The effect of breast-feeding duration on bone mineral density in postmenopausal Turkish women: a population-based study

Alcelik, Aytekin/0000-0002-3156-1076WOS: 000292798400018PubMed: 22295033Introduction: In the present study, we investigated the effects of breast-feeding time on bone mineral density (BMD) later in life. Material and methods: The current study was based on a retrospective analysis of 586 postmenopausal women with a mean age of 60.8 years, who were screened for osteoporosis by dual energy X-ray absorptiometry (DXA). They were classified into 4 groups with respect to the duration of their breast-feeding as never (group 1), 1-24 months (group 2), 25-60 months (group 3), or > 60 months (group 4). Bone mineral density results for the femur neck and lumbar spine were classified into 3 groups according to WHO criteria as normal (T score > -1.0 SD), osteopenia (T score -1.0 to -2.5 SD), and osteoporosis (T score < -2.5 SD). Patients with osteopenia or osteoporosis (T score < -1.0 SD) were considered as having low bone mass (LBM). Results: We found a correlation between duration of lactation and femur BMD or spine BMD in the study population (r = 0.116, p < 0.005; r = -0.151, p = 0.001, respectively). Significant differences were found between femur BMD and spine BMD of groups in one-way ANOVA analysis (p = 0.025, p = 0.005, respectively). Additionally, when compared with the other three groups, group 4 was older and had longer duration of menopause (p < 0.01). In logistic regression analysis, age and body mass index were found as independent risk factors of LBM [odds ratio: 1.084 (95% CI 1.031-1.141); odds ratio: 0.896 (95% CI 0.859-0.935)], while duration of lactation was not found as an independent predictor of LBM. Conclusions: In this study, we have found that changes of bone metabolism during lactation had no effect on postmenopausal BMD measured by DXA. Consequently, it can be suggested that long breast-feeding duration is not a risk factor for low bone mass later in life

Ocena zaburzeń przewodzenia przedsionkowego i czynności mechanicznej lewego przedsionka u chorych z subklinicznymi zaburzeniami czynności tarczycy

