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Sagcan G, Dogan Z, Uzun H, Cuhadaroglu C, Okumus G, Arseven O. Impact of Promising Biomarkers on Severity and Outcome of Acute Pulmonary Embolism. Int J Gen Med 2023; 16:3301-3309. [PMID: 37551292 PMCID: PMC10404424 DOI: 10.2147/ijgm.s416541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/28/2023] [Indexed: 08/09/2023] Open
Abstract
Background Acute pulmonary embolism (APE) is a common clinical condition. Its severity ranges from asymptomatic radiological findings to fatal obstructive shock. The potential circulating biomarkers have been studied to predict APE outcomes. This study aimed to explore their predictive power on prognosis in APE. Material and Method It was a prospective observational study between March 2008 and April 2010. All consecutive patients diagnosed with APE were categorized as massive/high-risk, submassive/moderate-risk, and non-massive/low-risk. Cardiac troponin T (cTnT), myoglobin, N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP), growth differentiation factor-15 (GDF-15), and D-dimer levels were measured. Results Of these patients, 14 (29.8%), 16 (34.0%), and 17 (36.2%) patients were categorized as low-risk, moderate-risk, and high risk-patients, respectively. There was no significant difference between the patient groups categorized based on the risk stratification in terms of demographic and clinical characteristics. The cTnT, myoglobin, HFABP, and D-dimer levels have also not differed significantly between the groups. There was a significant difference between the groups in respect of NT-proBNP and GDF-15 levels (p=0.009 and p=0.037, respectively). Nine (19.1%) patients had died by the 3rd-month follow-up. Adverse events were seen in 26 (55.3%) patients. GDF-15 had the highest area under the curve (AUC) value for predicting any adverse event (cut-off value=9.3 ng/mL, AUC=0.796, CI (confidence interval) 95%: 0.653-0.899). NT-ProBNP was determined as the best predictor for mortality (cut-off value=229.2 pg/mL, AUC=0.889, CI 95%: 0.756-0.964). Conclusion Higher levels of NT-proBNP and GDF-15 were found to be associated with more severe APE, worse outcomes, and mortality.
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Affiliation(s)
- Gulseren Sagcan
- Department of Chest Diseases, Faculty of Medicine, Acıbadem University, İstanbul, Turkey
| | - Zeki Dogan
- Department of Cardiology, Faculty of Medicine, Istanbul Atlas University, Istanbul, Turkey
| | - Hafize Uzun
- Department of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, Istanbul, Turkey
| | - Caglar Cuhadaroglu
- Department of Chest Diseases, Faculty of Medicine, Acıbadem University, İstanbul, Turkey
| | - Gulfer Okumus
- Department of Chest Diseases, Faculty of Medicine, Istanbul University, İstanbul, Turkey
| | - Orhan Arseven
- Department of Chest Diseases, Faculty of Medicine, Istanbul University, İstanbul, Turkey
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Isiklar A, Basaran G, Sepin B, Gumusay O, Kocagoz AS, Cuhadaroglu C. Alpelisib induced interstitial lung disease in a patient with advanced breast cancer. J Oncol Pharm Pract 2023; 29:484-488. [PMID: 35730191 DOI: 10.1177/10781552221107532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Interstitial lung disease interstitial lung disease is a group of respiratory diseases that causes progressive fibrosis. Many of the recently approved oncology drugs are associated with the development of interstitial lung disease as an adverse event. We report an alpelisib-induced interstitial lung disease in a patient with advanced breast cancer. CASE REPORT A 65-year-old breast cancer patient who had multiple bone metastases and had been previously treated with letrozole and ribociclib, started alpelisib and fulvestrant combination upon the development of liver metastases. Her past medical history was not significant except the history of hypertension. She developed fatigue and progressive dyspnea 3, 5 months after starting alpelisib and was hospitalized due to rapidly deteriorating hypoxia within 2-3 days. MANAGEMENT AND OUTCOME Naranjo Algorithm calculated score was 4 (probable Adverse Drug Reaction). Her thoracic computed tomography and angiography scan were consistent with interstitial infiltrate ground-glass appearance. She had no fever. Her workup for COVID-19 (coronavirus disease), other respiratory infectious agents, and pulmonary embolism was negative. There was a rapid clinical and radiologic response to corticosteroid therapy within one week. She was discharged from the hospital with a tapered steroid dose and complete resolution of her lung infiltrations. Alpelisib was discontinued despite radiological partial response in her liver metastases and a decline in her tumor marker. DISCUSSION Drug-induced interstitial lung disease is usually a diagnosis of exclusion, difficult to identify particularly during the COVID-19 pandemic for patients with cancer. Differential diagnosis includes infectious pneumonia, radiation pneumonitis, diffuse alveolar hemorrhage, pulmonary edema, and pulmonary lymphangitic metastasis.
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Affiliation(s)
- Aysun Isiklar
- Breast Health Center, Acibadem Altunizade Hospital, Internal Medicine, Medical Oncology Department, Istanbul, Turkey
| | - Gul Basaran
- Breast Health Center, Acibadem Altunizade Hospital, Internal Medicine, Medical Oncology Department, Istanbul, Turkey.,Acibadem University School of Medicine, Internal Medicine, Medical Oncology Department, Istanbul, Turkey
| | - Beyza Sepin
- Acibadem University School of Medicine, Internal Medicine, Medical Oncology Department, Istanbul, Turkey
| | - Ozge Gumusay
- Breast Health Center, Acibadem Altunizade Hospital, Internal Medicine, Medical Oncology Department, Istanbul, Turkey.,Acibadem University School of Medicine, Internal Medicine, Medical Oncology Department, Istanbul, Turkey
| | - Ayse Sesin Kocagoz
- Department of Infectious Diseases and Clinical Microbiology, Acibadem University School of Medicine, Infectious Diseases Department, Istanbul, Turkey
| | - Caglar Cuhadaroglu
- Pulmonary Medicine Department, Acibadem University School of Medicine, Istanbul, Turkey
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Baydar Toprak O, Akpolat T, Uzun O, Pınar Deniz P, Kokturk N, Varol A, Guzel E, Ercelik M, Gultekin O, Guner R, Turan S, Gökbulut Bektaş Ş, Coskun N, Bakan N, Nuri Yakar M, Eren Kutsoylu O, Ergan B, Argun Barış S, Başyiğit I, Boyacı H, Çetinkaya F, Çolak H, Aykac N, Baran Ketencioğlu B, Türe Yüce Z, Akkaya Isık S, Serap Yılmaz E, Karaoğlanoğlu S, Berik Safci S, Ozkan G, Kose N, Kizilirmak D, Havlucu Y, Nural S, Kerget F, Sunal Ö, Yuksel A, Bestepe Dursun Z, Deveci F, Kuluozturk M, Ataoglu O, Dursun M, Keskin S, Emin Sezgin M, Aktepe Sezgin EN, Eser F, Akyildiz L, Selim Almaz M, Kayaaslan B, Hasanoğlu I, Bayrak M, Gümüş A, Sağcan G, Cuhadaroglu C, Kucuk H, Onyilmaz T, Mete B, Kilinc O, Oya Itil B. COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission. Eur Rev Med Pharmacol Sci 2023; 27:2132-2142. [PMID: 36930513 DOI: 10.26355/eurrev_202303_31586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged groups.
