels of each region were not statistically different from each other in and between the groups. Superoxide dismutase levels were higher in C-BSs compared to CHs (for each comparison 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;lt; 0.01). CHs and C-BS MDA levels were similar in the control and H-I groups but MDA levels of both CHs of the GH-H-I group were significantly higher than the levels of the H-I group (p = 0.01; p = 0.024, respectively). Left CH MDA level of GH-H-I group was higher compared to left CH MDA of the control group (p = 0.045) while there was no difference between right CHs. In the GH-H-I group, left CH MDA level was higher than the C-BS (p = 0.03). MDA levels of the C-BSs did not differ between the groups (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;gt; 0.05). Although we have not evaluated the effect of GH histopathologically, increased lipid peroxidation especially in the H-I (left) hemisphere of the GH treated rats might suggest that GH treatment may be harmful in H-I encephalopathy.

Research paper thumbnail of Avascular Osteonecrosis and Accompanying Anemia, Leucocytosis, and Decreased Bone Mineral Density in Renal Transplant Recipients

Transplantation Proceedings, 2011

BackgroundAvascular osteonecrosis (AVN) is a complication of renal transplantation. In this study... more BackgroundAvascular osteonecrosis (AVN) is a complication of renal transplantation. In this study, we present 12 cases of AVN associated with renal transplantation.

Research paper thumbnail of Efficacy and Safety of Vardenafil in Renal Transplant Recipients With Erectile Dysfunction

Transplantation Proceedings, 2006

Erectile dysfunction (ED) profoundly affects the quality of life. The prevalence of ED in renal t... more Erectile dysfunction (ED) profoundly affects the quality of life. The prevalence of ED in renal transplant recipients is reported by high as 50% to 60%. We evaluated the efficacy and safety of vardenafil in these patients with ED as well as its effects on graft function and on cylosporine or tacrolimus concentrations. Thirty-nine recipients with ED and serum creatinine values

Research paper thumbnail of Does the decision in a validation process of a surrogate endpoint change with level of significance of treatment effect? A proposal on validation of surrogate endpoints

Contemporary Clinical Trials, 2009

In recent years the use of surrogate end points (S) has become an interesting issue. In clinical ... more In recent years the use of surrogate end points (S) has become an interesting issue. In clinical trials, it is important to get treatment outcomes as early as possible. For this reason there is a need for surrogate endpoints (S) which are measured earlier than the true endpoint (T). However, before a surrogate endpoint can be used it must be validated. For a candidate surrogate endpoint, for example time to recurrence, the validation result may change dramatically between clinical trials. The aim of this study is to show how the validation criterion (R(2)(trial)) proposed by Buyse et al. are influenced by the magnitude of treatment effect with an application using real data. The criterion R(2)(trial) proposed by Buyse et al. (2000) is applied to the four data sets from colon cancer clinical trials (C-01, C-02, C-03 and C-04). Each clinical trial is analyzed separately for treatment effect on survival (true endpoint) and recurrence free survival (surrogate endpoint) and this analysis is done also for each center in each trial. Results are used for standard validation analysis. The centers were grouped by the Wald statistic in 3 equal groups. Validation criteria R(2)(trial) were 0.641 95% CI (0.432-0.782), 0.223 95% CI (0.008-0.503), 0.761 95% CI (0.550-0.872) and 0.560 95% CI (0.404-0.687) for C-01, C-02, C-03 and C-04 respectively. The R(2)(trial) criteria changed by the Wald statistics observed for the centers used in the validation process. Higher the Wald statistic groups are higher the R(2)(trial) values observed. The recurrence free survival is not a good surrogate for overall survival in clinical trials with non significant treatment effects and moderate for significant treatment effects. This shows that the level of significance of treatment effect should be taken into account in validation process of surrogate endpoints.

