Browsing by Author "Gül, Cuma Bülent"

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An overlooked complication of bariatric surgery: Gluteal compartment syndrome
(Turk Nefroloji Diyaliz Transplantasyon Dergisi, 2016-01-01) Gül, Cuma Bülent; Topal, Ersun; Kahvecioğlu, Serdar; Akyağcı, Serpil Bilgin; Esen, Selin; Yıldız, Abdülmecit; YILDIZ, ABDULMECİT; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.
Gluteal compartment syndrome (GCS) is an uncommon non-traumatic rhabdomyolysis induced by staying in the same position for a long time during a surgical operation or under the effect of drugs. In bariatric surgery, overweight patients are more prone to this syndrome. If a patient has complaints such as hip or leg pain, sciatic nerve palsy and red-brown colored urine in the post-op period, GCS should be taken into consideration. For patients having a long operation time due to technical problems, the creatinine kinase level should be controlled and the gluteal region should be examined carefully. The treatment options of GCS include early aggressive fluid replacement, alkalinization of urine with sodium bicarbonate, surgical decompression and debridement. Here we present a case of a 40-year-old obese patient who underwent bariatric surgery resulting in GCS, renal failure, and death.
Analysis of liver function test abnormalities in kidney transplant recipients
(Oxford Univ Press, 2015-05-01) Dizdar, Oğuzhan Sıtkı; Ersoy, Alparslan; Yıldız, Abdulmecit; Ayar, Yavuz; Oruç, Ayşegül; Gül, Cuma Bülent; Dizdar, Oğuzhan Sıtkı; ERSOY, ALPARSLAN; YILDIZ, ABDULMECİT; Ayar, Yavuz; ORUÇ, AYŞEGÜL; GÜL, CUMA BÜLENT; Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bölümü; 0000-0002-4066-929X; 0000-0003-4607-9220; 0000-0002-0342-9692; 0000-0003-2467-9356; O-9948-2015; D-6213-2013; AAH-4002-2021; AGF-0767-2022; AAH-5054-2021; GSE-0029-2022; A-7063-2018
Association of morning blood pressure surge (mbps) with left ventricular hypertrophy in autosomal dominant polycystic kidney disease (ADPKD): Across sectional study
(Oxford Univ Press, 2016-05-01) Sağ, Saim; Yıldız, Abdulmecit; Ersoy, Alparslan; Ocakoğlu, Gökhan; Oruç, Ayşegül; Güngören, Fatih; Ayar, Yavuz; Gül, Cuma Bülent; Güllülü, Sümeyye; Güllülü, Mustafa; Sağ, Saim; YILDIZ, ABDULMECİT; ERSOY, ALPARSLAN; OCAKOĞLU, GÖKHAN; ORUÇ, AYŞEGÜL; Güngören, Fatih; Ayar, Yavuz; GÜL, CUMA BÜLENT; GÜLLÜLÜ, NAZMİYE SÜMEYYE; GÜLLÜLÜ, MUSTAFA; Uludağ Üniversitesi/Tıp Fakültesi/Kardioloji Bölümü; 0000-0002-1114-6051; 0000-0002-0342-9692; 0000-0003-4607-9220; 0000-0003-2467-9356; AAH-5180-2021; AGF-0767-2022; AAW-9185-2020; AAH-5054-2021; O-9948-2015; AAA-3163-2021; HLG-6346-2023; AAH-4002-2021; A-7063-2018; GSE-0029-2022; HIG-9032-2022; JGR-6552-2023; CTG-8811-2022
Comparative effects of pioglitazone and rosiglitazone on plasma levels of soluble receptor for advanced glycation end products in type 2 diabetes mellitus patients
(W B Saunders Co-Elsevier, 2010-01) Yılmaz, Yusuf; Gül, Özen Öz; Tuncel, Ercan; Ulukaya, Engin; Gül, Cuma Bülent; Kıyıcı, Sinem Küçüksaraç; Oral, Arzu Yılmaztepe; Güçlü, Metin; Ersoy, Canan; İmamoğlu, Şazi; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0003-0463-6818; 0000-0003-2467-9356; A-5841-2017; AAI-1005-2021; ABI-4847-2020; AAH-8861-2021; K-5792-2018; A-7063-2018; 26040787100; 7006929833; 6602927353; 23988796000; 12753880400; 23091316500; 15073842600; 6701485882; 6602297533
Low levels of soluble receptor for advanced glycation end products (sRAGE) have been associated with the occurrence of vascular complications in patients with type 2 diabetes mellitus. Preliminary evidence has suggested that thiazolidinediones have the ability to modulate circulating levels of this molecule in the hyperglycemic milieu. The aim of this pilot study was to assess the differential effect of 2 different thiazolidinediones pioglitazone and rosiglitazone on plasma levels of sRAGE in type 2 diabetes mellitus patients. Sixty type 2 diabetes mellitus subjects were randomly assigned to receive pioglitazone (30 mg/d, n = 19), rosiglitazone (4 mg/d, n = 20), or placebo (medical nutrition therapy, n = 21) for 12 weeks. Changes in plasma glucose, glycosylated hemoglobin, insulin resistance (homeostasis model assessment), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and sRAGE were evaluated at baseline and after 12 weeks. At 12 weeks, the pioglitazone (P < .001) group had a significant increase from baseline in sRAGE values that was not seen in the medical nutrition therapy and rosiglitazone groups. We conclude that, in type 2 diabetes mellitus patients, pioglitazone but not rosiglitazone significantly raised sRAGE, which may contribute to its antiatherogenic effects.
