DSpace Arşivi :: by Yazar "Yeksan, Mehdi" değerine göre listeleniyor

Yazar "Yeksan, Mehdi" seçeneğine göre listele

Listeleniyor 1 - 20 / 27

Amino asitli diyalizatların malnütrisyonlu SAPD hastalarında nütrisyonel ve diğer laboratuar parametreleri üzerine 1 yıllık dönemdeki etkileri
(2009) Güney, İbrahim; Altıntepe, Lütfullah; Okudan, Nilsel; Tonbul, H. Zeki; Türk, Süleyman; Yeksan, Mehdi
Amaç: Malnütrisyon periton diyaliz hastalarında ciddi bir problemdir ve morbitide-mortalitenin önemli nedenlerindendir. Amino asit içeren peritoneal diyaliz solüsyonları (nutrineal) ile diyaliz yapılan malnütrisyonlu hastalarda nutrisyonel durum ve diğer laboratuar parametrelerindeki değişiklikleri incelemeyi amaçladık. Yöntem: Serum albumin düzeyi 3.5 g/dl olan 19 SAPD hastası çalışmaya alındı. Hastaların bir yıllık takiplerinde; 5 hastanın exitus, 2 hastanın hemodiyalize ve bir hastanın ise APD’ye transfer olması, 2 hastada karın ağrısı, 1 hastada ise bulantı-kusma gelişmesi nedeni ile çalışmadan çıkarıldı. Çalışmayı tamamlayan 8 hastanın (6E/2K), yaş ortalaması 49.511.1 yıl idi. Başlangıç ve 1. yılda serum üre, kreatinin, total protein, albumin, ürik asid, fosfor, total kolesterol, trigliserid, hemoglobin düzeyleri, triseps deri kıvrım kalınlığı (TST), vücut yağ oranı ve vücut kitle indeksi (VKİ) belirlendi. Bulgular: Bir yıllık takip sonrasında ise başlangıç değerlerine göre serum albumin (p0.035), üre (p0.002) değerlerinde ve VKİ’de (p0.011) anlamlı artış saptanırken, ürik asit (p0.009) ve trigliserid (p0.004) değerlerinde anlamlı bir düşüş saptandı; diğer parametrelerde ise anlamlı bir fark saptanmadı. Sonuç: Amino asitli diyaliz solüsyonlarının malnütrisyonu bulunan SAPD hastalarında malnütrisyonu düzeltmek için kullanılabileceği kanaatindeyiz.
Association of fetuin-a levels with carotid ıntima media thickness and valvular calcification in hemodialysis and peritoneal dialysis patients
(2013) Solak, Yalçın; Atalay, Hüseyin; Bıyık, Zeynep; Türkmen, Kültigin; Yeksan, Mehdi; Türk, Süleyman; İnal, Ali
GİRİŞ: Fetuin A vasküler kalsifikasyonu önleyen bir negatif akut faz reaktanıdır. Koroner arter hastalığı (KAH) renal replasman tedavisi almakta olan hastalarda en önemli ölüm sebebidir. Diyalize giren son dönem böbrek yetmezliği hastalarında görülen kardiyovasküler hastalığın ana elementi hızlanmış kalsifik aterosklerozdur. Fetuin A seviyeleri açısından hemodiyaliz (HD) ve periton diyalizini(PD) karşılaştıran sınırlı sayıda çalışma mevcuttur. AMAÇ: HD ve PD hastalarında KAH prediktörleri ve valvüler kalsifikasyon ile serum fetuin A düzeyleri arasındaki ilişkiyi araştırmayı amaçladık. GEREÇ ve YÖNTEMLER: 39 HD (24 erkek, 15 kadın) ve 39 PD (25 erkek, 14 kadın) hastası çalışmaya alındı. Karotis intima media kalınlığı (KIMK) ultrason ile ölçüldü ve kalp kapağı kalsifikasyonları ekokardiyografi ile değerlendirildi. Ayrıca serum fetuin-A, CRP, ferritin, fibrinojen, ve albumin seviyeleri saptandı. Fetuin-A düzeylerine göre hastalar çeyreklere ayrıldı. Bulgular: Fetuin-A seviyesi HD hastalarında PD hastalarına göre daha düşüktü (hemodiyaliz 28,65,934 ng/ml, PD 324,8 ng/ml, p0,001). KIMK ile fetuin-A seviyesi arasında anlamlı negatif korelasyon vardı. KIMK, PD hastalarında HDe göre daha düşüktü. Fetuin-A seviyesi ile diyaliz
The Association of Peritoneal Transport Properties With 24-hour Blood Pressure Levels in Capd Patients
(Multimed Inc, 2003) Tonbul, Zeki; Altıntepe, Lütfullah ; Sözlü, Çetin; Yeksan, Mehdi; Yıldız, Alaattin; Türk, Süleyman
