Selim Kilic

Gulhane Military Medical Academy, Engüri, Ankara, Turkey

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Publications (166)369.32 Total impact

  • 01/2015; DOI:10.5455/bmmr.173581
  • Bulletin of Clinical Psychopharmacology 01/2015; DOI:10.5455/bcp.20150310105903 · 0.37 Impact Factor
  • Mesut Cetin, Selim Kilic
    Bulletin of Clinical Psychopharmacology 01/2015; DOI:10.5455/bcp.20150318073223 · 0.37 Impact Factor
  • Nurten Kalender, Nuran Tosun, Selim Kiliç
    01/2015; 7(1):10-19. DOI:10.5336/nurses.2013-34534
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    ABSTRACT: The aim of this cross-sectional epidemiologic study was to investigate the prevalence and distribution of musculoskeletal disorders causing unfitness to Turkish Military Service. This study has been carried out by examining the medical reports of 1.777.500 people who applied to the Turkish Armed Forces for military service between 2009-2011. Age and geographic region of individuals were compiled and organized in groups. Musculoskeletal disorders were classified mainly as fracture sequel, spine disorders, absence of phalanges, extremity amputation, aggressive or multiple benign tumors of bones and pes planus. Unfitness to military service caused by musculoskeletal disorders was found to be 6.53‰ in 2009, 7.10‰ in 2010 and 7.28‰ in 2011. The prevalence of musculoskeletal diseases has increased by years. The prevalence of fracture squeal by years was found to be 2.83‰ in 2009, 3.10‰ in 2010 and 3.03‰ in 2011. In this study, the most common musculoskeletal disorders were: limitation of joint mobility (0.89‰), degeneration of joint surface (0.69‰), lower and upper limb discrepancies (0.60‰), posterior fusion surgery (0.59‰) and the absence of the phalanges in hand (0.51‰). We found an increase in both the prevalence of posterior fusion surgery and the absence of the phalanges in study group. These results has given information about severe musculoskeletal disorders among young adult male in Turkey. New studies including young adult female will add important information to our knowledge about musculuskelatal problems in our community.
    Pakistan Journal of Medical Sciences Online 01/2015; 31(1):43-8. DOI:10.12669/pjms.311.5674 · 0.10 Impact Factor
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    ABSTRACT: The role of reversibility of nontraditional risk factors, like inflammation and CKD-mineral bone disorder, in the reduction of cardiovascular risk after renal transplantation is still scarcely defined. The longitudinal relationship between C-reactive protein, CKD-mineral bone disorder biomarkers, and intima media thickness was investigated in a series of 178 patients (age=32±10 years) with stage 5 CKD maintained on chronic dialysis who underwent echo-color Doppler studies of the carotid arteries before and after renal transplantation. Smokers and patients with diabetes were excluded from the study. In all patients, immunosuppression was performed by a standard regimen on the basis of calcineurin inhibitors. Healthy controls were specifically selected to match the age and sex distribution of the patients. Biochemical and intima media thickness assessments were repeated 6 months after transplantation. Before transplantation, intima media thickness in patients with stage 5 CKD on dialysis (average=0.9±0.2 mm) was higher (P<0.001) than in well matched healthy controls (0.6±0.1 mm) and reduced substantially (-22%; 95% confidence interval, -24% to -20%) after transplantation (P=0.001). GFR (multivariable-adjusted β=0.23; P<0.001), C-reactive protein (β=0.15; P<0.001), and fibroblast growth factor 23 (β=0.28; P<0.001) were the strongest independent correlates of intima media thickness before transplantation. Similarly, longitudinal changes in the same biomarkers were the sole independent correlates of simultaneous changes in intima media thickness (C-reactive protein: β=0.25; fibroblast growth factor 23: β=0.26; P<0.001 for both) after renal transplantation. The evolution of intima media thickness after transplantation was largely independent of classic risk factors, including BP, LDL cholesterol, and insulin resistance, as measured by homeostatic model assessment. Intima media thickness improves after renal transplantation. Such an improvement associates with parallel changes in serum C-reactive protein and fibroblast growth factor 23. These observations are in keeping with the hypothesis that the decline in cardiovascular risk after transplantation, in part, depends on partial resolution of nontraditional cardiovascular risk factors, like inflammation and CKD-mineral bone disorder. Copyright © 2014 by the American Society of Nephrology.
