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Öğe Altered diurnal variation of nitric oxide production in patients with panic disorder(Tohoku Univ Medical Press, 2004) Kaya, B; Ünal, S; Karabulut, AB; Türköz, YThe aim of this prospective study was to investigate the diurnal change in serum nitric oxide (NO) levels in active and remission phases of patients with panic disorder. This study included 15 patients fulfilling the criteria for panic disorder of Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition and 15 healthy controls matched for age and sex. All patients were receiving a selective serotonin reuptake inhibitor at therapeutic doses. The serum nitrite and nitrate levels of subjects were determined at 10: 00 a.m. after overnight fasting and at 3: 00 p.m. 2 hours after lunch. NO levels of all patients measured in the morning were significantly higher than those of controls. The patients were also divided into active and remission groups according to clinical status and Panic Agoraphobia Scale's cut-off point. There were no statistically significant differences in serum nitrite and nitrate levels of the active group between the 10:00 a.m. and 3:00 p.m. measurements. In contrast, statistically significant differences were found in the serum levels of nitrite (p<0.05) and nitrate (p<0.05) in the remission group. Notably, the afternoon nitrite and nitrate levels of the remission group were higher than those of the morning levels as seen in control subjects. Thus, diurnal variation of NO production is altered in patients with panic disorder but is resumed in the remission phase. The present study suggests that serum NO levels are a good marker for evaluation of panic disorder. (C) 2004 Tohoku University Medical Press.Öğe CRP and depression in patients on chronic dialysis(Dustri-Verlag Dr Karl Feistle, 2003) Taskapan, H; Ates, F; Kaya, B; Kaya, M; Emul, M; Taskapan, Ç; Sahin, I[Abstract Not Available]Öğe The onset and longitudinal course of a man-made post-traumatic morbidity: Survivors of the Sivas disaster(Taylor & Francis Ltd, 2001) Sungur, M; Kaya, BIntroduction: This study examined the onset and 18-month longitudinal course of post-traumatic stress disorder morbidity in 79 people who were exposed to the man-made Sivas disaster in Turkey, which caused 37 deaths and more than 60 injuries. Methods: The people who experienced the trauma were stratified into three groups, according to the extent of exposure to the disaster, to find out if the extent (severity) of trauma was the main predictor of onset and chronicity. Another aim of the study was to detect different patterns of post-traumatic morbidity and to see how Post-Traumatic Stress Disorder (PTSD) fluctuates in response to related stimuli such as the anniversary of the event and the result of the court hearings related to the event. Results: Contrary to theoretical knowledge and expectations, there were no significant differences in the emergence of acute PTSD between the three groups: that is, PTSD emerged in all the groups, and higher extent of trauma did not predict higher onset of acute PTSD. Differences emerged throughout further stages of the study; higher extent of trauma resulted in a higher number of chronic cases and thus extent of trauma was one of the predictors of chronicity. Interestingly, up to ten patterns (subgroups) of PTSD against the expectation of only three (acute, chronic and delayed) emerged during the course of the study. Contrary to expectations, the delayed pattern of morbidity was more common than the chronic and acute forms in one of the study groups.Öğe Possible malignant neuroleptic syndrome that associated with hypothyroidism(Pergamon-Elsevier Science Ltd, 2005) Taskapan, C; Sahin, I; Taskapan, H; Kaya, B; Kosar, FA 54-year-old woman with schizophrenia presented to hospital with unconsciousness, fever and marked muscle rigidity. She had been given fluphenazine decanoete 20 mg intramuscularly 15 days before the admission and she had continued taking haloperidol 20 mg daily and oral biperiden 2-4 mg. She was extremely rigid and unresponsive. On laboratory investigations revealed: serum sodium 120 mEq/l, creatinine phosphokinase 12,980 IU/l (normal up to 170), lactate dehydrogenase 1544 IU/l (150-500), free trioidothyronine <1.00 pg/ml (1.5-4.5), free throxyine 0.76 ng/dl (0.8-1.9), thyroid stimulating hormone 1.14 mu U/ml (0.4-4), cortisol (at 8.00 a.m.) 9 mu g/dl (5-25). Antipsychotic drugs were withdrawn after admission. A diagnosis of secondary adrenal insufficiency and secondary hypothyroidism was made. Hormonal substitution with hydrocortisone and levothyroxine and correction of hyponatremia with intravenous hypertonic saline solution resulted in rapid improvement of symptoms and signs. It seems that the symptoms and signs of hypothyroidism and hyponatremia were attributed to acute psychosis in this patient. As a conclusion failure to recognize the endocrinopathy may not only produce recovery difficulties but also psychiatric and endocrine repercussions if psychotropic medications are given in such masked cases. (C) 2005 Elsevier Inc. All rights reserved.