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    Diabetes mellitus increases plasma cardiothrophin-1 levels independently of heart failure and hypertension
    (Acta Medica Mediterranea, 2013) Aktas, Gulal; Alcelik, Aytekin; Tosun, Mehmet; Ozturk, Serkan; Ozlu, Mehmet Fatih; Savli, Haluk; Yazici, Mehmet
    Aims: Cardiothrophin-1 (CT-1) is a novel 201 amino acid cytokine that has pleiotropic protective effects in apoptosis, hepatic injury, myocardial infection and contrast nephropathy. CT-1 predicts a variety of disorders including atherosclerosis, heart failure, hypertension and cardiomyopathy. However, CT-1 has not been studied previously in diabetic patients without heart failure. The aim of this study was, therefore, to compare CT-1 levels in diabetic and non-diabetic patients. Methods: Thirty-eight patients with type 2 diabetes mellitus and 32 non-diabetic controls have been enrolled into the study. Subjects with severe hypertension, renal diseases, pregnancy and malignancy were excluded. The statistical analysis was performed with SPSS for Windows version 15.0. Results: There were no significant differences between the diabetic and non-diabetic groups with regard to age, hypertension, serum creatinine, systolic and diastolic blood pressure. Median plasma CT-1 was 9.05 (5.70-24.94) pg/ml in diabetic group and 7.16 (5.53-9.64) pg/ml in non-diabetic group (P <0.001). Conclusion: Plasma CT-1 levels increased in diabetic patients independently of hypertension (HT) and heart failure. Prospective studies with a larger cohort are now needed to observe the effects of CT-1 treatment in a diabetic population.
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    Mean platelet volume: A simple indicator of chronic prostatitis
    (Acta Medica Mediterranea, 2013) Aktas, Gulali; Cakiroglu, Basri; Sit, Mustafa; Uyeturk, Ugur; Alcelik, Aytekin; Savli, Haluk; Kemahli, Eray
    Background: Chronic prostatitis is a widespread urological disease, however, underlying pathophysiology is poorly understood and it is usually characterized with recurrences. Platelets take in charge in hemostasis, tissue repairment and inflammation. Mean platelet volume (MPV), is considered as a marker of platelet activation. The aim of present study is to find out the possible association between MPV and chronic prostatitis. Methods: A total of 40 patients with chronic prostatitis and 45 healthy controls enrolled to the study. Laboratory data of chronic prostatitis patients and healthy controls obtained from the computerized databases of the hospitals and platelet count (PLT) and mean platelet volume (MPV) values of the participants recorded. Results: There was no statistically significant difference between groups in terms of mean age and PLT count. However, patients with chronic prostatitis had significantly increased MPV compared to controls (p=0.004). Conclusion: Increased MPV should help the diagnosis of chronic prostatitis but, more studies with larger study population are needed to confirm our results.
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    A Preliminary Psychometric Evaluation of the Type D Personality Construct in Turkish Hemodialysis Patients
    (Yerkure Tanitim & Yayincilik Hizmetleri A S, 2012) Alcelik, Aytekin; Yildirim, Osman; Canan, Fatih; Eroglu, Mustafa; Aktas, Glali; Savli, Haluk
    Objective: Type D personality, which is defined by both negative affectivity (NA) and social inhibition (SI), is associated with adverse outcomes in cardiac patients. The validity and reliability of the Type D Scale (DS_14) have been confirmed in various countries, particularly among cardiac patients. The purpose of the present study was to cross-validate the DS_14 in Turkish hemodialysis patients. Method: One hundred one patients, who had received maintenance hemodialysis for more than 3 months at a center in north-west region of Turkey, completed the Turkish version of the DS_14. Hospital Anxiety and Depression Scale (HAD) was administered to establish discriminant validity. The DS_14 was re-administered 1 month after first administration in order to examine the stability of the DS_14 in 100 patients. Results: The two-factor structure of the DS_14 and the internal consistency of the NA (alpha = 0.82) and SI (alpha = 0.81) subscales were confirmed. Both NA and SI were found to correlate positively with anxiety and depression scores. The DS_14 was stable over a 1-month period (r = 0.84/0.78; p< 0.01). The prevalence of Type D personality was 27.7%. Type D individuals had significantly higher mean scores on anxiety (p<0.01) and depression (p<0.01) subscales of the HAD when compared with non-Type D individuals. Conclusion: Preliminary evidence suggests that the Turkish DS_14 is a valid and reliable tool for identifying Type D personality. Future studies are warranted to evaluate the utility of the scale in different groups of patients.
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    Primary hyperaldosteronism as a rare cause of hypokalemia
    (National Academy of Medical Science and Ministry of Health of Ukraine, 2020) Kurtkulagi, Ozge; Aktas, Gulali; Kocak, M. Zahid; Atak, Burcin M.; Duman, Tuba T.; Bilgin, Satilmis; Savli, Haluk
    Primary hyperaldosteronism (PHA) is a syndrome characterized by increased aldosterone release and suppressed renin-angiotensin cascade. Hypertension, alteration in potassium homeostasis, and target tissue damage are characteristic features of the disease. The importance of recognizing PHA is due to the fact that it has a very negative cardiovascular and renal effect which can result in death. In this case report, we present a patient with resistant hypokalemia whom consequently diagnosed with PHA. A 54-year-old female patient who was scheduled for operation due to congenital hip dislocation was found to have decreased serum potassium in her preoperative laboratory tests. Therefore, the patient was referred to the internal medicine outpatient clinic with a serum potassium value of 2.1 mmol/L. Her systolic and diastolic blood pressures were 150 and 90 mmHg, respectively. On electrocardiogram, prominent U waves were noted. Therefore, potassium replacement was initiated at once by intravenous route. The potassium value in spot urine was 12.4 mmol/L. A 24 hour urine collected and urinary potassium excretion in 24 hours of urine was detected as 15 mmol/L, which means transtubular potassium gradient was greater than 4 mmol/L. Since she was hypertensive during clinical follow up in the ward, hypertension along with hypokalemia raised the clinical suspicion of hyperaldosteronism. Serum aldosterone renin ratio was measured as 155 %. A computerized tomography scan revealed (22 × 16 mm) neoplasm which was suggestive of adrenal adenoma in the right adrenal gland. Cushing Syndrome was ruled out with a normal cortisol level and pheochromocytoma was ruled out by normal levels of metanephrine in the 24 hours of urine. Spironolactone 50 mg was initiated and serum potassium was raised to normal range. She scheduled for unilateral adrenalectomy and discharged with full recovery of hypokalemia. Since PHA has undesired cardiovascular and renal effects which may increase mortality and morbidity, establishing the diagnosis as soon as possible is crucial. Hypertensive patients with hypokalemia or adrenal incidentaloma or obstructive sleep apnea syndrome, resistant hypertensive subjects, patients with moderate or severe hypertension, and hypertensive patients with a family history of PHA should undergo screening for PHA. In conclusion, we suggest that PHA should be kept in mind in differential diagnosis of the patients with hypertension and hypokalemia. © 2020 National Academy of Medical Science and Ministry of Health of Ukraine. All rights reserved.