Objectives: We aimed to investigate the effects of peritoneal transport characteristics on blood pressure (BP) parameters, measured by 24-hour ambulatory blood pressure monitoring (ABPM), and on the development of left ventricular hypertrophy (LVH) in continuous ambulatory peritoneal dialysis (CAPD) patients. Design: Cross-sectional and prospective design. * Setting: Tertiary-care center. Patients: 25 CAPD patients (11 male, 14 female; mean age 47 +/- 14 years) were included. Mean time on CAPD was 22.9 +/- 18 months and all patients had been dialyzed for more than 6 months. The patients were divided into high, high-average, low-average, and low transport groups according to peritoneal equilibration test results. Main Outcome Measures: Daytime and nighttime systolic and diastolic BP and left ventricular mass index among the different peritoneal transport groups; changes in BP parameters before and after increase in ultrafiltration. Results: On 24-hour ABPM records, 13 patients (52%) were found to be hypertensive. Both mean systolic and diastolic BP were significantly increased in high-transporter groups compared to low transporters in both daytime and nighttime BP parameters. Left ventricular mass index was higher in high transporters compared to low transporters, without reaching statistical significance: 160 +/- 23 vs 119 +/- 41 g/m(2), p > 0.05. Following increase in ultrafiltration, mean systolic (145 +/- 13 vs 128 +/- 5 mmHg, p < 0.001) and diastolic (96 +/- 10 vs 81 +/- 3 mmHg, p < 0.001) BP decreased, and BP levels returned to normotensive levels in 6 (46%) of the 13 hypertensive patients, requiring discontinuation of anti hypertensive drugs. Conclusion: Improvement in volume status resulted in a decrease in both daytime and nighttime BR Differences in peritoneal transport properties were associated with the development of hypertension and LVH.
The association of peritoneal transport properties with 24-hour blood pressure levels in CARP patients
(2003) Tonbul, Halil Zeki; Altıntepe, Lütfullah; Sözlü, Çetin; Yeksan, Mehdi; Yıldız, Alaattin; Türk, Süleyman
Objectives: We aimed to investigate the effects of peritoneal transport characteristics on blood pressure (BP) parameters, measured by 24-hour ambulatory blood pressure monitoring (ABPM), and on the development of left ventricular hypertrophy (LVH) in continuous ambulatory peritoneal dialysis (CAPD) patients. Design: Cross-sectional and prospective design. Setting: Tertiary-care center. Patients: 25 CAPD patients (11 male, 14 female; mean age 47 ± 14 years) were included. Mean time on CAPD was 22.9 ± 18 months and all patients had been dialyzed for more than 6 months. The patients were divided into high, high-average, low-average, and low transport groups according to peritoneal equilibration test results. Main Outcome Measures: Daytime and nighttime systolic and diastolic BP and left ventricular mass index among the different peritoneal transport groups; changes in BP parameters before and after increase in ultrafiltration. Results: On 24-hour ABPM records, 13 patients (52%) were found to be hypertensive. Both mean systolic and diastolic BP were significantly increased in high-transporter groups compared to low transporters in both daytime and nighttime BP parameters. Left ventricular mass index was higher in high transporters compared to low transporters, without reaching statistical significance: 160 ± 23 vs 119 ± 41 g/m2, p > 0.05. Following increase in ultrafiltration, mean systolic (145 ± 13 vs 128 ± 5 mmHg, p < 0.001) and diastolic (96 ± 10 vs 81 ± 3 mmHg, p < 0.001) BP decreased, and BP levels returned to normotensive levels in 6 (46%) of the 13 hypertensive patients, requiring discontinuation of antihypertensive drugs. Conclusion: Improvement in volume status resulted in a decrease in both daytime and nighttime BP. Differences in peritoneal transport properties were associated with the development of hypertension and LVH.