Research paper thumbnail of Dipyridamole for renal phosphate leak in successfully renal transplanted hypophosphatemic patients

Clinical Nephrology, 2008

Hyphosphatemia can be seen in renal transplant recipients. Hyperparathyroidism, glucocorticoid tr... more Hyphosphatemia can be seen in renal transplant recipients. Hyperparathyroidism, glucocorticoid treatment, renal denervation and impairment of renal tubular phosphate reabsorption are the most common causes of hyphosphatemia in these patients. It is well-known that dipyridamole enhances renal tubular phosphate reabsorption in some clinical conditions. We did not find any information about the effect of dipyridamole in renal transplant recipients (RTRs) with hypophosphatemia. For this reason, we decided to give dipyridamole 11 RTRs with hypophosphatemia. Eleven RTRs whose serum phosphate and creatinine levels were below 2.5 mg/dl and 2 mg/dl, respectively, were included in this study. None of the patients received drugs altering phosphate metabolism and they did not change their routine diets. Urinary phosphate excretion and tubular phosphate reabsorption (TPR) were calculated before and 3 weeks after dipyridamole treatment. The mean levels of serum-urine (daily) phosphate and TPR before dipyridamole treatment were 1.94 +/- 0.46 mg/dl, 7,187.5 +/- 1,833.49 mg/day and -2.78 +/- 0.62, respectively. After treatment, the mean levels of serum-urine phosphate and TPR were 2.73 +/- 0.46 mg/dl, 4,845.27 +/- 1,138.99 mg/day and -1.48 +/- 0.80, respectively. Serum and urine phosphate levels and TPR were found to be significantly different before and after dipyridamole therapy (p &lt; 0.05). Short-term dipyridamole therapy increased TPR and serum phosphate levels and decreased urinary phosphate excretion. We did not observe negative effect on renal functions in these cases. Although the number of the cases included in this study is small, dipyridamole is an effective choice in management of hypophosphatemic RTRs.

Research paper thumbnail of Comparing the Performance of Logistic Regression and Different Classification Models

TEZ11114Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 2018.Kaynakça (s. 125-129) var.xvii,... more TEZ11114Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 2018.Kaynakça (s. 125-129) var.xvii, 130 s. : tablo ; 29 cm.Sağlık alanında sınıflama modelleri hastalıkların seyrinin tahmin edilmesinde ve tanı koymada sık kullanılan modellerdir. Bu modeller arasında en sık kullanılan ve en iyi bilineni Lojistik regresyon(LR) dur ancak son yıllarda kullanımı artan sınıflama modellerinin performansları konusunda henüz yeterli bilgiye sahip değiliz. Bu tezde kullanılan Karar Ağacı(KA), Random Forest(RF), Destek Vektör Makineleri(DVM) ve Naive Bayes(NB) sınıflama modelleri yanıt değişkenin iki değerli ve açıklayıcı değişkenlerin kategorik ve/veya sürekli olabildiği modellerden seçilmiştir. Bu tezde, LR yöntemi ile diğer yöntemlerin farklı örnek büyüklüğü, prevelans, açıklayıcı değişken tipi ve tanımlayıcılık katsayısı durumunda, etkileşim terimlerini bulunduran ve etkileşim terimlerini bulundurmayan 2 farklı model ile veri setleri üretilerek sınıflama modellerinin performanslarının karşıla...

Research paper thumbnail of Prevention of new sensitizations by specific immunotherapy in children with rhinitis and/or asthma monosensitized to house dust mite

Journal of investigational allergology & clinical immunology, 2007

Previous studies have suggested that single-allergen-specific immunotherapy (SIT) may prevent sen... more Previous studies have suggested that single-allergen-specific immunotherapy (SIT) may prevent sensitization to other airborne allergens in monosensitized children. We aimed to assess the prevention of new sensitizations in monosensitized children treated with single-allergen SIT injections in comparison with monosensitized patients given appropriate pharmacologic treatment for their disease. A total of 147 children with rhinitis and/or asthma monosensitized to house dust mite were studied; 45 patients underwent SIT with adsorbed extracts and 40 patients underwent SIT with aqueous extracts for 5 years. The control group was comprised of 62 patients given only pharmacologic treatment for at least 5 years. Skin prick tests, medication scores for rhinitis and asthma, and atopy scores according to skin prick tests were evaluated at the beginning and after 5 years of treatment. All groups were comparable in terms of age, sex, and disease characteristics. At the end of 5 years, 64 out of 8...