    Clinical Journal of the American Society of Nephrology 12/2014; 10(3). DOI:10.2215/CJN.07860814 · 5.25 Impact Factor
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    ABSTRACT: Tularemia is a zoonotic infection caused by Francisella tularensis and the disease has been seen in many parts of the Northern Hemisphere [1,2]. F. tularensis is a pretty potent human pathogen, which can produce infection with as low as 10 organisms. The microorganism is highly infectious that may enter to the human body through the skin when contacted with an infected animal, and transmission through the mucosal membranes of mouth, throat, eye, or bronchus may occur. Furthermore, ticks can also transmit the pathogen [3]. This article is protected by copyright. All rights reserved.
    Clinical Microbiology and Infection 06/2014; DOI:10.1111/1469-0691.12741 · 5.20 Impact Factor
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    ABSTRACT: In this multicentre study, which is the largest case series ever reported, we aimed to describe the features of tularaemia to provide detailed information. We retrospectively included 1034 patients from 41 medical centres. Before the definite diagnosis of tularaemia, tonsillitis (n = 653, 63%) and/or pharyngitis (n = 146, 14%) were the most frequent preliminary diagnoses. The most frequent clinical presentations were oropharyngeal (n = 832, 85.3%), glandular (n = 136, 13.1%) and oculoglandular (n = 105, 10.1%) forms. In 987 patients (95.5%), the lymph nodes were reported to be enlarged, most frequently at the cervical chain jugular (n = 599, 58%), submandibular (n = 401, 39%), and periauricular (n = 55, 5%). Ultrasound imaging showed hyperechoic and hypoechoic patterns (59% and 25%, respectively). Granulomatous inflammation was the most frequent histological finding (56%). The patients were previously given antibiotics for 1176 episodes, mostly with β-lactam/β-lactamase inhibitors (n = 793, 76%). Antituberculosis medications were provided in seven (2%) cases. The patients were given rational antibiotics for tularaemia after the start of symptoms, with a mean of 26.8 ± 37.5 days. Treatment failure was considered to have occurred in 495 patients (48%). The most frequent reasons for failure were the production of suppuration in the lymph nodes after the start of treatment (n = 426, 86.1%), the formation of new lymphadenomegalies under treatment (n = 146, 29.5%), and persisting complaints despite 2 weeks of treatment (n = 77, 15.6%). Fine-needle aspiration was performed in 521 patients (50%) as the most frequent drainage method. In conclusion, tularaemia is a long-lasting but curable disease in this part of the world. However, the treatment strategy still needs optimization.
    Clinical Microbiology and Infection 06/2014; DOI:10.1111/1469-0691.12741. · 5.20 Impact Factor
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    ABSTRACT: The aim of this study was to assess the infectious diseases (ID) wards of tertiary hospitals in France and Turkey for technical capacity, infection control, characteristics of patients, infections, infecting organisms, and therapeutic approaches. This cross-sectional study was carried out on a single day on one of the weekdays of June 17-21, 2013. Overall, 36 ID departments from Turkey (n = 21) and France (n = 15) were involved. On the study day, 273 patients were hospitalized in Turkish and 324 patients were followed in French ID departments. The numbers of patients and beds in the hospitals, and presence of an intensive care unit (ICU) room in the ID ward was not different in both France and Turkey. Bed occupancy in the ID ward, single rooms, and negative pressure rooms were significantly higher in France. The presence of a laboratory inside the ID ward was more common in Turkish ID wards. The configuration of infection control committees, and their qualifications and surveillance types were quite similar in both countries. Although differences existed based on epidemiology, the distribution of infections were uniform on both sides. In Turkey, anti-Gram-positive agents, carbapenems, and tigecycline, and in France, cephalosporins, penicillins, aminoglycosides, and metronidazole were more frequently preferred. Enteric Gram-negatives and hepatitis B and C were more frequent in Turkey, while human immunodeficiency virus (HIV) and streptococci were more common in France (p < 0.05 for all significances). Various differences and similarities existed in France and Turkey in the ID wards. However, the current scene is that ID are managed with high standards in both countries.