Comparative genotoxic and cytotoxic effects of the oral antidiabetic drugs sitagliptin, rosiglitazone, and pioglitazone in patients with type-2 diabetes: A cross-sectional, observational pilot study
(Elsevier, 2013-04-05) Gül, Özen Öz; Çinkılıç, Nilüfer; Gül, Cuma Bülent; Cander, Soner; Vatan, Özgür; Ersoy, Canan; Yılmaz, Dilek; Tuncel, Ercan; Uludağ Üniversitesi/Fen-Edebiyat Fakültesi/Biyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-7687-3284; 0000-0002-3595-6286; 0000-0003-2467-9356; AAH-8861-2021; O-7508-2015; AAH-5296-2021; AAI-1005-2021; A-7063-2018; 26040787100; 26533892300; 23988796000; 25027068600; 16235098100; 6701485882; 6701369462; 7006929833
This cross-sectional, observational pilot. study was designed to investigate the frequency of different endpoints of genotoxicity (sister-chromatid exchange, total chromosome aberrations, and micronucleus formation) and cytotoxicity (mitotic index, replication index, and nuclear division index) in the peripheral lymphocytes of patients with type-2 diabetes treated with different oral anti-diabetic agents for 6 months. A total of 104 patients who met the American Diabetes Association criteria for type-2 diabetes were enrolled in the study. Of the 104 patients, 33 were being treated with sitagliptin (100 mg/day), 25 with pioglitazone (30 mg/day), 22 with rosiglitazone (4 mg/day), and 24 with medical nutrition therapy (control group). The results for all the genotoxicity endpoints were significantly different across the four study groups. Post hoc analysis revealed that the genotoxicity observed in the sitagliptin group was significantly higher than that observed in the medical nutrition therapy group, but lower than that occurring in subjects who received thiazolidinediones. All of the three cytotoxicity endpoints were significantly lower in patients treated by oral anti-diabetic agents compared with those who received medical nutrition therapy. However, the three indexes did not differ significantly in the sitagliptin, rosiglitazone, and pioglitazone groups. Taken together, these pilot data indicate that sitagliptin and thiazolidinediones may exert genotoxic and cytotoxic effects in patients with type-2 diabetes. Further investigations are necessary to clarify the possible long-term differences between oral anti-diabetic drugs in terms of genotoxicity and cytotoxicity, and how these can modulate the risk of developing diabetic complications in general and cancer in particular.
Comparison of the effects of paricalcitol and calcitriol treatments on osteoprotegerin (OPG) levels in hemodialysis patients
(Corbone Editore, 2016-01-02) Gül, Cuma Bülent; Aktaş, Nimet; Oruç, Ayşegül; Yıldız, Abdülmecit; Bal, Öznur; Korkmaz, Serhat; Güllülü, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; AAH-4002-2021; D-4160-2016; 55133912100; 56256977500; 55327241300; 36009787600; 6602684544
Introduction: Osteoprotegerin (OPG), a natural glycoprotein, which plays important roles on regulation and development of vascular calcification, is a key regulator molecule in bone turnover. Studies revealed different results about effects of vitamin D receptor activators (VDRAs) on OPG levels. This study investigated the changes in serum OPG levels and its relationships following VDRAs, paricalcitol and calcitriol treatments, in hemodialysis patients. Materials and methods: Thirty-two hemodialysis patients (14 women, 18 men) were included the study. Demographics and ongoing treatments of patients were recorded. Paricalcitol and calcitriol treatments were initiated randomly. Serum OPG levels, biochemical and hematological tests were measured at baseline and 3th month of the treatment. Results: There was no significant difference between the groups in terms of demographics and basal laboratory tests. No difference was found between paricalcitol and calcitriol groups regarding change from baseline and percent change in biochemical markers and OPG levels. Significant increase in calcium (Ca) levels (p=0.025 vs 0.001), significant decreases in parathyroid hormone (PTH) (p=0.001 vs 0.039) and OPG (p=0.001 vs 0.006) levels were noted at 3th month compared to baseline in paricalcitol and calcitriol group. Conclusion: VDRAs, paricalcitol and calcitriol, both decreased OPG levels in hemodialysis patients. No difference was noted between two therapeutic agents regarding their effects on OPG levels. These findings should be confirmed by further large-scale studies.
