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Biomedical subjects

Mustafa Cankurtaran

Publications and source records attributed to Mustafa Cankurtaran.

At least 19 recordsLinked to original sources
PubMed2006

Short-term hemostatic safety of strontium ranelate treatment in elderly women with osteoporosis.

BACKGROUND: Strontium ranelate offers significant clinical benefits in terms of efficacy, tolerability, and ease of administration in the treatment of postmenopausal osteoporosis. However, there are some data revealing an association between strontium ranelate treatment and increased incidence of venous thromboembolism (VTE), suggesting possible adverse prothrombotic effects of the drug. OBJECTIVE: To assess the effect of strontium ranelate treatment on primary hemostasis, secondary hemostasis, and the natural anticoagulant defense system, together with prothrombotic markers, in elderly women with osteoporosis. METHODS: This study was designed in a prospective manner. Thirty-five elderly women diagnosed with osteoporosis were included. During a 2 month treatment period, participants received strontium ranelate 2 g. Platelet Function Analyzer-100 (PFA-100) in vitro bleeding time was performed to depict primary hemostasis. Secondary hemostatic parameters including prothrombin time, international normalized ratio, activated partial thromboplastin time, anti-cardiolipine immunoglobulin (Ig) M and IgG, antiphospholipid IgM and IgG, protein C, protein S, antithrombin III, lupus anticoagulant, fibrinogen, thrombin, activated protein C resistance, and plasma levels of d-dimer were assessed. These parameters were tested before and after 2 month treatment with strontium ranelate. RESULTS: Mean +/- SD age of the patients was 72.82 +/- 5.69 years. After 60 days of treatment, there was no statistically significant prolongation in PFA-100 in vitro bleeding time and no statistically significant change in the critical hemostatic parameters in patients receiving strontium ranelate that led to discontinuation of the treatment. None of the subjects developed clinical VTE during the 2 month period of strontium ranelate treatment. CONCLUSIONS: The hemostatic safety of strontium ranelate in the elderly population with osteoporosis was shown over 2 months of treatment; however, its long-term hemostatic safety should be evaluated further.

Aged↗
PubMed2006

Hippocampal atrophy correlates with the severity of cognitive decline.

BACKGROUND: The aim of this study is to compare the results of magnetic resonance (MR) imaging, particularly the decline in hippocampal volume, of patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) with healthy age-matched controls, to examine the reliability of hippocampal volumetry in the early diagnosis of AD and the correlation of the severity of hippocampal atrophy with the severity of cognitive decline. METHODS: Twenty-six AD, 22 MCI and 15 normal cognitive status (NCS) patients were scanned with a 3 Tesla MR scanner. Hippocampus volumes were detected manually by Osiris 4.18. RESULTS: Multivariate regression analysis, which was performed to adjust the covariate effects of education, age, gender, hypertension and diabetes mellitus, showed that hippocampal atrophy was correlated with AD and MCI for right hippocampus; AD, MCI and age for left hippocampus independent of other parameters. A second regression analysis revealed that MMSE was correlated with hippocampal volume. CONCLUSIONS: Hippocampal volumetry can be used in early diagnosis of cognitive impairment, as well as grading cognitive decline.

Aged↗
PubMed2006

Falls and the elderly: is there any difference in the developing world? A cross-sectional study from Turkey.

The phenomenon of falls is not well studied in developing world. However, being aware of possible correlates for falls specific to different populations and trying to eliminate these factors is very important to prevent falls. This study investigated occurrence and correlates of falls among elderly in a developing country, Turkey. A total of 2322 patients aged 65 years and over presented to outpatient clinics of a reference hospital were included in this cross-sectional study. All patients had a complete comprehensive geriatric assessment and questioned for fall history. Correlates for falls were analyzed by using logistic regression. The mean age of participants was 71.8 years; 63.5% were female and 28.5% were found to have fallen within one year. Female sex, visual problems, auditory problems, use of mobility aids, mobility problems and depression were the only independent correlates for falls. Although the cross-sectional design of this study may not prove the causal role of the risk indicators, the size of the study group as well as the large number of possible correlates examined enriches the study. The results from this cross-sectional study form a basis for further prospective study on falls in the Turkish elderly population.

