Browsing by Author "Usta, Mehmet"
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Item Angiotensin-II receptor antagonist losartan reduces micro albuminuria in hypertensive renal transplant recipients(Wiley, 2002-06) Alparslan, Ersoy; Dilek, Kamil; Usta, Mehmet; Yavuz, Mahmut; Güllülü, Mustafa; Yurtkuran, Mustafa Abbas; Oktay, Burçin; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-0710-0923; AAH-5054-2021; 35612977100; 56005080200; 7005030712; 7006244754; 6602684544; 6602172127; 7003389525In recent years, it has been demonstrated that losartan lowers macroproteinuria in diabetic or non-diabetic renal transplant recipients (RTx) similar to angiotensin converting enzyme (ACE) inhibitors. Microalbuminuria (MAU) may reflect subclinical hyperfiltration damage of the glomerulus. It could be a marker of kidney dysfunction in renal transplantation. The aim of the study was to assess the efficacy of losartan in hypertensive RTx with MAU. This study was conducted in 17 (M/F: 4/13) stable RTx. No change was made in the medical treatment of the patients. All cases received 50 mg/day losartan therapy for 12 wk. Renal functions and MAU were determined 12 and 6 wk and just before the treatment as well as sixth and twelfth week of the treatment in all patients. Losartan satisfactorily lowered systemic blood pressure. A significant reduction in MAU was observed from 103 +/- 53 mug/min at the beginning to 59 +/- 25 mug/min in the sixth week and 47 +/- 24 mug/min in the twelfth week (p = 0.0007 and 0.0005, respectively). From the sixth week of the treatment, the therapy significantly decreased hemoglobin, hematocrit and erythrocyte levels but did not change mean leukocyte and platelet counts, urea, creatinine levels and creatinine clearances. No serious side-effect was observed,during the study. In conclusion, we found that losartan decreased MAU in hypertensive RTx. For that reason, it might be considered as the first choise antihypertensive agent for the renoprotection in selected patients.Item Anjiyotensin II reseptör antagonisti losartanın hipertansif hemodiyaliz olgularında ambulatuar kan basıncı üzerine etkisi(Uludağ Üniversitesi, 2002-07-22) Ersoy, Alparslan; Ersoy, Canan; Dilek, Kamil; Usta, Mehmet; Güllülü, Mustafa; Yavuz, Mahmut; Yurtkuran, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Bilim Dalı.Bu çalışmada, 28 hipertansif hemodiyaliz olgusunda anjiyotensin reseptör antagonisti losartanın ambulatuar kan basıncı (AKB) üzerine etkisi araştırıldı. Olgular 2 gruba ayrıldılar. Losartan grubundaki 17 olgu 16 hafta boyunca 50-100 mg/gün losartan tedavisi aldı. Kontrol grubundaki 11 olgu ise herhangi bir tedavi almadı. Tüm olgularda hemen tedavi öncesi ve sonrası prediyaliz 24 saatlik AKB takibi yapıldı. Losartan grubunda 24 saatlik, gün boyu ve gece boyu sistolik kan basıncı (SKB) ve diyastolik kan basıncı (DKB) değerlerindeki tedavi sonrası değişiklikler tedavi öncesi ile karşılaştırıldığında, gün boyu SKB dışındakiler anlamlı olarak azaldı. Fakat kontrol grubu ile karşılaştırıldığında sadece gece boyu ortalama SKB ve DKB’ndaki değişiklikler arasında fark vardı (sırasıyla -%6 ± 9’a karşılık %1 ± 4 ve -%8 ± 12’ye karşılık %1 ± 7, p>0.05). Tedavi sonrası losartan grubunda SKB’nı 140 ile 160 mmHg arasında okuma oranı (%20), kontrol grubundan (%70) daha düşüktü. Losartan grubundaki iki olgunun diurnal varyasyonu düzeldi. Losartan grubunda gece boyu SKB’nı >140 mmHg ve 24 saatlik ve gece boyu DKB’nı >90 mmHg okuma yüzdeleri anlamlı azaldı. Losartan tedavisi olgular tarafından iyi tolere edildi. Sonuç olarak, hipertansif hemodiyaliz olgularında losartanın kan basıncını ve basınç yükünü azalttığı ve daha iyi gece boyu kan basıncı kontrolü sağladığı kanaatine vardık.Item Anti-proteinuric effect of angiotension II receptor antagonist losartan in cases with glomerular lesions(Dustri, 