Cenk Aypak

Dışkapı Yıldırım Beyazıt Training and Research Hospital, Engüri, Ankara, Turkey

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Publications (33)42.32 Total impact

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    ABSTRACT: Dear Sir,Despite the availability of effective preventive and curative medications for osteoporosis (OP), and guidelines for its diagnosis and management, few individuals are treated for OP.1 Data are scarce about the treatment practices against OP in Turkey. Our objective was to describe the patterns of use of medication for OP in a sample of Turkish patients who had been clinically referred for bone mineral density (BMD) analysis at nuclear medicine division of Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey between May 2013 and October 2013.
    The Journal of Clinical Pharmacology 08/2014; · 2.84 Impact Factor
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    ABSTRACT: Recent studies have reported an increasing prevalence of childhood hypertension. Obesity is probably the most important risk factor. The relationship between hypertension and BMI in children has not been studied in Ankara, which is the second largest city in Turkey.
    Public health nutrition. 05/2014;
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    ABSTRACT: Press Elmer Articles © The authors | Journal compilation © J Med Cases and Elmer Press™ | www.journalmc.org Abstract Musculoskeletal system is rarely involved by hydatid cyst. A 42-year-old man was diagnosed as having a cystic mass within right thigh. Preoperative magnetic resonance imaging suggested an un-usual location of hydatid disease, although serology was negative. A gray-white coloured cyst within right vastus lateralis muscle was enucleated during surgery. Histopathology confi rmed the diagnosis. This case underlies that hydatid disease should be kept in mind in the differential diagnosis of any soft tissue mass especially in re-gions where it is endemic.
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    ABSTRACT: Asymmetric dimethylarginine (ADMA), the main endogenous inhibitor of nitric oxide synthase, is considered to be associated with endothelial dysfunction. High ADMA levels have been shown to be related with disorders causing vascular inflammation such as hypertension, hypercholesterolemia, atherosclerosis, chronic heart failure, stroke and sepsis. Cutaneous anthrax (CA) is a serious infectious disease which may cause vasculitis. The aim of the study was to investigate the serum ADMA levels in patients with CA. A total of 35 serum samples of the patients with CA and 18 control sera were tested for ADMA levels using ADMA ELISA kit (Immunodiagnostik AG, Bensheim, Germany). ADMA levels were found to be significantly higher in the patients group than the controls (p < 0.001). In addition, ADMA levels were found to be positively associated with sedimentation rates (R = 0.413; p = 0.026), and inversely associated with international normalized ratio (INR) levels (R = -0.46; p = 0.011). A cut-off value of 0.475 of ADMA had a sensitivity of 74.3%, specificity of 77.8%, and accuracy of 75.5% in the diagnosis of CA. Although the exact mechanism still remains unclear, ADMA levels could be related to immune activation in CA. In addition, these data might suggest the higher ADMA levels in patients could be due to the perivascular inflammation and vasculitis in CA.
    Annals of Clinical Microbiology and Antimicrobials 03/2014; 13(1):12. · 1.62 Impact Factor
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    ABSTRACT: Background Adenosine deaminase (ADA) activity has been discovered in several inflammatory conditions; however, there are no data associated with cutaneous anthrax. The aim of this study was to investigate serum ADA activity in patients with cutaneous anthrax. Material and Methods Sixteen patients with cutaneous anthrax and 17 healthy controls were enrolled. We measured ADA activity; peripheral blood leukocyte, lymphocyte, neutrophil, and monocyte counts; erythrocyte sedimentation rate; and C reactive protein levels. Results Serum ADA activity was significantly higher in patients with cutaneous anthrax than in the controls (p<0.001). A positive correlation was observed between ADA activity and lymphocyte counts (r=0.589, p=0.021) in the patient group. Conclusions This study suggests that serum ADA could be used as a biochemical marker in cutaneous anthrax.