Correlation between arterial stiffness and inflammatory markers in autosomal dominant polycystic kidney disease patients with preserved renal function
(Springer, 2015-07-01) Gül, Cuma Bülent; Yıldız, Abdülmecit; Ersoy, Alparslan; Kahvecioğlu, Serdar; Asiltaş, Burak; Yıldırım, Fatih; Ermurat, Selime; Sağ, Saim; Oruç, Ayşegül; Güllülü, Sumeyye; Güllülü, Mustafa; YILDIZ, ABDULMECİT; ERSOY, ALPARSLAN; Asıltaş, Burak; YILDIRIM, FATİH; Ermurat, Selime; Sağ, Saim; ORUÇ, AYŞEGÜL; GÜLLÜLÜ, NAZMİYE SÜMEYYE; GÜLLÜLÜ, MUSTAFA; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; 0000-0003-2467-9356; 0000-0002-0342-9692; 0000-0002-3090-1585; 0000-0001-8404-8252; HIG-9032-2022; AAH-5054-2021; JCN-7114-2023; AAH-4002-2021; ABE-4424-2022; AAW-9185-2020; EKV-7386-2022; EXG-3181-2022; CTG-8811-2022
To evaluate the association between arterial stiffness and inflammatory markers including C-reactive protein (CRP), pentraxin 3 (PTX3) and neutrophil-to-lymphocyte ratio (NLR) in autosomal dominant polycystic kidney disease (ADPKD) patients with preserved renal function.A total of 52 ADPKD patients [mean (SD) age 38.2 (12.8) years, 69.2 % were females] with preserved renal function and 25 healthy volunteers [mean (SD) age 35.5 (6.5) years, 48.0 % were females] were included. Data on patient characteristics, blood biochemistry, inflammatory markers [PTX3 (pg/mL), CRP (mg/dL) and NLR] and arterial stiffness [large artery elasticity index (LAEI) (mL/mmHg x 10) and small artery elasticity index (SAEI) (mL/mmHg x 100)] were recorded in patient and control groups. Correlation between inflammatory markers and arterial stiffness parameters was analysed in patients.Overall, 42.3 % of ADPKD patients were hypertensive and 44.4 % were receiving renin-angiotensin-aldosterone system (RAAS) blockade therapy. Median levels for PTX3 [442.0 (20.0-4140.0) pg/mL vs. 220.5 (14.7-393.0) pg/mL, p < 0.001] and SAEI [4.90 (1.60-11.80) mL/mmHg x 100 vs. 6.45 (2.80-15.70) mL/mmHg x 10, p = 0.013] were significantly higher in ADPKD patients than in controls. PTX3 and CRP were not correlated with arterial elasticity, while NLR was significantly correlated with LAEI negatively (Rho = -0.278, p = 0.042).In conclusion, our findings revealed increased PTX3 levels and reduced SAEI in patients as compared with controls, while no correlation between inflammatory markers studied and the small artery elasticity.