Research paper thumbnail of Clinical Evaluation of Behçet's Disease: A Five Year Follow-Up Study

The Journal of Dermatology, 2005

The frequencies of clinical features of Behçet's disease vary in different studies according to t... more The frequencies of clinical features of Behçet's disease vary in different studies according to the diagnostic criteria used in the study, the department where the study is done, and the ethnic origin of patients included in the study. In this study, we aimed to evaluate the influence of the length of the follow-up period of patients on the frequencies of clinical features of Behçet's disease. Out of 231 patients who applied to our dermatology clinic from June of 1991 to October of 1996, only 52 patients that were followed up for at least five years were included in this retrospective study. The baseline characteristics of these 52 patients were almost the same as those of the 179 patients who dropped out. Almost all of the frequencies of clinical features at the end of the follow-up period of five years were higher than those at the time of presentation. The most prominent increases were observed for erythema nodosum (59.6% to 75.0%), papulopustular lesions (84.6% to 94.2%), and large vessel involvement (23.1% to 30.8%). According to our results, it is most likely that studies mainly including mostly patients with long-standing disease will report higher figures for the frequencies of these clinical features of Behçet's disease.

Research paper thumbnail of Thyroid Hormone Levels and their Relationship to Survival in Children with Bacterial Sepsis and Septic Shock

Journal of Pediatric Endocrinology and Metabolism, 2004

Reported studies have showed alternations of thyroid hormones in critical illness mostly in adult... more Reported studies have showed alternations of thyroid hormones in critical illness mostly in adults and some in children. In this study, we aimed to measure thyroid hormone levels in children with sepsis and septic shock and investigate the relationship of these hormones with clinical state and survival. Thyroid hormone levels of children with sepsis and septic shock, and age- and sex-matched controls were measured. There were 51 children in sepsis (group S), 21 children in septic shock (group SS) and 30 in the control (group C) group. Total triiodothyronine (TT3) levels were (nmol/l): 0.91 +/- 0.22, 0.64 +/- 0.23, 2.11 +/- 0.59; free triiodothyronine (FT3) (pmol/l): 0.027 +/- 0.006, 0.018 +/- 0.007, 0.049 +/- 0.010; total thyroxine (TT4) (nmol/l): 100.62 +/- 21.93, 65.79 +/- 19.35, 109.65 +/- 19.35; free thyroxine (FT4) (pmol/l): 18.06 +/- 3.87, 10.32 +/- 1.29, 19.35 +/- 3.87; and thyroid stimulating hormone (TSH) (mIU/ml): 5.0 +/- 2.0, 4.8 +/- 2.4, 5.2 +/- 3.0, in children with sepsis, septic shock, and controls, respectively. The TT3, FT3, TT4, and FT4 levels of group SS were significantly lower than those of groups S and C. The TT3 and FT3 levels of group S were lower than in group C, but there was no significant difference between TT4, and FT4 levels of groups S and C. TSH levels were slightly decreased in both sepsis and septic shock, but the difference was not significant. Eleven (21.6%) children with sepsis and 15 (71.4%) children with septic shock died (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The levels of TT3, FT3, TT4 and FT4 were markedly lower in non-survivors of groups S and SS compared to survivors (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). These changes in the hypothalamo-pituitary-thyroidal axis may suggest a possible prognostic value of thyroid hormone levels in children with sepsis and septic shock. To the best of our knowledge, this report is the first study to compare thyroid hormone levels in a large number of patients with sepsis and septic shock with those in healthy controls in childhood.