    Medical science monitor: international medical journal of experimental and clinical research 01/2014; 20:1151-1154. · 1.22 Impact Factor
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    ABSTRACT: Family caregivers of patient in long-term care facilities often have high rates of stress, burden and psychological illness. A descriptive study was carried out with 63 caregivers. Caregivers were asked to complete a demographic questionnaire, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Short form 36 (SF-36), which measures health related quality of life (QoL). The majority of caregivers were female (79.4%), and most often the daughter of the patient in long-term care (47.6%). The mean BDI score of the sample was 18.8 and the mean BAI score was 20.0. Almost all the mean scores referring to the QoL were decreased (lower than 50), with the exception of mental health. On the SF-36 questionnaire, the lowest scores were observed on the role-emotional, rolephysical, social functioning and vitality scales of the SF-36.
    Archives of Psychiatric Nursing. 01/2014;
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    ABSTRACT: Aim: Low serum vitamin D and calcium levels as well as high parathyroid hormone (PTH) levels are the most important risk factors in osteoporosis. The aim of our study was to estimate the optimal vitamin D status needed to prevent a rise in PTH concentrations in postmenopausal women. Materials and methods: A total of 197 postmenopausal women who were at the menopausal period for at least 1 year and who had body mass indexes (BMIs) <25 kg/m2 were recruited between November 2011 and February 2012. Patients were evaluated by dividing them into 4 age groups (39–50 years, 51–60 years, 61–70 years, and >70 years). Results:The mean age of patients was 60.8 ± 10.9 years. Serum 25-hydroxyvitamin D3 [25(OH)D3] levels were lower than 10 ng/mL in 94 patients (47.7%) and lower than 20 ng/mL in 167 (84.8%) patients. The mean vitamin D level was lowest in group 2 (51–60 years), but the difference was not statistically significant (P = 0.57). PTH levels were higher than 75 pg/dL in 52 patients, and 65.4% of those patients (n = 34) had vitamin D insufficiency (<10 ng/mL). Conclusion: Vitamin D insufficiency was very common in our study population (84.8%). Treatment should be aimed at achieving a 25(OH)D3 level, at which no further suppression of PTH occurs. Further studies are needed to increase awareness among physicians that with optimal vitamin D levels a rise in PTH and subsequent bone loss is prevented .
    Turkish Journal of Medical Sciences 11/2013; 43(6):990-994. · 0.45 Impact Factor
  • Cenk Aypak, Ozlem Türedi, Adnan Yüce
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    ABSTRACT: Low serum 25-hydroxyvitamin D3 (25(OH)D) levels have been associated with insulin resistance and cardiovascular diseases. The influences of gender, puberty and adiposity on vitamin D status and the relationship between 25(OH)D and cardiometabolic risk factors in obese and non-obese children were studied. A retrospective analysis was carried out on 168 Turkish children during late winter. Age, gender, puberty, body mass index (BMI), 25(OH)D levels and cardiometabolic risk factors including lipid profiles, high-sensitivity C-reactive protein and insulin resistance index calculated by homeostasis model assessment (HOMA-IR) were evaluated. The median age of the study population was 11 (4-16) years, and 102 children (60.7 %) were prepubertal. Overall, 98.2 % of patients had 25(OH)D levels lower than 20 ng/mL (median 10.0 (4.0-21.3) ng/mL). The 25(OH)D levels did not correlate with BMI. However, an inverse correlation was seen between serum 25(OH)D and HOMA-IR (rho = -0.656, p = 0.006) and insulin (rho = -0.715, p = 0.002) in pubertal obese subjects. Female gender and puberty were all negatively associated with 25(OH)D. Conclusion: The association between vitamin D status and BMI is complex, and it does not seem to be altered by mild obesity. In addition, potential influence of puberty should be kept in mind while assessing the relationship between serum 25(OH)D and cardiometabolic risk factors.