2001-03) Usta, Mehmet; Dilek, Kamil; Yavuz, Mahmut; Ersoy, Alparslan; Güllülü, Mustafa; Yurtkuran, Mustafa Abbas; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-0710-0923; AAH-5054-2021; 7005030712; 56005080200; 7006244754; 35612977100; 6602684544; 7003389525Item Aspergillus pneumonia in renal transplant recipients at a medical center in Turkey(Elsevier, 2004-11) Usta, Mehmet; Kahveci̇oğlu, Serdar; Akdağ, İbrahim; Güllülü, Mustafa; Özdemir, Bülent; Ener, Beyza; Ersoy, Alparslan; Çırak, Y.; Dilek, Kamil; Yavuz, Mahmut; Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-8886-7703; 0000-0002-4803-8206; 0000-0002-0710-0923; AAG-8523-2021; AAH-5054-2021; 7005030712; 55956719500; 8342488100; 6602684544; 7004168959; 15053025300; 35612977100; 57070235800; 56005080200; 7006244754Pulmonary aspergillosis is a devastating disease. Early diagnosis allowing early treatment may improve the prognosis. However, this goal remains difficult to achieve. When the diagnosis is confirmed, it is often already too late. Despite antifungal treatment, the mortality rate is high. Patients with immunosuppression show a high mortality rate. We present five patients of ages ranging between 34 and 43 years who displayed aspergillus pneumonia between 1991 and 2000. All patients received cyclosporine, azathioprine, and prednisone for maintenance immunosuppressive therapy. Their ages ranged from 34 to 43 years with the onset of infection between 1 to 25 months posttransplant. In all cases, the infection was localized to the lungs. Standard methods of fungal culture and identification were used. No coinfections with tuberculosis or other fungi or bacteria were, identified. Three cases were successfully treated but two patients showed deterioration despite appropriate therapy and died. Among patients with solid organ transplantation, lung, liver, and renal transplant patients are at the highest risk of developing aspergillus lung infections. A high degree of awareness and efforts for early diagnosis and therapy may improve the poor prognosis.Publication Comparison of endoscopic and pathological findings of the upper gastrointestinal tract in transplant candidate patients undergoing hemodialysis or peritoneal dialysis treatment: A review of literature(BMC, 2020-10-22) Usta, Mehmet; Ersoy, Alparslan; Ayar, Yavuz; Ocakoğlu, Gökhan; Yüzbaşıoğlu, Bilgehan; Erdem, Emrullah Düzgün; Erdoğan, Ömer; ERSOY, ALPARSLAN; OCAKOĞLU, GÖKHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Nefroloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-0710-0923; AAH-5180-2021; AAH-5054-2021Background: Dyspepsia is a common disorder in kidney transplant recipients, and the risk of post-transplant complications is increased in candidates with upper gastrointestinal disease. We evaluated gastrointestinal lesions of kidney transplant candidates on dialysis.Methods: In this study, endoscopic and pathological findings in hemodialysis (HD) and peritoneal dialysis (PD) patients with gastrointestinal symptoms on the waiting list were compared.Results: The most common non-ulcerous lesions in the endoscopic examination were gastritis (62.3%), erosive gastritis (38.7%), duodenal erosion or duodenitis (18.9%) and esophagitis (13.2%). The ulcerous lesion was present in only 3 patients. Gastroesophageal reflux disease, ulcerated lesion and non-ulcerated lesion rates were similar in both dialysis groups. Histopathological examination revealedHelicobacter pylori(HP) positivity in 28.3% of patients. HP positivity rate was significantly higher in PD patients than in HD patients (38.7% vs. 13.6%,p = 0.046). Chronic gastritis (75.5%) was the most common pathological finding. HP positivity rate was 37.5% in patients with chronic gastritis, but HP was negative in patients without chronic gastritis. In multivariate analysis, male gender, urea and albumin