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Öğe The abnormalities in the coagulation factory in patients with essential hypertension and relationship between the coagulation abnormalities and end organ damage(2005) Çelebi, Harika; Karaca, Ilgın; İlkay, Erdoǧan; Tamer, Ali; Koç, ZuhalHypertension is one of the important health problems in the world due to its high incidence and the fact that it causes mortality and morbidity. Mortality and morbidity in hypertensive patients are caused by damage of the target organ. Hypertensive patients are found to have impairments in coagulation mechanism in comparison to normotensive people. The relation between coagulation abnormalities in hypertensives and damage of the target organ is debatable. In this study we investigated coagulation abnormalities in hypertensive patients and the relation between the possible abnormality and target organ damage. Prothrombin time, partial thromboplastin time, fibrinogen, D-dimer and antithrombin III were measured in 50 essential hypertension patients and 50 normotensive controls. Target organ damage was assessed by clinical evaluation and laboratory tests including measurement of creatine clearance, proteinuria, ophthalmoscopy, electrocardiography, echocardiography, and ultrasound examination of major arteries. Plasma fibrinogen and D-dimer levels were significantly greater in hypertensives than normotensive controls. Antitrombin III level was significantly lower in hypertensives than controls. Hypertensive patients had greater body mass index and triglyceride and LDL cholesterol levels and lower HDL cholesterol than controls. The difference in terms of impairment of coagulation parameters was not statistically significant between hypertensive cases with target organ damage and hypertensive cases without target organ damage. Elevated plasma levels of fibrinogen, D-dimer and lower level of AT III in patients with essential hypertension may contribute to the development of atherosclerotic disease. Copyright © Hellenic Society of Haematology.Öğe Albendazole versus metronidazole treatment of adult giardiasis: An open randomized clinical study(WJG Press, 2004) Karabay, Oguz; Tamer, Ali; Gündüz, Hüseyin; Kayaş, Derya; Arınç, Hüseyin; Çelebi, HarikaAim: To investigate the efficacy and tolerability of albendazole and metranidazole treatment in giardiasis. Methods: The open comparative randomized trial was carried out prospectively from December 1999 to July 2001 in Duzce City of Turkey. The diagnosis was based on the presence of signs and symptoms compatible with giardiasis including a positive stool examination of giardia cysts or trophozoite. Metranidazole group consisted of 29 patients and was given metranidazole 500 mg, three times a day for 5 d and albendazole group was consisted of 28 patients and was given albendazole 400 mg/d for 5 d. Results: There were no significant differences in demographical and therapeutical effects and patient's compliance between both groups. But side effects were seen more in metranidazole group than in albendazole group. Conclusion: Albendazole is as effective as metranidazole in adults' giardiasis. Albendazole has less side effect potentials than metranidazole in the treatment of giardiasis. Copyright © 2004 by The WJG Press.Öğe Cytomegalovirus antigenemia is observed more frequently following allogeneic peripheral blood stem cell transplantation compared to bone marrow transplantation(2006) Çelebi, Harika; Dalva, Klara; Özhan, Murat; Beksaç, MeralOne of the major complications following hematopoietic stem cell transplantation (HSCT) is cytomegalovirus (CMV) infection. In our institution, three methods have been applied routinely for the diagnosis of CMV antigenemia (CMV-Ag): 1. Direct immunofluorescence microscopic (IFM) examination; 2. Flow cytometric (FC) analysis; and 3. Serological investigation. We were able to detect CMV-Ag by FC in 18 out of 75 transplanted cases. In 14 of these, positivity was confirmed by IFM as well. CMV-Ag was detected as positive by FC in samples from peripheral blood (14 cases) and/or bronchoalveolar lavage (BAL) fluid (4 cases). Eighteen patients had been