Browsing by Author "Kiliccioglu B."
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Item Skin findings in patients receiving lipid lowering drugs; [Lipid-dusurucu ilac kullananlarda meydana gelen deri degisiklikleri](1998) Gunduz K.; Saruc M.; Afsar S.; Ozmen B.; Kiliccioglu B.Background and design: Statins are lipid-lowering drugs inhibiting an early step of cholesterole biosynthesis. They may lead skin changes by affecting lipid components of the skin. In this study effects of Pravastatin therapy on the skin of 27 patients with hypercholesterolemia is reported. Results: Pruritus, xerosis and plantar hyperkeratosis were observed in 9, 2 and 2 patients, respectively. No such effects were observed in the rest. Conclusion: Lipid-lowering drug usage should be kept in mind while investigating aetiology of chronic pruritus.Item Diabetic nephropathy and angiotensin converting enzyme inhibition; [Diabetik nefropati ve anjiotensin donusturucu enzim inhibisyonu](1998) Saruc M.; Kursat S.; Kiliccioglu B.Diabetic nephropathy is the single most common cause of renal failure leading to end stage renal disease. The cost of providing dialysis for uremic diabetics is very expensive. Diabetic nephropathy is also associated with markedly increased morbidity and mortality for the patient with diabetes mellitus who develops this complication. Angiotensin converting enzyme inhibition has protective effects on renal functions and structure in diabetic nephropathy. This protection is probably independent of the systemic hypotensive effect of these agents. That is why effective antihypertensive treatment with angiotensin converting enzyme inhibitors in patients with diabetic nepropathy results in a large reduction in albuminuria and a low rate of decline in kidney function. As a conclusion, all patients with diabetes and documented diabetic glomerulopathy should be treated with an angiotensin converting enzyme inhibitor.Item Treatment of mild-to-moderate hypertension with calcium channel blockers: A multicentre comparison of once-daily nifedipine gits with once-daily amlodipine(2003) Kes S.; Caglar N.; Canberk A.; Deger N.; Demirtas M.; Dortlemez H.; Kiliccioglu B.; Kozan O.; Ovunc K.; Turkoglu C.Background: Hypertension is one of the most important causes of cardiovascular disease, and treatment of hypertension leads to a significant reduction in cardiovascular mortality and morbidity. Although calcium channel blockers are regarded as an important part of the therapeutic armamentarium against cardiovascular diseases, and are among the most frequently prescribed antihypertensive medications, concern has been aroused about these drugs, particularly the short-acting dihydropyridine derivatives. However, the value of nifedipine GITS (Adalat-Crono*), the long-acting dihydropyridine, is in need of being re-established. Objective: To compare the effectiveness, safety and tolerability of once-daily nifedipine and amlodipine treatment in patients with mild-to-moderate essential hypertension. Design: Randomised multicentre trial with an open comparison of treatments for 12 weeks, with a preceding placebo run-in period of 2 weeks (patients on beta-blockers at the time of enrolment entered a mandatory 2-week wash-out period before being allowed in the placebo run-in period; this wash-out period was one week for patients using any antihypertensive medication other than beta-blockers). Setting: Nine centres (all university hospitals) in Turkey. Patients: 155 patients with essential hypertension (diastolic blood pressure 95-109 mmHg). Interventions: Initial treatment (step 1) consisted of 30 mg nifedipine GITS (n = 76; (Adalat-Crono tablets), or 5 mg amlodipine (n = 79; Norvasc† 5-mg tablets), either administered once daily, as a morning dose, or if the blood pressure was not below 140/90 mmHg, or the reduction in diastolic blood pressure was lower than 10 mmHg after a treatment period of 6 weeks, the dose was increased (Step 2) to 60 mg once daily in the nifedipine group, or 10 mg once daily in the amlodipine group. Main efficacy parameter: Diastolic blood pressure at trough after 12 weeks of active compound therapy adjusted to baseline. Results: After 12 weeks of treatment, the mean diastolic blood pressure was 83.1 and 81.9 mmHg, in the nifedipine and amlodipine groups, respectively (p = 0.436). The mean decrease in systolic blood pressure (28.5 ± 11.9 and 28.2 ± 11.2 mmHg in the nifedipine and amlodipine groups, respectively) and the mean decrease in diastolic blood pressure (16.4 ± 7.0 and 17.5 ± 6.9 mmHg in the nifedipine and amlodipine groups, respectively), as well as the responder rates (88.1 % and 92.1%, in the nifedipine and amlodipine groups, respectively) were comparable at the end of the study. No significant differences between groups were detected in the efficacy parameters assessed in this study. Both drugs were well tolerated. The overall incidence of adverse events was 7.9% in the nifedipine group and 10.1% in the amlodipine group. However, more patients discontinued treatment prematurely in the amlodipine group (13 patients; 19.7%), than in the nifedipine group (four patients; 5.6%). Conclusions: The results of this study demonstrated that once-daily nifedipine in GITS formulation and amlodipine are comparably safe and effective treatment options in patients with mild-to-moderate essential hypertension.Item Increased expression of angiogenic markers in patients with seasonal allergic rhinitis(2004) Kirmaz C.; Ozbilgin K.; Yuksel H.; Bayrak P.; Unlu H.; Giray G.; Kiliccioglu B.Background. Increased vascularity due to neo-angiogenesis is an essential part of airway remodelling. Vascular endothelial growth factor (VEGF), CD34 and von Willebrand's factor (FvW) are known angiogenic markers. Angiogenesis and airway remodelling has been documented in asthma but not in allergic rhinitis.Objective: We aimed to investigate the presence of increased angiogenesis and its relation to angiogenic molecules, namely VEGF, CD34 and FvW, in endothelial cells of nasal mucosa in patients with seasonal allergic rhinitis (SAR), using three different immunohistochemical analysis methods, namely HSCORE, microvessel density (MVD) and vascular surface density (VSD). The findings in allergic rhinitis were compared with the findings in nasal septal deviation (NSD), which is not associated with increased angiogenesis. Methods. Twenty patients with symptomatic SAR, who were not under treatment, were enrolled in the study. Ten patients with NSD, who needed surgical therapy, served as the control group. Demographic characteristics did not differ between the two groups. Inferior turbinate biopsy was obtained from SAR patients and control patients, under local anaesthesia and during surgery respectively. All biopsies were evaluated for angiogenesis on the basis of VEGF, CD34 and FvW by two blinded histologists using three immunohistochemical analysis methods (HSCORE, MVD and VSD). Results. HSCORE, estimated on the basis of each staining technique, showed statistically significant differences among the two groups (p=0.002; p=0.045; p=0.016, respectively). Anti-CD34 and anti-VEGF showed higher MVD values in SAR when compared to the controls (p=0.038; p=0,009, respectively). No statistically significant difference was found in Anti-FvW-based MVD between SAR patients and controls (p=0.071). The measurements of VSD for FvW and VEGF from nasal biopsy specimens displayed a statistically significant difference between the two groups (p=0.004; p=0.0001, respectively). However, measurement of VSD for CD-34 was not significantly different between the groups (p=0.086). On the other hand, morphometric data obtained by all three methods did not correlated. Conclusion. There are a few studies that have investigated the essential role of angiogenesis in the pathogenesis of allergic rhinitis. We conclude that, increased angiogenesis may be as prominent in patients with allergic rhinitis as in patients with non-allergic nasal pathologies and may play an important role in the remodelling of nasal mucosa of subjects with SAR.