Cytokine signal suppressor (SOCS) 1-1478 CA/del gene polymorphism in Turkish patients with polycystic ovary syndrome
(Taylor & Francis, 2017-10-03) Gül, Cuma Bülent; Gül, Özen Öz; Cander, Soner; Budak, Ferah; Oral, Barbaros; Ersoy, Canan; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İmmünoloji Anabilim Dalı.; 0000-0001-7625-9148; 0000-0003-0463-6818; AAI-1005-2021; F-4657-2014; K-7285-2012; AAH-8861-2021; 26040787100; 25027068600; 6701913697; 7004498001; 6701485882
Eighty-four subjects, premenopausal female patients (n=42, mean (SD) age: 26.4 (4.2) years) diagnosed with polycystic ovary syndrome (PCOS) and age-matched healthy volunteers (n=42, mean (SD) age: 27.6(3.4) years), were included in this study. Data on physical examination, anthropometric measurements and blood biochemistry analysis were recorded for each subject along with analysis for SOCS1-1478 CA/del polymorphism by polymerase chain reaction-restriction fragment length polymorphism. The relation of SOCS1-1478 CA/del polymorphism to PCOS status and insulin resistance was analysed via logistic regression analysis. Mean (SD) levels for BMI (28.5(6.5) vs.22.5 (4.9) kg/m(2), p<.001), HOMA-IR (3.1(1.8) vs.1.5 (1.0), p<.001), LDL-cholesterol (115.9(32.7) vs.100.7 (27.3)mg/dL, p=.03) and triglyceride (113.8(64.9) vs.83.3(36.3)mg/dL, p=.017) were significantly higher in patients. Groups were similar in terms of SOCS1-1478 CA/del polymorphism. No significant relation of this polymorphism was noted to PCOS and HOMA-IR. Our findings revealed no difference between groups in terms of the rate of SOCS1-1478 CA/del polymorphism, and no significant relation of this polymorphism to insulin resistance and PCOS status. IMPACT STATEMENT Polycystic ovary syndrome (PCOS), the most common cause of anovulation and the most commonly encountered form of female endocrine disease. SOCS proteins have been suggested to play a fundamental role in the negative feedback regulation of the JAK-STAT pathway, which is the major signalling pathway involved in a wide range of physiologic and pathologic processes, including inflammatory diseases, malignancies and immune disorders. Pathways involving the induction of suppression of SOCS proteins were also shown likely to be involved in mediating cytokine-induced insulin resistance. The present study was designed to determine the frequency of SOCS1-1478 CA/del gene polymorphism in patients with PCOS in relation to healthy controls and insulin resistance. Our findings revealed significantly higher rates of insulin resistance, obesity and dyslipidaemia in Turkish patients with PCOS compared with age-matched healthy controls, while no difference between study groups in terms of the rate of SOCS1-1478 CA/del polymorphism along with no significant relation of SOCS1-1478 CA/del polymorphism to insulin resistance and PCOS status. Future larger scale studies with the application of standardised diagnostic methods and criteria, and of state-of-the-art modern techniques including genomics, proteomics and pharmacogenetics would provide better understanding of the association between PCOS and genomic variants.
Decreased plasma levels of soluble receptor for advanced glycation endproducts (sRAGE) in patients with nonalcoholic fatty liver disease
(Pergamon-Elsevier Science, 2009-06) Atuğ, Özlen; Yılmaz, Yusuf; Ulukaya, Engin; Gül, Özen Öz; Arabul, Mahmut; Gül, Cuma Bülent; Oral, Arzu Yılmaztepe; Aker, Sibel; Dolar, Mahmut Enver; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Anabilim Dalı.; 0000-0003-2467-9356; 0000-0003-0463-6818; 0000-0003-4518-5283; A-7063-2018; AAI-1005-2021; AAG-9177-2021; A-5841-2017; K-5792-2018; 22936014300; 6602927353; 26040787100; 15925230900; 23988796000; 23091316500; 12795285000; 6602075084
Objectives: Levels of soluble receptor for advanced glycation endproducts (sRAGE) have been linked to several components of the metabolic syndrome. We tested the hypothesis that plasma levels of sRAGE may be associated with non-alcoholic fatty liver disease. Design and methods: We enrolled subjects with definite nonalcoholic steatohepatitis (NASH, n=40), borderline NASH (n=8), simple fatty liver (n=9) and healthy controls (n=14). Plasma levels of sRAGE were measured by ELISA. Results: Concentrations of sRAGE were significantly lower in patients with definite NASH (1080 +/- 392 pg/mL, P<0.01) and borderline NASH (1050 +/- 278 pg/mL, P<0.05) compared to controls (1480 +/- 387 pg/mL). Levels of sRAGE were significantly and inversely correlated with ALT (r=-0.30, P<0.05) and AST (r=-0.23, P<0.05). Conclusion: Plasma levels of sRAGE are significantly reduced in definite and borderline NASH.
