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Öğe Association of eNOS Glu298Asp gene polymorphism with ischemic stroke in Turkish patients(Wiley-Blackwell, 2008) Guldiken, B.; Sipahi, T.; Guldiken, S.; Ustundag, S.; Turgut, N.; Budak, M.; Ozkan, H.[Abstract Not Available]Öğe Association of renal dysfunction with stroke subtypes in acute stroke patients(Medcom Ltd, 2010) Kavalci, C.; Guldiken, B.; Ustundag, S.; Guldiken, S.Objectives: There are conflicting published data about the association of renal dysfunction with cerebrovascular diseases. Both diseases have shared risk factors such as hypertension, diabetes mellitus and smoking. In the present study, the relationship of renal dysfunction with stroke subtypes and stroke severity was investigated. Materials and methods: One hundred and sixty-two acute stroke patients without known history of renal disease and 148 control subjects were enrolled in the study. Serum urea, serum creatinine level and glomerular filtration rate (GFR) as estimated by the Modification of Diet in Renal Disease formula were used to evaluate renal dysfunction. Stroke patients were divided into two groups as haemorrhagic and ischemic stroke, the latter being further subdivided into small and large vessel disease subtypes according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria. Stroke severity was assessed by the modified Rankin Scale. Results: Serum creatinine and urea levels were significantly higher and GFR was significantly lower in the stroke group than the controls (p<0.001, p<0.001, p<0.001, respectively). Serum creatinine level was found significantly higher in haemorrhagic stroke than ischaemic stroke subtypes (p<0.001). There was no difference between ischemic subtypes regarding the measured renal parameters. Stroke severity correlated with increased creatinine levels (p<0.001, beta=0.404, 95% CI=1.85-3.50). Conclusion: Acute stoke patients have impaired renal function. Renal dysfunction is particularly more prominent in haemorrhagic stroke and exists probably prior to the stroke. Whether renal dysfunction is an independent risk factor for stroke needs to be clarified by large population studies. (Hong Kong j.emerg.med. 20 10; 17:22-26)Öğe Asymmetric dimethylarginine and nitric oxide levels in migraine during interictal period(Wiley-Blackwell, 2008) Guldiken, B.; Demir, M.; Guldiken, S.; Turgut, N.; Ozkan, H.; Kabayel, L.; Tugrul, A.[Abstract Not Available]Öğe Asymmetric dimethylarginine and nitric oxide levels in migraine during the interictal period(Elsevier Sci Ltd, 2009) Guldiken, B.; Demir, M.; Guldiken, S.; Turgut, N.; Ozkan, H.; Kabayel, L.; Tugrul, A.Nitric oxide (NO), which modulates endothelial function, is thought to be pivotal in the pathophysiology of migraines. The connection between migraine and cardiovascular diseases has also drawn attention to the endothelial dysfunctions and NO pathway abnormalities seen in patients with migraine. Our goal was to assess the levels of NO and the endogenous NO synthase inhibitor, asymmetric dimethylarginine (ADMA), in people with migraine during the interictal period. A total of 49 patients with migraine and 22 control subjects were enrolled in the study. Their plasma NO metabolites (nitrite [NO2-] and nitrate [NO3-]) and ADMA levels were measured using the enzyme-linked immunosorbent assay method, and were then compared with their cardiovascular risk factors, anthropometric measurements, and headache frequency and severity. The plasma ADMA, NO2 and NO3 levels of the patients with migraine during the interictal period did not differ from the control group, and no relationship was found between cardiovascular risk factors and migraine attack severity and frequency. We conclude that, in patients with migraine, there is no dysfunction of baseline NO and ADMA metabolism during the interictal period. (C) 2008 Elsevier Ltd. All rights reserved.