Introduction: Changes of thyroid hormones levels may lead to effects, not only in ventricular function, but also atrial function. The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical coupling and P wave dispersion in patients with subclinical thyroid disorders. Material and methods: Eighty patients with subclinical thyroid disorders and forty controls were included. A diagnosis of subclinical thyroid disorders were reached with increased or decreased serum TSH and normal free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay were measured by tissue Doppler imaging (TDI). Results: All groups had similar demographic findings. LA mechanical functions significantly impaired in subclinical thyroid disorders than control group. Intra- and Interatrial delay, were measured significantly higher in patients with subclinical thyroid disorders than control group. PA lateral and interatrial delay were positively correlated with TSH (r = 0.507, p = 0.006 and r = 0.455, p = 0.015, respectively) in subclinical hypothyroid patients. There was negative correlation between TSH and interatrial delay (r = &#8211;0.492, p = 0.006) in subclinical hyperthyroid patients. Linear multivariate regression analysis demonstrated that, TSH was the only an independent factor of interatrial delay in patients with subclinica tlhyroid disorders. Conclusions: This study showed that impaired LA mechanical and electromechanical function in subclinical thyroid disorders. TSH was an independent determinant of interatrial delay. Prolonged atrial electromechanical coupling time and impaired mechanical atrial functions may be related to the increased incidence of arrhythmias.Wstęp: Zmiany stężeń hormonów tarczycy mogą wpływać nie tylko na czynność komór serca, ale również na czynność przedsionków. Niniejsze badanie przeprowadzono w celu oceny czynności mechanicznej lewego przedsionka (LA), sprzężenia elektromechanicznego i dyspersji załamka P u chorych z subklinicznymi zaburzeniami czynności tarczycy. Materiał i metody: Do badania włączono 80 chorych z subklinicznymi zaburzeniami czynności tarczycy i 40 osób stanowiących grupę kontrolną. Zaburzenia czynności tarczycy rozpoznawano na podstawie obniżonego lub podwyższonego stężenia TSH w surowicy i prawidłowego stężenia wolnej T4 (fT4). Zmierzono objętości LA, posługując się dwupłaszczyznową metodą area-lenght (pole&#8211; wymiar podłużny). Obliczono również objętości i frakcje aktywnego i biernego opróżniania LA. Do pomiaru opóźnienia przewodnictwa wewnątrzi międzyprzedsionkowego zastosowano technikę doplera tkankowego. Wyniki: Grupy nie różniły się pod względem charakterystyki demograficznej. W grupie z zaburzeniami czynności tarczycy mechaniczna funkcja przedsionków była istotnie upośledzona w porównaniu z osobami z grupy kontrolnej. Opóźnienie przewodnictwa wewnątrzi międzyprzedsionkowego stwierdzano istotnie częściej u osób z zaburzeniami czynności tarczycy. Stwierdzono dodatnią korelację miedzy opóźnieniem elektromechanicznym (PA lateral) i opóźnieniem przewodzenia międzyprzedsionkowego a TSH (odpowiednio r = 0,507; p = 0,006 i r = 0,455; p = 0,015) u osób z subkliniczną niedoczynnością tarczycy. Z kolei u osób z subkliniczną nadczynnością tarczycy zaobserwowano ujemną korelację między TSH i opóźnieniem przewodzenia międzyprzedsionkowego (r = &#8211;0,492; p = 0,006). W wieloczynnikowej analizie regresji liniowej wykazano, że stężenie TSH było jedynym parametrem niezależnie związanym z opóźnieniem przewodzenia międzyprzedsionkowego u chorych z subklinicznymi zaburzeniami czynności tarczycy. Wnioski: W niniejszym badaniu wykazano upośledzoną czynność mechaniczną i elektromechaniczną LA u chorych z subklinicznymi zaburzeniami czynności tarczycy. Stężenie TSH było niezależnym czynnikiem determinującym opóźnienie przewodzenia międzyprzedsionkowego. Wydłużenie czasu sprzężenia elektromechanicznego i upośledzenie mechanicznej czynności przedsionków mogą się wiązać ze zwiększoną zapadalnością na zaburzenia rytmu

Brain natriuretic peptide levels in type 2 diabetic patients treated with rosiglitazone

YÖK Tez No: 194727[Özet Yok

Olanzapine Intoxication-Related Transient Diabetes Insipidus

Alcelik, Aytekin/0000-0002-3156-1076WOS: 000294118700017PubMed: 21777173Olanzapine is a second-generation atypical antipsychotic agent approved for the treatment of psychotic disorders and mania. The effects of olanzapine intoxication include central nervous system depression, hyperthermia, myosis, tachycardia, and orthostatic hypotension. Heretofore, only one case has been reported to develop polyuria after olanzapine overdose (560 mg). We describe a case that developed diabetes insipidus following massive olanzapine ingestion and returned to normal after desmopressin treatment

Evaluation of tuberculosis in chronic renal failure

PubMed ID: 22233319[No abstract available

Increased P wave duration in patients with depression or anxiety disorder

Kocer, Abdulkadir/0000-0003-2866-555X; Alcelik, Aytekin/0000-0002-3156-1076WOS: 000277425100011BACKGROUND: Activation of the sympathetic nervous system plays an important role in regulating cardiovascular actions. P wave parameters can provide general information on central cardiovascular autonomic regulatory responses, which are altered in patients with anxiety disorders and depression. In particular, there are no reports addressing changes in P wave duration and dispersion. OBJECTIVE: To compare the differences in P wave duration and P wave dispersion between patients with anxiety disorders and depression, because patients with anxiety disorders and depression develop abnormal electrocardiograms. DESIGN, TIME AND SETTING: A non-randomized concurrent controlled study was performed. Patients with depression and general anxiety disorders were admitted at the psychiatry outpatient clinics of the Medical Faculty of Duzce University of Turkey between May 2005 and October 2006. PARTICIPANTS: A total of 71 consecutive patients with depression and anxiety disorders, as well as 50 physically and mentally healthy age-and gender-matched controls were selected. METHODS: Electrocardiogram records were obtained at the time of admission to the outpatient clinics. MAIN OUTCOME MEASURES: P wave duration and P wave dispersion were measured. RESULTS: Both the maximum (P-max) and minimum (P-min) P wave duration were greater in patients with psychiatric disorders than in healthy controls. P-max was significantly greater in patients with depression or anxiety disorders (Bonferroni test, P 0.017). P waves were similar between panic patients and other anxiety patients. Beck depression results were positively correlated with P-min and P-max (r = 0.374, 0.302, P = 0.013, 0.049, respectively), and not associated with P wave dispersion (P > 0.05). CONCLUSION: Psychiatric disorders are associated with increases in P-max, but not with P wave dispersion. The P wave changes were associated with the degree of depression