levels were associated with the presence of pathological chronic gastritis. The presence of gastritis, total cholesterol and ferritin levels were found significant for HP positivity. A total cholesterol > 243 mg/dL was significantly related to an increased risk of the presence of HP positivity.Conclusions: Gastrointestinal lesions and HP infection are common in dialysis patients. Dialysis modality may affect the frequency of some lesions. It may be useful to have an endoscopic examination before entering the transplant waiting list for all candidates.Item Determination of flavan-3-ols and trans-resveratrol in grapes and wine using HPLC with fluorescence detection(Elsevier Science, 2007) Gürbüz, Ozan; Göçmen, Duygu; Gürsoy, Murat; Aydın, Sami; Büyükuysal, Levent R.; Dağdelen, Fatih; Şahin, İsmet; Usta, Mehmet; Uludağ Üniversitesi/Tıp Fakültesi/Farmakoloji Anabilim Dalı.; 0000-0001-7871-1628; 8528582100; 55967047900; 18133776200; 57197640824; 7005387015; 14020460400; 6507171811; 14020897700Concentrations of trans-resveratrol, catechin and epicatechin were analyzed in musts and wines produced from seven red and four white grape cultivars from various wine growing regions of Turkey. Phenolics were quantified using an HPLC method optimized for the separation of wine phenolics. Wine samples contained higher phenolics levels than the corresponding musts. With the exception of Semillion, white wines and musts contained lower concentrations of phenolics than red wines and musts. However, the white cultivar Semillion had the highest concentrations of catechin and epicatechin among all wine and must samples. Semillion wine catechin and epicatechin were 13.7 and 11.8 mg/L, respectively. The highest level of trans-resveratrol among the white cultivars was found in Narince wine (1.93 mg/L). Within the red wine and must cultivars, Bogazkere, Okuzgozu, and Cabernet contained the highest concentrations of flavan-3-ols and trans-resveratrol. Catechin was the major phenolic in all wines and most musts. Epicatechin was the major phenolic in 6 of the 11 must samples, but none of the wine samples. trans-Resveratrol was generally found in lowest concentrations in both wines and musts.Item Effect of omega-3 polyunsaturated fatty acid supplementation on glycemic control and renal function in type 2 diabetic patients with chronic kidney disease(Carbone Editore, 2020-01-20) Usta, Mehmet; Ayar, Yavuz; Göksel, Gültekin; Karagöz, İsminur Saka; Ersoy, Alparslan; Ersoy, Canan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; 0000-0002-0710-0923; AAH-5054-2021; AAH-8861-2021; 35612977100; 6701485882Introduction: The aim of this study was to evaluate the short-term effects of omega-3 polyunsaturated fatty acids (n-3 PUFA) supplementation on glycemic control and renal function in type 2 diabetic patients with chronic kidney disease. Materials and methods: Twenty-five diabetic patients received medication containing 2 g/day n-3 PUFA orally in addition to standard treatments. Their estimated glomerular filtration rates (eGFR) were <80 mL/min/1.73 m(2). Biochemical values were evaluated before and 3 months after treatment. Results: After three months of supplementation, the changes in serum creatinine, uric acid, eGFR and urinary albumin excretion levels did not reach statistical significance. There was no difference between serum glucose, HbAlC and lipid profile values before and after the n-3 PUFA.supplementation in patients. Only serum albumin significantly increased from 4.10 +/- 0.26 to 4.28 +/- 0.31 g/dL (p=0.016), and systolic blood pressure decreased from 121.4 +/- 14.5 to 116 .6 +/- 14.9 mmHg (p=0.001). Conclusion: Short-term n-3 PUFA supplementation did not affect renal function and glycemic control in patients with type 2 diabetes with chronic kidney disease.Publication Effect of omega-3 polyunsaturated