Öğe Asymmetric dimethylarginine levels in thyroid diseases(Editrice Kurtis S R L, 2007) Arikan, E.; Karadag, C. H.; Guldiken, S.Thyroid diseases may lead to endothelial dysfunction; however, the mechanism underlying the endothelial dysfunction in thyroid disease is not clear yet. Asymmetric dimethylarginine (ADMA), a novel inhibitor of endothelial nitric oxide synthase (eNOS), blocks nitric oxide (NO) synthesis from L-arginine. Symmetric dimethylarginine (SDMA) is the structural isomer of the eNOS inhibitor ADMA. SDMA does not directly inhibit eNOS but is a competitive inhibitor of arginine transport. Increased plasma ADMA, SDMA concentrations, and low Larginine/ADMA ratio were considered as possible contributing factors for endothelial dysfunction in hyperthyroid patients. On the other hand, plasma ADMA, SDMA levels and L-arginine/ADMA ratio in the hypothyroid group were unexpectedly found to be similar to those of the control subjects. The aim of this study is to evaluate and compare the plasma ADMA levels in hyperthyroid, hypothyroid and healthy subjects. Plasma ADMA, SDMA, and L-arginine levels were measured by high performance liquid chromatography. Plasma ADMA levels were significantly higher in both patients with hyperthyroidism and hypothyroidism than in the control group. SDMA concentrations were significantly increased in hypothyroid patients compared to control subjects. Patients with hyperthyroidism and hypothyroidism had significantly higher plasma L-arginine levels compared with healthy controls. L-arginine/ADMA ratio, which shows NO bioavailability, was significantly lower in hyperthyroid patients than in both hypothyroid and control subjects. In hyperthyroidism, plasma ADMA levels were related to age, L-arginine, and SDMA levels. SDMA was associated with age and L-arginine. L-arginine/ADMA ratio was negatively associated with freeT(4) levels. There was a relationship between ADMA and L-arginine in hypothyroid patients. SDMA was significantly related to L-arginine, total cholesterol, and LDL. In conclusion, not only hyperthyroidism but also hypothyroidism was associated with alterations of ADMA and SDMA metabolism.Öğe Clinical efficacies of lidocaine injection and lidocaine iontophoresis in myofascial pain syndrome(B M J Publishing Group, 2006) Guldiken, S.; Hakguder, A.; Birtane, M.[Abstract Not Available]Öğe CLINICALLY UNDETECTABLE OCCULT THYROID PAPILLARY CARCINOMA PRESENTING WITH CERVICAL LYMPH NODE METASTASIS(Editura Acad Romane, 2016) Tastekin, E.; Can, N.; Ayturk, S.; Celik, M.; Ustun, F.; Guldiken, S.; Sezer, A.Background. Occult papillary thyroid carcinoma presented as isolated cervical lymphadenopathy without clinical and radiologic findings has been rarely reported. Case report. A 47 years old female patient admitted to otorhinolaryngology clinic with 4X3 cm sized cervical mass. Physical examination of the patient was noted as a nontender, firm, mobile lymph node at right lateral cervical region. There was no inflammatory or infection disease in the history of patients anamnesis and no abnormal value on laboratory tests. Ultrasound screening of the neck detected a lymph node with suspicious features for malignancy. Head and neck examination was normal and there is no evidence of a tumoral mass or nodule in the thyroid gland. Whole body scan of MRI showed no pathologic sign both in the neck and body. Excisional biopsy was performed and revealed a carcinoma with papillary morphology. Immunohistochemical staining features of the tumor confirmed a papillary carcinoma derived from the thyroid gland. Second look USG of the neck and thyroid was performed but it revealed no tumoral mass. The patient underwent total thyroidectomy with right functional and central lymph node dissection. Histological examination of the thyroid gland showed multicentric 2 mm sized, three foci of papillary carcinoma located in bilateral thyroid lobes and metastatic lymph nodes in the right side of the neck. Conclusion. A metastatic cervical lymph node can be evidence of a clinically undetected occult papillary thyroid carcinoma. Specific immunohistochemistry staining of specimen may lead to appropriate surgery and progression of carcinoma may be hindered by application of additional RAI therapy.