    European Journal of Clinical Microbiology 05/2014; · 2.54 Impact Factor
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    ABSTRACT: The aim of this study was to assess the infectious diseases (ID) wards of tertiary hospitals in France and Turkey for technical capacity, infection control, characteristics of patients, infections, infecting organisms, and therapeutic approaches. This cross-sectional study was carried out on a single day on one of the weekdays of June 17-21, 2013. Overall, 36 ID departments from Turkey (n = 21) and France (n = 15) were involved. On the study day, 273 patients were hospitalized in Turkish and 324 patients were followed in French ID departments. The numbers of patients and beds in the hospitals, and presence of an intensive care unit (ICU) room in the ID ward was not different in both France and Turkey. Bed occupancy in the ID ward, single rooms, and negative pressure rooms were significantly higher in France. The presence of a laboratory inside the ID ward was more common in Turkish ID wards. The configuration of infection control committees, and their qualifications and surveillance types were quite similar in both countries. Although differences existed based on epidemiology, the distribution of infections were uniform on both sides. In Turkey, anti-Gram-positive agents, carbapenems, and tigecycline, and in France, cephalosporins, penicillins, aminoglycosides, and metronidazole were more frequently preferred. Enteric Gram-negatives and hepatitis B and C were more frequent in Turkey, while human immunodeficiency virus (HIV) and streptococci were more common in France (p < 0.05 for all significances). Various differences and similarities existed in France and Turkey in the ID wards. However, the current scene is that ID are managed with high standards in both countries.
    European Journal of Clinical Microbiology 05/2014; 33(9). DOI:10.1007/s10096-014-2116-9 · 2.54 Impact Factor
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    ABSTRACT: Psoriasis vulgaris is associated with an increased risk of atherosclerosis. Carotid intima-media thickness (cIMT) may predict atherosclerosis. We assessed the correlation between bilirubin (a potent endogenous antioxidant) levels and cIMT in patients with psoriasis vulgaris. We also compared the levels of serum total bilirubin (TBil) and its fractions in control subjects and patients with psoriasis. We enrolled 115 participants (60 patients with psoriasis vulgaris and 55 control subjects). The levels of indirect bilirubin were calculated as the difference between TBil and direct bilirubin values. cIMT was measured in both common carotid arteries. TBil levels were lower in patients with psoriasis than in the control group [median (range) 0.55 (0.30-1.23) vs. 0.59 (0.30-1.44) mg/dL] as were indirect bilirubin [0.43 (0.22-1.00) vs. 0.48 (0.25-1.12) mg/dL] and direct bilirubin [0.10 (0.01-0.23) vs. 0.13 (0.03-0.32) mg/dL]. Only direct bilirubin differed significantly (p = 0.0002) but the number of patients with higher values of TBil and indirect bilirubin were significantly greater in the control group (p = 0.0019 by the Fisher's test). The patients with psoriasis had a significantly greater cIMT compared with control subjects (0.54 ± 0.08 vs. 0.50 ± 0.07 mm, p = 0.005). High-sensitivity C-reactive protein levels were higher in patients with psoriasis compared with controls (2.95 ± 3.50 and 0.99 ± 0.72 mg/L, p < 0.001). There was a negative correlation between cIMT and TBil levels (r = -0.383, p < 0.01). The results of the correlations were reinforced by multiple regression analysis. To our knowledge, this is the first study to assess the association between TBil and cIMT in patients with psoriasis. Our results support the concept that psoriasis vulgaris is associated with an increased risk of atherosclerosis.