Accidental Falls↗
PubMed2006

Complications due to late diagnosis of celiac disease with co-existing plasma cell dyscrasia in an elderly patient.

Celiac disease is a genetic disorder, presenting with malabsorption-related problems because of mucosal damage after ingestion of gluten. The only known effective treatment is a gluten-free diet. Early diagnosis and treatment are essential in preventing complications due to malabsorption. Here we report the case of an elderly patient with a fifteen-year history of diarrhea, diagnosed with celiac disease, who had developed several complications due to malabsorption such as anemia, electrolyte imbalance and osteoporosis. We believe that late diagnosis of celiac disease had played a great role in the development of complications. Moreover, celiac disease poses an increased risk for all types of malignancies. Our patient also had concurrent plasma cell dyscrasia, but did not fulfil the criteria for diagnosis of multiple myeloma.

Aged↗
PubMed2006

Awareness and control of hypertension among the elderly in a university hospital.

Because medically useful information could also be gathered through hospital-based studies, the aim of this study was to assess the prevalence, awareness, treatment, and control of HT among the elderly at a university hospital in Turkey. A total of 3,038 elderly were enrolled. Overall, 75.1% of the patients had HT. Among the hypertensive elderly, 88.9% were aware that they had HT, and only 20.9% had BPs that were under control. The low prevalence of control, even among individuals aware of their HT, suggests that the education of health care providers at all stages of professional training is especially important.

Aged↗
PubMed2006

QT dispersion increases with aging.

BACKGROUND: Age-related changes in cardiovascular system are well-known. Arrhythmias in elderly patients constitute most of the urgencies, consultations, or hospitalizations. QT dispersion (QTd) is a simple noninvasive arrhythmogenic marker to demonstrate the electrical instability of the heart. The aim of this study was to investigate how QTd changes with increasing age by calculating the QTd in the elderly and younger subjects. METHODS: One hundred and forty-six consecutive subjects (62 males and 84 females; age range: 18-82 years) were enrolled in the study. Sixty-seven of the subjects were 65 years and over (mean age, 70 +/- 4), 79 were younger than 65 (mean age, 37 +/- 11). A 12-lead ECG was recorded. The longest and the shortest QT intervals were measured manually on these ECG recordings. QTd was calculated from the formula, QTd = QTmax - QTmin. RESULTS: Demographic features were similar between the two groups. QTd of the elderly group was found to be significantly higher than the younger group (35.6 +/- 15.6 in elderly, 24.2 +/- 12.4 in younger group, P < 0.001). A positive relationship was found between QTd and age (r = 0.415, P < 0.001). QTd was greater in female than in male (31.9 +/- 16.7 ms vs 26.0 +/- 11.3 ms, respectively, P = 0.018). CONCLUSIONS: Our study shows that QTd increases with advancing age. We think that long-term follow-up of these patients would be useful to show if there is any relationship between the clinical outcomes and the increase in QTd.

Adolescent↗
PubMed2006

Elderly patient with delirium after myocardial infarction.

Delirium is a transient global disorder of cognition. Almost any medical illness or medication can cause delirium. Here, we report a 71-year-old male who presented to the emergency department with a sudden change in mental status, which later resolved. An electrocardiogram was consistent with acute myocardial infarction. The patient later developed symptoms of delirium, and haloperidol was administered. The symptoms did not resolve, and risperidone was initiated instead. The patient subsequently became hypotensive, and treatment was again changed to olanzapine. He returned to full consciousness with olanzapine treatment. When the potential hypotensive effects of haloperidol and risperidone are taken into consideration, in patients with high cardiac risk, olanzapine may provide a better option for the treatment of delirium.

Aged↗
PubMed2006

Influence of medical education on students' attitudes towards the elderly.