fatty acid supplementation on glysemic control and renal function in type 2 diabetic patients with chronic kidney disease(Oxford Universitesi, 2021-05-01) Usta, Mehmet; Ayar, Yavuz; Goksel, Gultekin; Karagoz, Isminur Saka; Ersoy, Alpaslan; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; 0000-0003-4607-9220; GSE-0029-2022; O-9948-2015; AGF-0767-2022Item Efficacy of losartan in patients with primary focal segmental glomerulosclerosis resistant to immunosuppressive treatment(Wiley, 2003-03) Usta, Mehmet; Ersoy, Alparslan; Dilek, Kamil; Özdemir, Bülent; Yavuz, Mahmut; Güllülü, Mustafa; Yurtkuran, Mustafa Abbas; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; 0000-0002-0710-0923; AAH-5054-2021; 7005030712; 35612977100; 56005080200; 7004168959; 7006244754; 6602684544; 7003389525Objectives. Angiotensin II may play an important role in the progression of renal disease. Currently, angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists are commonly used for renoprotection. To our knowledge, there is no study investigating this effect of angiotensin II receptor antagonists in patients with primary focal segmental glomerulosclerosis (FSGS) in the literature. The aim of this study was to evaluate the effects of losartan on proteinuria and renal function in patients with FSGS refractory to immunosuppressive treatment. Design. Twenty-three normotensive patients with FSGS proven through renal biopsy were included in the study. Thirteen of them, five men and eight women, were given losartan in a dose of 50 mg day(-1) during 12 months, and 10, four men and six women, were in the control group. Mean arterial blood pressure (MAP), 24-h urine protein excretion, serum total protein and albumin levels were determined just before the start of treatment as well as after 1, 6 and 12 months of the study. In addition, serum creatinine, creatinine clearence (CrCl), cholesterol and triglyceride levels were determined at the beginning and end of the study. Results. Age, gender and baseline levels of proteinuria, serum albumin, total protein, creatinine, CrCl and MAPs were similar in the two groups. Nephrotic range of proteinuria was present in five of 13 patients (38.4%) in the losartan group and in four of 10 patients (40%) in the control group. In the losartan group, 24-h proteinuria had decreased from 3.6 +/- 0.5 g to 2.3 +/- 0.5 g after 1 month, to 2.4 +/- 0.7 g after 6 months and to 1.9 +/- 0.7 g after 12 months. In the control group, a significant increase in proteinuria compared with the baseline value was noticed after 12 months. Proteinuria levels were significantly higher in the control group than in the losartan group after 6 and 12 months. Whilst total protein and albumin levels increased in the losartan group, they did not change significantly in the control group. The total protein levels after 6 and 12 months, and albumin levels after 6 months were significantly higher in the losartan group than in the control group. No significant change was observed between the baseline and the 12-month creatinine and CrCl levels of the groups when intra- and inter-group comparisons were made. Furthermore, serum cholesterol levels of the losartan group were reduced significantly. The changes in MAP values did not reach significant levels in either of the groups. There was no correlation between the percentage changes in MAP and in proteinuria of the losartan group after 12 months. Conclusions. Angiotensin II receptor antagonists may be an alternative therapy in FSGS patients who are resistant to immunosuppressive therapy.Item Farklı dozlarda vitamin C tedavisinin renal anemi üzerine etkisi(Uludağ Üniversitesi, 2002-07-22) Ersoy, Alparslan; Ersoy, Canan; Dilek, Kamil; Usta, Mehmet; Güllülü, Mustafa; Yavuz, Mahmut; Yurtkuran, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.Bu çalışmada, 55 