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B Tokgöz

Publications and source records attributed to B Tokgöz.

7 recordsLinked to original sources
PubMed2005

Obstructive icterus directly related to visceral artery aneurysm in a CAPD patient.

Visceral artery aneurysms (VAA) are uncommon pathologies. We report a case of the first CAPD patient with obstructive jaundice directly related to VAA. A 25-year-old man with a four-year history of hemodialysis followed by two years of CAPD was admitted due to jaundice. He had two episodes of peritonitis. An abdominal ultrasonogram and a selective common hepatic arteriogram confirmed the presence of a 5 cm saccular aneurysm supplied from the gastroduodenal artery and a 4 cm fusiform aneurysm supplied from the proximal part of the common hepatic artery. The gastroduodenal artery was responsible for the impression of the common bile duct. In the operation, the gastroduodenal artery aneurysm was completely excised after its proximal and distal ends were ligated. The proximal and distal ends of the hepatic artery were also ligated. A prosthetic graft (PTFE), which extended from the splenic artery to the distal portion of the hepatic artery, was placed. In this way, the arterial blood flow of the liver was re-established. Patients with VAAs present with a constellation of symptoms including abdominal pain, jaundice and shock (due to rupture of aneurysm). Pancreatitis, and atherosclerosis have been reported to be the most common causes of VAAs. In conclusion, when CAPD patients present with jaundice or hemorrhagic shock with abdominal pain, VAA should be considered in differential diagnosis, especially if patients have a history of frequent pancreatitis episodes, and severe risk factors for atherosclerosis.

Adult↗
PubMed2004

Effects of azithromycin on cyclosporine-induced gingival hyperplasia in renal transplant patients.

BACKGROUND: Gingival hyperplasia is a well-known complication of cyclosporine therapy, affecting 21% to 35% of renal transplant patients. Metronidazole, clarithromycin, and azithromycin, all azalid antimicrobial agents derived from the macrolide antibiotic erythromycin, have been used for treatment. Marked improvements in gingival hyperplasia have been recorded in particular with azithromycin. The aim of the present study was to investigate histopathological features of cyclosporine-induced gingival hyperplasia and to evaluate the quantitative efficacy of short-term azithromycin therapy. METHODS: Eighteen renal transplant patients with cyclosporine-induced gingival hyperplasia were included in the study. All patients received azithromycin with a dose of 500 mg/d for 3 consecutive days. Changes in gingival hyperplasia were evaluated by measuring the gingival sulcus depth to the cementum-enamel junction of every tooth in each of the four quadrants on days 0, 7, 30, 90, 180. Gum biopsies were obtained on days 0 and 30; the degree of inflammation was classified as "mild," "intermediate," and "severe". RESULTS: Gingival hyperplasia was reduced in all treated patients throughout the study. The degree of improvement was more significant between 0 to 7 and 7 to 30 days than at other times (respectively, P < .0001 and P < .002). Histopathologically, eight patients had severe and one patient moderate chronic inflammation at the beginning of therapy. Three other biopsies were reported as papilloma, mucosal hyperplasia, and normal gingival tissue biopsy. CONCLUSIONS: Azithromycin appears to be useful to treat cyclosporine-induced gingival hyperplasia in renal transplant patients. Treatment is inexpensive and free from known adverse effects.

Adult↗
PubMed2003

Relationship between different body size indicators and hernia development in CAPD patients.

AIMS: A small body size may increase the risk for hernia development in patients on continuous ambulatory peritoneal dialysis (CAPD). The present study investigates whether there is a relationship between body size and hernia development in CAPD patients. MATERIAL AND METHODS: The records of 78 patients on CAPD were reviewed retrospectively. Body mass index (BMI), body surface area (BSA) and total body water (TBW) were calculated in all patients. Correlations between different body size indicators (BMI, BSA and TBW) and hernia development were assessed using analysis of covariance in which we adjusted for sex. RESULTS: A total of 14 patients (17.9%) with no physical evidence of hernia before catheter insertion developed hernias. Body size was significantly lower in CAPD patients with hernias than those without hernias when adjusted for sex. CONCLUSIONS: We conclude that patients with small body size tend to have an increased risk for hernia development. A simple estimation of patients' height, weight, body surface area and total body water would be helpful to predict development of hernias or other complications related to increased intraperitoneal pressure in CAPD patients.

Adult↗
PubMed2002

Continuous ambulatory peritoneal dialysis.