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Affiliation(s)
- O Baydar Toprak
- Department of Chest Diseases, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Sagcan G, Konukoglu D, Uzun H, Arseven O, Okumus G, Cuhadaroglu C. Importance of oxidative stress in the evaluation of acute pulmonary embolism severity. BMC Pulm Med 2022; 22:382. [PMID: 36253755 PMCID: PMC9575210 DOI: 10.1186/s12890-022-02076-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 05/23/2022] [Indexed: 12/05/2022] Open
Abstract
Background Pulmonary embolism (PE) is a common and potentially life-threatening disorder. Our study was aimed to investigate whether oxidative stress markers can be used as clinical markers in the evaluation of acute PE (APE) severity. Methods 47 patients with objectively documented diagnosis of APE were recorded. Of these patients, 14 had low-risk PE, 16 had moderate-risk PE, and 17 had high-risk PE. 21 healthy subjects were also enrolled in this study. Ischemia-modified albumin (IMA), prooxidants-antioxidants balance (PAB), advanced protein oxidation products (AOPPs), and ferric reducing antioxidant power (FRAP) were measured as oxidative stress parameters to evaluate the role of oxidative stress. Results In the low-risk and moderate-risk APE groups, AOPPs and PAB levels were significantly higher and FRAP levels were significantly lower than those in the control group. AOPPs and IMA levels in the patients with high-risk PE were significantly higher than those in both the low-risk and moderate-risk APE patients. There was a significant correlation between levels of AOPPs and the levels of both IMA (r: 0.462, p < 0.001) and PAB (r:0.378, p < 0.005). Serum FRAP levels were negatively correlated with PAB (r:− 0.683, p < 0.001) and AOPPs levels (r:− 0,384, p < 0.001). There was also a significant positive correlation between the serum IMA and PAB levels. Conclusions We clearly demonstrated that reactive oxygen species formation is significantly enhanced in APE. IMA and AOPPs may be used as clinical markers in the evaluation of APE severity in clinical practice. However, further studies with larger patient populations and longer follow-up periods are required to confirm the mechanisms underlying these findings.
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Affiliation(s)
- Gülseren Sagcan
- Department of Respiratory Medicine, Acibadem Medical Faculty, Acibadem University, Istanbul, Turkey.
| | - Dildar Konukoglu
- Department of Medical Biochemistry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hafize Uzun
- Department of Medical Biochemistry, Faculty of Medicine, İstanbul Atlas University, Istanbul, Turkey
| | - Orhan Arseven
- Department of Respiratory Medicine, İstanbul Medical Faculty, İstanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Department of Respiratory Medicine, İstanbul Medical Faculty, İstanbul University, Istanbul, Turkey
| | - Caglar Cuhadaroglu
- Department of Respiratory Medicine, Acibadem Medical Faculty, Acibadem University, Istanbul, Turkey
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Babayigit C, Kokturk N, Kul S, Cetinkaya PD, Atis Nayci S, Argun Baris S, Karcioglu O, Aysert P, Irmak I, Akbas Yuksel A, Sekibag Y, Baydar Toprak O, Azak E, Mulamahmutoglu S, Cuhadaroglu C, Demirel A, Kerget B, Baran Ketencioglu B, Ozger HS, Ozkan G, Ture Z, Ergan B, Avkan Oguz V, Kilinc O, Ercelik M, Ulukavak Ciftci T, Alici O, Nurlu Temel E, Ataoglu O, Aydin A, Cetiner Bahcetepe D, Gullu YT, Fakili F, Deveci F, Kose N, Tor MM, Gunluoglu G, Altin S, Turgut T, Tuna T, Ozturk O, Dikensoy O, Yildiz Gulhan P, Basyigit I, Boyaci H, Oguzulgen IK, Borekci S, Gemicioglu B, Bayraktar F, Elbek O, Hanta I, Kuzu Okur H, Sagcan G, Uzun O, Akgun M, Altinisik G, Dursun B, Cakir Edis E, Gulhan E, Oner Eyuboglu F, Gultekin O, Havlucu Y, Ozkan M, Sakar Coskun A, Sayiner A, Kalyoncu AF, Itil O, Bayram H. The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort. Front Med (Lausanne) 2022; 9:894126. [PMID: 36117966 PMCID: PMC9471091 DOI: 10.3389/fmed.2022.894126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background and objectives Although several repurposed antiviral drugs have been used for the treatment of COVID-19, only a few such as remdesivir and molnupiravir have shown promising effects. The objectives of our study were to investigate the association of repurposed antiviral drugs with COVID-19 morbidity. Methods Patients admitted to 26 different hospitals located in 16 different provinces between March 11–July 18, 2020, were enrolled. Case definition was based on WHO criteria. Patients were managed according to the guidelines by Scientific Board of Ministry of Health of Turkey. Primary outcomes were length of hospitalization, intensive care unit (ICU) requirement, and intubation. Results We retrospectively evaluated 1,472 COVID-19 adult patients; 57.1% were men (mean age = 51.9 ± 17.7years). A total of 210 (14.3%) had severe pneumonia, 115 (7.8%) were admitted to ICUs, and 69 (4.7%) were intubated during hospitalization. The median (interquartile range) of duration of hospitalization, including ICU admission, was 7 (5–12) days. Favipiravir (n = 328), lopinavir/ritonavir (n = 55), and oseltamivir (n = 761) were administered as antiviral agents, and hydroxychloroquine (HCQ, n = 1,382) and azithromycin (n = 738) were used for their immunomodulatory activity. Lopinavir/ritonavir (β [95% CI]: 4.71 [2.31–7.11]; p = 0.001), favipiravir (β [95% CI]: 3.55 [2.56–4.55]; p = 0.001) and HCQ (β [95% CI]: 0.84 [0.02–1.67]; p = 0.046) were associated with increased risk of lengthy hospital stays. Furthermore, favipiravir was associated with increased risks of ICU admission (OR [95% CI]: 3.02 [1.70–5.35]; p = 0.001) and invasive mechanical ventilation requirement (OR [95% CI]: 2.94 [1.28–6.75]; p = 0.011). Conclusion Our findings demonstrated that antiviral drugs including lopinavir, ritonavir, and favipiravir were associated with negative clinical outcomes such as increased risks for lengthy hospital stay, ICU admission, and invasive mechanical ventilation requirement. Therefore, repurposing such agents without proven clinical evidence might not be the best approach for COVID-19 treatment.