Research paper thumbnail of Effect of Botulinum Toxin-A in Myofascial Pain Patients With or Without Functional Disc Displacement

Journal of Oral and Maxillofacial Surgery, 2008

To evaluate the effects of botulinum toxin-A in the treatment of patients who have myofascial pai... more To evaluate the effects of botulinum toxin-A in the treatment of patients who have myofascial pain with or without functional disc displacement. Twenty-four participants were randomly assigned to the study by using Research Diagnostic Criteria for Temporomandibular Disorders. All patients were informed about botulinum toxin-A, and were required to give informed consent. Before the injections, patients were asked to fill out a Biobehavioral Questionnaire to evaluate their pain and psychological status, and afterward, electromyography of the right and left masseter and anterior temporal muscles was recorded. Saline was injected into the masseter and anterior temporal muscles in the placebo group, and botulinum toxin-A was used in the study group. On days 14 and 28, patients were asked to fill out a Biobehavioral Questionnaire again, and electromyography of the right and left masseter and anterior temporal muscles was recorded again. The study group showed improvement in pain and psychological status. Although a decrease in the action potentials of the masseter muscles on day 14 was followed by an increase on day 28, the reduction of pain scores and improvement in psychological status continued on day 28. The injection of botulinum toxin-A decreases the muscle action potential in 14 days. The patients also show improvement in pain and psychological status.

Research paper thumbnail of Analysis of peripheral blood T-cell subsets, natural killer cells and serum levels of cytokines in children with Down syndrome

International Journal of Immunogenetics, 2010

The objective of this study was to evaluate the relationship between humoral and cell-mediated im... more The objective of this study was to evaluate the relationship between humoral and cell-mediated immune response parameters and impairment of immune functions in children with Down syndrome (DS). The patient group was consisted of cytogenetically documented 32 children with DS. Lymphocyte subsets and natural killer cells were counted by flow-cytometry system. Levels of interleukin (IL)-1b, IL-2, IL-4, IL-6, IL-8, IL-10 and tumour necrosis factor-alpha (TNF-a) were detected by enzyme-linked immunosorbent assay method. Serum IgG, IgM, IgA levels were measured by turbidimetric methods. The percentage of CD8+ lymphocytes and CD56+ cells of patients with DS were significantly higher, whereas CD20+ lymphocytes were lower than that of controls (P < 0.05). The percentage of CD2 and CD4 levels and CD4 ⁄ CD8 ratio of patients with DS and normal controls were similar (P > 0.05). Levels of IL-4 and IL-10 were significantly increased, but IL-6 and TNF-a levels were decreased in children with DS (P < 0.05). Levels of other studied cytokines between patients with DS and controls were not statistically different (P > 0.05, for all). Serum IgG, IgM and IgA levels were found to be similar between the groups (P > 0.05). It has been known that IL-4 and IL-10 are anti-inflammatory molecules which inhibit the synthesis of proinflammatory cytokines such as IL-6 and TNF-a. In this study, levels of IL-4 and IL-10 were significantly increased, but IL-6 and TNF-a levels were decreased in children with DS. These results may suggest that continuing anti-inflammatory state in DS and this process may explain the cause of recurrent infection of the disease. On the other hand, in contrast to the low percentage of CD20+ cells, high percentage of CD8+ and CD56+ cells were found. Our findings may demonstrate that the cell-mediated and humoral immune system parameters in children with DS were altered according to healthy children.

Research paper thumbnail of Correlation of simultaneously obtained capillary, venous, and arterial blood gases of patients in a paediatric intensive care unit