    European Journal of Pediatrics 10/2013; · 1.98 Impact Factor
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    ABSTRACT: Objective: There are not enough age-specific studies of secondary prevention in elderly stroke patients in Turkey. The aim of our study is to investigate comorbid diseases and the actual cholesterol levels of elderly home-care stroke patients. Materials and Methods:This is a descriptive study done by screening the files of the stroke patients visited by home health care personnel between January 01 and December 31, 2012. Lipid profiles and comorbid diseases were investigated in stroke patients aged 65 years or older. Results: A total of 112 stroke patients were recruited to the study. Most common comorbid diseases along with stroke were hypertension and diabetes mellitus. Total cholesterol, triglyceride (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels were 173.6 ±46.2 mg/dL, 130.8 ±64.3 mg/dL, 40.5 ±12.9 mg/dL and 105.0 ±36.9 mg/dL respectively. The mean total cholesterol, HDL and LDL levels seemed to increase with age, however there were not statistically significant differences between age groups. However, there was a significant difference of TG levels between age groups 65-74 years and >85years (P = 0.02). Among patients, 53.6% had LDL levels higher than 100 mg/dL and 82.1% had LDL levels higher than 70 mg/dL. Conclusion: Dyslipidemia is found to be frequent among stroke patients and in secondary prevention; hypercholesterolemia is undertreated in older patients, mainly in this age subgroup.
    Acta medica 10/2013; 2:48-52.
  • The Journal of Clinical Pharmacology 09/2013; · 2.84 Impact Factor
  • Haseki Tıp Bülteni. 09/2013; 51(3):95-98.
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    ABSTRACT: Abstract Interest in childhood metabolic syndrome (MetS) has increased substantially due to the increasing prevalence of childhood obesity on a global scale. Early recognition of MetS is critical in order to delay the development of cardiovascular disease (CVD). In this study, we evaluated the relationship between complete blood count (CBC) parameters and MetS among pre-pubertal children which may provide evidence in support of using low cost, readily available clinical haematological parameters for the detection of MetS. A retrospective analysis was carried out on 330 (125 lean vs. 205 overweight) Turkish pre-pubertal children who attend to a paediatric outpatient clinic. Age, gender, puberty, body mass index, CBC parameters, cardiometabolic risk factors including lipid profiles, high sensitive serum reactive protein (hsCRP) and insulin resistance index calculated by homeostasis model assessment (HOMA-IR) were evaluated and compared among lean, overweight children and children with MetS. The mean age of the study population was 7.4 ± 1.9 years. In both gender, the mean values of mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were significantly lower and red blood cell (RBC), platelet (PLT) counts were significantly higher in overweight children. Overall, 8.4% (n = 28) of patients met the criteria of MetS. Children with MetS had higher levels of PLT and lower levels of mean platelet volume (MPV). Of all the haematological parameters analysed, PLT was positively, whereas MPV was negatively correlated with MetS in girls. In addition, MPV was inversely correlated with fasting blood glucose, HOMA-IR, low density lipoprotein-cholesterol (LDL-C) and low density lipoprotein-cholesterol/high density lipoprotein-cholesterol (LDL-C/HDL-C) ratio in girls after adjusting for confounding factors. The risk analyses of MetS in terms of MPV quartiles showed that the adjusted OR (95% CI) for the lowest vs. the highest quartile was 7.71 (1.45-40.89) in girls. These data might suggest that MPV could be another feature of MetS in pre-pubertal girls and might be used as a surrogate marker for MetS in clinical settings.
    Platelets 08/2013; · 2.24 Impact Factor
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    ABSTRACT: Abstract Objective: In recent years, there has been increasing focus on thyroid function in pediatric obese patients. Our aims were to investigate whether there is an association between serum thyroid-stimulating hormone (TSH) within the normal range and body mass index (BMI), and to determine if TSH levels correlate with metabolic risk factors in children. Methods: A retrospective cross-sectional analysis was carried out on 528 euthyroid, age- and sex-matched lean, overweight, or obese children. Anthropometric indices, blood pressure, fasting blood glucose, hepatic enzymes, lipid profiles, TSH, free triiodothyronine (fT3), and free thyroxine (fT4) were assessed from medical records and compared among groups. Subjects with known presence of diabetes, using medications altering blood pressure and glucose or lipid metabolism, with TSH levels >97.5 or <2.5 percentile, or with autoimmune thyroid disease were excluded. Results: Hypertension, dyslipidemia, and elevated levels of hepatic enzymes were found to be more common in overweight and obese children (p<0.001), and those metabolic changes were significantly correlated with the increase in BMI (p<0.05). Serum concentrations of TSH and fT3 within the normal range were higher in overweight and obese children (p<0.01), and TSH was positively correlated with total cholesterol, triglycerides, and systolic blood pressure (p<0.05). Conclusion: Our findings suggest that obese children have higher serum TSH and fT3 levels even within the normal range, and that an increase in TSH is associated with dyslipidemia and higher systolic blood pressure. It remains to be seen whether TSH might serve as a potential marker of metabolic risk factors in obese pediatric patients.