Capd-Related Peritonitis After Renal Transplantation
(Multimed Inc, 2010) Solak, Yalçın; Atalay, Hüseyin; Polat, İlker; Yeksan, Mehdi
We admitted a 53-year-old male for deceased-donor kidney transplantation. He had been on continuous ambulatory peritoneal dialysis (CAPD) for 52 months. His native kidney disease was unknown. He was doing well on CAPD and had never experienced peritonitis. We did not have a measurement of panel reactive antibodies prior to his transplant surgery. The kidney was placed into the right inguinal fossa and his peritoneal dialysis (PD) catheter was left in place. Since he was thought to be immunologically high risk, we administered rabbit antithymocyte globulin (ATG) at a dose of 3 mg/kg body weight as an induction agent, along with 1 g methylprednisolone and mycophenolate mofetil. No surgical complications occurred; however, his urine output was not adequate. Doppler ultrasound ruled out urinary tract obstruction and renal vein thrombosis. Tc-99m DTPA scintigraphy revealed a normally perfused kidney but concentration and excretion were diminished considerably. Percutaneous allograft biopsy was consistent with acute humoral rejection. We instituted 3 days of pulse prednisolone (1 g daily) along with alternate-day double-filtration (cascade) plasmapheresis, daily ATG, and mycophenolate mofetil. During the course of hospitalization, PD was resumed due to uremia. White blood cell (WBC) counts were followed and were typically below 100/mm3. Despite rigorous antirejection therapy, urine output remained below 15 mL per hour. Because of significantly reduced lymphocyte counts, we withheld ATG. Twelve days after transplantation, the patient complained of severe extensive abdominal pain. Peritoneal effluent was cloudy and total effluent WBC count was 27 × 103/mm3, with 75% polymorphs. His abdominal pain was very variable in severity. He did not develop fever. Broad-spectrum antibiotics were started promptly on an empirical basis. Cultures of the peritoneal effluent showed Acinetobacter baumanii sensitive only to aminoglycosides and tigecycline. Tigecycline was given intravenously as 100 mg initial dose then 50 mg twice daily. Despite an initial response, the patient died on the 17th day after transplantation due to refractory septic shock.
Comparative Effect of Oral Pulse and Intravenous Calcitriol Treatment in Hemodialysis Patients: The Effect on Serum Il-1 and Il-6 Levels and Bone Mineral Density
(Karger, 2002) Türk, Süleyman; Akbulut, Mehmet; Yıldız, Alaattin; Gürbilek, Mehmet; Gönen, Said; Tombul, Zeki; Yeksan, Mehdi
Introduction: Increased serum levels of bone-resorptive cytokines such as interleukin-1beta (IL-1beta) and interleukin-6 (IL-6) have been implicated for changes in bone remodeling in hemodialysis patients. In this prospective randomized study, we aimed to compare the effect of oral and intravenous (IV) pulse calcitriol on serum levels of IL-1beta and IL-6. Patients and Methods: Twenty-eight hemodialysis patients were included and consecutively randomized to receive either oral (n = 14, M/F = 7/7, mean age 42 +/- 15 years) or IV pulse (n = 14, M/F = 6/8, mean age 38 +/- 14 years) calcitriol treatment. No difference was found between groups for age, sex distribution, primary renal disease, mean time on hemodialysis and baseline biochemical parameters including serum levels of IL-1beta and IL-6. Results: The percent fall of intact parathyroid hormone iPTH) was significantly less with oral compared to IV calcitriol between 0 and the 3rd month (32 +/- 21 vs. 56 +/- 28%, p = 0.03). However, the percent fall in iPTH at the 6th month of the therapy was not different in the oral group compared to the IV group (57 +/- 22 vs. 73 +/- 24%, p = 0.12). The increase in bone mineral densities was higher in the IV group than the oral group. Oral and IV calcitriol caused a significant fall in IL-1beta (p =0.02 and p= 0.03, respectively) and IL-6 levels (p = 0.02 and p < 0.001, respectively) at the 6th month of treatment. The percent fall in serum IL-6 levels at the 6th month was significantly greater in the IV compared to the oral group (61 18 vs. 36 +/- 33%, p = 0.04), while the percent changes in serum IL-1beta levels were similar. Conclusion: IV calcitriol therapy has a greater suppression of PTH at the 3rd month of the therapy. Despite no difference in serum PTH levels at the 6th month, IV therapy has a greater increase in bone mineral densities and a greater decrease in serum IL-6 levels. These findings suggest IV calcitriol treatment has a superior effect on bone remodeling by influencing the levels of bone-resorptive cytokines as compared to the oral therapy group, beyond its suppressive effect on iPTH.