Öğe IODINE DEFICIENCY IN PREGNANT WOMEN LIVING IN WESTERN TURKEY (EDIRNE)(Editura Acad Romane, 2016) Celik, H.; Guldiken, S.; Celik, O.; Taymez, F.; Dagdeviren, N.; Tugrul, A.Objective. Data about iodine status in pregnant women in Turkey is not sufficient. We aimed to determine the iodine status, goiter prevalence, iodized salt consumption among first trimester pregnant women living in Edirne. Design and Setting. Cross-sectional study was performed on pregnant women living in Edirne. Subjects and Methods. A total of 275 pregnant women in their first trimester were examined regarding iodized salt use, median urinary iodine concentration (UIC), presence or absence of goitre and thyroid function. Goitre status was determined by palpation. Participants filled out a questionnaire, which included questions regarding sociodemographic features, iodized salt consumption, knowledge, and behavior regarding iodine deficiency. UIC was measured using colorimetric method based on Sandell-Kolthoff reaction. Thyroid hormones and TSH were measured by chemiluminescence immunoassays. Results. While the proportion of iodized salt use was 96.6%, UIC was below 150 mu g/L in 88.4 % of the women. The median UIC was 77 mu g/L, indicating insufficient iodine intake. Total goitre rate was 19.3%. Conclusions. Our study shows that iodine deficiency is a serious problem among pregnant women in Edirne. We suggest that pregnant women living in Edirne should be supplemented by iodine-containing preparations in addition to iodized salt.Öğe Is there any effect of obesity on thrombin activatable fibrinolysis inhibitor levels in postmenopausal women?(Elsevier Science Inc, 2009) Taskiran, B.; Guldiken, S.; Demir, M.; Kilic-Okman, T.; Arikan, E.; Turgut, B.; Tugrul, A.[Abstract Not Available]Öğe THE MANAGEMENT OF THYROTOXICOSIS BY THERAPEUTIC PLASMA EXCHANGE IN PATIENTS COMPLICATED WITH ANTITHYROID DRUGS(Editura Acad Romane, 2011) Sezer, A.; Guldiken, S.; Turgut, B.; Irfanoglu, M. E.Objective. Antithyroid drugs, surgical excision, and radiation therapy with I-131 are the common treatment modalities thyrotoxicosis. The medical treatment of thyrotoxicosis has approximately 0.35% serious complications which consist of agranulocytosis, liver necrosis and failure. Therapeutic plasma exchange is an effective preoperative preparation method in thyrotoxicosis patients who are candidates for surgery and unable to manage an euthyroid state with medical treatment. Patients and Methods. This study was constructed between 2002-2009 in 9 patients who were resistant or had complications with medical treatment of thyrotoxicosis. The therapeutic plasma exchange procedures were performed with discontinuous flow cell separator devices. Results. Seven patients were females and 2 patients were males. The mean age was 51.22 years (32-78 years). The mean duration of the disease was 35.4 months (3-120 months). The patients underwent 3.3 (2-6 sessions) session of therapeutic plasma exchange before surgery. The mean volume of plasma exchange was 10549 mL (7150-18372 mL). The plasma is exchanged with %10 albumin and/or fresh frozen plasma. The complication rate was 22% during therapeutic plasma exchange. Four patients underwent near total thyroidectomy and five patients underwent total thyroidectomy. The mortality rate was zero. Neck hematoma causing acute respiratory compromise and requiring urgent evacuation developed in one patient. Conclusions. Total plasma exchange is an effective and safe procedure in preoperative preparation of the patients with thyrotoxicosis who were resistant or complicated with antithyroid drug in which a high level of concern and steady supervision is mandatory to prevent life threatening preoperative and postoperative complications.