    American Journal of Clinical Dermatology 04/2014; 15(2). DOI:10.1007/s40257-014-0069-5 · 2.52 Impact Factor
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    ABSTRACT: Objective: We aimed to evaluate the relationship between estimated glomerular filtration rate (eGFR) and QT dispersion (QTd) in patients with coronary artery disease (CAD). Methods: Sixty patients(mean age 62.72 ± 12.48 years) included 46 male, (mean age 60.89 ± 12.70 years)and 14 female (mean age 68.71± 9.86 years) were enrolled in this study. Patients were divided into 2 groups according to their eGFR using the 6 variable MDRD equation. Group 1 consisted of patients with estimated eGFR<60 ml/min/1.73m2 and Group 2 consisted of patients witheGFR ≥ 60 ml/min/1.73m2. Results: Baseline patient characteristics were homogeneous in both groups except for age, gender and smoking.Also, the extent of CAD was similar in both groups (p > 0.05) QTd values were found higher in group 1 than those of group 2 (57.23 ± 40.65 ms vs. 31.23 ± 14.47 ms, p = 0.002). After adjustment for age, gender and smoking using one-way ANCOVA test, statistically significant difference in QTd still existedbetween the groups (p=0.038). Conclusion:QTd tends to be higher in patients with poor renal function independent of severity of angiographical CAD. QTd may be a potentially useful non-invasive test in the management of patients with poor renal function, especially those with CAD.
    Pakistan Journal of Medical Sciences Online 03/2014; 30(2):266-71. DOI:10.12669/pjms.302.4271 · 0.10 Impact Factor
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    01/2014; 23(01):51-55. DOI:10.5262/tndt.2014.1001.10
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    ABSTRACT: Lipids are the main source of calories and considered very important in infant growth. We aimed to compare fatty acid composition of term and preterm breast milk. This is the first study that compares the fatty acid levels of preterm and term breast milk in Turkish women. Breast milk samples were obtained from mothers of term (n = 15) and preterm (n = 15) infants on postnatal days 3, 7, and 28. Fatty acid composition of human breast milk was determined longitudinally by gas-chromatography/mass spectrometry. There Were 31 fatty acids measured in the milk samples. In the first month, 17 fatty acid levels had significant differences. In group comparison, some fatty acids (C14:0, C16:0, C18:1 and C20:5) had significantly increased in the preterm group (P = 0.041, P = 0.046, P = 0.027, P = 0.033, respectively), whereas myristoleic acid (C14:1) and eicosanoic acid (C20:0) had significantly increased in the term group (P = 0.015, P = 0.048, respectively). Term and preterm milk have different compositions of fatty acids. Breast milk composition changes over time. As a general conclusion, breast milk provides the lipid requirements of infants.
    Turkish Journal of Medical Sciences 01/2014; 44(2):305-10. DOI:10.3906/sag-1302-131 · 0.84 Impact Factor
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    ABSTRACT: Objective: Mental diseases are vital community health problems because they are common in public, and have negative social reflection and result in a disability. Methods: This cross-sectional study has been conducted by reviewing health reports of 1.777.500 people applying for military service examination in Turkish Armed Forces between 2009 and 2011. Results: Prevalence of psychiatric diseases leading to disability has been detected as 9.4 per thousand in 2009, 10.7 per thousand in 2010 and 10.0 per thousand in 2011. Mental retardation and schizophrenia prevalence have been detected as 6.4/1.6 per thousand in 2009, 7.2/1.7 per thousand in 2010, 7.1/1.3 per thousand in 2011. As a result of our study, it has been seen that mental retardation prevalence is parallel to world's average, and prevalence of psychotic disorders is a bit lower because study group is young. Conclusion: Supporting this study with community based studies to be carried out in different populations proves benefit for policies to be improved in social and health area.