stabil hemodiyaliz hastasında farklı dozlarda vitamin C tedavisinin renal anemi üzerine olan etkisini inceledik. Hastalar dört gruba bölündü. Üç gruba 100, 1000 ve 2000 mg/gün dozlarında oral vitamin C üç ay süreyle verildi. Kontrol grubuna ise vitamin C uygulanmadı. Tedavi öncesi, tedavinin 1., 2. ve 3. aylarında hemoglobin (Hb), hematokrit (Hct), eritrosit ve serum ferritin düzeyleri ölçüldü. Üç ay sonra, 100 ve 1000 mg/gün vitamin C tedavisi alan gruplarda tedavi öncesi ve kontrol grubu ile karşılaştırıldığı zaman ortalama Hb, Hct ve eritrosit düzeylerinde anlamlı değişiklik saptanmadı. 2000 mg/gün vitamin C tedavisi alan grupta tedavi öncesi ile karşılaştırıldığı zaman ortalama Hb, Hct ve eritrosit düzeyleri anlamlı artış gösterdi. Kontrol grubu ile karşılaştırıldığında ise anlamlı değişiklik saptanmadı. Bu grupta anemide görülen olumlu etkinin vitamin C tedavisine bağlı olup olmadığını daha iyi değerlendirebilmek amacıyla vitamin C tedavisi 3 ay süreyle kesildi. Tedavi kesilmeden önceki değerlerle karşılaştırdığımızda ortalama Hb, Hct ve eritrosit düzeylerinde anlamlı azalma olmadı. Tedavi öncesi ve kontrol grubu ile karşılaştırıldığı zaman her üç grupta da ferritin düzeylerinde anlamlı bir değişiklik olmadı. Sonuç olarak çeşitli dozlarda vitamin C tedavisinin hemodiyaliz hastalarında renal anemi üzerine etkisi olmadığı kanaatine vardık.Item 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.Item Long-term effects of losartan on proteinuria and renal function in patients with renal amyloidosis(Informa Healthcare, 2002) Dilek, Kamil; Usta, Mehmet; Ersoy, Alparslan; Yavuz, Mahmut; Güllülü, Mustafa; Yurtkuran, Mustafa Abbas; Özdemir, Binnaz Handan; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-7528-3557; 0000-0002-0710-0923; X-8540-2019; AAH-5054-2021; 56005080200; 7005030712; 35612977100; 7004168959; 7006244754; 6602684544; 7003389525Objective: To investigate the effect of the angiotensin II receptor antagonist losartan oil proteinuria in secondary amyloidosis cases. Material and Methods: Sixteen patients with renal biopsy-proven AA amyloidosis with proteinuria were included in the study. All the patients had received colchicine treatment for at least 18 months. The patients were divided into two groups with similar age and gender distributions. Eight patients were given losartan at a dose of 50 mg/day for 12 months and the other 8 patients served as controls. Mean arterial blood pressure, proteinuria, serum albumin level and renal function were determined at the initiation of the study and after 1 and 12 months. Results: There were no significant differences in proteinuria, serum albumin level, renal function or mean arterial blood pressure at the initiation of the study. In the losartan group daily proteinuria decreased significantly from 5.2 +/- 0.7 at the initiation of the study to 3.9 +/- 1.2 g at 1 month and 3.6 +/- 0.8 g at 12 months, while in the control group it changed from 4.6 +/- 1.0 to 4.7 +/- 1.0 g and 6.1 +/- 1.2 g, respectively. The increment at 12 months was significant. After 12 months of treatment with losartan, proteinuria was significantly lower in comparison to the degree of proteinuria in the control group. Serum albumin level increased significantly in the losartan group but was unchanged in the control group. In the control group, creatinine clearance showed a significant decrease. There was no significant difference in mean arterial blood pressure measurements, serum creatinine levels, total protein, albumin and creatinine clearance levels between the two groups. Conclusions: Losartan seemed to prevent an increase in proteinuria without altering the creatinine clearance level in patients with amyloidosis type AA during a 12-month period. This indicates that losartan may be used to decrease proteinuria in this patient group. However, our results