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Affiliation(s)
- Cenk Babayigit
- Department of Pulmonary Medicine, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Nurdan Kokturk
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Seval Kul
- Department of Biostatistics, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Pelin Duru Cetinkaya
- Department of Pulmonary Medicine, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
- Department of Pulmonary Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Sibel Atis Nayci
- Department of Pulmonary Medicine, Faculty of Medicine, Mersin University, Yenişehir, Turkey
| | - Serap Argun Baris
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | - Oguz Karcioglu
- Department of Pulmonary Medicine, Halil Şıvgın Cubuk State Hospital, Ankara, Turkey
| | - Pinar Aysert
- Department of Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ilim Irmak
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Aycan Akbas Yuksel
- Department of Pulmonary Medicine, Faculty of Medicine, Ufuk University, Ankara, Turkey
| | - Yonca Sekibag
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Oya Baydar Toprak
- Department of Pulmonary Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Emel Azak
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | - Sait Mulamahmutoglu
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Caglar Cuhadaroglu
- Department of Pulmonary Medicine, Faculty of Medicine, Altunizade Acibadem Hospital, Acibadem University, Istanbul, Turkey
| | - Aslihan Demirel
- Department of Infectious Disease, Kadıköy Florence Nightingale Hospital, Istanbul, Turkey
| | - Bugra Kerget
- Department of Pulmonary Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | | | - Hasan Selcuk Ozger
- Department of Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Gulcihan Ozkan
- Department of Pulmonary Medicine, Acibadem Maslak Hospital, Istanbul, Turkey
- Operating Room Services Department, Vocational School, Nişantaşı University, Istanbul, Turkey
| | - Zeynep Ture
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Begum Ergan
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Vildan Avkan Oguz
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Oguz Kilinc
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Merve Ercelik
- Department of Pulmonary Medicine, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Tansu Ulukavak Ciftci
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ozlem Alici
- Department of Infectious Disease, Turkiye Gazetesi Private Hospital, Istanbul, Turkey
| | - Esra Nurlu Temel
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Ozlem Ataoglu
- Department of Pulmonary Medicine, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Asena Aydin
- Department of Pulmonary Medicine, Kestel State Hospital, Bursa, Turkey
| | | | - Yusuf Taha Gullu
- Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Fusun Fakili
- Department of Pulmonary Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Figen Deveci
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazıg˘, Turkey
| | - Neslihan Kose
- Department of Pulmonary Medicine, Bilecik Training and Research Hospital, Bilecik, Turkey
| | - Muge Meltem Tor
- Department of Pulmonary Medicine, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Gulsah Gunluoglu
- Department of Pulmonary Medicine, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Sedat Altin
- Department of Pulmonary Medicine, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Teyfik Turgut
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazıg˘, Turkey
| | - Tibel Tuna
- Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Onder Ozturk
- Department of Pulmonary Medicine, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Oner Dikensoy
- Department of Pulmonary Medicine, Faculty of Medicine, Taksim, Acibadem University, Istanbul, Turkey
| | - Pinar Yildiz Gulhan
- Department of Pulmonary Medicine, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Ilknur Basyigit
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | - Hasim Boyaci
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | | | - Sermin Borekci
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Bilun Gemicioglu
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Firat Bayraktar
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Osman Elbek
- Department of Pulmonary Medicine, Kadıköy Florence Nightingale Hospital, Istanbul, Turkey
| | - Ismail Hanta
- Department of Pulmonary Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Hacer Kuzu Okur
- Department of Pulmonary Medicine, Faculty of Medicine, Altunizade Acibadem Hospital, Acibadem University, Istanbul, Turkey
| | - Gulseren Sagcan
- Department of Pulmonary Medicine, Faculty of Medicine, Altunizade Acibadem Hospital, Acibadem University, Istanbul, Turkey
| | - Oguz Uzun
- Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Metin Akgun
- Department of Pulmonary Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Goksel Altinisik
- Department of Pulmonary Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Berna Dursun
- Department of Pulmonary Medicine, Ankara Memorial Hospital, Ankara, Turkey
| | - Ebru Cakir Edis
- Department of Pulmonary Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Erkmen Gulhan
- Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Fusun Oner Eyuboglu
- Department of Pulmonary Medicine, School of Medicine, Başkent University, Ankara, Turkey
| | - Okkes Gultekin
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Yavuz Havlucu
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Metin Ozkan
- Department of Pulmonary Medicine, Ankara Memorial Hospital, Ankara, Turkey
| | - Aysin Sakar Coskun
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Abdullah Sayiner
- Department of Pulmonary Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
| | - A. Fuat Kalyoncu
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Oya Itil
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Hasan Bayram
- Department of Pulmonary Medicine, Koç University School of Medicine, Istanbul, Turkey
- Koç University Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
- *Correspondence: Hasan Bayram,
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Uysal P, Teksoz D, Aksan H, Durmus S, Uslu-Besli L, Cuhadaroglu C, Gelisgen R, Simsek G, Uzun H. Relationship between serum sialic acid levels and prolidase activity with airflow obstruction in patients with COPD. Medicine (Baltimore) 2022; 101:e28949. [PMID: 35356903 PMCID: PMC10684178 DOI: 10.1097/md.0000000000028949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Our aim in this study was to evaluate the prognostic significance of sialic acid (SA) and prolidase activity and to evaluate the association between airflow obstruction severity and these parameters in chronic obstructive pulmonary disease (COPD) patients.Ninety-four patients (84 M, 10 F) and 34 healthy subjects (19 M, 15 F) were included into the study. COPD staging was performed to COPD patients according to new global initiative for chronic obstructive lung disease criteria which includes pulmonary function tests, symptoms and hospitalization; COPD patients were divided into 4 subgroups as group A (n = 25), group B (n = 19), group C (n = 20), and group D (n = 28).SA and C-reactive protein levels were significantly higher than the control group in all COPD groups. SA levels were significantly higher in group B patients than the control and group A. Prolidase activity was significantly lower than control group in total COPD groups (P < .05). There was a weak negative correlation between SA and forced vital capacity (r = -0.217, P = .038) and forced expiratory volume in 1 second (FEV1) (r = -0.210, P = .045), whereas weak positive correlation was present between SA and Creactive protein (r = 0.247, P = .018) in all patient groups. There was weak positive correlation between prolidase and FEV1 (r = 0.222, P = .033) and FEV1/forced vital capacity (r = 0.230, P = .027).Our study shows that systemic inflammation, prolidase activity, and SA levels in stable COPD patients are associated with airflow obstruction severity. In addition to the prolidase activity; SA levels might be associated with inflammation.
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Affiliation(s)
- Pelin Uysal
- Department of Chest Diseases, Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, Maslak Hospital, Istanbul, Turkey,Department of Biochemistry, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey,Department of Biochemistry, Faculty of Medicine, Halic University, Istanbul, Turkey,Department of Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey,Department of Nuclear Medicine, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey,Department of Physiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey,Department of Medical Biochemistry, Faculty of Medicine, Istanbul Atlas University, Istanbul, Turkey
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Uzun O, Akpolat T, Varol A, Turan S, Bektas SG, Cetinkaya PD, Dursun M, Bakan N, Ketencioglu BB, Bayrak M, Baris SA, Guner R, Gunal O, Nural S, Deniz PP, Toprak OB, Ozkan G, Gumus A, Kerget F, Ercelik M, Ataoglu O, Yuksel A, Ates G, Kutsoylu OE, Kose N, Kizilirmak D, Keskin S, Gultekin O, Coskun N, Yilmaz ES, Uslu S, Basyigit İ, Ergan B, Deveci F, Yakar MN, Zuhur C, Sagcan G, Yuce ZT, Kuluozturk M, Sezgin ME, Sezgin ENA, Havlucu Y, Cuhadaroglu C, Kilinc O, Boyaci H, Altunay H, Akti M, Dursun ZB, Kalem AK, Isik SA, Akyildiz L, Aykac N, Almaz MS, Kokturk N, Itil O. COVID-19: vaccination vs. hospitalization. Infection 2022; 50:747-752. [PMID: 34984646 PMCID: PMC8725959 DOI: 10.1007/s15010-021-01751-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 12/21/2021] [Indexed: 12/20/2022]
Abstract
Objective Vaccination is the most efficient way to control the coronavirus disease 2019 (COVID-19) pandemic, but vaccination rates remain below the target level in most countries. This multicenter study aimed to evaluate the vaccination status of hospitalized patients and compare two different booster vaccine protocols. Setting Inoculation in Turkey began in mid-January 2021. Sinovac was the only available vaccine until April 2021, when BioNTech was added. At the beginning of July 2021, the government offered a third booster dose to healthcare workers and people aged > 50 years who had received the two doses of Sinovac. Of the participants who received a booster, most chose BioNTech as the third dose. Methods We collected data from 25 hospitals in 16 cities. Patients hospitalized between August 1 and 10, 2021, were included and categorized into eight groups according to their vaccination status. Results We identified 1401 patients, of which 529 (37.7%) were admitted to intensive care units. Nearly half (47.8%) of the patients were not vaccinated, and those with two doses of Sinovac formed the second largest group (32.9%). Hospitalizations were lower in the group which received 2 doses of Sinovac and a booster dose of BioNTech than in the group which received 3 doses of Sinovac. Conclusion Effective vaccinations decreased COVID-19-related hospitalizations. The efficacy after two doses of Sinovac may decrease over time; however, it may be enhanced by adding a booster dose. Moreover, unvaccinated patients may be persuaded to undergo vaccination.