Comparison of Effects of Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis on Health-Related Quality of Life, Sleep Quality, and Depression
(Wiley-Blackwell, 2010) Güney, İbrahim; Solak, Yalçın; Atalay, Hüseyin; Yazıcı, Raziye; Altıntepe, Lütfullah; Kara, Fatih; Yeksan, Mehdi; Türk, Süleyman
Few studies investigating the effects of automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) on health-related quality of life (HRQoL), depression, and sleep quality exist in the literature. We aimed to determine differences between APD and CAPD modalities with respect to these parameters. Twenty APD and 48 CAPD patients were included in this crosssectional study. Biochemical values were measured at outpatient evaluation. A modified postsleep inventory was used to evaluate sleep quality. Health-related quality of life and depression were evaluated by the Short Form of Medical Outcomes Study and Beck Depression Inventory, respectively. Automated peritoneal dialysis and CAPD patients were compared in terms of sleep quality, HRQoL, and depression. Our results showed that there were no significant differences between APD and CAPD in any of the studied parameters. Moderate or severe sleep problems were found in 60% and 69% of the APD and CAPD patients, respectively. Mean HRQoL scores for any of the 8 Short Form of Medical Outcomes Study-36 domains were similar in the 2 groups. The mean physical component score was 51.1 +/- 21.2 and 48.9 +/- 18.2 in APD and CAPD patients, respectively (P=0.672). The mean mental component score was 47.5 +/- 20.1 in APD patients, whereas it was 42.4 +/- 19.5 in CAPD patients (P=0.291). Depression was detected in 70% of APD and 62.5% of the CAPD patients. The mean Beck Depression Inventory scores were also similar in the 2 groups. This study showed that HRQoL, sleep quality, and depression were similar in APD and CAPD patients.
Depression and Quality of Life in Continuous Ambulatory Peritoneal Dialysis Patients
(Oxford Univ Press, 2006) Yeksan, Mehdi; Güney, İbrahim; Yazıcı, Raziye; Atalay, Hüseyin; Altıntepe, Lütfullah; Türk, Süleyman; Tonbul, H. Zeki
[Abstract not Available]
Early and intensive fluid replacement prevents acute renal failure in the crush cases associated with spontaneous collapse of an apartment in Konya
(TAYLOR & FRANCIS LTD, 2007) Altıntepe, Lütfullah; Güney, İbrahim; Tonbul, Zeki; Türk, Süleyman; Mazı, Mehmet; Ağca, Erhan; Yeksan, Mehdi
Background. Crush syndrome developing as a result of earthquake and other natural disasters has been investigated from many angles to date. Data are scarce, however, on cases associated with the spontaneous crash of buildings. This study presents the results on seven rhabdomyolysis patients treated in our clinics out of nine casualties who were rescued from the rubble of Zumrut apartment after the building collapsed suddenly and spontaneously. Methods. As a result of the sudden, spontaneous collapse of the 10-floor Zumrut apartment in Konya at 20:15 hours on February 2, 2004, 92 out of a total of 121 persons who were inside the building lost their lives, and 29 casualties were rescued from the rubble. Nine hospitalized patients had crush syndrome, and a prophylactic mannitol-bicarbonate cocktail was started in all at admission. Results. The time they remained entrapped under the rubble was 11.1 +/- 7.3 (5-24 hours) on average. The highest CPK level of the patients was 