are only preliminary and need to be confirmed by larger studies.Item Prevalence of transfusion-transmitted virus (TTV) in patients with primary glomerulopathies(Dustri Verlag, 2001-04) Usta, Mehmet; Dilek, Kevser; Dalkılıç, Ediz; Güllülü, Mustafa; Mıstık, R.; Yavuz, Mahmut; Ersoy, Alparslan; Yurtkuran, Mustafa Abbas; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-0710-0923; AAH-5054-2021; 7005030712; 56005080200; 6506739457; 6602684544; 6504789868; 7006244754; 35612977100; 7003389525Item The relationship between lymphocyte subsets, nutritional status and tuberculin reactivity in continuous ambulatory peritoneal dialysis and hemodialysis patients(Springer, 2020-06) Usta, Mehmet; Alparslan, Ersoy; Ayar, Yavuz; Budak, Ferah; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji ve İmmünoloji Anabilim Dalı.; 0000-0002-0710-0923; 0000-0001-7625-9148; AAH-5054-2021; AGF-0767-2022; F-4657-2014; 35612977100; 55860143300; 57216531873Aim Skin test anergy is common in patients with uremia and during maintenance hemodialysis treatment. However, up to date only one study concerning skin test in peritoneal dialysis patients has focused on the issue. Our cross-sectional controlled study was conducted to analyze the correlation of purified protein derivative (PPD) test response with demographical features, nutritional parameters and the distribution of peripheral blood lymphocyte subsets in peritoneal dialysis and hemodialysis patients Patients and methods Stable 30 hemodialysis (HD) patients (16 men, 14 women) and 30 continuous ambulatory peritoneal dialysis (PD) patients (17 men, 13 women) were included. Thirty healthy cases (15 men, 15 women) with a mean age of 32.4 +/- 9.4 constituted the control group. Results In the HD group, 14 patients (46.6%) were PPD positive, and in the PD group 16 patients (53.3%) were PPD positive. In the PPD-positive HD patients 64.2% (9/14), and in the PPD-positive PD patients 62.4% (10/16) had an induration of 10 mm or greater. In the control group, 21 of 30 patients (70%) were PPD positive. Comparison of both HD and PD groups with the control group showed significant differences in PPD reactivity (p < 0.01). Albumin levels were significantly high in the control groups (p < 0.01), and cholesterol levels were significantly high in the PD and the control groups (p < 0.05). Transferrin levels were significantly high in the PD (p < 0.01). The lymphocyte counts were significantly high in the control group compared to the HD patients (p < 0.05). The lymphocyte subset percentages CD19 were high in the control groups (p < 0.05), and CD16/56 was significantly high in the PD groups (p < 0.05). All the parameters were also similar between PPD-positive and -negative same groups. Conclusion The prevalence of PPD positivity was lower in the PD and HD groups. The PPD test responses were not related to the peripheral lymphocyte counts, subsets and malnutrition parameters.Item A renal transplant recipient with pulmonary tuberculosis and visceral leishmaniasis: Review of superimposed infections and therapy approaches(Dustri-Verlag, 2003-10) Ersoy, Alparslan; Güllülü, Mustafa; Usta, Mehmet; Özçelik, Tülay; Yılmaz, E.; Uzaslan, Esra Kunt; Vuruşkan, Hakan; Yavuz, Mahmut; Oktay, Bülent; Dilek, Kamil; Yurtkuran, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-0710-0923; AAH-5054-2021; AAI-1004-2021; 35612977100; 6602684544; 7005030712; 7005424333; 57224424133; 8761653500; 6507328150; 7006244754; 6602172127; 56005080200; 7003389525Visceral leishmaniasis (VL) is an acute or subacute disease that is almost invariably fatal if untreated. It is a rare disease in renal transplant recipients and frequently reported together with other infectious agents. A 39-year-old renal transplant patient was admitted to hospital for elective coronary surgery. In the post-operative period, he