    Anadolu Psikiyatri Dergisi 01/2014; 16(1):1. DOI:10.5455/apd.46401 · 0.20 Impact Factor
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    ABSTRACT: ZET: Psikofarmakoloji Derneği Türkiye'de psikotrop ilaç tüketimi ve mevcut uygulamaların tıbbi, etik ve ekonomik sonuçları raporu Bu raporda, Sağlık Bakanlığı, Türkiye İstatistik Kurumu, Türkiye Ruh Sağlığı Profili ve Intercontinental Marketing Service (IMSHealth) verileri kullanılarak ülkemizdeki psikotropik ilaç kullanımı değerlendirilmiştir. İkibinüç yılında 14.24 milyon kutu antidepresan kullanılırken, 2012 yılı sonu itibarıyla bu sayı %162 artışla 37.35 milyon kutu olmuştur. Antipsikotik ilaç kullanımı son 5 yılda %71 artarak 2005 yılında 7.20 milyon kutudan 2012 yılı sonu itibarıyla 12.32 milyon kutuya ulaşmıştır. Antidepresan içeren reçete sayısı son 5 yılda %50 artışla 2007 yılında 18.14 milyondan, 2012 yılı sonunda 26.60 milyona ulaşmıştır. Antipsikotik ilaç içeren reçete sayısı da son 5 yılda %46.7 artışla 2007 yılında 3.92 milyondan, 2012 yılı sonunda 5.76 milyona ulaşmıştır. En kötümser durumda, antidepresan ve antipsikotik ilaç kullanımını gerektiren çoklu psikiyatrik sorunların sırasıyla %20 ve %5 oranında olduğu varsayımında bulunulduğunda bile reçete üzerinden hesaplanan psikiyatrik hastalıkların prevalansı (reçete sayısı/nüfus) oldukça yüksek kalmaktadır. Aile hekimleri-pratisyenler, psikiyatristler, nörologlar ve diğer uzmanlar 2007 yılında antidepresan reçetelemede sırasıyla %33, %37, %20 ve %11'lik paya sahip olmuş; 2012 yılında %48, %31, %14 ve %7'lik paya sahip bulunmuştur. Bu grup hekimlerin 2012 yılında antidepresanların ilk defa reçetelenmesindeki oranlarının ise sırasıyla %37, %34, %19 ve %11 olduğu belirlenmiştir. Aile hekimleri-pratisyenler, psikiyatristler, nörologlar ve diğer uzmanlar 2007 yılında antipsikotik ilaç reçetelemede sırasıyla %18, %67, %13 ve %3'lük paya sahip olurken: 2012 yılında bu değerler sırasıyla %21, %63, %14 ve %2 şeklinde bulunmuştur. Bu grup hekimlerin 2012 yılında antidepresanların ilk defa reçetelenmesindeki oranlarının ise sırasıyla %6, %73, %19 ve %3 olduğu belirlenmiştir. Sonuç olarak, veriler Türkiye'de psikotrop ilaçların gereksiz ve/veya aşırı kullanıldığı izlenimini vermektedir. İlaç kullanımındaki artış, nüfus artışı ve psikiyatrik hastalıklarının insidansının artışıyla ilişkili görünmemektedir. İlk defa reçetelenme rakamları psikiyatrist olmayan hekimlerin psikiyatrik hastalıklara uygun olmayan bir şekilde tanı koyduğunu ve tedavilerini başlattığını düşündürmektedir. Bu durum psikotrop ilaçların reçetelenmesinde yetkilendirme konusunun tekrar ele alınmasını zorunlu kılmaktadır. Anahtar sözcükler: psikotrop ilaçlar, antidepresanlar, antipsikotikler, aşırı tüketim Kli nik Psikofarmakoloji Bulteni 2013;23(4):390-402 ABS TRACT: A report by Turkish Association for Psychopharmacology on the psychotropic drug usage in Turkey and medical, ethical and economical consequences of current applications This report evaluation of the psychotropic drug usage in Turkey based on the data provided by Intercontinental Marketing Service (IMSHealth), Ministry of Health, Turkish Statistical Institute, Turkish Mental Health Profile. A total of 14.24 millions units of antidepressants were used in 2003. By increasing 162%, annual antidepressant usage reached 37.35 millions units by the end of 2012. Antipsychotic drug usage increased by 71% during the last 5 years, from 7.20 millions units in 2005 to 12.32 millions as of the end of 2012. The total number of prescriptions including an antidepressant was 18.14 millions in 2007, by increasing 50% in the last 5 years, it reached 26.60 millions in 2012. The total number of prescriptions including any antipsychotic drug increased from 3.92 millions in 2007 to 5.76 millions in 2012, increasing by 46.7%. In the worst case scenario considering concurrent psychiatric disorders, prevalence of disorders requiring antidepressants and antipsychotic drugs could be as high as 20% and 5%, respectively. The calculated frequency (prescription/population) was much