transplanted [peripheral blood stem cell transplantation (PBSCT)/bone marrow transplantation (BMT): 16/2]. CMV-Ag was detected in 34% of PBSCTs and 7% of BMTs (p<0.008). Antigenemia was observed at a median of 4.5 months. In most of the patients, graft-versus-host disease (GVHD) was accompained by CMV-Ag. The ratio of acute GVHD/chronic GVHD was 6/10. Out of 18 CMV-Ag positive patients, 16 also had signs of infection. They were all positive by IFM as well. The two methods of CMV-Ag detection were correlated (r=0.619, p<0.0001). An important finding is the higher frequency of CMV-Ag and GVHD in patients who had received PBSCT. © Turkish Society of Hematology.Öğe Dose Chronic(2006) Karbay, Oğuz; Tamer, Ali; Sahin, İdris; Çelebi, HarikaObjectives: To determine the prevalence of Staphylococcus aureus nasal carriage in patients with chronic hepatitis B virus infection. Patients and Methods: The prevalence of S. aureus nasal carriage was determined in patients with chronic hepatitis B virus infection and compared with the prevalence of S. aureus nasal carriage among control patients. Results: Between February 2003 and November 2004, 70 chronic hepatitis B patients and 70 control patients were enrolled in the study. S. aureus nasal carriage was shown in 15(12%) of the patients with chronic hepatitis B and 13 (19%) of the control group (P>0.05). There was no difference in nasal colonization between the cases and controls when analysed by age, sex, frequency of skin infection, prior use of antibiotics and hospital admission in the preceding six months. Conclusion: The results of our study show that chronic hepatitis B virus infection is not associated with S. aureus nasal carriage.Öğe Effectiveness of lamivudine and interferon-? combination therapy versus interferon-? monotherapy for the treatment of HBeAg-negative chronic hepatitis B patients: A randomized clinical trial(2005) Karabay, Oğuz; Tamer, Ali; Tahtaci, Mustafa; Vardi, Şeref; Çelebi, HarikaResults comparing the effectiveness of lamivudine used as monotherapy or in combination with interferon-alpha (IFN-?) in the treatment of chronic hepatitis B are not conclusive. This study compared the effects of IFN-? alone or in combination with lamivudine for the treatment of hepatitis B e antigen (HBeAg)-negative patients with chronic hepatitis B. Participation of patients in the IFN-? monotherapy and combination groups was randomized to a 1:1 ratio. Twenty seven HBeAg-negative patients with chronic hepatitis B received IFN-? (13 patients) at 9 million units 3 times weekly for 24 weeks or IFN-? at 9 million units 3 times weekly for 24 weeks plus lamivudine 100 mg/day (14 patients) daily for 1 year. Hepatitis B virus (HBV) DNA was measured quantitatively by real-time polymerase chain reaction at 0, 6, 12 and 18 months after the start of treatment. Sustained virologic response was defined as non-detectable serum HBV DNA 72 weeks after starting treatment. Sustained biochemical response was defined as normalization of alanine aminotransferase (ALT) values 72 weeks after starting treatment. The baseline characteristics of the 2 treatment groups were similar with respect to age, gender, ALT, HBV DNA levels and histologic diagnosis. Sustained biochemical responses were found at week 72 in 7 patients in each group (54% with IFN-? monotherapy and 50% with combination therapy) [p>0.05]. Sustained virologic responses were found at week 72 in 5 patients (38%) in the monotherapy and 7 patients (50%) in the combination therapy group (p>0.05). Combination therapy was not superior to IFN-? alone for the treatment of chronic hepatitis B. Combination treatment was associated with some disadvantages, such as additional cost. Lamivudine, on the other hand, may be more suitable for patients with cirrhosis, non-responders to IFN-? or in cases with contraindication for IFN-?.Öğe Genç olgularda retinal ven oklüzyonu: MTHFR ve PAI-1 mutasyonu birlikteliği(2012) Erdurmuş, Mesut; Çelebi, Serdal; Düzenli, Selma Gepdiremen; Çelebi, HarikaBu olgu sunumunda retinal ven oklüzyonu gelişen 3 genç hasta rapor edildi. Ayrıntılı sistemik araştırmalar sonucunda hiçbir olguda bir risk faktörü saptanamadı. Yapılan genetik analizlerde, her 3 olguda da metilentetrahidrofolat redüktaz C677T ve A1298C ile plazminojen aktivatör inhibitör-1 heterozigot gen mutasyonları saptandı. Retinal ven oklüzyonlu genç hastalarda trombofilik risk faktörlerinin varlığı dikkate alınmalıdır.