The effect of hemodialysis, peritoneal dialysis and renal transplantation on nutritional status and serum micronutrient levels in patients with end-stage renal disease; Multicenter, 6-month period, longitudinal study
(Elsevier, 2020-03-12) Dizdar, Oğuzhan Sıtkı; Gül, Cuma Bülent; Günal, Ali İhsan; Gundoğan, Kürşat; Yıldız, Abdülmecit; Ersoy, Alparslan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-0710-0923; HIG-9032-2022; 56256977500; 35612977100
Purpose: Nutritional status and micronutrient levels of end stage renal disease (ESRD) patients may vary depending on the mode of renal replacement therapy (RRT). We aimed to compare the effects of hemodialysis, peritoneal dialysis (PD) and renal transplantation (RT) on micronutrient levels and nutritional status in ESRD patients. Patients and Methods: A total of 77 ESRD patients who had not received RRT were included in this prospective longitudinal study. All ESRD patients underwent a blood serum analysis that assessed the micronutrients such as selenium, copper, zinc, chromium, retinol, thiamine and vitamin B6 as well as a nutritional status assessment. After the baseline assessments and the initiation of RRT was accomplished, all patients were followed for 6 months. Results: The study showed significant improvements in subjective global assessment scores (percentage increases in score A were 26.6 and 36.6; p= 0.039 and p= 0.001; respectively), mid-arm circumference and the skin-fold thicknesses (p < 0.001, p < 0.001; respectively) in the RT and hemodialysis groups. The examinations at sixth month revealed a significant increase in body weight (4.8 kg; p= 0.002) and albumin levels (0.6 g/dL; p < 0.001) in only RT group. Zinc, thiamin and vitamin B6 were the most deficient micronutrients (44.1 %, 24.7 % and 35.1 %; respectively) in ESRD patients. There was a significant increase in selenium and retinol levels (p= 0.020 and p < 0.001; respectively) but a significant decrease in thiamin levels (p= 0.041) in RT patients. A significant increase in retinol levels (p= 0.028) and a significant decrease in thiamin levels (p= 0.022) was observed in the hemodialysis patients. However, no significant change in micronutrient levels was observed in the PD patients. Conclusion: The results support the recommendation that ESRD patients should be supplemented with watersoluble vitamins, especially thiamine and vitamin B6, and trace elements, especially zinc. RT appears to be superior to other modes of RRT when examining SGA score, anthropometric measurements, albumin and micronutrient levels.
Effect of sitagliptin monotherapy on serum total ghrelin levels in people with type 2 diabetes
(Elsevier Ireland, 2011-11) Gül, Özen Öz; Kıyıcı, Sinem Kücçuüksaraç; Ersoy, Canan; Cander, Soner; Yorulmaz, Hakan; Gül, Cuma Bülent; Sarandöl, Emre; Kırhan, Emine; Sığırlı, Deniz; Ertürk, Erdinç; Tuncel, Ercan; İmamoğlu, Sazi; Ünal, Oğuz Kağan; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0003-2467-9356; 0000-0002-2593-7196; AAI-1005-2021; A-7063-2018; AAJ-6536-2021; AAA-7472-2021; ABE-1716-2020; AAH-8861-2021; 26040787100; 12753880400; 6701485882; 25027068600; 24438635700; 23988796000; 55943324800; 37104411100; 24482063400; 7005488796; 7006929833; 55042241400
Aim: Sitagliptin is not associated with weight gain and has neutral effects on body weight. It is unclear whether sitagliptin treatment alters serum ghrelin levels in people with type 2 diabetes. Methods: Forty-four subjects with type 2 diabetes were randomly assigned to receive sitagliptin or medical nutrition therapy (MNT) for 12 weeks. Changes in anthropometric variables, glycemic control, insulin resistance, lipid parameters, and total ghrelin levels were evaluated at baseline and following 12 weeks of treatment. Results: Significant decreases in body weight and body mass index were observed over the entire study period in both treatment groups. Glycosylated hemoglobin and postprandial plasma glucose levels were statistically significant decreased in the groups receiving sitagliptin compared with baseline values (p = 0.021 and p = 0.021, respectively), while they were unchanged in the groups receiving MNT. There was a significant decrease in total ghrelin in the groups receiving sitagliptin (p = 0.04) compared with baseline values but not in the groups receiving MNT (p = 0.46) at the end of the 12 weeks. Conclusions: In this study of patients with type 2 diabetes, treatment with sitagliptin was associated with a significant decrease in serum ghrelin levels. These results suggest that the neutral effect of sitagliptin on weight might be associated with the suppression of fasting serum ghrelin levels.
