Kadir Kayatas's research while affiliated with Haydarpasa Numune Research and Teaching Hospital and other places

Background Some studies have investigated the relationship between Behçet’s disease (BD) and insulin resistance; however, since they did not exclude obese patients from their sample, it remains unclear whether BD itself causes insulin resistance independently of obesity. Methods The study included 60 patients with BD and 45 age-, gender- and body mass index (BMI)-matched healthy controls. Obese patients with a BMI of ≥30 kg/m² were excluded. Insulin resistance according to the homeostasis model assessment for insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI), fasting plasma glucose, and one-hour and two-hour plasma glucose in the oral glucose tolerance test (OGTT 1-h and OGTT 2-h PG, respectively) were evaluated in all patients. Results The mean fasting plasma glucose levels and the rate of those with impaired glucose tolerance according to OGTT 2-h PG were significantly higher in the BD patients compared to the controls. The rates of those with insulin resistance according to HOMA-IR and QUICKI were significantly higher in the BD patients than in the controls. When compared to the control group, the rates of those with impaired fasting glucose and impaired glucose tolerance were significantly higher and the mean QUICKI value was significantly lower in the active group, in contrast to the inactive group. Conclusions Insulin resistance occurs in BD patients independently of obesity. In the follow-up of BD patients, especially in the active phase, not only fasting blood glucose but also other diagnostic tests for insulin resistance should be added to the examination panels.

Objectives The aim of the present study is to evaluate the diagnostic powers of fractional magnesium, sodium and potassium as markers of renal tubular damage in normotensive type 2 diabetes mellitus (T2DM) patients with respect to microalbuminuria and estimated glomerular filtration rate (eGFR). Materials and methods Forty healthy volunteers and 91 normotensive T2DM patients were included in the study. Patient group was divided into two according to albuminuria level; 49 were normoalbuminuric and 42 were microalbuminuric. In addition to albumin in urine, urine and serum Na, K, Mg and creatinine values were measured to calculate fractional electrolyte excretion rates. Results In normoalbuminuric and microalbuminuric groups, fractional excretion of magnesium (FEMg) values were found to be significantly higher than the control group (p < 0.05). There was a moderate correlation between FEMg and albümin to cratinin ratio (ACR) (Spearman r = 0.3215, p < 0.05). In the ROC analysis for eGFR and FEMg based on microalbuminuria, the areas under the curve were 0.625 and 0.732, respectively (diagnostic sensitivity 59.52% and 66.67%; specificity 70.79% and 77.53%, p < 0.05). Conclusion For renal tubular damage predicted by microalbuminuria, FEMg could be accepted as a candidate biochemical marker with diagnostic and prognostic value.

Background/aim: This study aimed to compare washed red blood cell (WRBC) transfusion versus nonwashed RBC (NWRBC) transfusion in terms of posttransfusion potassium levels in dialysis patients on a day when the patient did not receive dialysis. Materials and methods: The patients were randomly assigned into two groups, i.e. those receiving WRBCs (n = 21) and those receiving NWRBCs (n = 17). Both groups received one unit of RBCs. Serum potassium and sodium levels were measured before and at the 1st, 2nd, 3rd, 4th, and 6th hours after transfusion. Results: In the WRBC group, the changes in the serum potassium levels at the 3rd, 4th, and 6th hours after transfusion were significant compared with pretransfusion levels. In the serum potassium levels mean decreases by 0.38 ± 0.57 mEq/L at the 3rd hour (P = 0.006), by 0.32 ± 0.47 mEq/L at the 4th hour (P = 0.005), and by 0.32 ± 0.51 mEq/L at the 6th hour (P = 0.009) after transfusion were significant compared with the pretransfusion levels. Conclusion: Although nonwashed RBC transfusion does not change serum potassium levels, washed RBC transfusion significantly reduces serum potassium levels. Washed RBC transfusion is considered to be safer in hemodialysis patients with hyperkalemia and anemia.

