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    The 6-month drug survival rate in patients with rheumatoid arthritis treated with tofacitinib
    (2021) Karatas, Ahmet; Gur, Burak; Oz, Burak; Piskin Sagir, Rabia; Hohluoglu, Abdulvahap; Gozel, Nevzat; Koca, Suleyman Serdar
    Aim: Rheumatoid arthritis (RA) is a progressive, inflammatory, autoimmune disease that particularly affects the joints. Tofacitinib is the first oral Janus kinase inhibitor approved for RA treatment. We aimed to analyze the 6-month drug survival rate and factors affecting the discontinuation of tofacitinib in RA patients. Materials and Methods: Age, gender, rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) levels, whether to continue treatment tofacitinib, if treatment is not continued what treatment is applied, use of biological agent before tofacitinib treatment were retrospectively recorded from the patient data. Results: 30 RA patients included in the study (29 female, 1 male) with a mean age of 50.5 ± 11.3 years. At the 6th month of treatment of tofacitinib, the drug survival rates were 50%. There was no significant difference between CCP positive and negative patients as well as between RF positive and negative patients in terms of drug survival rates (p = 0.92 and p = 0.90, respectively). The drug survival rates were alike in tofacitinib monotherapy and combined therapy of tofacitinib with any conventional DMARD (p = 0.36). The tofacitinib survival rates were similar in biologically naïve patients and in patients who had received at least one previous biological DMARD (p = 0.70). Conclusion: Half of the RA patients receiving tofacitinib treatment continue their treatment at the 6th month. The drug survival rate was not associated with co-treatment with conventional DMARD, auto-antibody positivities, and previously used biological DMARD therapy. These findings support that tofacitinib shows similar efficacy when used as combined or monotherapy, in seronegative or seropositive patients, and in biologic resistant or naive patients.
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    Oxidant and antioxidant mechanisms in chronic kidney disease
    (2019) Karatas, Ahmet; Bayrak, Ahmet; Bayrak, Tulin; Canakci, Ebru
    Aim: The objective of this study was to evaluate the correlation of inflammation, oxidant and antioxidant biomarkers with the stages of CKD. It is well known that inflammation has an important role in CKD. While PON-1 and PAF-AH are biomarkers with antioxidant characteristics, MDA is an oxidant biomarker. Material and Methods: The participants were divided into 3 groups. Control (n=37) group, non-hemodialysis chronic kidney disease (non-HD CKD) group and hemodialysis group (n=40) . One hudred twenty-one participants were included in this cross-sectional and observational study. Serum PON-1, PAF-AH, MDA levels were measured. Results: There was a significant difference between the groups regarding the median MDRD values (p<0.001). The median MDRD value in the control, non-HD CKD and dialysis groups was 93. 36 and 7 respectively. There was also a significant difference between the groups regarding the median PON-1 value (p<0.001). The median PON-1 value in the control, predialysis and dialysis groups was 67, 63.1 and 62 respectively. There was also no significant difference between the groups regarding the median PAF-AH value (p=0.469). The median PAF-AH value in the control, predialysis and dialysis groups was 115.7, 116.95 and 117.4 respectively. There was also a significant difference between the groups regarding the median MDA value (p<0.001). Conclusion: We concluded that PON-1 and MDA might be considered as useful biomarkers in CKD patients. The correlation between PAF-AH and CKD, larger subject sizes are needed. We believe that our study will be a starting point for larger studies focused on CKD severity and antioxidant/oxidant biomarkers.
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    Protective effect of ibuprofen against renal ischemia-reperfusion injury
    (2020) Karatas, Ahmet; Canakci, Ebru; Bayrak, Tulin; Benli, Erdal; Bayrak, Ahmet; Akcay Celik, Muruvvet
    Aim: Ibuprofen is an older agent, but its intravenous form is a very new drug. The aim of this study was to investigate whether intravenous form of ibuprofen has protective effect against renal ischemia reperfusion injury at two different doses such as 10-30 mg/kg.Material and Methods: Thirty-two Wistar Albino type female rats were divided into 4 groups as sham, control, IBU-10, IBU-30. In the control group, 60 minutes renal ischemia and 60 minutes reperfusion were performed. In the ibuprofen groups, at the 45th minute of ischemia, ibuprofen was administered in different doses at 10 mg/kg and 30 mg/kg through intraperitoneally. After 60 minutes of ischemia, the clamps were opened. Renal tissue and blood samples were collected from the rats at the end of the reperfusion period. Serum TAS, TOS and prolidase enzyme levels were analyzed in plasma samples. Both histopathological and biochemical evaluations were performed with kidney tissue. Results: In the groups given intravenous ibuprofen, less cellular damage was always detected. Cellular damage indicators were significantly lower in the treated rats than in the control group. Serum and tissue prolidase values were different between groups (p0.001, p0.001). Serum TAS and TOS levels were also different between groups (p=0.001, p=0.003). Serum OSI levels were also different between groups (p=0.017).Conclusion: The biochemical and pathological results obtained in our study suggest that intravenous ibuprofen, has a protective effect against kidney damage. We believe that our study will shed light on future clinical prospective studies.