Tip 2 diyabet hastalarında tıkınırcasına yeme bozuklu?u ve glisemik kontrol arasındaki i?lişki

Objective: Our aim was to assess the prevalence of binge eating disorder (BED) in individuals with type 2 diabetes and to investigate whether a comorbidity with BED would affect glycemic control in these patients. Materials and Methods: Eighty-two type 2 diabetic patients were enrolled. The participants were assessed for eating disorders by a psychiatrist. Blood samples were drawn and HbA1c and other biochemical parameters were measured. Results: Of the 82 subjects, 27 (34.1%) met the criteria for BED. No other types of eating disorders were detected. HbA1c was significantly higher in individuals with BED (p<0.05). Conclusion: Our findings reveal that BED is highly prevalent among type 2 diabetic patients and it impairs glycemic control. Thus, patients with type 2 diabetes should be assessed carefully for eating disorders

Pantoprazole-induced thrombocytopenia in a patient with upper gastrointestinal bleeding

Alcelik, Aytekin/0000-0002-3156-1076; Aktas, Gulali/0000-0001-7306-5233WOS: 000316739900024PubMed: 23518793

Aplastic crisis due to Parvovirus B19 in an adult hereditary spherocytosis patient: Case report

Bilir, Cemil/0000-0002-1372-4791; Alcelik, Aytekin/0000-0002-3156-1076WOS: 000259856300026Parvovirus B19 may cause transient aplastic crises in hereditary hemolytic anemia patients. A 29-year-old male presenting with fatigue, fever and diffuse joint and Muscle pain was admitted to the internal medicine service. He later developed leukopenia, thrombocytopenia and marked anemia with 0.8% reticulocytes. The bone marrow biopsy proved normocellular with increased proetrithroblasts and decreased mature erythroblasts. On day 6 of admission, his complete blood count (CBC) started to return to normal and the aplastic crisis was attributed to parvovirus B19 infection. Anti-IgM B19 antibody positivity supported the diagnosis and the clinical picture. This is the first reported Parvovirus B19-induced aplastic crisis in an adult hereditary spherocytosis patient in Turkey

Latent fatality due to hydatid cyst rupture after a severe cough episode

Alcelik, Aytekin/0000-0002-3156-1076WOS: 000226961600011PubMed: 15718822Hydatid disease is a parasitic disease caused by Ecinococcus granulosus characterised by cyst formation in various organs. The infestation mostly involves the liver. Hydatid cysts of the liver can rupture either spontaneously or due to trauma. Incidence of rupture is about 3-17% of all cases with hydatid disease. Unless treated surgically, rupture can result in death. Here, we present a case of hydatid cyst ruptured after a severe cough episode and disseminated first to the subcapsular area, then to the peritoneal space. Probably due to a decrease in parenchymal pressure in the liver after decompressive effect of rupture, the patient felt an improvement in abdominal pain, refused operation, and left the hospital on his own responsibility. This unfortunate relief resulted in a delay of 55 hours in management. The leakage of liquid materials into peritoneal space resulted in a severe inflammatory reaction and eventually death of the patient. The patient died of a late peritonitis rather than anaphylaxis, which is the most common reason for death in such patients. As a conclusion, physicians should be aware of a temporary relief in abdominal pain after cyst rupture that may cause a delay in management and in turn loss of patient due to peritonitis