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Affiliation(s)
- Oguz Uzun
- Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
- Ondokuz Mayıs Üniversitesi Göğüs Hst, 55139, Samsun, Turkey.
| | - Tekin Akpolat
- Department of Internal Medicine and Nephrology, Faculty of Medicine, Istinye University, Istanbul, Turkey
| | | | - Sema Turan
- Department of Intensive Care Unit, Ankara City Hospital, Ankara, Turkey
| | | | | | | | - Nurten Bakan
- Şehit Prof Dr İlhan Varank Training and Research Hospital, İstanbul, Turkey
| | | | | | - Serap Argun Baris
- Department of Pulmonary Disease, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Rahmet Guner
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Ozgur Gunal
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, University of Medical Science, Samsun, Turkey
| | - Serkan Nural
- Department of Pulmonary Medicine, Training and Research Hospital, Hatay, İstanbul, Turkey
| | | | - Oya Baydar Toprak
- Department of Pulmonary Medicine, Faculty of Medicine, Cukuroca University, Adana, Turkey
| | - Gulcihan Ozkan
- Maslak Acibadem Hospital, Operating Room Services Department and Private Acıbadem Maslak Hospital, Vocational School, Nişantaşı University, İstanbul, Turkey
| | | | - Ferhan Kerget
- Department of Infection Diseases and Clinical Microbiology, Faculty of Medicine, Erzurum Regional Education and Research Hospital, Health Sciences University, Erzurum, Turkey
| | | | | | - Aycan Yuksel
- Department of Pulmonary Medicine, Faculty of Medicine, Ufuk University, Ankara, Turkey
| | - Gungor Ates
- Genesis Private Hospital, Diyarbakır, Turkey
| | - Oya Eren Kutsoylu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | | | - Deniz Kizilirmak
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | | | | | - Nilüfer Coskun
- Şehit Prof Dr İlhan Varank Training and Research Hospital, İstanbul, Turkey
| | - Emine Serap Yilmaz
- Department of Pulmonary Medicine, Medical Faculty, Training and Research Hospital, Ordu University, Ordu, Turkey
| | - Selen Uslu
- Department of Pulmonary Medicine, Medical Faculty, Training and Research Hospital, Ordu University, Ordu, Turkey
| | - İlknur Basyigit
- Department of Pulmonary Disease, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Begüm Ergan
- Division of Intensive Care, Department of Pulmonary and Critical Care, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Figen Deveci
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazıg, Turkey
| | - Mehmet Nuri Yakar
- Division of Intensive Care, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | | | | | - Zeynep Ture Yuce
- Department of Infectious Diseases and Clinical Microbiology, Erciyes University, Kayseri, Turkey
| | - Mutlu Kuluozturk
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazıg, Turkey
| | | | | | - Yavuz Havlucu
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | | | - Oguz Kilinc
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Hasim Boyaci
- Department of Pulmonary Disease, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | | | - Mehmet Akti
- Siirt Training and Research Hospital, Siirt, Turkey
| | - Zehra Bastepe Dursun
- Department of Infectious Diseases and Clinical Microbiology, Kayseri City Hospital, Health Science University, Kayseri, Turkey
| | - Ayse Kaya Kalem
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University, Ankara, Turkey
| | - Sinem Akkaya Isik
- Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
| | | | | | | | - Nurdan Kokturk
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Oya Itil
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey
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Fakili F, Cetinkaya P, Baydar O, Baris S, Kokturk N, Kul S, Karcioglu O, Yildiz P, Irmak I, Sekibag Y, Azak E, Mulamahmutoglu S, Cuhadaroglu C, Kerget B, Ketencioglu B, Ozger H, Ozkan G, Ture Z, Ercelik M, Ciftci T, Alici O, Temel E, Ataoglu O, Kose N, Tor M, Gunluoglu G, Altin S, Ozturk O, Gulhan P, Basyigit I, Boyaci H, Oguzulgen IK, Borekci S, Gemicioglu B, Hanta I, Okur H, Sagcan G, Akgun M, Kalyoncu A, Itil O, Bayram H. Post−discharge mortality in the first wave of COVID−19 in Turkey. ASIAN PAC J TROP MED 2022. [DOI: 10.4103/1995-7645.361853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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9
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Argun Baris S, Kokturk N, Baydar Toprak O, Duru Cetinkaya P, Fakili F, Kul S, Kayalar O, Tutuncu Y, Azak E, Kuluozturk M, Yildiz P, Deniz P, Kilinc O, Basyigit I, Boyaci H, Hanta I, Kose N, Sagcan G, Cuhadaroglu C, Okur H, Ozger H, Ergan B, Hafizoglu M, Sayiner A, Temel E, Ozturk O, Ciftci T, Oguzulgen I, Oguz V, Bayraktar F, Ataoglu O, Ercelik M, Gulhan P, Erdem A, Tor M, Itil O, Bayram H. The predictors of long–COVID in the cohort of Turkish Thoracic Society– TURCOVID multicenter registry: One year follow–up results. ASIAN PAC J TROP MED 2022. [DOI: 10.4103/1995-7645.354422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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10
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Kokturk N, Babayigit C, Kul S, Duru Cetinkaya P, Atis Nayci S, Argun Baris S, Karcioglu O, Aysert P, Irmak I, Akbas Yuksel A, Sekibag Y, Baydar Toprak O, Azak E, Mulamahmutoglu S, Cuhadaroglu C, Demirel A, Kerget B, Baran Ketencioglu B, Ozger HS, Ozkan G, Ture Z, Ergan B, Avkan Oguz V, Kilinc O, Ercelik M, Ulukavak Ciftci T, Alici O, Nurlu Temel E, Ataoglu O, Aydin A, Cetiner Bahcetepe D, Gullu YT, Fakili F, Deveci F, Kose N, Tor MM, Gunluoglu G, Altin S, Turgut T, Tuna T, Ozturk O, Dikensoy O, Yildiz Gulhan P, Basyigit I, Boyaci H, Oguzulgen IK, Borekci S, Gemicioglu B, Bayraktar F, Elbek O, Hanta I, Kuzu Okur H, Sagcan G, Uzun O, Akgun M, Altinisik G, Dursun B, Cakir Edis E, Gulhan E, Oner Eyuboglu F, Gultekin O, Havlucu Y, Ozkan M, Sakar Coskun A, Sayiner A, Kalyoncu AF, Itil O, Bayram H. The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients. Respir Med 2021; 183:106433. [PMID: 33957434 PMCID: PMC8079263 DOI: 10.1016/j.rmed.2021.106433] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 01/08/2023]
Abstract
The COVID-19-related death rate varies between countries and is affected by various risk factors. This multicenter registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. In the study group, 1041 and 459 cases were diagnosed as definite and highly probable cases, respectively. There were 993 PCR-positive cases (66.2%). Among all cases, 1144 (76.3%) were diagnosed with non-severe pneumonia, whereas 212 (14.1%) had severe pneumonia. Death occurred in 67 patients, corresponding to a mortality rate of 4.5% (95% CI:3.5–5.6). The univariate analysis demonstrated that various factors, including male sex, age ≥65 years and the presence of dyspnea or confusion, malignity, chronic obstructive lung disease, interstitial lung disease, immunosuppressive conditions, severe pneumonia, multiorgan dysfunction, and sepsis, were positively associated with mortality. Favipiravir, hydroxychloroquine and azithromycin were not associated with survival. Following multivariate analysis, male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were found to be independent risk factors for mortality. Among the biomarkers, procalcitonin levels on the 3rd-5th days of admission showed the strongest associations with mortality (OR: 6.18; 1.6–23.93). This study demonstrated that the mortality rate in hospitalized patients in the early phase of the COVID-19 pandemic was a serious threat and that those patients with male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were at increased risk of mortality; therefore, such patients should be closely monitored.