As life expectancy increases, the elderly population grows accordingly. Today, physicians interface with elderly patients more frequently and, therefore, geriatric education should be a part of medical training. Examining medical students' knowledge and attitudes about elderly will provide valuable information in planning the geriatric education in medical school. The aim of this study is to determine and compare the attitudes and knowledge of class-1, -4 and -6 Turkish medical students about the elderly. A questionnaire that included statements about physical and social situations of the elderly, developed by Reuben et al., was used. Five-hundred-thirty-five students educating in Hacettepe University Medical Faculty took part in the study. Age, gender and the number of people aged >65 living with the students were also asked. Gender and number of old people living with the students had no significant effect on the answers. Social statements were answered positively, and there were no significant changes among the classes. Statements about physical situations and illnesses were significantly associated with the students' years of education. Geriatric education in developing countries needs more attention because the students' attitudes towards elderly and caregiver preference are mostly affected by the students' own experiences and knowledge.

Aged↗
PubMed2005

Fever of unknown origin: what is remarkable in the elderly in a developing country?

OBJECTIVES: To investigate fever of unknown origin (FUO) in 97 patients and compare geriatric and adult population. METHODS: We investigated 97 (22 elderly) patients with FUO using the criteria of Petersdorf and Beeson [Medicine 40 (1961) 1] hospitalized between January 1990 and May 2005 at Hacettepe University Hospital. RESULTS: Infectious diseases were the most common cause in the adult (33.3%) and the elderly (45.5%) patients both. Neoplasms were seen in 18.7; 4.5% and collagen vascular diseases were diagnosed in 9.3; 4.5% of the adults and the elderly respectively. Tuberculosis accounted for 60% of all the infectious causes and empirical anti-tuberculous treatment served as a diagnostic method in 43% of the cases with tuberculosis. Lymphadenopathy was more common among the adults with FUO. A diagnosis could be reached in all the elderly patients with a very high erythrocyte sedimentation rate (ESR>100mm/h). At the end of the hospitalization, 14.7% (11/75) of the adult patients and 13.6% (3/22) of the elderly patients died. CONCLUSION: Geriatric patients with FUO usually have characteristics similar to the adult patients with respect to the hospitalization time, diagnosis, and inpatient mortality. Lymphoid organ hyperplasia might be expected less frequently and very high ESR might be a more reliable indicator of systemic disease in the elderly. Empirical anti-tuberculous treatment plays an important diagnostic role in the developing countries with a higher prevalence of tuberculosis.

Adult↗
PubMed2005

Prevalence and correlates of metabolic syndrome (MS) in older adults.

Metabolic syndrome (MS) is known to increase risks for cardiovascular disease. Risks for cardiovascular disease also increase with aging. The aim of the study was to describe prevalence and correlates of MS in older adults. Patients aged 65 years and over without any acute illness that were referred to our geriatrics unite for comprehensive geriatric assessment were included in this cross-sectional study. MS was defined by using the WHO and the National Cholesterol Education Program (NCEP) definitions. The correlates were age, gender, low-grade inflammation as assessed by C-reactive protein (CRP) levels, high-homocysteine, total and LDL cholesterol, lipoprotein-a (Lip-a), apolipoprotein-A (Apo-A), apolipoprotein-B (Apo-B), nutrition point, coronary artery disease (CAD) and cerebrovascular event history. Total 1255 patients, 789 (62.9%) females, 466 (37.1%) males with a mean age of 71.8+/-6.3 years were included in our study. MS prevalence was 16.2% with WHO definition and 23.8% with NCEP definition. Prevalence of CAD in MS and non-metabolic syndrome (non-MS) patients was 38.4% versus 29.5% (p=0.010) in WHO and 35.3% versus 29.6% (p=0.066) in NCEP group, respectively. Prevalence of cerebrovascular event history was 11.3% versus 6.2% in WHO (p=0.008) and 9.9% versus 6.1% (p=0.026) in NCEP group, respectively. Multiple logistic regression analysis was performed to investigate the independent association of variables with the MS. Female sex, high-homocysteine, low-grade inflammation, CAD and cerebrovascular event history was found to be associated with both modified WHO and NCEP MS groups in the multivariate analysis. This study has shown that MS is common in elderly patients with strongly related to CAD and cerebrovascular events. Low grade inflammation as assessed by CRP and high-homocysteine level is strongly related to MS.