Archives of Disease in Childhood, 2004

To investigate the correlation of pH, partial pressure of oxygen (PO 2), partial pressure of carb... more To investigate the correlation of pH, partial pressure of oxygen (PO 2), partial pressure of carbon dioxide (PCO 2), base excess (BE), and bicarbonate (HCO 3) between arterial (ABG), venous (VBG), and capillary (CBG) blood gases. Methods: Patients admitted to the paediatric intensive care unit (PICU) in Ç ukurova University between August 2000 and February 2002 were enrolled. Results: A total of 116 simultaneous venous, arterial, and capillary blood samples were obtained from 116 patients (mean age 56.91 months, range 15 days to 160 months). Eight (7%) were neonates. Sixty six (57%) were males. pH, PCO 2 , BE, and HCO 3 were all significantly correlated in ABG, VBG, and CBG. Correlation in PO 2 was also significant, but less so. Correlation between pH, PCO 2 , PO 2 , BE, and HCO 3 was similar in the presence of hypothermia, hyperthermia, and prolonged capillary refilling time. In hypotension, correlation in PO 2 between VBG and CBG was similar but disappeared in ABG-VBG and ABG-CBG. Conclusions: There is a significant correlation in pH, PCO 2 , PO 2 , BE, and HCO 3 among ABG, VBG, and CBG values, except for a poor correlation in PO 2 in the presence of hypotension. Capillary and venous blood gas measurements may be useful alternatives to arterial samples for patients who do not require regular continuous blood pressure recordings and close monitoring of PaO 2. We do not recommend CBG and VBG for determining PO 2 of ABG.

Research paper thumbnail of 39: A Randomized Clinical Trial: Oral Ondansetron for Reducing Vomiting Secondary to Acute Gastroenteritis in Children

Annals of Emergency Medicine, 2008

Research paper thumbnail of Clinical trial: oral ondansetron for reducing vomiting secondary to acute gastroenteritis in children – a double-blind randomized study

Alimentary Pharmacology & Therapeutics, 2010

Vomiting as a consequence of gastroenteritis frequently occurs in children. It is still debatable... more Vomiting as a consequence of gastroenteritis frequently occurs in children. It is still debatable whether vomiting should be treated with antiemetic drugs. To investigate potential beneficial effects of ondansetron in treating vomiting during acute gastroenteritis. A randomized, double blind, placebo-controlled trial was performed in our emergency departments. Children, aged 5 months to 8 years, were randomized to receive either ondansetron 0.2 mg/kg or placebo at 8h intervals. The primary outcome measure was the frequency of emesis during an 8-h-period after enrollment. A hundred and nine patients were enrolled; 54 received placebo and 55 received ondansetron. As compared with the children who received placebo, children who received ondansetron were less likely to vomit both during the first 8-h follow-up in the emergency department [relative risk (RR): 0.33, 95% CI: 0.19-0.56, NNT: 2, 95% CI: 1.6-3.5], and during the next 24-h follow-up (RR: 0.15, 95% CI: 0.07-0.33, NNT: 2, 95% CI: 1.3-2.1). Ondansetron may be an effective and efficient treatment that reduces the incidence of vomiting from gastroenteritis during both the first 8 h and the next 24 h, and is probably a useful adjunct to oral rehydration.

Research paper thumbnail of Alterations of ghrelin with weights and correlation among ghrelin, cytokine and survival in patients receiving chemoradiotherapy for gastrointestinal cancers

International journal of clinical and experimental medicine, 2015

This study involved 30 patients (16 had gastric, 9 pancreatic and 5 gall bladder cancer) who had ... more This study involved 30 patients (16 had gastric, 9 pancreatic and 5 gall bladder cancer) who had received concomitant chemoradiotherapy (CRT). Blood ghrelin and IL-6 values were compared before, in the last week of, and 3 months after CRT. Meanwhile, changes in body weight of patients were also investigated with changes in ghrelin and IL-6 levels before, in the last week of, and after radiotherapy (RT). Informed consent of the patients and the ethical committee approval from Cukurova University Medical Faculty were taken. Blood ghrelin and IL-6 levels were measured by using the ELISA method. Survival analysis was performed by the Kaplan Maier method, and data were evaluated by using the SPSS 19.0 package. Categorical measurements were calculated as numbers and percentages, whereas numerical data were summarized as mean and standard deviation. The correlation between ghrelin and IL-6 values at the baseline of RT and overall survival rates at the end of the 30-month follow up was anal...

