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    Associations between neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, albuminuria and uric acid and the estimated glomerular filtration rate in hypertensive patients with chronic kidney disease stages 1-3
    (Termedia Publishing House Ltd, 2019) Sevencan, Nurhayat Ozkan; Ozkan, Aysegul Ertinmaz
    Introduction: The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), albuminuria and uric acid are known to be independent predictors of hypertension and cardiovascular mortality. However, to date, no study has been conducted describing the relationships between the NLR, PLR and estimated glomerular filtration rate (eGFR) in hypertensive patients with chronic kidney disease (CKD) who do not require renal replacement therapy. Material and methods: This prospective study included 271 patients with essential hypertension and eGFR >= 30 ml/min/1.73 m(2). The patients were divided into two groups: those with CKD stages 1 and 2 and those with stage 3. We used the complete blood count to calculate the NLR and PLR, and we measured the albuminuria and uric acid levels. Then, we studied their associations with the eGFR and their potential uses as independent risk factors for renal damage. Results: The NLR, albuminuria and uric acid were higher in patients with CKD stage 3 than in those with stages 1 and 2 (p = 0.013, p = 0.001 and p = 0.001, respectively). However, no significant difference was detected in the PLR. In stage 3 patients, albuminuria and uric acid were found to be independent risk factors affecting the eGFR (p = 0.042 and p = 0.001, respectively). However, the effects of the NLR and PLR on the eGFR were not significant (p = 0.104 and p = 0.578, respectively). Conclusions: The NLR, similar to albuminuria and uric acid, the NLR was found to be a specific marker for CKD stage 3 patients. However, the NLR and PLR did not act as independent risk factors affecting the eGFR.
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    Effectiveness of a Transtheoretical Model-Based Foot Care Program in Improving Foot Care Behaviors and Self-Efficacy in Adults With Type 2 Diabetes: An Assessor-Blinded Randomized Controlled Trial
    (Springer Publishing Co, 2022) Kes, Duygu; Sahin, Fatime; Ozkan, Aysegul Ertinmaz; Basmaz, Seda Erem
    This study aimed to evaluate the effects of a transtheoretical model (TTM)-based foot care program on foot self-care behaviors and self-efficacy among adults with type 2 diabetes (T2DM). A prospective, assessor-blinded, randomized controlled trial was conducted between January 2020 and October 2020 at the endocrinology outpatient unit of a hospital in the north-west Turkey. The sample was composed of 51 adults with T2DM randomly allocated to the intervention group (n = 25) and control group (n = 26). The intervention group received the TTM-based foot care program during a 6-month period. The data were analyzed using the two-way repeated measure analysis of variance (ANOVA). After intervention, the intervention group's the diabetic foot care self-efficacy scale scores increased significantly at 3 and 6 months, compared with the control group. Similarly, the intervention group's the foot self-care behavior scale scores also increased significantly at 3 months and 6 months.
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    Linagliptin-related pancreatitis in a diabetic patient with biliary calculus A case report
    (Lippincott Williams & Wilkins, 2018) Sevencan, Nurhayat Ozkan; Ozkan, Aysegul Ertinmaz; Kayhan, Burcak
    Rationale: Dipeptidyl peptidase-4 inhibitors are commonly used drugs for the treatment of type 2 diabetes mellitus. While acute pancreatitis cases induced by saxagliptin, sitagliptin, and vildagliptin (all of which are members of the dipeptidyl peptidase-4 group) have been reported, there is no clear evidence suggesting that linagliptin may cause pancreatitis, and information in this regard is limited to a few studies. Moreover, no pancreatitis cases have been reported that were directly associated with linagliptin. Patient concerns: We present a case of linagliptin-related pancreatitis in a 79-year-old male diabetic patient with biliary calculi. The patient, who was diagnosed with acute pancreatitis 4 months after initiating linagliptin 5mg/d treatment, was admitted to our hospital. Diagnoses: The patient's pancreatic enzymes were high. Ultrasonography showed multiple biliary calculi, and abdominal computed tomography showed edematous pancreatitis. Interventions: Linagliptin was discontinued and clinical improvement was achieved with standard acute pancreatitis treatment. Outcomes: This is the 1st case report suggesting that linagliptin might be associated with the risk of pancreatitis and could be an etiologic cause of pancreatitis, similar to the other members of its group. Lessons: While the results of previous studies stated that there was no data to prove a causal relationship between dipeptidyl peptidase-4 inhibitors and pancreatitis, concerns regarding this subject have continued to arise. Therefore, new and comprehensive studies are needed to determine the long-term effects of dipeptidyl peptidase-4 inhibitors on type 2 diabetes mellitus patients and to shed light on the side effects of these medications.