Effect of the direct renin Inhibitor aliskiren in the prevention of experimental contrast-induced nephropathy in the rat
(Karger, 2012) Kedrah, Alla Eldeen; Arı, Elif; Alahdab, Yeşim; Macunluoğlu, Beyza; Atakan, Aydın; Aşıcıoğlu, Ebru; Çakalağaoğlu, Fulya; Koç, Mehmet; Gül, Cuma Bülent; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0003-2467-9356; A-7063-2018; 23988796000
Background: Renal vasoconstriction, activated by the reninangiotensin system, plays a pivotal role in the pathogenesis of contrast-induced nephropathy (CIN). The purpose of this study was to evaluate the effect of aliskiren, a direct renin inhibitor, for the prophylaxis of experimental CIN in the rat. Methods: Thirty-two Wistar albino rats were divided into four groups of 8 rats each, namely the control (C), aliskiren (A), contrast media (CM) and aliskiren plus contrast media (ACM) groups. Aliskiren was given orally at a dose of 50 mg/kg/day once daily for 5 consecutive days. CIN was induced by intravenous administration of indomethacin, N-nitro-L-arginine methyl ester and high-osmolar contrast medium meglumine amidotrizoate. Renal function parameters, kidney histology and tubular expression of vascular endothelial growth factor were determined. Results: Mean serum creatinine was significantly lower (p < 0.001) and mean creatinine clearance was higher (p < 0.001) in the ACM group compared with the CM group. However, there were no differences between the ACM and CM groups in terms of tubular necrosis, proteinaceous casts, medullary congestion and vascular endothelial growth factor expression. Conclusion: Our preliminary data seem to suggest a potential role of aliskiren for the prophylaxis of CIN in an experimental rat model.
Effects of anti-tumor necrosis factor therapy on kidney function in patients with inflammatory arthritis
(Oxford Univ Press, 2013-05-01) Öztürk, Oğuzhan; Yıldız, Abdulmecit; Gül, Cuma Bülent; Dilek, Kamil; GÜL, CUMA BÜLENT; DİLEK, KAMİL; Uludağ Üniversitesi/Tıp Fakültesi; 0000-0003-2467-9356; A-7063-2018; EUF-5229-2022
Elevated serum levels of caspase-cleaved cytokeratin 18 (CK18-Asp396) in patients with nonalcoholic steatohepatitis and chronic hepatitis C
(Int Scientific Literature, 2009-04) Yılmaz, Yusuf; Dolar, Enver; Ulukaya, Engin; Akgöz, Semra; Keskin, Murat; Kıyıcı, Murat; Yerci, Ömer; Oral, Arzu Yılmaztepe; Gül, Cuma Bülent; Gürel, Selim; Nak, Selim Giray; Gülten, Macit; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0003-2467-9356; 0000-0003-0463-6818; 0000-0003-4518-5283; 0000-0002-3208-6211; 0000-0003-4526-4352; A-7063-2018; AAG-9177-2021; AAI-4213-2021; A-5841-2017; K-5792-2018; K-6651-2012; 22936014300; 6602075084; 6602927353; 14061863400; 23050640000; 6507627491; 6603810549; 23091316500; 23988796000; 7003706434; 6603336505; 6603629209
Background: Caspase-cleaved cytokeratin 18 (CK18-Asp396) is released from hepatocytes during apoptosis. Recent studies have indicated that serum levels of CK18-Asp396 could be clinically useful biomarker of chronic liver disease. To shed more light on the rate of hepatocyte loss by apoptosis in chronic liver disease, serum levels of CK18-Asp396 were examined in patients with nonalcoholic steatohepatitis (NASH) and chronic hepatitis C. Material/Methods: Apoptotic CK18-Asp396 levels were quantified in sera from 35 patients with nonalcoholic steato-hepatitis (NASH), 21 patients with chronic hepatitis C (HCV), and 18 healthy controls. Results: Analysis of serum CK18-Asp396 levels showed an increasing trend starting from healthy controls (median: 34.5 U/l), to HCV patients (80.1 U/l), to patients with NASH (144.1 U/l. Kruskall-Wallis test: P<0.001). Post hoc analyses revealed that CK18-Asp396 levels were significantly higher in the NASH patients than in both HCV patients (P=0.008) and healthy controls (P<0.001). Moreover, the levels were significantly higher in patients with HCV than in control individuals (P<0.05). In patients with chronic HCV infection there was a significant positive correlation between serum CK18-Asp396 levels and AST (r=0.442, p<0.05), the ultrasonographic grade of steatosis (r = 0.446, P<0.05), and the histological steatosis score (r=0.759, P<0.001). Conclusions: Although subject to future confirmation, these pilot findings seem to indicate that serum levels of caspase-cleaved cytokeratin 18 (CK18-Asp396) are higher in patients with NASH than in those with chronic HCV infection. These data suggest that NASH patients have and increased hepatocyte loss by apoptosis compared with chronic hepatitis C patients.