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Affiliation(s)
- Nurdan Kokturk
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Cenk Babayigit
- Department of Pulmonary Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.
| | - Seval Kul
- Department of Biostatistics, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.
| | - Pelin Duru Cetinkaya
- Department of Pulmonary Medicine, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey.
| | - Sibel Atis Nayci
- Department of Pulmonary Medicine, Faculty of Medicine, Mersin University, Mersin, Turkey.
| | - Serap Argun Baris
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
| | - Oguz Karcioglu
- Department of Pulmonary Medicine, Halil Sıvgın Cubuk State Hospital, Ankara, Turkey.
| | - Pinar Aysert
- Department of Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Ilim Irmak
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Aycan Akbas Yuksel
- Department of Pulmonary Medicine, Faculty of Medicine, Ufuk University, Ankara, Turkey.
| | - Yonca Sekibag
- Department of Pulmonary Disease, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Oya Baydar Toprak
- Department of Pulmonary Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | - Emel Azak
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Kocaeli University, Kocaeli Turkey.
| | - Sait Mulamahmutoglu
- Department of Pulmonary Disease, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Caglar Cuhadaroglu
- Department of Pulmonary Medicine, Altunizade Acibadem Hospital, Istanbul, Turkey.
| | - Aslihan Demirel
- Department of Infectious Disease, Kadikoy Florence Nightingale Hospital, Istanbul, Turkey.
| | - Bugra Kerget
- Department of Pulmonary Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
| | | | - Hasan Selcuk Ozger
- Department of Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Gulcihan Ozkan
- Department of Pulmonary Medicine, Maslak Acibadem Hospital, Istanbul, Turkey; Operating Room Services Department, Nisantasi University, Vocational School, Istanbul, Turkey.
| | - Zeynep Ture
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
| | - Begum Ergan
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Vildan Avkan Oguz
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Oguz Kilinc
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Merve Ercelik
- Department of Pulmonary Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey.
| | - Tansu Ulukavak Ciftci
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Ozlem Alici
- Department of Infectious Disease, Faculty of Medicine, Turkiye Gazetesi Private Hospital, Istanbul, Turkey.
| | - Esra Nurlu Temel
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
| | - Ozlem Ataoglu
- Department of Pulmonary Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey.
| | - Asena Aydin
- Department of Pulmonary Medicine, Kestel State Hospital, Bursa, Turkey.
| | | | - Yusuf Taha Gullu
- Department of Pulmonary Medicine, Faculty of Medicine, On Dokuz Mayis University, Samsun, Turkey.
| | - Fusun Fakili
- Department of Pulmonary Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.
| | - Figen Deveci
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazig, Turkey.
| | - Neslihan Kose
- Department of Pulmonary Medicine, Bilecik Training and Research Hospital, Bilecik, Turkey.
| | - Muge Meltem Tor
- Department of Pulmonary Medicine, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey.
| | - Gulsah Gunluoglu
- Department of Pulmonary Medicine, University of Health Science, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey.
| | - Sedat Altin
- Department of Pulmonary Medicine, University of Health Science, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey.
| | - Teyfik Turgut
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazig, Turkey.
| | - Tibel Tuna
- Department of Pulmonary Medicine, Faculty of Medicine, On Dokuz Mayis University, Samsun, Turkey.
| | - Onder Ozturk
- Department of Pulmonary Medicine, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
| | - Oner Dikensoy
- Department of Pulmonary Medicine, Faculty of Medicine, Taksim, Acibadem University, Istanbul, Turkey.
| | - Pinar Yildiz Gulhan
- Department of Pulmonary Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey.
| | - Ilknur Basyigit
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
| | - Hasim Boyaci
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
| | - I Kivilcim Oguzulgen
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Sermin Borekci
- Department of Pulmonary Disease, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Bilun Gemicioglu
- Department of Pulmonary Disease, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Firat Bayraktar
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Osman Elbek
- Department of Pulmonary Medicine, Kadikoy Florence Nightingale Hospital, Istanbul, Turkey.
| | - Ismail Hanta
- Department of Pulmonary Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | - Hacer Kuzu Okur
- Department of Pulmonary Medicine, Altunizade Acibadem Hospital, Istanbul, Turkey.
| | - Gulseren Sagcan
- Department of Pulmonary Medicine, Altunizade Acibadem Hospital, Istanbul, Turkey.
| | - Oguz Uzun
- Department of Pulmonary Medicine, Faculty of Medicine, On Dokuz Mayis University, Samsun, Turkey.
| | - Metin Akgun
- Department of Pulmonary Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
| | - Goksel Altinisik
- Department of Pulmonary Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
| | - Berna Dursun
- Department of Pulmonary Medicine, Ankara Memorial Hospital, Ankara, Turkey.
| | - Ebru Cakir Edis
- Department of Pulmonary Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey.
| | - Erkmen Gulhan
- Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
| | - Fusun Oner Eyuboglu
- Department of Pulmonary Medicine, Baskent University, School of Medicine, Ankara, Turkey.
| | - Okkes Gultekin
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
| | - Yavuz Havlucu
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
| | - Metin Ozkan
- Department of Pulmonary Medicine, Ankara Memorial Hospital, Ankara, Turkey.
| | - Aysin Sakar Coskun
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
| | - Abdullah Sayiner
- Department of Pulmonary Medicine, Faculty of Medicine, Ege University, Izmir, Turkey.
| | - Ali Fuat Kalyoncu
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Oya Itil
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Hasan Bayram
- Department of Pulmonary Medicine, Koc University Research Center for Translational Medicine (KUTTAM), Koc University School of Medicine, Istanbul, Turkey.
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Uysal P, Afsar CU, Sozer V, Inanc B, Agaoglu F, Gural Z, Fazlıoglu NY, Cuhadaroglu C, Uzun H. Evaluation of the relationship between serum ghrelin levels and cancer cachexia in patients with locally advanced nonsmall-cell lung cancer treated with chemoradiotherapy. J Cancer Res Ther 2020; 16:855-859. [PMID: 32930130 DOI: 110.4103/jcrt.jcrt_10_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Ghrelin plays a role in mechanisms related to cancer progression - including cell proliferation, invasion and migration, and resistance to apoptosis in the cell lines from several cancers. We investigated the role of ghrelin levels in cancer cachexia-anorexia in patients with locally advanced nonsmall-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT). Materials and Methods This study involved 84 NSCLC patients who had received concomitant CRT. Blood ghrelin levels were compared before and 3 months after CRT. Meanwhile, changes in body weight of the patients were also investigated with changes in ghrelin levels before and after CRT. Results Ghrelin levels were significantly decreased in line with changes in patients' weights in patients receiving CRT (P < 0.001). Serum albumin levels and inflammatory-nutritional index were significantly decreased after radiotherapy (RT) (3.01 ± 0.40 g/dL, 0.38 ± 0.20) when compared with its baseline levels (3.40 ± 0.55 g/dL,P < 0.001; 0.86 ± 0.71,P < 0.001, respectively). Serum C-reactive protein levels were significantly increased after CRT (7.49 ± 6.53 mg/L) when compared with its baseline levels (9.54 ± 3.80 mg/L,P = 0.038). After RT, ghrelin levels in patients were positively correlated with body mass index (r = 0.830,P < 0.001) and albumin (r = 0.758,P < 0.001). Conclusion Ghrelin may play a role in the pathogenesis of weight loss in NSCLC patients. Ghrelin seems to be implicated in cancer-related weight loss. Ghrelin, cancer, and RT all together have a role in tumor-related anorexia-cachexia in patients with NSCLC. Results of this study need further evaluation as regards to its potential role as an adjuvant diagnostic or prognostic marker.