79049 +/- 75374 u/L (17478-223600 u/L), observed on the median day 1.7 +/- 1.1 (days 1-4) following the incident. ARF developed in only two cases (28.6%) owing to the prophylactic mannitol-bicarbonate cocktail administered to prevent ARF, and because of hyperpotassemia, hemodialysis (HD) treatment was administered to these patients. One patient required two sessions of HD, and another required four. In both patients who received HD treatment, the level of potassium was in excess of 7 mEq/L. A total of eight fasciotomies were performed on five (71.4%) of the seven patients with crush syndrome. Five of the fasciotomies (62.5%) were performed on two of our patients who required HD treatment. None of our patients with crush syndrome developed permanent kidney damage, and no mortality occurred. Conclusion. It was deduced that rapid fluid therapy accompanied by the prophylactic administration of mannitol-bicarbonate are largely effective in preventing the development of ARF in cases with crush syndrome resulting from disasters.
Effect of Anti-Hcv Positivity on Response to Hepatitis B Virus Vaccine in Haemodialysis Patients
(1998) Koşar, Ali; Dalmaz, Mahmut; Sağmanlıgil, Şerife; Yeksan, Mehdi; Türk, Süleyman
There are different factors that affect the response of recombinant hepatitis B vaccine in hemodialysis patients. A total of 36 patients on a hemodialysis program (HD) were included in this study; 17 of patients were anti-HCV-positive and 19 were anti-HCV-negative. All serological markers of anti-HBs, HBs, anti-HBc IgM and anti-HBc total were negative in all patients. A 20 g dose of vaccine (Genhevac B Pasteur Merieux, France) was given intramuscularly at 0, 1 and 6 months. Anti-HBs levels were measured at 1, 2, 7 and 16 months and an anti-HBs titer>10 IU/mL was accepted as a protective level against hepatitis B virus infection. At 1, 2 and 7 months there was no statistically significant difference between these groups according to anti- HBs levels. However, anti-HBs levels were lower in anti-HCV-positive group at the 16th month (p<0.05). Anti-HCV positivity in HD patients has a negative effect on the antibody response to hepatitis B virus vaccine. This can be a result of the hepatitis or of the effect on the immune system which is caused by HCV. This negative effect could not be explained in this study and we believe more studies should be carried out in selected patients and larger series.
Enoxaparine-Related Internal Oblique Muscle Hematoma in a Patient With Renal Insufficiency
(2010) Solak, Yalçın; Atalay, Hüseyin; Polat, İlker; Yeksan, Mehdi
Low-molecular-weight heparins (LMWHs) are increasingly being used in thromboembolic settings due to some advantages over unfractioned heparin. However, these beneficial effects may transform into potentially hazardous effects in patients with impaired renal function if standard doses are used. Inappropriately high-doses may lead to hematomas. Enoxaparine is the first and most extensively studied LMWH. The most frequently encountered hematomas related with enoxaparine occur at the rectus sheath and retroperitoneum. Lateral abdominal wall hematomas related with enoxaparine use have rarely been reported to date. We report an internal oblique muscle hematoma in a patient with moderate renal insufficiency despite adequate dose reduction and suggest some take-home points to prevent or treat hematoma complications.