Enkapsüle peritoneal sklerozis gelişiminin önlenmesinde parikalsitolün etkinliği
(Uludağ Üniversitesi, 2012) Gül, Cuma Bülent; Yurtkuran, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Nefroloji Bilim Dalı.
Enkapsüle sklerozan peritonit (ESP), periton diyalizi (PD) uygulanan hastalarda ortaya çıkan ve tedavisi tam olarak bilinmeyen oldukça ölümcül bir komplikasyondur. Bu çalışmanın amacı; D vitamini benzeri olan parikalsitolün ESP gelişimini önlemedeki etkisini araştırmaktır. Çalışmada, 40 adet üremik olmayan 200-220 gram ağırlığında,albino wistar cinsi, dişi sıçan kullanıldı. Sıçanlar rastgele eşit sayıda dört gruba ayrıldı. Üç hafta süreyle birinci gruba intraperitoneal (İP) 2 mL serum fizyolojik verildi, ikinci gruba 2 mL/ 200 gram serum fizyolojik içinde çözünmüş kalsiyum glukonat (KG) (%0.1) ve etanol (%15) İP verildi. Üçüncü ve dördüncü gruba üç hafta boyunca KG ile birlikte sırasıyla 0.2 mcg/kg/gün ve 0.4 mcg/kg/gün derialtı parikalsitol yapıldı. İP uygulamalar peritonun aynı tarafından yapıldı (sol taraf). Çalışma sonunda tüm gruplara 1 saatlik 25mL %3.86 PD solüsyonu ile periton eşitleme testi yapıldı. Peritoneal sıvı, intrakardiyak kan örnekleri elde edildi ve patolojik inceleme için peritonun İP uygulama yapılmayan tarafı alındı. TGF-ß1 düzeyi periton sıvısından çalışıldı. Her iki tedavi grubunda D/P üre (diyalizat üre/plazma üre), grup 2 ile karşılaştırıldığında anlamlı olarak düşüktü. Ancak periton morfolojisi ve TGF-ß 1 düzeyleri arasında grup 2 ile anlamlı fark saptanmadı. Bir D vitamini benzeri olan parikalsitolün fibrozisi önlediği daha önce gösterilmiş olsa da, çalışmamızda deneysel EPS örneğinde belirgin faydası gösterilememiştir.
Evaluation of serum spondin 2 levels in the different etiologies of glomerular diseases
(Oxford University, 2015-05-01) Kahvecioğlu, Serdar; Ersoy, Alparslan; Ayar, Yavuz; Güçlü, Metin; Gül, Cuma Bülent; Üstündağ, Yasemin; Doğan, Ibrahim; Yıldız, Abdülmecit; ERSOY, ALPARSLAN; AYAR, YAVUZ; YILDIZ, ABDULMECİT; 0000-0003-4607-9220; 0000-0002-0710-0923; AGF-0767-2022; AAH-5054-2021; HIG-9032-2022
Girişimsel işlemler sonrası gelişen her böbrek yetmezliği kontrast madde nefropatisi midir?
(Uludağ Üniversitesi, 2015-09-16) Gül, Cuma Bülent; Yıldız, Abdülmecit; Güllülü, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bilim Dalı.
Genelde klinisyenler girişimsel işlemler sonrasında ortaya çıkan her böbrek yetmezliğini kontrast aracılı nefropati olarak değerlendirme eğilimindedirler. Bu nedenle multisistemik bir hastalık olan ateroembolik renal hastalık sıklıkla gözden kaçar. Hastalık genelde yaşlı, aterosklerotik erkeklerde klasik triadı ile ortaya çıkar; girişimsel işlem, akut böbrek yetmezliği ve cilt bulguları. Bu olgu sunumu ateroembolik renal hastalığa dikkat çekmek için yapılmıştır.
Helicobacter pylori: A role in schizophrenia?