developed spiking fever and non-productive cough and his general condition deteriorated. While he was taking medication for nonspecific pneumonia, a cavitary lesion occurred in his lung, and he had the diagnosis of pulmonary tuberculosis and antituberculous treatment was started. Despite treatment, his fever continued. As the patient developed pancytopenia and splenomegaly, a bone marrow aspiration was done. Evaluation of bone marrow aspirate indicated Leishmania parasites. He was successfully treated with a more intensive liposomal amphotericin (L-AmB). Complete cure was achieved during follow-up period of 10 months without clinical relapse. In the existence of fever and long-standing pancytopenia, VL should be suspected although the patient had another proved infection and did not live or visit an endemic area. L-AmB usage can be safely preferred for treatment of selected renal transplant recipients with VL as first-line therapy.Item Survival analysis of the factors affecting in mortality in injured patients requiring dialysis due to acute renal failure during the Marmara earthquake: Survivors vs non-survivors(Dustri-Verlag Dr Karl Feistle, 2003-05) Ersoy, Alparslan; Yavuz, Mahmut; Usta, Mehmet; Ercan, İlker; Aslanhan, İsmail; Güllülü, Mustafa; Kurt, Ender; Emir, Gönül; Dilek, Kamil; Yurtkuran, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0002-0710-0923; 0000-0002-2382-290X; AAH-5054-2021; 35612977100; 7006244754; 7005030712; 6603789069; 6506580844; 6602684544; 7006207332; 57189602234; 56005080200; 7003389525Background: We reviewed medical records of dialyzed patients admitted to our hospital after the Marmara earthquake and evaluated the factors affecting mortality in survivors and non-survivors according to the survival times. Patients and methods: Crush syndrome ( CS) was diagnosed in 110 patients. Dialysis treatment was initiated in 60 patients; 21 of all died. The patients were divided into 2 groups which consisted of 39 survivors ( Group A, 25 male, 14 female, mean age: 31 +/- 2.2 years) and 21 nonsurvivors ( Group B, 9 male, 12 female, mean age: 27 +/- 3.0 years). Victims treated by any form of renal replacement therapy, including daily or intermittant hemodialysis and/or continuous venovenous hemodiafiltration. Clinical and laboratory findings were recorded regularly. Statistical analysis was performed with Kaplan-Meier method, log rank test and Cox regression analysis for the survival functions. Results: APACHE II scores were 13.5 +/- 0.5 for Group A and 13 +/- 0.9 for Group B. Dialysis support was started to patients in Group A in a mean period of 2.8 +/- 0.2 days and in Group B in a mean period of 3.7 +/- 0.6 days after the earthquake ( p > 0.05). The most frequent site of trauma was lower extremity (61.5%) and upper + lower extremities (23%) in Group A, and lower extremity (38.1%) and trunk + lower extremity (23.8%) in Group B. The frequencies of abdominal trauma, pelvic fracture and thoracic trauma in Group B were 23.8%, 19% and 14.2%, respectively. Multiple trauma was more frequent in Group B than in Group A (42.8% vs 2.5%). The rates of fasciotomy, amputation and surgery were similar in both groups. The frequency of sepsis was higher in nonsurvivors. In our center, the overall mortality rate was 8%, mortality rate in CS was 21% and in dialyzed patients it was 35%. Mortality was mainly associated with sepsis. Survival periods (52.3 +/- 4.0 days) in Group A were longer than in Group B (17.3 +/- 2.5 days). With Cox regression analysis, the parameters such as systolic hypotension on admission, female gender, high serum peak creatine kinase (> 20,000 U/l) and multiple trauma including thoracic and abdominal regions, were factors increasing risk of mortality. Conclusion: As a result, sepsis, multiple trauma and severe crush injury were the main factors increasing