Research paper thumbnail of Health care–associated infections in the neonatal intensive care unit

American Journal of Infection Control, 2005

Research paper thumbnail of Gastric lavage with normal saline: effects on serum electrolytes

Bratislavské lekárske listy, 2010

The aim of this study is to determine the intensity of changes in serum calcium, ionized calcium,... more The aim of this study is to determine the intensity of changes in serum calcium, ionized calcium, and magnesium levels after gastric lavage with normal saline in patients with amitriptyline intoxication. In this study, thirty patients older than 16 years with the history of intoxication with amitriptyline were included. After the baseline serum calcium, ionized calcium, and magnesium levels had been measured, gastric lavage with normal saline was performed. Serum levels of calcium, ionized calcium, and magnesium were monitored at 15 minutes, 6 hours, and 12 hours. Serum calcium levels decreased significantly from 9.32 +/- 0.47 mg/dL to 8.40 +/- 0.61 mg/dL (15 minutes, p < 0.001), 8.92 +/- 0.54 mg/dL (6 hours, p < 0.001), and 8.93 +/- 0.54 mg/dL (12 hours, p < 0.001). Serum ionized calcium levels decreased significantly from 1.26 +/- 0.10 mmol/L to 1.20 +/- 0.07 mmol/L (15 minutes, p = 0.004), 1.21 +/- 0.08 mmol/L (6 hours, p = 0.024), and 1.21 +/- 0.08 mmol/L (12 hours, p =...

Research paper thumbnail of Effects of Pentoxifylline on the Cytokines That May Play a Role in Rejection and Resistive Index in Renal Transplant Recipients

Transplantation Proceedings - TRANSPLANT PROC, 2006

Pentoxifylline (PTX) is a nonselective phosphodiesterase inhibitor that inhibits the production o... more Pentoxifylline (PTX) is a nonselective phosphodiesterase inhibitor that inhibits the production of TNFα and IL6 and IL-10 cytokines. In renal rejection TNFα, IL-6, and IL-10 may have important roles. In this study, 22 renal transplant recipients treated with tacrolimus, prednisolone, and mycophenolate mofetil were prescribed PTX (2 × 600 mg/d) for 3 months (GI), and 20 similar patients not receiving PTX were used as controls (GII). Stable subjects whose serum creatinine was lower than 1.8 mg/dL and were more than 6 months posttransplant, were enrolled into this study if the blood pressure was well controlled and there was no diabetes mellitus, infection, or inflammation. At the end of 3 months TNF-α decreased from 4.2 ± 2.1 to 2.4 ± 0.7 (P = .001) and 4.0 ± 2.2 to 3.9 ± 1.7 (P = .718), IL-10 also decreased from 3.90 ± 1.9 to 2.38 ± 0.6 (P = .001) and 4.02 ± 1.6 to 3.82 ± 1.5 (P = .225) in GI and GII, respectively. For IL-10 and TNF-α the alterations between baseline and the last vis...

Research paper thumbnail of Diagnostic value of neuroimaging in patients with primary headaches

The Pain Clinic, 2006

ABSTRACT Emergencies in headache, requiring prompt diagnosis and treatment, are frequently import... more ABSTRACT Emergencies in headache, requiring prompt diagnosis and treatment, are frequently important issues for the physician. Neuroimaging with computed tomography and magnetic resonance in the differential diagnosis of headache emergencies is the major diagnostic tool. To determine the differential diagnostic contribution of the imaging techniques, 275 consecutive patients with migraine with or without aura, tension type headache and other types of headaches were included in this study. The diagnoses were based on the International Headache Society&#39;s (IHS-2004) criteria. Regardless of the clinical diagnosis, CT and/or MRI images were performed in all cases.Abnormal images were encountered in 9.9% (27 of 275) of patients with headache. These findings were serious in 14 cases and led to the diagnosis of lacunar infarct, vascular malformation, mass lesion, calcification, subarachnoidal hemorrhage and leptomeningitis, while they were nonspesific in the other 13 patients (cortical or cerebral artophy and small anatomical alterations). Mean age was significantly higher in the patients with positive radiological findings (p &lt; 0.0001). Radiological findings were more frequent in patients with tension type headache.