(INT Scientific Information, 2008-07) Yılmaz, Yusuf; Gül, Cuma Bülent; Arabul, Mahmut; Eren, Mehmet Ali; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0003-2467-9356; 0000-0003-4518-5283; A-7063-2018; K-6651-2012; ABH-7279-2020; 22936014300; 23988796000; 15925230900; 7006788432
Schizophrenia is a devestating psychiatric disorder that affects approximately one percent of the world's adult population. Despite substantial investigative efforts over the last decades, the exact mechanisms and pathogenesis of this condition are not yet fully understood. Published data support certain infectious agents as potential risk factors for schizophrenia. Since its discovery, Helicobacter pylori has been implicated in a variety of extradigestive diseases, but its potential role in the pathogenesis of psychiatric disorders has thus far been neglected. It is hypothesized here that infection with H. pylori occurring in early childhood may induce persisting systemic biochemical aberrations, including dopaminergic dysfunction, decreased levels of essential polyunsaturated fatty acids, subtle inflammation, and homocysteine alterations, that may play a crucial role in the development of schizophrenia in genetically predisposed individuals. Evidence in favor of this hypothesis is provided and possible therapeutic implications are discussed.
Higher predialysis potassium level is independently associated with intradialytic hypotension in elderly and younger hemodialysis patients
(Carbone Editore, 2016-01-02) Yıldız, Demet; Çimen, Doğan; Gül, Cuma Bülent; Aktaş, Nimet; Tufan, Fatih; Oruç, Ayşegül; Yıldız, Abdülmecit; Şahin, Ahmet Bilgehan; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-0342-9692; 0000-0002-7846-0870; AAH-4002-2021; AAM-4927-2020; HIG-9032-2022; 55133912100; 56256977500; 57188809248
Introduction: Intradialytic hypotension (IDH) is an important cause of morbidity and mortality in patients under maintenance hemodialysis (HD) treatment. Seeking factors associated with IDH may provide clinically relevant information.Materials and method: We enrolled a total of 103 patients receiving thrice-weekly HD. Besides hemodynamic and laboratory parameters, we evaluated nutritional status, depressive symptoms, and anxiety symptoms.Results: Female subjects had a significantly higher rate of IDH compared to males (42.6% vs. 14.9%, p=0.003). Older patients (>= 65 years old) tended to have a higher rate of IDH compared to those younger than 65 years, but the difference was not statistically significant (31% vs. 21%, p=0.2). Univariate correlation analysis revealed gender, orthostatism, history of falls, dialysis duration, fasting glucose, albumin, and potassium levels to be correlated with IDH. Logistic regression analysis revealed that higher potassium level was the only independent factor in association with IDH.Conclusion: We observed an independent association between higher predialysis potassium levels and IDH. Further studies are needed to confirm this association and to see if measures to control predialysis potassium levels better would translate into a decreased rate of IDH in these patients.
İkinci basamak bir hastanede renal biyopsi deneyimi
(Uludağ Üniversitesi, 2011-11-01) Usta, Mehmet; Kılıçarslan, Işın; Gül, Cuma Bülent; Yıldız, Abdülmecit; Ersoy, Alparslan; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Nefroloji Bilim Dalı.
Böbrek biyopsisi günümüzde böbrek parenkim hastalıklarının tanı ve tedavisinde kullanılan en iyi yöntemdir. Çalışmamızda böbrek biyopsilerini klinik ve patolojik açıdan değerlendirmeyi amaçladık. Bu çalışma 2005 ve 2010 tarihleri arasında Bursa Devlet Hastanesi Nefroloji Servisinde renal biyopsi gerçekleştirilen 30 hastanın verilerinin retrospektif olarak analiz edilmesiyle yapılmıştır. Biyopsiler ikinci basamak tek merkezde ultrasonografi eşliğinde yapıldı. Biyopsilerin tamamı nativ böbrek biyopsisi idi. Biyopsilerin çoğu proteinüri (%40) nedeni ile yapıldı. Endikasyon olarak ikinci sırayı proteinüri ile birlikte hematüri (%33.3) takip etti. Biyopsi tanılarımız ise %30 membranöz glomerülonefrit (MGN), IgA nefropatisi (%16.7), amiloidoz (%16.7), membranoproliferatif glomerülonefrit (%10), lupus nefriti (%10), tubüler interstisyel nefropati (%6.6), fokal segmental glomerüloskleroz (%3.3), hipertansif nefroskleroz (%3.3) ve vaskülit (%3.3) idi. Çalışmaya alınan hastalarda majör komplikasyon görülmedi. Sıklıkla proteinüri nedeni ile yaptığımız renal biyopsi sonucu; en sık MGN, ikinci sırada amiloidoz ve IgA nefropatisi tanısı konmuştur. Bu çalışma ikinci basamak hastanelerin uygun koşullar sağlandığında primer glomerüler hastalıkların tanı ve tedavisinde etkin rol oynayabileceğini göstermiştir.