mortality risk in dialyzed injuries after the earthquake.Item Systemic AA amyloidosis and nephrotic syndrome associated with small cell carcinoma of the bladder(Oxford University, 2003-11) Kanat, Ozkan; Evrensel, Türkkan; Filiz, Gülaydan; Usta, Mehmet; Başkan, Emel Bülbül; Dilek, Kamil; Manavoğlu, Osman; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Deri ve Zührevi Hastalıklar Anabilim Dalı.; 0000-0002-9732-5340; AAJ-1027-2021; 55881548500; 6603942124; 6602693514; 7005030712; 6602518817; 56005080200; 6602587152Item Tedavi sonrasında tümör lizis sendromu gelişen iki hodgkin dışı lenfoma olgusu(Uludağ Üniversitesi, 1998) Manavoğlu, Osman; Orhan, Bülent; Evrensel, Türkkan; Usta, Mehmet; Özkocaman, Vildan; Uludağ Üniversitesi/Tıp Fakültesi/Onkoloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dal.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.Akut tümör lizis sendromu (TLS), hızlı prolifere olan malign tümör/erin tedavisi sırasında; nadiren de spontan olarak gelişen fatal bir sendromdur. Takdim edilen olgulardan ilki; boyunda hızlı büyüyen kitle sebebi ile başvurmuştu ve yapılan biyopsi sonucunda Diffüz Büyük Hücreli lenfoma tanısı konularak tedavi başlandı. ikinci olgu ise, anemi ve boyunda lenfadenopati nedeni ile başvurmuş sonrasında lenfoblastik lenfoma tanısı konularak tedaviye başlanmıştır. Her iki vakada da tedaviyi takiben TLS gelişmesi nedeni ile nadir görülen bu klinik tablo literatür bilgilerinin ışığı altında gözden geçirildi.Publication The relationship between lymphocyte subsets, nutritional status and tuberculin reactivity in continuous ambulatory peritonel dialysis and hemodialysis patients(Oxford University Press, 2021-05) Usta, Mehmet; Ersoy, Alpaslan; Ayar, Yavuz; Budak, Ferrah; ERSOY, ALPARSLAN; BUDAK, FERAH; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bölümü; 0000-0001-7625-9148; JXD-1615-2024; IZP-9398-2023Background and Aims: Skin test anergy is common in patients with uremia and during maintenance hemodialysis treatment. However, up to date only one study concerning skin test in peritoneal dialysis patients has focused on the issue. Our cross-sectional controlled study was conducted to analyze the correlation of purifed protein derivative (PPD) test response with demographical features, nutritional parameters and the distribution of peripheral blood lymphocyte subsets in peritoneal dialysis and hemodialysis patients. Method: Stable 30 hemodialysis (HD) patients (16 men, 14 women) and 30 continuous ambulatory peritoneal dialysis (PD) patients (17 men, 13 women) were included. Thirty healthy cases (15 men, 15 women) with a mean age of 32.4±9.4 constituted the control group. Results: In the HD group, 14 patients (46.6%) were PPD positive, and ın the PD group 16 patients (53.3%) were PPD positive. In the PPD-positive HD patients 64.2% (9/14), and in the PPD-positive PD patients 62.4% (10/16) had an induration of 10 mm or greater. In the control group, 21 of 30 patients (70%) were PPD positive. Comparison of both HD and PD groups with the control group showed signifcant diferences in PPD reactivity (p<0.01). Albumin levels were signifcantly high in the control groups (p<0.01), and cholesterol levels were signifcantly high in the PD and the control groups (p<0.05). Transferrin levels were signifcantly high in the PD (p<0.01). The lymphocyte counts were signifcantly high in the control group compared to the HD patients (p<0.05). The lymphocyte subset percentages CD19 were high in the control groups (p<0.05), and CD16/56 was signifcantly high in the PD groups (p<0.05). All the parameters were also similar between PPD-positive and -negative same groups. Conclusion: The prevalence of PPD positivity was lower in the PD and HD groups. The PPD test responses were not related to the peripheral lymphocyte counts, subsets and malnutrition parameters.