Research paper thumbnail of The effect of two different parenteral nutrition regimens on parenteral nutrition-associated cholestasis

Journal of Maternal-Fetal and Neonatal Medicine, 2013

Exposure to parenteral nutrition (PN) is one major factor in the development of cholestasis. The ... more Exposure to parenteral nutrition (PN) is one major factor in the development of cholestasis. The aim of this retrospective study was to compare the effect of these two different PN regimens on PN-associated cholestasis (PNAC). The files of the patients who have received different PN regimens for &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;14 d in 2005 and 2009 were retrospectively reviewed. 133 patients have received PN more than 14 d. 22 (16.5%) patients had PNAC. 90 neonates were in Group low-dose parenteral (LDpn) and 43 neonates in Group high-dose parenteral. Mean gestational age and birth weight were statistically significantly lower in LDpn Group (p = 0.016, p = 0.434). Cholestasis rate was significantly higher in high dose group. (p = 0.023). Although several risk factors for PNAC are unavoidable, research is still needed to define the optimal parenteral amino acid solution for neonatal patients. Individualized PN may be more affective in allowing growth and minimizing side effects.

Research paper thumbnail of The Effect of Human Growth Hormone on Superoxide Dismutase Activity, Glutathione and Malondialdehyde Levels of Hypoxic-Ischemic Newborn Rat Brain

Biology of the Neonate, 2006

We investigated the effect of human growth hormone (GH) on newborn rat brain superoxide dismutase... more We investigated the effect of human growth hormone (GH) on newborn rat brain superoxide dismutase, glutathione and malondialdehyde (MDA) levels in hypoxic-ischemic (H-I) newborn rats. Fourty-eight 7 days old newborn rats were randomized to a healthy (n: 15), H-I (n: 18) and GH administered H-I (GH-H-I, n: 15) group. Permanent, left common carotid ligation was performed in the H-I groups. In the GH-H-I group, 50 mg/kg human GH (Norditropin Simplex, Novo Nordisk A/S) was administered subcutaneously just before carotid artery ligation. Two hours after ligation, rats were subjected to 2 h of hypoxemia and then were decapitated. Right and left cerebral hemispheres (CHs) and cerebellum-brain stem (C-BS) were separated. Glutathione levels of each region were not statistically different from each other in and between the groups. Superoxide dismutase levels were higher in C-BSs compared to CHs (for each comparison 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;lt; 0.01). CHs and C-BS MDA levels were similar in the control and H-I groups but MDA levels of both CHs of the GH-H-I group were significantly higher than the levels of the H-I group (p = 0.01; p = 0.024, respectively). Left CH MDA level of GH-H-I group was higher compared to left CH MDA of the control group (p = 0.045) while there was no difference between right CHs. In the GH-H-I group, left CH MDA level was higher than the C-BS (p = 0.03). MDA levels of the C-BSs did not differ between the groups (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;gt; 0.05). Although we have not evaluated the effect of GH histopathologically, increased lipid peroxidation especially in the H-I (left) hemisphere of the GH treated rats might suggest that GH treatment may be harmful in H-I encephalopathy.

Research paper thumbnail of Avascular Osteonecrosis and Accompanying Anemia, Leucocytosis, and Decreased Bone Mineral Density in Renal Transplant Recipients

Transplantation Proceedings, 2011

BackgroundAvascular osteonecrosis (AVN) is a complication of renal transplantation. In this study... more BackgroundAvascular osteonecrosis (AVN) is a complication of renal transplantation. In this study, we present 12 cases of AVN associated with renal transplantation.