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Affiliation(s)
- Pelin Uysal
- Department of Chest Diseases, Faculty of Medicine, Atakent Hospital, Mehmet Ali Aydınlar University, Tekirdag, Turkey
| | - Cigdem Usul Afsar
- Department of Medical Oncology, Faculty of Medicine, Bakırkoy Hospital, Mehmet Ali Aydınlar University, Tekirdag, Turkey
| | - Volkan Sozer
- Department of Biochemistry, Yildiz Technical University, Tekirdag, Turkey
| | - Berrin Inanc
- Department of Radiation Oncology, İstanbul Education and Research Hospital, Tekirdag, Turkey
| | - Fulya Agaoglu
- Department of Chest Diseases, Faculty of Medicine, Atakent Hospital, Mehmet Ali Aydınlar University, Tekirdag, Turkey
| | - Zeynep Gural
- Department of Chest Diseases, Faculty of Medicine, Atakent Hospital, Mehmet Ali Aydınlar University, Tekirdag, Turkey
| | - Nevin Yaman Fazlıoglu
- Department of Chest Diseases, Faculty of Medicine, Tekirdag Namık Kemal University, Tekirdag, Turkey
| | - Caglar Cuhadaroglu
- Department of Chest Diseases, Faculty of Medicine, Altunizade Hospital, Mehmet Ali Aydınlar University, Tekirdag, Turkey
| | - Hafize Uzun
- Department of Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Zengin R, Beyaz O, Koc ES, Akinci IO, Kocagoz S, Sagcan G, Ovali E, Cuhadaroglu C. Mesenchymal stem cell treatment in a critically ill COVID-19 patient: a case report. Stem Cell Investig 2020; 7:17. [PMID: 33110915 DOI: 10.21037/sci-2020-024] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/05/2020] [Indexed: 12/19/2022]
Abstract
An outbreak of a new coronavirus causing severe respiratory disease (COVID-19) was first reported in China and rapidly spread worldwide. Clinical spectrum changes from asymptomatic infection to severe illness and even death, and no specific treatment is currently available. A range of antiviral, antimalarial and antibiotic agents are being used. We report a case of a COVID-19 patient that progressed to severe disease requiring intubation and intensive care. We performed mesenchymal stem cell (MSC) transplantation considering the signs showing persistent excessive immune response and deterioration despite all supportive and drug therapies. The two rounds of transplantation did not result in any severe complications and was well-tolerated. Clinical signs were improved. The use of MSC therapy may be considered for compassionate use in selected patients.
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Affiliation(s)
- Rehile Zengin
- Department of Infectious Diseases, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - Oyku Beyaz
- Department of Internal Medicine, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - Elif S Koc
- Department of Internal Medicine, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - Ibrahim O Akinci
- Department of Anesthesiology and Reanimation, Acibadem Mehmet Ali Aydinlar University School of Medicine, Turkey
| | - Sesin Kocagoz
- Department of Infectious Diseases, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - Gulseren Sagcan
- Department of Pulmonary Medicine, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - Ercument Ovali
- Department of Hematology, Acibadem Labcell Laboratories, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - Caglar Cuhadaroglu
- Department of Pulmonary Medicine, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
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13
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Okur HK, Yalcin K, Tastan C, Demir S, Yurtsever B, Karakus GS, Kancagi DD, Abanuz S, Seyis U, Zengin R, Hemsinlioglu C, Kara M, Yildiz ME, Deliceo E, Birgen N, Pelit NB, Cuhadaroglu C, Kocagoz AS, Ovali E. Preliminary report of in vitro and in vivo effectiveness of dornase alfa on SARS-CoV-2 infection. New Microbes New Infect 2020; 37:100756. [PMID: 32922804 PMCID: PMC7476504 DOI: 10.1016/j.nmni.2020.100756] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 12/21/2022] Open
Abstract
Dornase alfa, the recombinant form of the human DNase I enzyme, breaks down neutrophil extracellular traps (NET) that include a vast amount of DNA fragments, histones, microbicidal proteins and oxidant enzymes released from necrotic neutrophils in the highly viscous mucus of cystic fibrosis patients. Dornase alfa has been used for decades in patients with cystic fibrosis to reduce the viscoelasticity of respiratory tract secretions, to decrease the severity of respiratory tract infections, and to improve lung function. Previous studies have linked abnormal NET formations to lung diseases, especially to acute respiratory distress syndrome (ARDS). It is well known that novel coronavirus disease 2019 (COVID-19) pneumonia progresses to ARDS and even multiple organ failure. High blood neutrophil levels are an early indicator of COVID-19 and predict severe respiratory diseases. Also it is reported that mucus structure in COVID-19 is very similar to that in cystic fibrosis due to the accumulation of excessive NET in the lungs. In this study, we showed the recovery of three individuals with COVID-19 after including dornase alfa in their treatment. We followed clinical improvement in the radiological analysis (two of three cases), oxygen saturation (Spo2), respiratory rate, disappearance of dyspnoea, coughing and a decrease in NET formation and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load after the treatment. Also here, we share our preliminary results suggesting that dornase alfa has an anti-viral effect against SARS-CoV-2 infection in a green monkey kidney cell line, Vero, and a bovine kidney cell line, MDBK, without determined cytotoxicity on healthy peripheral blood mononuclear cells.
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Affiliation(s)
- H K Okur
- Acibadem Altunizade Hospital, Chest Disease Unit, Istanbul, Turkey
| | - K Yalcin
- Acibadem Labcell Cellular Therapy Laboratory, Istanbul, Turkey.,Medical Park Goztepe Hospital, Paediatric Bone Marrow Transplantation Unit, Istanbul, Turkey
| | - C Tastan
- Acibadem Labcell Cellular Therapy Laboratory, Istanbul, Turkey
| | - S Demir
- Genetic and Bioengineering Department, Yeditepe University, Istanbul, Turkey
| | - B Yurtsever
- Acibadem Labcell Cellular Therapy Laboratory, Istanbul, Turkey
| | - G S Karakus
- Acibadem Labcell Cellular Therapy Laboratory, Istanbul, Turkey
| | - D D Kancagi
- Acibadem Labcell Cellular Therapy Laboratory, Istanbul, Turkey
| | - S Abanuz
- Acibadem Labcell Cellular Therapy Laboratory, Istanbul, Turkey
| | - U Seyis
- Acibadem Labcell Cellular Therapy Laboratory, Istanbul, Turkey
| | - R Zengin
- Acibadem Altunizade Hospital, Infectious Disease Unit, Istanbul, Turkey
| | - C Hemsinlioglu
- Acibadem Labcell Cellular Therapy Laboratory, Istanbul, Turkey
| | - M Kara
- Acibadem Altunizade Hospital, Internal Medicine Unit Department of Endocrinology, Istanbul, Turkey
| | - M E Yildiz
- Acibadem Altunizade Hospital, Radiology Unit, Istanbul, Turkey
| | - E Deliceo
- Acibadem Mehmet Ali Aydinlar University, School of Medicine, Department of Pediatrics, Istanbul, Turkey
| | - N Birgen
- Acibadem Altunizade Hospital, Cellular Therapy Centre, Istanbul, Turkey
| | - N B Pelit
- Acibadem Labcell Cellular Therapy Laboratory, Istanbul, Turkey
| | - C Cuhadaroglu
- Acibadem Altunizade Hospital, Chest Disease Unit, Istanbul, Turkey
| | - A S Kocagoz
- Acibadem Altunizade Hospital, Infectious Disease Unit, Istanbul, Turkey
| | - E Ovali
- Acibadem Labcell Cellular Therapy Laboratory, Istanbul, Turkey