Aged↗
PubMed2005

Anasarca edema with amlodipine treatment.

OBJECTIVE: To report a case of anasarca edema associated with amlodipine use. CASE SUMMARY: A 77-year-old woman with essential hypertension who had not been treated with any other drug was prescribed amlodipine 10 mg/day to control her blood pressure. She developed anasarca edema soon after amlodipine treatment was initiated. Laboratory test results for possible etiologies were negative. Discontinuation of amlodipine resulted in dramatic improvement. DISCUSSION: To our knowledge, as of February 3, 2005, there have been no other reports of amlodipine-related anasarca edema in the English literature, and only one case was described in the Japanese literature. Pretibial edema is the most common adverse effect of amlodipine. Periocular and perioral edema have occurred less frequently, but anasarca edema has not emerged as a problem. An objective causality assessment revealed amlodipine to be a probable cause of anasarca edema. CONCLUSIONS: In rare instances, amlodipine may cause generalized edema, which will resolve upon discontinuation of the drug.

Aged↗
PubMed2005

General characteristics, clinical features and related factors of osteoporosis in a group of elderly Turkish men.

BACKGROUND AND AIMS: Osteoporosis is an important problem for men as well as women, but data and trials for male osteoporosis, prevalence, evaluation and prognosis are limited. There are insufficient randomized placebo-controlled, multicenter trial data. The aim of this study was to determine the frequency of osteoporosis in patients admitted to the Division of Geriatric Medicine of Hacettepe University, to compare osteoporosis in men and women, and to determine risk factors, relations with social and cultural differences, body weight and functional status. METHODS: A retrospective study was conducted from February 2002 through July 2003. Participants were 783 female and 464 male patients aged 65 years and over. BMD measures were performed using dual-energy X-ray absorptiometry at femoral neck and lumbar spine. Data on calcium intake, history of fractures, smoking, alcohol habits, other possible risk factors, serum 25OH-Vitamin D and iPTH levels were obtained. Creatinine clearance was calculated with the Cockcroft-Gaut formula. Functional status was evaluated by geriatric evaluation scales. RESULTS: 29.5% of cases of osteoporosis were found in males; 45.9% of male patients had osteoporosis, 36.6% had osteopenia. Risk factors for male osteoporosis were evaluated. Men with low body weight (< 57 kg), BMI < 19, physically inactive, and poorly educated men were significantly more osteoporotic. No relationships between 25OH-Vitamin D, iPTH levels, creatinine clearance, quality of life scales or osteoporosis were found. CONCLUSIONS: Geriatrists and internists should focus on male as well as female osteoporosis. Nutritional support and physical activity should be encouraged. Age over 65 is identified as a major risk factor. Every man over 65 years of age should undergo BMD testing for osteoporosis screening.

Aged↗
PubMed2005

No alteration in the PFA-100 in vitro bleeding time induced by the Ginkgo biloba special extract, EGb 761, in elderly patients with mild cognitive impairment.

EGb 761 is widely used in the management of mild cognitive impairment in the elderly population. Elucidation of the effects of EGb 761 on primary haemostasis via PFA-100 could represent an important step for better understanding of the haemostatic safety of EGb 761. The purpose of this prospective study is to assess the effects of Ginkgo biloba special extract, EGb 761, on PFA-100 in vitro bleeding time in elderly patients with mild cognitive impairment. A total of 40 elderly patients aged 65-79 years who were referred for geriatric assessment and who were diagnosed as having mild cognitive impairment were included. Patients were started on 80 mg EGb-761 three times daily. The complete set of PFA-100 in vitro bleeding time and coagulation parameters including prothrombin time, activated partial thromboplastin time and International Normalized Ratio were assessed before and on the seventh day of treatment with EGb 761. There was no statistically significant prolongation in PFA-100 in vitro bleeding time or coagulation parameters in patients receiving EGb 761 after 7 days. The data about the safety of EGb 761 from the point of primary haemostasis in our elderly patient population with mild cognitive impairment casts hope for the future management of this 'difficult-to-treat' population with the promising Ginkgo extracts.

Aged↗
PubMed2005

Renal dysfunction after oral acyclovir treatment in a geriatric woman: a case report.