Öğe Psychiatric disorders and large interdialytic weight gain in patients on chronic haemodialysis(Blackwell Publishing Asia, 2005) Taskapan, H; Ates, F; Kaya, B; Emul, M; Kaya, M; Taskapan, Ç; Sahin, IAims: Psychiatric disorders have been considered in terms of non-compliant behaviour and low life quality in haemodialysis patients. The aim of this study is to investigate the potential association of psychiatric disorders with compliance of fluid restriction and nutritional status and to measure the effects of psychiatric disorders on the life quality in chronic renal failure patients on haemodialysis. Methods: The study was conducted between April 2002 and December 2002 at a University hospital haemodialysis unit. The study population included 40 chronic renal failure patients (15 females/25 males). The Hamilton Depression Rating Scale ( HDRS), Hamilton Anxiety Rating Scale (HARS) and Primary Care Evaluation of Mental Disorders (PRIME-MD), The Mini Mental State Examination (MMSE) and Short Form Health Survey 36 (SF-36) were used for patient assessment by a trained psychiatrist. The subjects' medical charts were reviewed by a physician who was unaware of the the results of the psychiatric assesments. Interdialytic weight gain (IDWG %) and nutritional status were used as an index of diet compliance. Nutrition was assessed by using subjective global assessment ( SGA), serum albumin, predialysis phosphorus and potassium levels. Results: All patients' MMSE were normal. A diagnosis of a depressive or anxiety or somatoform disorder by the PRIME MD was made in 65% of the patients. Fourteen (35%) of the patients had a depressive disorder, 13 (32.5%) of the patients had a somatoform disorder, and 12 (30%) had an anxiety disorder. We found no relationship between any psychiatric disorder and age, sex, duration of dialysis therapy, education, marital status, employment, socioeconomic status, serum albumin, phosphorus, potassium or SGA (P > 0.05). In patients with depression or a somatoform disorder, the interdialytic weight (%) was significantly higher than those of the patients without these disorders (P < 0.05). All indices of quality of life decreased in patients diagnosed with a psychiatric disorder. Conclusion: Depressive symptoms are important determinants of patients' large interdialytic weight gain and psychiatric disorders that effect a patients' overall quality of life. Evaluation of psychiatric status should be part of the care provided to haemodialysis patients.Öğe Sevoflurane as an alternative anaesthetic for electroconvulsive therapy(Lippincott Williams & Wilkins, 2005) Toprak, HI; Gedik, E; Begeç, Z; Öztürk, E; Kaya, B; Ersoy, MÖObjectives: The aim of this study was to investigate the effects of sevoflurane and propofol used in electroconvulsive therapy (ECT) on hemodynamic variables and duration of seizure activity and recovery profiles. Methods: Sixteen patients who were not premedicated, with a mean age 27.1 years, were enrolled in this prospective open trial, receiving a total of 64 ECT treatments. Each patient was given the following 2 anesthetic regimens in random order: In group S, anesthesia was induced with 7% sevoflurame in 100% oxygen at 6 L min (1) fresh gas flow until the loss of consciousness and 1.5 mg kg(-1) propofol in group P. Adequate muscle relaxation was achieved with suxamethonium, 1.0 - 1.2 mg kg(-1). Noninvasive mean arterial pressure (MAP) and heart rate (HR) values, duration of motor seizure activity, and recovery times were recorded. Results: The mean motor seizure duration was significantly longer with sevoflurane (mean [SD]: 43.09 [16.6] s) than with propofol (28.91 [7.9] s; P < 0.05). The MAP 1 minute and 10 minutes after ECT (10 1.25 [7.5] mm Hg and 100.16 [11.0] min mu g, respectively) was significantly increased compared with before ECT (94,56 [6.91 mm fig) in sevoflurane group (P < 0.05). Time to spontaneous breathing, eye opening and obeying commands, and changes in MAP and HR during and after ECT were similar in both regimens. Conclusion: Induction with 7% sevoflurane allows prolonged duration of motor seizures in ECT. We concluded that induction of anesthesia with sevoflurane inhalation is a reasonable alternative for patients undergoing ECT.Öğe Weight gain and improvement with quetiapine in bipolar I disorder - A case report(Pergamon-Elsevier Science Ltd, 2004) Ozcan, ME; Kaya, B; Polat, RObservations made with quetiapine (QUET) in this case give clues for some aspects of its use for patients with bipolar disorder. Weight gain (11 kg; 16.6% increase in 21 weeks) and improvement in manic symptoms occurred after QUET add-on to lithium (Li). Patient's mood improved after QUET add-on without causing extrapyramidal symptoms (EPS), while QUET was discontinued due to weight gain. Shortterm QUET add-on to Li may help mood stabilization in bipolar I disorder. Weight changes must be observed carefully. (C) 2003 Elsevier Inc. All rights reserved.