Background: Although an enlarged left atrium has recently emerged as a marker of adverse outcomes in various diseases, its discriminatory value and prognostic role in acute ischemic stroke (AIS) are not well studied. We studied whether left atrial volume index (LAVI) predicts mortality and discriminates stroke subtypes after AIS. Methods: We prospectively followed 310 consecutive first-ever AIS patients aged 50 years or older who were admitted to the hospital within 24 hours of the onset of stroke symptoms. The type of AIS was classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. All of the patients underwent transthoracic echocardiography within the first 24 hours. LAVI was measured with the biplane area-length method and categorized as 28 mL/m(2) or lower (normal), 28.1-32 mL/m(2), 32.1-36 mL/m(2), and >36 mL/m(2). The patients were followed for 1 year or until death, whichever came first. Results: The LAVI of the cardioembolic group was significantly higher than that of the noncardioembolic group (32.4 ± 4.0 versus 29.7 ± 3.4 mL/m(2), respectively; P < .001). The optimal cutoff value, sensitivity, and specificity of LAVI to distinguish cardioembolic stroke from noncardioembolic stroke were 30 mL/m(2), 81%, and 64%, respectively. Mortality in each LAVI category was 4%, 7.8%, 25.9%, and 70.9%, respectively (P = .026). Kaplan-Meier analysis showed that there was a stepwise increase in risk of mortality with each increment of LAVI category. Conclusions: The LAVI can distinguish cardioembolic stroke from noncardioembolic stroke and provides an independent information over clinical and other echocardiographic variables for predicting mortality in patients with first-ever AIS.

We present a case of tuberculous peritonitis in a 46-year-old woman with rheumatoid arthritis treated with adalimumab, and we review the association between anti-tumour necrosis factor therapy and tuberculosis. This case illustrates that tuberculosis can develop with atypical clinic and uncertain laboratory findings and may mimic malignancies during adalimumab therapy.

OBJECTIVES: The mammalian target of rapamycin inhibitors sirolimus and everolimus are immunosuppressive drugs for kidney transplant patients, but adverse events may include proteinuria. The purpose of this study was to compare the effects of sirolimus and everolimus on creatinine clearance and proteinuria after kidney transplant. MATERIALS AND METHODS: This study was a prospective evaluation period of 50 patients (age, 16-65 y) who had kidney transplant. There were 25 patients who used sirolimus and 25 patients who used everolimus. Evaluation at the beginning mTOR and end of the evaluation period included complete blood count, blood pressure, serum creatinine level, creatinine clearance, and proteinuria level in a 24-hour urine collection. RESULTS: Mean creatinine clearance at the beginning and end of the evaluation period was significantly less in the everolimus than sirolimus group. There was no significant change in creatinine clearance from the beginning to end of the evaluation period in either the sirolimus or everolimus group. Mean proteinuria at the beginning and end of the evaluation period was similar between the sirolimus and everolimus groups. Both groups had a significant increase in mean proteinuria from beginning to end of the evaluation period, but the increase in proteinuria was similar for the sirolimus and everolimus groups (difference not significant). CONCLUSIONS: In kidney transplant recipients, sirolimus and everolimus are associated with a similar level of increased mean proteinuria.

Method: The study included in 99 type 2 diabetics undergoing coronary artery bypass grafting (CABG). Overnight fasting blood samples (10-12 hours) were collected between 08: 00 and 08: 30 a.m for testing fasting blood glucose, BUN, creatinine, HbA1c (%), TSH, free T4, free T3.Arterial blood pressure, body weight, height, waist circumference were measured and recorded. Duration of diabetes, the age at its onset, oral antidiabetic medication, its dosages, duration of use, insulin use, dosage (U / kg) and duration were noted. . The statistical analyses were performed using SPSS for Windows 16.0 software. Findings: The study included 99 type 2 diabetics undergoing coronary artery bypass graft (CABG) at Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital. The mean age was 59.74 ± 8.51 years, 25.3% were females and 74,7% were males. The mean duration of diabetes was 7.9 ± 6.68 yrs and BMI 28.64 ± 4.11 (kg / m²), height 168.09 ± 8.26 (cm), weight 80.91 ± 12.69 (kg). In Koroner Arter ByPass Graft Yapılan Tip 2 Diyabetik Hastalarda Postaperatif Dönemde İntensif İnsülin Tedavisi the preoperative period, 14.1% patients were on insulin therapy, 58,6% were on oral antidiabetic drugs; 4% were on the diabetic diet, 23.2% were without any treatment for diabetes. Patients were discharged on basal insulin dosage unit (U), 20.2 ± 5.81 U; basal insulin U / kg 0.25 ± 0.08; bolus insulin 22.11 ± 7.11 U; bolus insulin U / kg 0, 28 ± 0.1.As to the incidence of thyroid dysfunction, 20 patients had subclinical hyperthyroidism, 3 subclinical hypothyroidism and 2 overt hypothyroidism. Conslusion: Regulating of glycemia in type 2 diabetics undergoing CABG significantly reduces the major postoperative complications, mortality and risk of infection. As high insulin resistance in patients undergoing coronary artery bypass surgery continues for a week or two in the postoperative period, basal and bolus insulin need should be taken into account at discharge.