    Journal of pediatric endocrinology & metabolism: JPEM 04/2013; · 0.75 Impact Factor
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    ABSTRACT: Montelukast is a leukotriene receptor antagonist that has been found to be effective in the treatment of allergic rhinitis and asthma. We report a rare case of a 31-year-old woman, with a history of allergic rhinitis and moderate persistent asthma, who experienced severe bruising on her lower extremities after starting montelukast treatment. Clinicians should be aware of the possibility of unusual bruising during montelukast therapy, and in those patients, treatment with montelukast should be discontinued.
    Respiratory care 01/2013; · 2.03 Impact Factor
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    ABSTRACT: The risk of infection in burns is well-known. In recent decades, the antimicrobial resistance of bacteria isolated from burn patients has increased. For this reason, a retrospective study was conducted at Van Training and Research Hospital to analyze the bacterial isolates from the wounds of patients admitted to the Burn Unit and to determine the susceptibility patterns of the commonly cultured organisms over a 3-year period, January 2009 to December 2011.A total of 250 microorganisms were isolated from burn wounds of 179 patients. Our results revealed that the most frequent isolate was Acinetobacter baumannii (23.6%), Pseudomonas aeruginosa (12%), Staphylococcus aureus (11.2%), Escherichia coli (10%) respectively. Multidrug-resistance has emerged as an important concern in our burn unit. Tigecycline, and colistin were found to be the most active drugs against Acinetobacter baumannii. Carbapenems and amikacin, were found to be the most active drugs against other gram negative bacteria. Vancomycin and linezolid were active against gram positive bacteria.Aggressive infection control measures should be applied to limit the emergence and spread of multidrug-resistant pathogens.
    International journal of medical sciences 01/2013; 10(1):19-23. · 2.07 Impact Factor
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    ABSTRACT: Purpose: Brucellosis is a worldwide zoonotic disease and still constitutes a major public health problem. In this study, we aimed to identify biovars of Brucella strains isolated from clinical specimens taken from brucellosis patients from the Eastern Anatolia region as well determine the susceptibility of these isolates to tigecycline and azithromycin, drugs that may serve as alternatives to the conventional drugs used in the therapy. Materials and methods: Seventy-five Brucella spp. isolates were included in the study. All strains were identified by both conventional and molecular methods. Brucella Multiplex PCR kit (FC-Biotech, Code: 0301, Turkey) and B. melitensis biovar typing PCR kit (FC-Biotech, Code: 0302, Turkey) were used for molecular typing. Antimicrobial susceptibilities of all strains were determined by E-tests. Results: By conventional biotyping, 73 strains were identified as B. melitensis biovar 3 and two strains as B. abortus biovar 3. Molecular typing results were compatible with conventional methods. The MIC50 and MIC90 values of doxycycline were 0.047 and 0.094; tigecycline 0.094 and 0.125; trimethoprim/sulfamethoxazole 0.064 and 0.19; ciprofloxacin 0.19 for both; streptomycin 0.75 and 1; rifampin 1 and 2 and azithromycin 4 and 8. According to the MIC values, doxycycline was found to be the most effective antibiotic, followed by tigecycline, trimethoprim-sulfamethoxazole and ciprofloxacin. Conclusion: Currently recommended antibiotics for the treatment of brucellosis such as doxycycline, rifampin, streptomycin, trimethoprim-sulfamethoxazole and ciprofloxacin were found to be still effective. While our results showed that tigecycline can be used an alternative agent in the treatment of brucellosis, azithromycin has not been confirmed as an appropriate agent for the treatment.