Öğe MEAN PLATELET VOLUME LEVELS IN PATIENTS WITH OVERT HYPOTHYROIDISM BEFORE AND AFTER LEVOTHYROXINE TREATMENT(Editura Acad Romane, 2012) Atile, N. Soysal; Bilir, B. Ekiz; Bilir, B.; Guldiken, S.Objective. Hypothyroidism accelerates atherosclerosis and thyroid hormone replacement inhibits this progression. Platelet activation and aggregation play major role in the pathophysiology of atherothrombosis. Mean platelet volume (MPV), a determinant of platelet function, is a newly emerging risk factor for atherosclerosis. The present study was designed to evaluate levels of MPV before and after the levothyroxine (LT4) treatment in patients with overt hypothyroidism. Design. The study included 30 Hashimoto's thyroiditis patients with overt hypothyroidism and 20 healthy control subjects. Hypothyroid patients were given LT4 replacement therapy. Fasting glucose, lipid levels and blood counts were assessed before and after the maintenance of euthyroidism. Results. Fasting glucose, platelet count and all lipid parameters were similar between the two groups. The mean MPV level of hypothyroid patients was hither than of the control group (p<0.01). A significant decrease in the mean MPV level was detected after the maintenance of euthyroidism with LT4 treatment (p<0.05). Conclusion. This study suggests that patients with overt hypothyroidism tend to have increased platelet activation. This activation may cause increased risk of atherothrombotic complications that may be reversed by treatment of hypothyroidism.Öğe Oxidative stress and antioxidant capacity in diabetic and non-diabetic acute ischemic stroke patients(Wiley-Blackwell, 2008) Guldiken, B.; Demir, M.; Guldiken, S.; Turgut, N.; Turgut, B.; Tugrul, A.[Abstract Not Available]Öğe The plasma levels of thrombin activatable fibrinolysis inhibitor in patients with primary hypothyroidism before and after treatment(Elsevier Science Inc, 2009) Ermantas, N.; Guldiken, S.; Demir, M.; Tugrul, A.[Abstract Not Available]Öğe Polymorphisms of the angiotensin-converting enzyme and angiotensin II receptor type 1 genes and association with stroke in Turkish subjects of the Trakya region(Wiley-Blackwell, 2008) Sipahi, T.; Guldiken, B.; Budak, M.; Guldiken, S.; Ustundag, S.; Turgut, N.; Ozkan, H.[Abstract Not Available]Öğe A RARE CLINICAL PRESENTATION: A PATIENT WITH CHRONIC RENAL FAILURE, SECONDARY HYPERPARATHYROIDISM AND CALCIPHYLAXIS(Editura Acad Romane, 2016) Celik, M.; Ayturk, S.; Celik, H.; Can, N.; Kucukarda, A.; Sezer, A.; Guldiken, S.Calciphylaxis, also known as calcific uremic arteriolopathy (CUA), is usually observed in women and it is a serious complication of hyperparathyroidism secondary to chronic renal failure. CUA is characterized by ischemic tissue loss secondary to progressive vascular degeneration. Although it is rare, it may end up with sepsis and organ failure and can be fatal. Its pathogenesis is not fully understood, but it is thought that it occurs secondary to increased calcification activators such as oxidized LDL, TNF-alpha, calcitriol, fibronectin, collagen-I, and TGF-1 alpha. The most effective treatment is managing underlying pathology and decreasing serum calcium and phosphorus levels. In this report, we aimed to present an end stage renal failure case with coexisting hyperparathyroidism, hyperthyroidism and calciphylaxis in whom cutaneous manifestations were healed 6 months after parathyroidectomy.Öğe The relationship between obesity and carotid intima-media thickness in healthy women(Wiley-Blackwell, 2010) Guldiken, S.; Tuncbilek, N.; Bilir, B. Ekiz; Unlu, E.[Abstract Not Available]Öğe Relationship between the carotid intima-media thickness and mammographic vascular calcification(Wiley-Blackwell, 2010) Tuncbilek, N.; Guldiken, S.; Sezer, A.; Mentes, A.; Cagli, B.[Abstract Not Available]Öğe SIALADENOSIS IN A PATIENT WITH DIABETES MELLITUS: CASE REPORT(Editura Acad Romane, 2012) Celik, O.; Celik, H.; Guldiken, S.; Turkmen, M. T.; Koten, M.Sialadenosis is an uncommon, noninflammatory condition which usually causes bilateral, diffuse enlargement of the salivary glands, particularly of the parotid. Sialadenosis has been associated most often with alcoholism, eating disorders, malnutrition, medications and diabetes mellitus. Herein, we. describe a case report of a patient with sialadenosis precipitated by poorly controlled diabetes mellitus.Öğe Soluble CD40 ligand and prolactin levels in migraine patients during the interictal period(Wiley-Blackwell, 2010) Guldiken, S.; Guldiken, B.; Demir, M.; Kabayel, L.; Ozkan, H.; Turgut, N.; Hunkar, R.[Abstract Not Available]Öğe Soluble endothelial protein C receptor and high sensitive CRP levels in obesity(Elsevier Science Inc, 2009) Taskiran, B.; Guldiken, S.; Demir, M.; Kilic-Okman, T.[Abstract Not Available]