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Uzun H, Uysal P, Afsar C, Sozer V, Inanc B, Agaoglu F, Gural Z, Fazlıoglu N, Cuhadaroglu C. Evaluation of the relationship between serum ghrelin levels and cancer cachexia in patients with locally advanced nonsmall-cell lung cancer treated with chemoradiotherapy. J Cancer Res Ther 2020. [DOI: 10.4103/jcrt.jcrt_10_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Uysal P, Simsek G, Durmus S, Sozer V, Aksan H, Yurt S, Cuhadaroglu C, Kosar F, Gelisgen R, Uzun H. Evaluation of plasma antimicrobial peptide LL-37 and nuclear factor-kappaB levels in stable chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2019; 14:321-330. [PMID: 30774329 PMCID: PMC6354692 DOI: 10.2147/copd.s185602] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Antimicrobial peptides are effectors of host defence against infection and inflammation and can encourage wound repair. Objectives The objectives of this study were to investigate the plasma antimicrobial peptide LL-37 and nuclear factor-kappaB (NF-κB) levels in patients with stable COPD compared with a control group and to highlight their importance in immune inflammation. Methods One hundred and thirty-eight stable COPD patients and 33 control subjects were enrolled in the study. The COPD patients were classified into four groups based on FEV1 (groups I-IV) and also divided into "low-risk and high-risk" groups (groups A-B [low risk], C-D [high risk]). Results Plasma LL-37 levels were significantly lower while plasma NF-κB levels of the COPD patients were significantly higher than those of the control subjects (P<0.001, both). LL-37 levels were significantly lower in group IV than in groups I, II, and III (P<0.01, all). NF-κB levels were significantly higher in groups III and IV than in groups I and II (P<0.05, both). There was a positive correlation between FEV1 and FEV1/FVC in all COPD patients (r=0.742, P<0.001) and in group D (r=0.741, P<0.001). Furthermore, there was an inverse correlation between LL-37 and NF-κB in both the groups C (r=-0.566, P<0.001) and D (r=-0.694, P<0.001) and group C+D combined (r=-0.593, P<0.001). Furthermore, in group C, LL-37 and FEV1 were positively correlated (r=0.633, P<0.001). Conclusion Our study indicated that plasma LL-37 and NF-κB may play an important role in chronic immune inflammation. Decreased LL-37 levels may be particularly high risk for patients in stage IV disease. The role of LL-37 as a target for treatment of the immune system and COPD must be widely evaluated.
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Affiliation(s)
- Pelin Uysal
- Department of Chest Diseases, Faculty of Medicine, Mehmet Ali Aydınlar University, Atakent Hospital, Istanbul, Turkey
| | - Gonul Simsek
- Department of Physiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sinem Durmus
- Department of Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey,
| | - Volkan Sozer
- Department of Biochemistry, Yildiz Technical University, Istanbul, Turkey
| | - Hulya Aksan
- Deparment of Biochemistry, Faculty of Medicine, Halic University, I˙stanbul, Turkey
| | - Sibel Yurt
- Clinic of Chest Diseases, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, I˙stanbul, Turkey
| | - Caglar Cuhadaroglu
- Department of Chest Diseases, Faculty of Medicine, Mehmet Ali Aydınlar University, Atakent Hospital, Istanbul, Turkey
| | - Filiz Kosar
- Clinic of Chest Diseases, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, I˙stanbul, Turkey
| | - Remise Gelisgen
- Department of Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey,
| | - Hafize Uzun
- Department of Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey,
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Abstract
This study aimed to determine the economic burden and affecting factors in adult community-acquired pneumonia (CAP) patients (≥ 18 years) by retrospectively evaluating the data of 2 centers in Istanbul province, Turkey. Data of outpatients and inpatients with CAP from January 2013 through June 2014 were evaluated. The numbers of laboratory analyses, imaging, hospitalization days, and specialist visits were multiplied by the relevant unit costs and the costs of the relevant items per patient were obtained. Total medication costs were calculated according to the duration of use and dosage. The mean age was 61.56 ± 17.87 y for the inpatients (n = 211; 48.6% female) and 53.78 ± 17.46 y for the outpatients (n = 208; 46.4% male). The total mean cost was €556.09 ± 1,004.77 for the inpatients and €51.16 ± 40.92 for the outpatients. In the inpatients, laboratory, medication, and hospitalization costs and total cost were significantly higher in those ≥ 65 y than in those <65 y. Besides the hospitalization duration, specialist visit, imaging, laboratory, medication, and hospitalization costs and total cost were significantly higher in those hospitalized more than once than in those hospitalized once. While the specialist visit cost was higher in the inpatients with comorbidities, the imaging cost was higher in the outpatients with comorbidities. CAP poses a higher cost in inpatients, elders, and individuals with comorbidities. Costs can be decreased by rational decisions about hospitalization and antibiotic use according to the recommendations of guidelines and authorities. Vaccination may decrease medical burden and contribute to economy by preventing the disease, especially in risk groups.
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Affiliation(s)
- Filiz Kosar
- a Yedikule Chest Diseases and Chest Surgery , Pulmonary Medicine , Istanbul , Turkey
| | | | - Basak Hacibedel
- c Pfizer Pharmaceuticals , Health Economics and Outcomes Research , Istanbul , Turkey
| | | | - Pejman Golabi
- d Acibadem University Faculty of Medicine, Department of Chest Diseases , Istanbul , Turkey
| | - Caglar Cuhadaroglu
- d Acibadem University Faculty of Medicine, Department of Chest Diseases , Istanbul , Turkey
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Pihtili A, Galle M, Cuhadaroglu C, Kilicaslan Z, Issever H, Erkan F, Cagatay T, Gulbaran Z. Evidence for the Efficacy of a Bioresonance Method in Smoking Cessation: A Pilot Study. Complement Med Res 2014; 21:239-45. [DOI: 10.1159/000365742] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
<b><i>Background: </i></b>Since the 1970s, MORA bioresonance therapy has globally been applied in the context of complementary medicine for various indications. In this regard, practitioners also report successful application in smoking cessation. The present study aims to verify these reports in a controlled study setting. <b><i>Methods: </i></b>In order to achieve the aforementioned objective, we subjected the bioresonance method to a prospective, placebo-controlled, double-blind, parallel-group study involving 190 smokers. In both study groups (placebo n = 95; active bioresonance group; n = 95) the course of treatment and study conditions were standardized. <b><i>Results: </i></b>1 week (77.2% vs. 54.8%), 2 weeks (62.4% vs. 34.4%), 1 month (51.1% vs. 28.6%), and 1 year (28.6% vs. 16.1%) after treatment, the success rate in the verum group differed significantly from the results in the placebo group. Also, the subjective health condition after treatment and subjective assessment of efficacy, polled after 1 week, were significantly more positive among participants in the active bioresonance therapy group than among those in the placebo group. Adverse side effects were not observed. <b><i>Conclusion: </i></b>According to the findings attained by this pilot study, bioresonance therapy is clinically effective in smoking cessation and does not show any adverse side effects.