higher than the worst case scenario estimates. In 2007, family physicans and practitioners, psychiatrists, neurologists, and specialists of other disciplines prescribed 33, 37, 20, and 11% of all antidepressants, respectively. In 2012, they prescribed 48, 31, 14, and 7% of all antidepressants, respectively. The first time antidepressant prescriptions in 2012 were done at the rate of 37, 34, 19, and 11% by above mentioned specialists, respectively. In 2007, family physicans and practitioners, psychiatrists, neurologists, and specialists of other disciplines prescribed 18, 67, 13, and 3% of all antipsychotics, respectively. In 2012, the same set of specialisations prescribed 21, 63, 14, and 2% of antipsychotics, respectively. The "first time" antipsychotics were prescribed at the rate of 6, 73, 19, and 3% by above mentioned order of specialists, respectively. In conclusion, the data suggest that there was an unnecessary and/or excessive prescribing of psychotropic agents. The increase is not related to increased population and/ or prevalance of psychiatric disorders. The numbers of first time prescriptions suggest that non-psychiatrists diagnose and initiate treatment for psychiatric disorders. This requires re-evaluation of authorization to presribe psychotropic agents.
    Bulletin of Clinical Psychopharmacology 12/2013; 23(4):390-402. DOI:10.5455/bcp.20131230121254 · 0.37 Impact Factor
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    ABSTRACT: Objective: Disability is one of the significant problems that the public faces as regards social aspects, economics, public health and politics. Our aim was to review the prevalence of diseases causing disabilities in young adult men who are declared “unfit for military service” in Turkey after medical examination. Methods: We reviewed the prevalence of diseases among 113,175 young adult men who were referred for medical examination between 2009 and 2011. Results: Prevalence of unfitness for military service was 5.56% in 2009, 6.74% in 2010 and 6.77% in 2011. Leading causes for young adult men to be rejected from military service was intellectual disability 6.88, hearing loss 3.71, epilepsy 1.59, schizophrenia 1.54 and diabetes mellitus 1.47 per thousand people. Conclusion: Screening for the prevalence of disability conditions is an important data source for policies to be developed. Supporting such survey with community based studies in different populations in future shall be beneficial for improvement of policies in social and health fields.
    Pakistan Journal of Medical Sciences Online 09/2013; 29(5):1240-4. DOI:10.12669/pjms.295.3770 · 0.10 Impact Factor
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    ABSTRACT: High level of circulating red cell distribution width (RDW) and neutrophil/lymphocyte ratio (N/L) may reflect ongoing vascular inflammation and plays an important role in pathophysiology of hypertension. We evaluate the effects of nebivolol and metoprolol on the RDW and N/L in new essential hypertensives. After baseline assessment, 72 patients were randomly allocated to 5 mg/day of nebivolol (n=37, 20 males) or 100 mg/day of metoprolol (n=35, 18 males) and treated for 6 months. Blood pressure (BP), heart rate (HR), RDW and N/L were measured before and after treatment. BP significantly decreased with both drugs (P<0.001). Analogue reduction was observed for resting HRs (P<0.001), but metoprolol caused greater HR fall as compared to nebivolol (P<0.001). After 6 months treatment, nebivolol significantly lowered not only RDW but also total WBC and N/L (P<0.001, P=0.023, P=0.017, respectively). No changes were observed in metoprolol group. Percent decrease in RDW was found to be significantly higher in nebivolol than in metoprolol group (P=0.001) and remained also after correction for confounders (P=0.012). Nebivolol improved RDW and N/L to a greater extent that metoprolol in hypertensives. These favourable effects may participate, together with the BP reduction, at the favourable properties of the drug in hypertension.