Öğe Is lipid lowering treatment aiming for very low LDL levels safe in terms of the synthesis of steroid hormones?(Elsevier Ltd., 2007) Kanat, Mustafa; Sipahioğlu, Murat; Arınç, Hüseyin; Serin, Erdinç; Yıldız, Özcan; Tunçkale, Aydın; Çelebi, HarikaToday atherosclerotic diseases are among the most important causes of death in the world. Epidemiological, clinical, genetic, experimental and pathological studies have clearly shown the role of lipoproteins in atherosclerosis. LDL is the major atherogenic lipoprotein and has been defined as the primary target of lipid lowering treatment by NCEP. Although the level of LDL, the primary target in the treatment of dyslipidemia, has been set as below 100 mg/dl in coronary heart diseases (CHD) and CHD risk equivalents, this level has been putted down to below 70 mg/dl for the group defined as very high risk group by the ATP (Adult Treatment Panel) guide that has been updated following the new clinical studies. As we already know, cholesterol is the precursor of glucocorticoids, mineralocorticoids and sex steroids, besides being a structural component of the cell membrane. Both adrenal and non-adrenal (ovarian + testicular) all steroid hormones are primarily synthesized using the LDL-cholesterol in the circulation. In addition to this, there is 'de novo' cholesterol synthesis in both the adrenals and gonads controlled by the HMG-CoA reductase enzyme. A third pathway, which under normal circumstances has little contribution as compared to the first two, is the use of circulatory HDL-cholesterol by the adrenal and gonadal tissues for the synthesis of steroids. Our knowledge on extremely towered LDL levels is quite limited. However, since statins both decrease circulatory LDL and inhibit de novo cholesterol synthesis, they are likely to affect the synthesis of steroid hormones. (c) 2006 Elsevier Ltd. All rights reserved.Öğe Oküler albinizmi ve kanama diyatezi olan Hermansky-Pudlak sendromlu bir olgu(2006) Çelebi, Harika; Çelebi, Serdal; Elkıran, Tamer; Kükner, A. Şahap; Köhle, ÜlküHermansky-Pudlak Sendromu (HPS), tirozinaz-pozitif okülokütanöz albinizm, trombosit disfonksiyonuna bağlı kanama diyatezi ve çeşitli dokularda seroid benzeri madde birikimi ile karakterize otozomal resesif geçişli genetik bir hastalıktır. Kanama diyatezi nedeniyle hematoloji servisine başvuran, bu amaçla trombosit süspansiyonu verilen ve bu esnada bilateral görme kaybı gelişen bir hasta konsülte edildiğinde HPS tanısı konuldu. Amacımız, albinizmli bazı hastalarda akla getirilmediğinde kolayca gözden kaçabilen HPS’nın karakteristik özelliklerini literatür ışığında gözden geçirmektir.Öğe The prevalence of neuropathy and relationship with risk factors in diabetic patients: a single-center experience(Karger, 2006) Tamer, Ali; Yıldız, Serpil; Yıldız, Nebil; Kanat, Mustafa; Gündüz, Hüseyin; Tahtacı, Mustafa; Çelebi, HarikaObjective: To determine the rate of distal symmetrical polyneuropathy (DSP) in patients with type 2 diabetes mellitus, to evaluate the role of history, neurological examination and the electrodiagnostic methods in the diagnosis of DSP, and to determine the association between electromyography-supported neuropathy (ESN), neuropathic complaints (NCs) and risk factors. Subjects and Methods: A total of 191 type 2 DM patients (109 female, 82 male; mean age 58.7 +/- 10 years) were recruited. The NCs were recorded. All patients had electromyographic (EMG) examinations. The relationship between ESN, NCs and risk factors were evaluated. Results: Of the 191 patients, 83 (43.5%) had DSP on EMG examinations and 92 (48.2%) patients suffered from NCs. Among the ESN patients, a significant relationship existed with HbA1(c) level, illness duration, smoking, male gender or insulin usage (p < 0.05) but not with age, hypertension, hypercholesterolemia or hypertriglyceridemia. The frequency of NCs was higher in patients with ESN. There was also a significant association between NCs and ESN (p < 0.05). The presence of NCs was not related to age, gender, smoking, hypertension, hypercholesterolemia and hypertriglyceridemia (p > 0.05) but NCs were correlated to HbA1(c) level, illness duration and insulin usage (p < 0.05). Conclusion: Our data show that a strong association exists between the presence of DSP and illness duration, HbA1(c), smoking, thereby indicating that cessation of smoking and near normal glycemic control would be additional precautions to delay the beginning or progression of polyneuropathy.