Oral acylovir treatment rarely results in renal dysfunction. In reported cases concerning renal failure due to oral acyclovir, baseline creatinine levels were unknown or impaired or a predisposing factor for nephrotoxicity was present. We report a 78-y-old female with documented normal baseline renal function and no contributing possible nephrotoxic factor, who developed irreversible renal dysfunction after oral acyclovir treatment. We suggest that in geriatric age groups chronic renal insufficiency should be taken into consideration during oral acyclovir therapy.

Acyclovir↗
PubMed2004

Are serum lipid and lipoprotein levels related to dementia?

Although hyperlipidemia is known to contribute to vascular disease and it may play a role in dementia, specific studies for elderly are limited. The aim of this study is to examine the relationship between dyslipidemia and dementia. In this study, 1251 patients admitted to the Hacettepe University Division of Geriatric Medicine were enrolled. On the basis of the mini mental state examination (MMSE), the clock drawing test (CDT) scores, the APA DSM-IV and the NINCDS-ADRDA criteria and the Hachinski ischemic score (HIS), the subjects were divided into four groups: Alzheimer's disease (AD), vascular dementia (VD), mild cognitive impairment (MCI) and normal cognitive status (NCS). The lipoprotein levels were measured, and we analyzed the data using chi2 and the one-way analysis of variance methods. Among the subjects, 14.8% had low high-density lipoproteins (HDL), 58.5% had high triglyceride (TG), 73.6% had high low-density lipoproteins (LDL), and 21.6% had high lipoprotein-a (Lp(a)) of our study population. There was no difference between the dementia subgroups and the NCS group in the lipoprotein levels. The only significant relationship was between high TG levels and the AD, as well as the MCI groups. Low HDL and high LDL are important problems in elderly. Although serum lipid levels, especially of Lp(a), has recently been thought to be related with dementia, our study suggests the absence of such a relationship. The national data regarding the elderly population should be evaluated on the basis of genetic and environmental factors in each country. The present study showing no significant relationship between Lp(a) and the cognitive status adds new information to the available literature.

Aged↗
PubMed2004

Depression and concomitant diseases in a Turkish geriatric outpatient setting.

Depression is an important but inadequately diagnosed mood disorder in elderly. Depressed elderly patients often have chronic concomitant diseases. This paper intended to determine the prevalence of depression and its relation with concomitant disorders and social status among the patients admitted to our geriatric unit. Seven hundred and eighty-nine females and 466 males admitted to our unit were examined for the presence of depression by using the geriatric depression scale (GDS) test. The presence of concomitant diseases was assessed. Depression was diagnosed in 273 patients (21.8%), 193 (70.7%) females and 80 (29.3%) males. Depressed patients suffered from a wide range of other diseases the number and prevalence of which were as follows: Alzheimer's disease (AD) (34; 12.5%), vascular dementia (27; 9.9%), hypertension (HT) (211; 77.3%), diabetes mellitus (DM) (64; 23.4%), osteoporosis (182; 66.7%), atherosclerotic coronary artery disease (CAD) (89; 32.6%), cardiac failure (23; 8.5%), bronchial asthma (8; 2.9%), chronic obstructive pulmonary disease (COPD) (25; 9.2%) and osteoarthritis (133; 48.8%). The correlation between depression and concomitant diseases was statistically significant in hypertensive, demented and osteoporotic patients, as determined in a large elderly population. Previous studies examined the correlation of depression with only one concomitant disease, while we performed the analysis on multiple correlations.

Aged↗
PubMed2004

Idiopathic fibrosclerosis of bilateral orbits, bilateral ureters, thyroid: a case report and review of the literature.

INTRODUCTION: Idiopathic multifocal fibrosclerosis is a rare disorder which is usually misdiagnosed in the clinics. We try to make a review of the literature about this large spectrum syndrome and treatment modalities other than surgery. Our patient interestingly have both fibrosclerosis of bilateral ureters, orbits and thyroid. Steroids, radiotherapy, tamoxifen, vitaminD3, colchisine was found to be in effective in treatment of progressive fibrosis.

Adult↗