Erectile Dysfunction and the Effects of Sildenafil Treatment in Patients on Haemodialysis and Continuous Ambulatory Peritoneal Dialysis
(Oxford Univ Press, 2001) Türk, Süleyman; Karalezli, Giray; Tonbul, Halil Zeki; Yıldız, Mustafa; Altıntepe, Lütfullah; Yıldız, Alaattin; Yeksan, Mehdi
Background. Sexual dysfunction, including erectile dysfunction, is common in patients with uraemia. Despite successful treatment of male sexual dysfunction with sildenafil in non-uraemic population, its efficacy in dialysis patients is unknown. Patients and methods. In this study, 35 male HD patients (mean age 48 +/- 12 years) and 15 male CAPD patients (mean age 44 +/- 12 years) were included. In the baseline period, haemoglobin, serum urea, and albumin, Kt/V, several hormonal parameters, Beck depression scale, and penile Doppler blood flow, (peak systolic velocity after intracavernous papaverine administration) were measured. The international index of erectile function (IIEF) form was used to evaluate erectile dysfunction. Sildenafil was given to patients with erectile dysfunction at a dose of 50-100 mg/day twice a week. Results. The percentage of erectile dysfunction was similar between patients on HD (71%) and those on CAPD (80%). Patients with erectile dysfunction were significantly older and had lower free-testosterone serum levels and penile blood flow than those without. In linear regression analysis for baseline IIEF score, penile blood flow was the only independent variable associated with erectile dysfunction. IIEF score increased to a similar extent after sildenafil treatment in both HD patients (from 8.10 +/-5.54 to 21.70 +/-9.61, P <0.001) and CAPD patients (from 9.90 +/-3.87 to 21.60 +/- 10.18, P=0.011). Changes in IIEF scores after sildenafil treatment were associated with baseline penile blood flow as an independent variable by linear regression analysis. Adverse events observed during sildenafil treatment were dyspepsia in two patients and headache in one patient. Conclusion. The rate of erectile dysfunction is high in dialysis patients. Penile blood flow is the most important factor for predicting both the development of erectile dysfunction and the response to sildenafil therapy in such patients. Oral sildenafil is an effective, reliable, well-tolerated treatment for uraemic patients with erectile dysfunction.
Familial Hiperlipidemik Bir Hastada Gebelikte Tekrarlayan Akut Pankreatit Olgusu
(2002) Polat, Hakkı; Çetinkaya, Figen; Küçükkartallar, Fatih; Yeksan, Mehdi; Kaya, Ahmet
Familial hipertrigliseridemili gebelerde lipitlerin biyokimyasal değerleri büyük oranda artmakta ve akut pankreatite yol açarak anne ve fetus için fatal sonuçlar doğurabilmektedir. Erken teşhis konulduğunda bu hastalarda diyet ve plazma exchange uygulamaları gibi yaklaşımlarla akut pankreatit gelişimine engel olmak mümkün gözükmektedir.1966 yılından bu yana 21 vaka bildirilmiştir. Nadir görülen böyle bir vakayı kliniğimizde ikinci kez tespit ederek, yayınlamayı uygun bulduk.
Female sexual dysfunction in end stage renal disease and relation with quality of life and depression
(OXFORD UNIV PRESS, 2007) Yazıcı, Raziye; Altıntepe, Lütfullah; Güney, İbrahim; Yeksan, Mehdi; Atalay, Hüseyin; Türk, Süleyman; Tonbul, Halil Zeki
[Abstract not Available]
Female Sexual Dysfunction in Peritoneal Dialysis and Hemodialysis Patients
(TAYLOR & FRANCIS LTD, 2009) Yazıcı, Raziye; Altıntepe, Lütfullah; Güney, İbrahim; Yeksan, Mehdi; Atalay, Hüseyin; Türk, Süleyman; Tonbul, Halil Zeki
Background. Sexual dysfunction (SD) is a common problem in end-stage renal disease (ESRD). In contrast to basic and clinical research in the field of male SD, the sexual problems of women have received relatively little attention and are often under-treated. We evaluated sexual function in female ESRD patients using the validated Female Sexual Function Index (FSFI) and relation with QOL, depression, and some laboratory parameters. Methods. 117 ESRD patients (85 peritoneal dialysis [PD], 32 hemodialysis [HD], mean age 48.5 +/- 13.9 years) were enrolled. All patients had been dialyzed (PD or HD) for more than three months. In addition, an age-matched married control group of 48 subjects (mean age 47.1 +/- 12.7 years) were enrolled in the study. All patients were asked to complete three questionnaires of the FSFI, Beck Depression Index (BDI) and SF-36. Results. Female sexual dysfunction was found in 80 of the 85 peritoneal dialysis patients (94.1%) and all of the HD patients (100%), but in only 22 subjects of the control group (45.8%). A significant negative correlation was found between total FSFI score and age (r = -0.288, p = 0.002), BDI score (r = -0.471, p < 0.001), mental-physical component score of QOL (r = -0.463, p < 0.001 and r = -0.491, p < 0.001, respectively) in PD and HD patients. The rates of depression were 75.3, 43.8, and 4.2% in the PD and HD patients and control subjects, respectively. Conclusion. Female sexual dysfunction is common problem ESRD. This problem especially related with depression and QOL. Thus, sexual function should be evaluated in female subjects to determine its impact on quality of life.