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    Mean platelet volume and red cell distribution width as potential new biomarkers in children with gastroesophageal reflux disease
    (E-Century Publishing Corp, 2019) Sevencan, Nurhayat Ozkan; Cesur, Ozkan; Cakar, Murat; Dogan, Erkan; Ozkan, Aysegul Ertinmaz; Benli, Ali Ramazan
    The aim of this study was to calculate the corrected rate of reflux in children with gastroesophageal reflux (GER)-like complaints by 24-hour pH monitoring and esophagogastroduodenoscopy (EGD), and to determine the utility of mean platelet volume (MPV) and red cell distribution width (RDW) as diagnostic biomarkers of GER disease (GERD) in children. The subjects in this prospective study were 109 children, 6 to 18 years old. Of them, 74 subjects were with GER symptoms and 35 healthy controls. The subjects were divided into three groups: those who underwent 24-hour pH monitoring (Group 1), those who underwent EGD together with pH monitoring (Group 2), and the healthy controls (Group 3). The results of pH monitoring and EGD and hematological parameters with controls were compared between Groups 1 and 2. In Groups 1 and 2, the overall rate of reflux was 40%, of esophagitis was 27.8%, and of Helicobacter pylori infection was 31.2%. The MPV and RDW cut-offs in subjects with reflux were <= 8.97 (sensitivity 89%, specificity 89%) and <= 12.78 (sensitivity 80%, specificity 97%), with an area under the Receiver Operating Characteristic (ROC) curve +/- standard error (AUC +/- SE) = 0.917 +/- 0.027 (P < 0.001) and AUC +/- SE = 0.866 +/- 0.036 (P < 0.001), respectively. The endoscopic procedures are not practical due to being invasive and expensive. However, hemogram is a simple test which can be performed in an outpatient clinic. MPV and RDW calculated in hemogram could be easy, cost-effective, and high sensitive new biomarkers that can be used in children with GERD.
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    Renal resistive index and aortic knob width relationship as a predictor of renal prognosis in essential hypertension
    (Lippincott Williams & Wilkins, 2018) Sevencan, Nurhayat Ozkan; Ozkan, Aysegul Ertinmaz
    The scientific studies that have been conducted so far highlight that renal resistive index (RI) and aortic knob width (AKW) indicate poor prognosis regarding renal and cardiovascular mortality. But the existence of a direct relationship RI and AKW is unclear. This study aims investigating the relationship between RI and the measured AKW in chest radiography of the patients with hypertensive nephropathy who do not require renal replacement therapy. This prospective study included 268 consecutive patients with essential hypertension. Patients were divided into 2 groups as RI >= 0.7 and RI < 0.7. The ROC curve, sensitivity, and specificity ratios were evaluated to determine which AKW value is the best predictive one for the RI >= 0.7. The cutoff point of AKW was evaluated as >= 36 for the cases with RI >= 0.7: sensitivity was 71.22%; specificity was 71.32%; the positive predictive value (PPV) was 72.79; the negative predictive value (NPV) was 69.70, and the accuracy was 71.27. Area under the ROC curve +/- standard error (AUC +/- SE)=0.729 +/- 0.031 (P < .001). AKW can provide important predictive information about the subclinical renal dysfunction in hypertensive patients with RI >= 0.7. Moreover; AKW is a predictive factor for both the diagnostic and prognostic evaluation of renal pathologies.
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    An unusual cause of anaemia: Rapunzel syndrome, a case report
    (Pakistan Medical Assoc, 2020) Ozkan, Aysegul Ertinmaz; Danis, Nilay; Altundal, Mustafa; Sevencan, Nurhayat Ozkan; Karatas, Fatih; Kayhan, Burcak
    Trichobezoars present with stomach ache and with a mass in the stomach. It's common in the young and middle-aged women having psychiatric disorder, presenting with stomach ache and existence of mass in the stomach. Although it's one of the rare causes of anaemia it should be considered when dealing with cases of chronic and unresponsive anaemia.
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    An unusual location of squamous cell carcinoma and a rare cutaneous infection caused by serratia marcescens on the tumoral tissue A case report
    (Lippincott Williams & Wilkins, 2018) Sevencan, Nurhayat Ozkan; Cakmakliogullari, Elcin Kal; Ozkan, Aysegul Ertinmaz; Kayhan, Burcak
    Rationale: Serratia marcescens (S. marcescens) is an opportunistic pathogen of the Enterobacteriaceae family. Although S. marcescens is known to cause sepsis, meningitis, endocarditis, urinary system and ocular infections, skin infections are sporadic. Squamous cell carcinoma (SCC) is the most aggressive skin cancer type that is often located in the head and neck region, and rarely in the scalp tissue. Patient concerns: An 89-years-old male patient was diagnosed with SCC three years ago. The frontal region of the skull showed an ulcerated tumor, irregular borders, and exophytic growth pattern. The destruction of the frontal bone made the vibrating brain tissue visible, and the lower part had haemopurulent flow. Diagnoses: Gram staining showed the proliferation of gram (-) bacilli. Bacteria were identified as non-pigmented S. marcessens in the wound culture. To the best of our knowledge, there have not been any cases reported with S. marcescens causing cutaneous infections on SCC. Therefore, our report is the first case in the literature. Interventions: According to the culture antibiogram, S. marcescens was ciprofloxacin sensitive. Consequently, 1000mg/day ciprofloxacin was initiated for 14 days. Outcomes: Purulent exudate in skin cancers may be caused by the nature of carcinoma tissue as well as the colonization of opportunistic pathogen microorganisms as seen in our patient. Lessons: Examination of the wound cultures and elimination of infections are critical in these cases.