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- 저자 : ( Betul Borku Uysal ) (검색결과 3 건)
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( Betul Borku Uysal ),( Feray Akbas ),( Esma Altunoglu ),( Gulhan Ipek Deniz ),( Duygu Uysal ),( Harun Uysal ),( Hanife Usta Atmaca ),( Yasin Yuksel ),( Hale Aral ),( Guven Cetin ),( M Cem Ar ),( Must 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Anemia is an accelerating problem among patients with heart failure. In this study, we investigated whether anemia in heart failure was related to hepcidin level. Methods: Totally 70 patients; 50 patients with heart failure and 20 otherwise healthy subjects with no history of a chronic illness including heart failure as control group, were included in the study. Heart failure was verifi ed by echocardiography in each subject and patients were defi ned as ones with reduced ejection fraction (HFrEF) if EF = 40% and with preserved ejection fraction (HFpEF) if EF 40-50%. Exclusion criteria included presence of kidney failure (serum creatinine level>1.4), history of hemorrhage (gastrointestinal or severe menstrual bleeding), chronic liver disease (ALT>2 folds), hematologic disease, iron replacement therapy or blood transfusion in the past six months, hypothyroidism, autoimmune disease and manifest infection. Results: There was no correlation between hepcidin concentration and age, weight, creatinine, iron, vitamin B12, folate, white blood cell (WBC), platetelet, mean corpuscular volume, ESR, ejection fraction (EF) (p > 0,05). There was a positive correlation between hepcidin level and urea, ferritin, hemoglobin, hematocrite, C-reactive protein (p < 0,05). Hepcidin levels of anemic heart failure patients were signifi cantly lower than the non-anemic heart failure patients (p < 0,05). Conclusions: We found that serum hepcidin level in anemic patients with heart failure was lower than in heart failure patients without anemia. Previously, progression of heart failure was found to be associated with decline in circulating hepcidin and the development of iron defi ciency and low hepcidin level was related to unfavorable out come. We believe that iron defi ency occurs as a result of infl ammatory process in heart failure and therefore hepcidin concentrations decrease as a response. However, long-term follow up studies are needed.
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( Hanife Usta Atmaca ),( Feray Akbas ),( Yesim Karagoz ),( Betul Borku Uysal ),( Mustafa Boz ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Case report: 64 year-old male patient was presented with cough, fever and sputum production. His medical history was unremarkable. He was producing and selling pickled vegetables. Only pathological fi nding in his physical examination was the reduction of pulmonary sounds in the lower part of left lung. Hemogram showed; leukocyte:5500/mm³ (neutrophil 65%, lymphocyte 30%), platelet: 287000/mm³, hematocrit 28%. Biochemical tests revealed normal, serum CRP level was 11,7 mg/dl. Pleural effusion was present in chest X-ray. Pleural ponction was performed. Gram-positive cocci and high concentration of leukocytes were seen in gram-staining in the exudative pleural fi uid. In the culture Leuconostoc mesenteroides was grown. CT showed pleural effusion and a consolidation containing air bronchogram. The patient was diagnosed with pleural empyema and drainage treatment with thorax tube and 2 grams of ceftriakson and 1 gr claritromycin daily were started. The symptoms regressed beginning from the fourth day. On the fourteenth day, CRP level returned to normal. The treatment was stopped at twenty-fi rst day with full recovery. Discussion: Leuconostocs are members of the family Streptococcacae and have only recently been recognized as potential pathogens. Infections by Leuconostoc species bacteria are uncommon, and usually affect patients with an underlying disease, or those fi tted with a venous catheter or subjects previously treated with vancomycin. Bacterias are found naturally in plants and vegetables and are used in milk, pickle and wine industries. While an underlying factor is needed for those organisms to become pathogenic, our case was completely healthy and had no invasive procedure previously. Because he was selling and directly producing pickles, it was considered that the organism could have passed directly. This case points out that; Leuconostoc mesenteroides should be considered as a causative agent in nasocomial infections, also in non- immunocompromised patients.
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( Feray Akbas ),( Hanife Usta Atmaca ),( Cigdem Alkac ),( Betul Borku Uysal ),( Burak Alkac ),( Mustafa Boz ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Atherosclerotic coronary artery disease is an important health issue and a leading mortality reason in developed countries. In this study; we aimed to diagnose diabetes and other glucose disturbances early by evaluating the glycemic profile in hyperlipidemic patients and to decrease the cardiovascular morbidity and mortality by an early intervention. Methods: 46 female and 19 male, totally 65 hyperlipidemic normoglycemic patients were included in the study. Patients had no history of diabetes and normal fasting blood glucose levels and were diagnosed with hyperlipidemia during routine blood tests. There were no limitations for age, gender or body mass index. Coronary heart disease risk factors were questioned and findings were used to determine the pathological low density lipoprotein (LDL) levels. 2-hour oral glucose tolerance test (OGTT) was performed for all patients. Results were evaluated according to American Diabetes Association (ADA) 1997 criteria. Results: Mean total cholesterol level of patients was 236±41 mg/dl, mean trigliserid level was 223±141 mg/dl and mean LDL level was 153±38 mg/dl. According to OGTT results ; mean fasting blood glucose level was 95±13 mg/dl and mean 2nd hour glucose level was 128±34 mg/dl. According to ADA 97 criteria; OGTT of 33 (51%) patients were normal. 2 (3%) patients had impaired fasting glucose (IFG), 11 (17%) patients had impaired glucose tolerance (IGT) and 19 patients (29%) had diabetes. Conclusions: Hyperlipidemia and diabetes are important risk factors for cardiovascular disease and they usually coexist. Identification and early intervention of these risk factors are prognostically important. Thus; patients who are diagnosed with hyperlipidemia should be screened for glucose disturbances as a secondary risk factor and by early intervention of both risk factors, cardiovascular morbidity and mortality should be decreased.
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