PURPOSE: To assess complications of continuous ambulatory peritoneal dialysis (CAPD) in uremic patients with and without clinical symptoms by CT peritoneography. MATERIAL AND METHODS: A total of 64 patients with end-stage renal disease and on continuous CAPD were investigated. Twenty-eight had some clinical symptoms, which might be related to the complications of CAPD. Thirty-six patients had no complaints or symptoms due to the dialysis treatment. RESULTS: CT peritoneography revealed various complications including hernias (50%), dialysate leakage (46%), localized fluid collection (4%) and peritoneal adhesions (4%) in the patients who had clinical symptoms that might be related to the dialysis treatment. Moreover, similar complications were found in the asymptomatic patients at a lower rate: hernia (3%), dialysate leakage (17%), peritoneal adhesions (3%) and abdominal wall laxity (3%). Complication detection rate by CT peritoneography was 68% (n=19) in the symptomatic patients and 22% (n=8) in the asymptomatic patients. The number of complications found in each group was significant. CONCLUSION: CT peritoneography was an effective modality in detecting complications from CAPD in patients with and without clinical symptoms.

Adult↗
PubMed2002

Case report. Candida lusitaniae peritonitis in a patient on continuous ambulatory peritoneal dialysis.

We report a case of Candida lusitania peritonitis in continuous ambulatory peritoneal dialysis. Since fluconazole therapy was not successful in this patient, the peritoneal catheter was removed and antifungal therapy continued, and the patient was then converted to haemodialysis. This treatment protocol was successful. We suggest that early peritoneal catheter removal should be considered in such cases.

Adult↗
PubMedDate not supplied

Effects of long-term erythropoietin therapy on the hypothalamo-pituitary-testicular axis in male CAPD patients.

OBJECTIVE: Gonadal dysfunction has been recognized for a long time in uremic male patients. The present study assesses the hypothalamo-pituitary-testicular axis and growth hormone status in male continuous ambulatory peritoneal dialysis (CAPD) patients, before and after recombinant human erythropoietin (rHuEPO) therapy. DESIGN: Single-center prospective study. SUBJECTS: Ten anemic male patients with chronic renal insufficiency, and 11 healthy volunteers with normal renal function, matched for age, were included in the study. All patients were on CAPD therapy and none had received rHuEPO treatment previously. MAIN OUTCOME MEASURES: Blood samples were collected between 0800 and 0900 hr from all patients for the determination of basal follicle stimulating hormone (FSH), luteinizing hormone (LH), and growth hormone (GH) levels. A luteinizing hormone-releasing hormone (LH-RH) stimulation test was carried out using LH-RH 100 microg intravenous as a bolus injection. Blood for FSH, LH, and GH determinations was drawn every 30 minutes during the 3-hour test period. Human chorionic gonadotropin (hCG) test was performed after 48 hours. After estimations of basal serum total and free testosterone levels, 2000 IU hCG was administered intramuscularly and repeated 48 hours later. Total and free testosterone levels were measured in blood samples collected before and 48 hours after two injections of hCG. After improvement in anemia with exogenous rHuEPO, LH-RH and hCG tests were repeated. RESULTS: Baseline FSH concentrations before and after rHuEPO treatment were slightly higher in CAPD patients than in healthy volunteers (p = 0.85 and p = 0.70, respectively). Areas-under-the-curve (AUCs) for FSH secretion before and after rHuEPO treatment were also slightly higher in patients than in healthy volunteers (p = 1.00 and p = 0.75, respectively). The pretreatment basal LH levels in patients were significantly higher than in controls (p < 0.001). After the improvement in anemia with rHuEPO, serum LH levels declined significantly (p < 0.05). The AUCs for LH secretion before and after rHuEPO treatment were significantly higher in patients than in controls (p < 0.05). All patients had elevated basal levels of GH with paradoxical response to LH-RH. Baseline GH levels in patients were significantly higher than those in healthy subjects (p < 0.001) before rHuEPO treatment. After treatment with rHuEPO, basal GH levels declined but did not normalize, and baseline levels of free testosterone increased significantly (p < 0.05). CONCLUSION: Anemic uremic male patients on CAPD have normal levels of testosterone with normal response to hCG administration, elevated basal levels of GH, and elevated basal levels of LH, with exaggerated response to LH-RH administration. Improvement in anemia with rHuEPO reduced the basal levels of LH and GH, but exaggerated the LH response; paradoxical GH response to LH-RH administration persisted. These results indicate a defect at the level of the hypothalamus and pituitary gland in uremic male patients undergoing CAPD, and that the improvement in anemia with rHuEPO partially restores some of these endocrine abnormalities.

Adult↗