Öğe Retinal vein occlusion in young patients: Combined MTHFR and PAI-1 mutations(2012) Erdurmuş, Mesut; Çelebi, Serdal; Düzenli Gepdiremen, Selma; Çelebi, HarikaIn this case presentation, we reported 3 young patients with retinal vein occlusion. None of the patients showed any risc factors at the end of detailed systemic examinations. Methylenetetrahydrofolate reductase C677T and A1298C with plasminogen activator inhibitor-1 heterozygote gene mutations were detected in all patients on genetic analysis. The presence of thrombophilic risk factors should be considered in young patients with central retinal vein occlusion.Öğe Sekonder demir yüklenmesi ile başvuran talasemi minör'lü olgu(2004) Tamer, Ali; Çelebi, Harika; Boran, Çetin; Karabay, Oğuz; Tahtaci, Mustafa; Arinç, Hüseyin; Gündüz, HüseyinDemir yüklenmesi; doku hasarı olup olmadığına bakılmaksızın vucut demir depolarında artış olarak tanımlanır. Oral demir alımına bağlı sekonder demir yüklenmesi çok nadirdir. İç hastalıkları polikliniğine halsizlik yakınması ile başvuran, kliniğimizde yapılan tetkikler sonrası ß talasemi minör tanısı alan, 67 yaşında bayan hastaya demir eksikliği düşünülerek uzun süreli demir tedavisi verilmesine bağlı sekonder demir yüklenmesi saptanan olgunun literatür ışığında sunulması amaçlanmıştır. Sonuç olarak özellikle hipokrom mikrositer anemi nedeni dikkatlice irdelenmelidir. Ülkemizde talasemi taşıyıcılığı sıklığı göz önüne alınırsa demir tedavisine cevap vermeyen hipokrom mikrositer anemili hastalarda ayırıcı tanıda talasemi akılda tutulmalıdır.Öğe Sekonder demir yüklenmesi ile başvuran talasemi minörlü olgu(2004) Tamer, Ali; Çelebi, Harika; Boran, Çetin; Karabay, Oğuz; Tahtacı, Mustafa; Arınç, Hüseyin; Gündüz, HüseyinDemir yüklenmesi; doku hasarı olup olmadığına bakılmaksızın vucut demir depolarında artış olarak tanımlanır. Oral demir alımına bağlı sekonder demir yüklenmesi çok nadirdir. İç hastalıkları polikliniğine halsizlik yakınması ile başvuran, kliniğimizde yapılan tetkikler sonrası ß talasemi minör tanısı alan, 67 yaşında bayan hastaya demir eksikliği düşünülerek uzun süreli demir tedavisi verilmesine bağlı sekonder demir yüklenmesi saptanan olgunun literatür ışığında sunulması amaçlanmıştır. Sonuç olarak özellikle hipokrom mikrositer anemi nedeni dikkatlice irdelenmelidir. Ülkemizde talasemi taşıyıcılığı sıklığı göz önüne alınırsa demir tedavisine cevap vermeyen hipokrom mikrositer anemili hastalarda ayırıcı tanıda talasemi akılda tutulmalıdır.Öğe Tip II diyabetli olgularda hepatit B virus yüzey antijeni (HBsAg) ve anti-hepatit C virus (Anti-HCV) prevalansının araştırılması(2005) Karabay, Oğuz; Tamer, Ali; Tahtacı, Mustafa; Çelebi, HarikaBu araştırmada, tip II diyabet (DM) olgularındaki Hepatit B virus yüzey antijeni (HBsAg) ve anti-hepatit C virus (anti-HCV) seropozitifiiğinin araştırılarak, elde edilen verilerin kontrol grubuyla karşılaştırılması amaçlanmıştır. Çalışma grupları İzzet Baysal Tıp Fakültesi Diyabet Polikliniği tarafından izlenen tip II DM'ü 248 olgudan, kontrol grubu ise diyabetli olmayan 1208 kan vericisinden oluşturulmuştur. HBsAg ve aAnti-HCV ELISA ile araştırılmıştır. HBsAg pozitifliği diyabetli olgularda ve kontrol grubunda sırasıyla %4 ve %2.8 oranında saptanmıştır (p>0.05). Anti-HCV pozitifliği ise diyabetli olgularda %3.2 ve kontrol grubunda, %0.5 olarak bulun¬muştur (p<0.001). Bulgulara göre, HBsAg sıklığı kontrol grubundan farksızken, aıiti-HCV pozitifliği diyabetli olgularda daha sıktır. Tip II DM ile HCV infeksiyonu arasındaki ilişkiyi ve biyolojik mekanizmaları ortaya çıkaracak yeni araştırmalara gereksinim vardır.