Health-Related Guality of Life, Sleep Guality, and Depression in Peritoneal Dialysis and Hemodialysis Patients
(Wiley-Blackwell, 2012) Türkmen, Kültigin; Yazıcı, Raziye; Solak, Yalçın; Güney, İbrahim; Altıntepe, Lutfullah; Yeksan, Mehdi; Tonbul, Halil Zeki
Health-related quality of life (HRQoL) and sleep quality (SQ) were impaired in patients with end-stage renal disease (ESRD). The impairment of both HRQoL and SQ and being in a depressive mood were found to be associated with increased morbidity and mortality in dialysis patients. We aimed to investigate the association between SQ, HRQoL, and depression, and to define independent predictors of SQ and depression in peritoneal dialysis (PD) and hemodialysis (HD) patients. Ninety HD patients (41 females, 49 males with mean age 50 +/- 15.7 years) and 64 PD patients (27 females, 37 males with mean age 52.4 +/- 15.3 years) receiving renal replacement therapy for at least 3 months were screened for the assessment of SQ, HRQoL, and depression in this cross-sectional study. A modified postsleep inventory, Short Form of Medical Outcomes Study (SF-36) and Beck depression inventory (BDI) were applied to all patients for evaluating SQ, HRQoL, and depression, respectively. HD and PD patients had similar total SQ scores. Physical and mental component scale of HRQoL were found to be significantly higher in HD patients (p?
Malnutrition-inflammation-atherosclerosis (MIA) syndrome components in hemodialysis and peritoneal dialysis patients
(TAYLOR & FRANCIS LTD, 2006) Tonbul, Halil Zeki; Demir, Murat; Altıntepe, Lütfullah; Güney, İbrahim; Yeter, Ekrem; Türk, Süleyman; Yeksan, Mehdi
Background. Malnutrition, inflammation, and atherosclerosis (MIA syndrome) are common in end-stage renal disease (ESRD) patients. Each component of MIA syndrome is the predictor of outcomes in ESRD patients. In this cross-sectional study, we aimed to compare both dialysis modalities for MIA syndrome components. Material and Methods. Thirty hemodialysis (HD) (mean age 44 +/- 11 years, 14 male and 16 female, mean time on dialysis: 31.0 +/- 19.0 months) and 30 continuous ambulatory peritoneal dialysis (CAPD) patients (41 +/- 9 years, 12 male and 18 female, mean time on dialysis: 25.5 +/- 21.5 months) were included. In order to determine malnutrition in ESRD patients, serum albumin level and anthropometric measurements were used. For inflammation, serum C-reactive protein level, erythrocyte sedimentation rate, and fibrinogen levels were measured. Mean-carotid artery intima media thickness (m-CIMT), presence of carotid plaque and serum homocysteine level were used to determine atherosclerosis. Results. Five CAPD patients (16%) and one HD patient (3%) was hypoalbuminemic. HD and CAPD groups were similar for inflammation. Mean-CIMT and serum homocysteine level were higher in HD patients than CAPD patients. There was a positive correlation between homocysteine and m-CIMT. Conclusion. Before choosing renal replacement therapy, malnutrition, inflammation, and atherosclerosis parameters must be investigated in ESRD patients. Hemodialysis seems to be more advantageous for malnutrition components than CAPD. Both dialysis modalities seem to be similar for inflammation, and CAPD modality has superiority for atherosclerosis. Before choosing the type of renal replacement therapy, assessment of MIA syndrome components could be useful for individualization of the decision on which dialytic modality is appropriate in ESRD patients.