    Journal of cardiovascular pharmacology 08/2013; 62(4). DOI:10.1097/FJC.0b013e31829f716a · 2.11 Impact Factor
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    ABSTRACT: Psoriasis vulgaris is an inflammatory disease characterized by epidermal hyperproliferation, leucocyte adhesion molecule expression and leucocyte infiltration. Psoriasis is associated with an increased risk of cardiovascular disease. Endothelial dysfunction is widely regarded as being the initial lesion in the development of atherosclerosis Human endothelial-cell specific molecule-1(endocan) is a novel human endothelial cell specific molecule. Previous studies suggested that endocan may be a novel endothelial dysfunction marker. To investigate the relationship between serum levels of endocan and cardiovascular risk as well as disease activity in patients with psoriasis vulgaris. A total of 29 patients with psoriasis vulgaris and 35 control subjects were included in the study. Endocan, high-sensitivity C-reactive protein (hsCRP) and carotid artery intima-media thickness (cIMT) were measured in all subjects. Serum endocan levels were significantly different between the two groups (p< 0.001). In patients with psoriasis, serum endocan levels correlated with psoriasis activity and severity index (PASI), hsCRP and cIMT (r=0.477, p=0.009; r=0.408, p=0.02; r=484, p=0.008, respectively). Circulating endocan may represent a new marker that correlates with cardiovascular risk as well as the severity of disease in patients with psoriasis vulgaris. Endocan may be a surrogate endothelial dysfunction marker and may have a functional role in endothelium-dependent pathological disorders. Whether endocan levels could become a treatment target merits further investigation. This article is protected by copyright. All rights reserved.
    British Journal of Dermatology 07/2013; 169(5). DOI:10.1111/bjd.12525 · 4.10 Impact Factor
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    ABSTRACT: Background/Aims: The role of chronic kidney disease-mineral bone disorder (CKD-MBD) reversibility in the amelioration of vascular function and in the reduction of the risk for cardiovascular events after renal transplantation is still unknown. Methods: We investigated the longitudinal relationship between the main biomarkers of CKD-MBD and the evolution of vascular function [flow-mediated dilatation (FMD)] after transplantation in a series of 161 patients with kidney failure maintained on chronic dialysis (5D-CKD). Results: Before transplantation, FMD in patients was markedly lower (-40%, p < 0.001) than in well-matched healthy subjects and increased by 27% after transplantation (p = 0.001). Fibroblast growth factor 23 (FGF23), 25-hydroxy-vitamin D (25OHVD) and serum phosphate (p < 0.01) were independently associated with simultaneous changes in FMD. Changes in classical risk factors and in risk factors related to CKD like the glomerular filtration rate, serum albumin, C-reactive protein and insulin resistance failed to independently explain the variability in FMD changes after transplantation. Conclusion: Endothelium-dependent vasodilatation improves after kidney transplantation, which is parallel to the dramatic fall in FGF23, the reduction in serum phosphorus and the increase in 25OHVD levels. If these associations are causal, a part of decline in cardiovascular risk after transplantation is related to partial resolution of CKD-MBD.
    American Journal of Nephrology 01/2013; 37(2):126-134. DOI:10.1159/000346711 · 2.65 Impact Factor

Publication Stats

2k Citations
369.32 Total Impact Points

Institutions

  • 2005–2015
    • Gulhane Military Medical Academy
      • • Department of Public Health
      • • Department of Cardiology
      • • Gülhane Military Medical Academy
      • • Department of General Surgery
      • • Department of Urology
      Engüri, Ankara, Turkey
  • 2009
    • University of Iowa
      Iowa City, Iowa, United States
    • Ankara Numune Training and Research Hospital
      Engüri, Ankara, Turkey
  • 2004
    • Medical Biochemistry - Ministry Of Health Turkey
      Engüri, Ankara, Turkey