    International journal of medical sciences 01/2013; 10(10):1406-11. · 2.07 Impact Factor
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    ABSTRACT: Family practice training takes place at primary care based training centers linked to Education and Research State Hospitals in Turkey. There is a discussion if these units are adequate to train primary care staff and if the patients of these units reflect the applicants of primary care. THE AIM OF OUR STUDY IS TO INVESTIGATE THE DEMOGRAPHIC CHARACTERISTICS, THE EFFECT OF DISTANCE ON PRIMARY CARE UTILIZATION, AND MOST COMMON DIAGNOSIS OF THE PATIENTS WHO APPLIED TO TWO DIFFERENT OUTPATIENT CLINICS: One urban and one rural. Study was conducted from the electronic health records of the patients applied to outpatient clinics of Ankara Diskapi Yildirim Beyazit Training and Research Hospital Department of Family Medicine between 1 January and 31 December 2009. Total number of patients applied to both of the outpatient clinics was 34,632 [urban clinic: 16.506 (47.7%), rural clinic: 18.126 (52.3%)]. Leading three diagnoses were upper respiratory tract infection (URTI), general medical examination (GME), and hypertension (HT) in the most common 10 diagnosis. In our study, the rural outpatient clinic is regarded as a primary care unit in the neighborhood of living area and the urban clinic as close to working environment. We found statistically meaningful differences in most common diagnosis, gender, age, and consultation time between the rural and urban clinics. According to our results, family practitioners' field training should take place at different primary care units according to sociodemographic characteristics of each country.
    Journal of Family Medicine and Primary Care 01/2013; 2(1):15-9.
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    ABSTRACT: Neonatal vaccination against hepatitis B virus (HBV) infection was launched in 1998 in Turkey. The aim was to evaluate the persistence of seroprotection after HBV vaccination in order to determine the necessity of a single booster dose in 2- to 12-year-old children. This study was conducted retrospectively using hospital records of the children aged 2-12 years old who attended the pediatric outpatient clinics of Diskapi Training and Research Hospital, Ankara, Turkey between January 2010 and June 2011. Children who had received three doses of HBV vaccination in their infancy were included. A total of 530 children enrolled into the study, and 352 (66.4 %) of them had protective antibody to hepatitis surface antigens (anti-HBs) titer greater than 10 mIU/ml. The proportions of children with low, intermediate, and high anti-HB titers are different for those under 3 years of age. The majority were in the intermediate category. Those aged 4-10 years and 11 or older represented two-thirds of the children with high titers (p = 0.000). None of the children had chronic HBV infection. Unprotected children responded well after receiving the booster dose. The mean anti-HB concentration after the booster dose was more than 200 times higher than the mean antibody concentration before (p < 0.001). Conclusion: Our data suggest that HBV vaccination may confer long-term immunity. Use of routine booster doses of vaccine at these ages does not appear necessary to maintain long-term protection in successfully vaccinated immunocompetent children in the region.
    European Journal of Pediatrics 08/2012; · 1.98 Impact Factor
  • The Journal of Dermatology 03/2012; 39(8):741-2. · 2.35 Impact Factor
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    ABSTRACT: Background: It is important to identify and immunize susceptible healthcare workers to prevent and control hospital infections. Our aim was to evaluate the specific antibodies against the measles, mumps, and rubella viruses and the varicella zoster virus among healthcare workers in a tertiary-care hospital. Patients and Methods: A total of 284 healthcare workers (89 men and 195 women; mean age, 33.5 ± 11 years), including 111 nurses, 87 physicians, 34 laboratory technicians, and 52 members of the housekeeping staff, of Van Training and Research Hospital were enrolled in this study. Antibodies were detected with an enzyme-linked immunosorbent assay. Results: The numbers of workers with serological susceptibility to mumps, measles, rubella, or chicken pox were 26 (9.2%), 18 (6.3%), 7 (2.5%), and 5 (1.8%), respectively. Although the difference was not statistical significant, the rate of seroprevalence of antibodies was lowest for measles (90.8%; p>0.05). Susceptibility to measles, mumps, and rubella, and chicken pox was more prevalent among young healthcare workers (p<0.001). Not all healthcare workers born before 1957 were immune to these vaccine-preventable diseases. Conclusion: These data confirm that screening and vaccination of susceptible healthcare workers is essential regardless of age.
    Journal of Nippon Medical School 01/2012; 79(6):453-8.