Massive Haematuria Successfully Managed by Intravesical Ankaferd in a Haemodialysis Patient Complicated With Disseminated Intravascular Coagulation
(BMJ Publishing Group, 2012) Solak, Yalçın; Gaipov, Abduzhappar; Özbek, Orhan; Hassan, Mustafa Aziz; Yeksan, Mehdi
Massive haematuria is a life-threatening condition, demanding immediate management of bleeding. The mortality is very high in the case of delayed management of bleeding, especially in elderly patients with concomitant comorbidity. The treatment options of haematuria are wide, and depend on underlying conditions. However, therapeutic choices are limited in the presence of massive and intractable haematuria caused by disseminated intravascular coagulation (DIC). Ankaferd blood stopper (ABS) is a novel, commercially available, haemostatic agent, which has been approved by the Ministry of Health for local use in Turkey. Here, for the first time in the literature, we report a case of diffuse intravesical bleeding stopped by intravesical use of ABS in a 72-year-old man, haemodialysis patient complicated with sepsis and DIC.
Psychiatric Symptom Levels and the Way of Coping with the Stress in Dialysis Patients
(2000) Herken, Hakan; Aşkın, Rüstem; Karaca, Sıtkı; Doğan, Ekrem; Yeksan, Mehdi; Türk, Süleyman; Alıcı, Süleyman
Başa çıkma düzenekleri birey kronik strese karşı koymasında kullanılır. Birey bu yolla psikolojik strese karşı koyabilir. Başa çıkma düzenekleri toplumun kültürel düzeyi ile ilişkilidir. Bu çalışmada dializ hastalarının psikolojik sorunları ile nasıl başa çıktıklarını belirlemeyi amaçladık. Bu çalışma sürekli periton dializi alan ve hemodiyalize devam eden hastalar üzerinde yapıldı. Çalışmaya 32 hemodiyaliz ve 10 periton dializi hastası alındı. Hastalara Ruhsal Belirti Tarama Listesi (RBTL), Hamilton Depresyon Ölçeği (Ham-D), Durumluluk ve Süreklilik Kaygı Envanteri (DSKE) ve Stresle Başa çıkma Ölçeği (SBÖ) uygulandı. Hemodiyaliz hastalarında tüm stresle başa çıkma alt ölçekleri periton diyalizli hastalardan yüksekti. Hemodializli hastalar ruhsal durumlarının bozulması nedeniyle periton diyalizli hastalara göre daha fazla başa çıkma yollarına başvurmaktadırlar. Periton diyalizli hastaların hayat kalitelerinin hemodiyalizi! hastalara kıyasla daha yüksek olduğu söylenebilir.
A Rare but Ominous Association: Intracardiac Thrombus and Vegetation Simultaneously in a Hemodialysis Patient
(Wiley-Blackwell, 2010) Solak, Yalçın; Tekinalp, Mehmet; Atalay, Hüseyin; Kayrak, Mehmet; Yeksan, Mehdi
A 74-year-old woman with metastatic endometrium cancer presented with complaints of nausea and vomiting. She was commenced on hemodialysis due to acute renal failure via a right jugular central venous catheter (CVC). We also administered enoxaparine as deep qvein thrombosis prophylaxis. She developed fever during the course of hospitalization. Two sets of blood cultures yielded methicillin-resistant Staphylococcus aureus. qEnoxaparine was stopped due to thrombocytopenia. We administered appropriate broad-spectrum antibiotics; however, she remained febrile after 72 hours. We found that the patient developed swelling and redness in the right calf, in which Doppler ultrasound revealed acute deep vein thrombosis. Transthoracic echocardiography depicted a mobile thrombus in the right atrium, which was moving in and out of the right ventricle.

Yazar "Yeksan, Mehdi" seçeneğine göre listele

Sayfa Başına Sonuç

Sıralama seçenekleri