Research paper thumbnail of Efficacy and Safety of Vardenafil in Renal Transplant Recipients With Erectile Dysfunction

Transplantation Proceedings, 2006

Erectile dysfunction (ED) profoundly affects the quality of life. The prevalence of ED in renal t... more Erectile dysfunction (ED) profoundly affects the quality of life. The prevalence of ED in renal transplant recipients is reported by high as 50% to 60%. We evaluated the efficacy and safety of vardenafil in these patients with ED as well as its effects on graft function and on cylosporine or tacrolimus concentrations. Thirty-nine recipients with ED and serum creatinine values

Research paper thumbnail of Does the decision in a validation process of a surrogate endpoint change with level of significance of treatment effect? A proposal on validation of surrogate endpoints

Contemporary Clinical Trials, 2009

In recent years the use of surrogate end points (S) has become an interesting issue. In clinical ... more In recent years the use of surrogate end points (S) has become an interesting issue. In clinical trials, it is important to get treatment outcomes as early as possible. For this reason there is a need for surrogate endpoints (S) which are measured earlier than the true endpoint (T). However, before a surrogate endpoint can be used it must be validated. For a candidate surrogate endpoint, for example time to recurrence, the validation result may change dramatically between clinical trials. The aim of this study is to show how the validation criterion (R(2)(trial)) proposed by Buyse et al. are influenced by the magnitude of treatment effect with an application using real data. The criterion R(2)(trial) proposed by Buyse et al. (2000) is applied to the four data sets from colon cancer clinical trials (C-01, C-02, C-03 and C-04). Each clinical trial is analyzed separately for treatment effect on survival (true endpoint) and recurrence free survival (surrogate endpoint) and this analysis is done also for each center in each trial. Results are used for standard validation analysis. The centers were grouped by the Wald statistic in 3 equal groups. Validation criteria R(2)(trial) were 0.641 95% CI (0.432-0.782), 0.223 95% CI (0.008-0.503), 0.761 95% CI (0.550-0.872) and 0.560 95% CI (0.404-0.687) for C-01, C-02, C-03 and C-04 respectively. The R(2)(trial) criteria changed by the Wald statistics observed for the centers used in the validation process. Higher the Wald statistic groups are higher the R(2)(trial) values observed. The recurrence free survival is not a good surrogate for overall survival in clinical trials with non significant treatment effects and moderate for significant treatment effects. This shows that the level of significance of treatment effect should be taken into account in validation process of surrogate endpoints.

Research paper thumbnail of Dipyridamole for renal phosphate leak in successfully renal transplanted hypophosphatemic patients

Clinical Nephrology, 2008

Hyphosphatemia can be seen in renal transplant recipients. Hyperparathyroidism, glucocorticoid tr... more Hyphosphatemia can be seen in renal transplant recipients. Hyperparathyroidism, glucocorticoid treatment, renal denervation and impairment of renal tubular phosphate reabsorption are the most common causes of hyphosphatemia in these patients. It is well-known that dipyridamole enhances renal tubular phosphate reabsorption in some clinical conditions. We did not find any information about the effect of dipyridamole in renal transplant recipients (RTRs) with hypophosphatemia. For this reason, we decided to give dipyridamole 11 RTRs with hypophosphatemia. Eleven RTRs whose serum phosphate and creatinine levels were below 2.5 mg/dl and 2 mg/dl, respectively, were included in this study. None of the patients received drugs altering phosphate metabolism and they did not change their routine diets. Urinary phosphate excretion and tubular phosphate reabsorption (TPR) were calculated before and 3 weeks after dipyridamole treatment. The mean levels of serum-urine (daily) phosphate and TPR before dipyridamole treatment were 1.94 +/- 0.46 mg/dl, 7,187.5 +/- 1,833.49 mg/day and -2.78 +/- 0.62, respectively. After treatment, the mean levels of serum-urine phosphate and TPR were 2.73 +/- 0.46 mg/dl, 4,845.27 +/- 1,138.99 mg/day and -1.48 +/- 0.80, respectively. Serum and urine phosphate levels and TPR were found to be significantly different before and after dipyridamole therapy (p &lt; 0.05). Short-term dipyridamole therapy increased TPR and serum phosphate levels and decreased urinary phosphate excretion. We did not observe negative effect on renal functions in these cases. Although the number of the cases included in this study is small, dipyridamole is an effective choice in management of hypophosphatemic RTRs.