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Pihtili A, Bingol Z, Kiyan E, Cuhadaroglu C, Issever H, Gulbaran Z. Obstructive sleep apnea is common in patients with interstitial lung disease. Sleep Breath 2013; 17:1281-8. [PMID: 23563999 DOI: 10.1007/s11325-013-0834-3] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 11/26/2012] [Accepted: 03/22/2013] [Indexed: 01/09/2023]
Abstract
PURPOSE The incidence of obstructive sleep apnea (OSA) in interstitial lung disease (ILD) has been reported at different frequencies in several studies. The aims of our study were to evaluate the frequency of OSA in ILD and to analyze the relationship between polysomnography (PSG) findings and pulmonary function, disease severity, parenchymal involvement, and Epworth Sleepiness Scale (ESS) scores. METHODS ILD patients with parenchymal involvement were evaluated. The disease severity was assessed using an index consisting of body mass index (BMI), carbon monoxide diffusion capacity, the Modified Medical Research Council dyspnea scale, and the 6-min walking distance. All of the patients had lung function, chest X-ray, PSG, ESS scoring, and an upper airway examination. Patients with a BMI ≥ 30 or significant upper airway pathologies were excluded. RESULTS Of 62 patients, 50 patients comprised the study group (14 male, 36 female; mean age 54 ± 12.35 years, mean BMI 25.9 ± 3.44 kg/m(2)) with diagnoses of idiopathic pulmonary fibrosis (IPF; n = 17), stage II-III sarcoidosis (n = 15), or scleroderma (n = 18). The frequency of OSA was 68 %. The mean apnea-hypopnea index (AHI) was 11.4 ± 12.5. OSA was more common in IPF patients (p = 0.009). The frequency of rapid eye movement-related sleep apnea was 52.9 %. The frequency of OSA was higher in patients with a disease severity index ≥3 (p = 0.04). The oxygen desaturation index and the AHI were higher in patients with diffuse radiological involvement (p = 0.007 and p = 0.043, respectively). CONCLUSIONS OSA is common in ILD. PSG or at minimum nocturnal oximetry should be performed, particularly in patients with functionally and radiologically severe disease.
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Affiliation(s)
- Aylin Pihtili
- Department of Pulmonary Diseases, Istanbul Medical Faculty, Istanbul University, 34 360, Capa, Istanbul, Turkey
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Tanyeri H, Serin GM, Ayanoglu Aksoy E, Polat S, Cuhadaroglu C. Effect of uvulopalatopharyngoplasty on retropalatal region. Eur Arch Otorhinolaryngol 2012; 270:1161-5. [DOI: 10.1007/s00405-012-2250-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 10/25/2012] [Indexed: 11/30/2022]
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Civelek S, Emre IE, Dizdar D, Cuhadaroglu C, Eksioglu BK, Eraslan AK, Turgut S. Comparison of conventional continuous positive airway pressure to continuous positive airway pressure titration performed with sleep endoscopy. Laryngoscope 2012; 122:691-5. [DOI: 10.1002/lary.22494] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Revised: 11/15/2011] [Accepted: 11/16/2011] [Indexed: 12/31/2022]
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Uslu A, Erdem O, Ergen M, Ozdemir O, Cuhadaroglu C, Demiralp T. Cognitive evaluation of bupropion sustained release in heavy tobacco smokers using event-related potentials. Medicina (Kaunas) 2012; 48:235-43. [PMID: 22864270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE. The aim of this study was to investigate the effects of bupropion sustained release (SR) on cognitive function, evaluated by event-related potentials (ERPs), in heavy tobacco smokers. MATERIAL AND METHODS. A total of 10 healthy volunteers (6 men and 4 women) were enrolled into the study. P3a and P3b components were evaluated by the novelty P3 paradigm. The ERP recordings were taken after the overnight abstaining and the first dose on the 1st day, on the 7th day, and 45th day of the therapy. RESULTS. The analysis of electrophysiological data in response to the standard stimuli in the parietal area after 7-day bupropion SR treatment revealed a significant increase in the P2 latency (P<0.05). With respect to the drug use × topography effect, an increasing trend of borderline significance in the P3b and P2 amplitudes against target events in the parietal area was observed (P=0.08 for both). A significant increase in the P3a amplitude in the parietocentral area was also observed on the seventh day of treatment (P<0.05). CONCLUSIONS. The reduction of P3a in the frontal area may be due to the decreased distractibility of task-irrelevant novel events, which may mean an augmentation of focused attention to task-relevant target events. The increases in the P3b and P2 amplitudes for target events in the parietal area are very suggestive of this hypothesis, since these components reflect the response to task-relevant target events. Meanwhile, the increased P2 latency for standard events may reflect reduced attention resources for the processing of standard events due to increased attention resources allocated for task-relevant target events. Decreased distractibility and increased attention are believed to be caused by bupropion.
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Affiliation(s)
- Atilla Uslu
- Department of Physiology, Istanbul University, Capa, Istanbul, Turkey.
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Ermis F, Akyuz F, Arici S, Uyanikoglu A, Yakar F, Pinarbasi B, Demir K, Özdil S, Besisik F, Kaymakoglu S, Boztas G, Cuhadaroglu C, Mungan Z. Effect of Proton Pump Inhibitor (PPI) Treatment in Obstructive Sleep Apnea Syndrome: An Esophageal Impedance-pHmetry Study. ACTA ACUST UNITED AC 2011; 58:1566-73. [DOI: 10.5754/hge10465] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kiyan E, Okumus G, Cuhadaroglu C, Deymeer F. Sleep apnea in adult myotonic dystrophy patients who have no excessive daytime sleepiness. Sleep Breath 2009; 14:19-24. [PMID: 19484280 DOI: 10.1007/s11325-009-0270-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 05/10/2009] [Accepted: 05/13/2009] [Indexed: 11/28/2022]
Abstract
PURPOSE Sleep apnea is common in myotonic dystrophy (MD) and may cause respiratory failure. Most of the sleep studies have been performed in patients with excessive daytime sleepiness (EDS), which is a characteristic and strong predictor of sleep apnea. Therefore, we investigated the prevalence of sleep apnea in adult MD patients who have no EDS. MATERIALS AND METHODS Epworth Sleepiness Scale was used to exclude EDS and a score over 10 was accepted as an indicator of EDS. Sleep studies of 17 adult MD patients with the Epworth sleepiness scale score < or =10 were retrospectively reviewed. Spirometry (n = 16) and daytime arterial blood gasses were used to evaluate the relationship with nocturnal parameters. RESULTS On admission to the outpatient chest clinic, seven patients had normal spirometry, and ten had daytime hypercapnia and/or hypoxemia. All but one had sleep apnea (apnea-hypopnea index > or =5 events/h of sleep; mild in five, moderate in seven, and severe in four). Hypopneas were more common than apneas (16.9 +/- 13.2 events/h vs. 4.6 +/- 4.1 events/h). Nocturnal desaturation episodes were very frequent (oxygen desaturation index, 19.7 +/- 20.3/h of sleep). Three patients had central sleep apnea and 13 had obstructive sleep apnea. Body mass index, spirometry parameters (FVC and FEV1) and arterial oxygen tension were moderately correlated with nocturnal oxygenation parameters. Apnea-hypopnea index showed moderate correlation with spirometry parameters (FVC and FEV1). CONCLUSION Sleep apnea and oxygen desaturations are very common in MD patients who report no excessive daytime sleepiness. Daytime lung function parameters are not sufficiently reliable for screening sleep apnea. Therefore, we recommend routine polysomnography in MD patients.
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Affiliation(s)
- Esen Kiyan
- Department of Pulmonary Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Onem K, Erol B, Sanli O, Kadioglu P, Yalin AS, Canik U, Cuhadaroglu C, Kadioglu A. ORIGINAL RESEARCH—WOMEN'S SEXUAL HEALTH: Is Sexual Dysfunction in Women with Obstructive Sleep Apnea‐Hypopnea Syndrome Associated with the Severity of the Disease? A Pilot Study. J Sex Med 2008; 5:2600-9. [DOI: 10.1111/j.1743-6109.2008.00934.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Kasikcioglu HA, Karasulu L, Tartan Z, Kasikcioglu E, Cuhadaroglu C, Cam N. Occult cardiac dysfunction in patients with obstructive sleep apnea syndrome revealed by tissue Doppler imaging. Int J Cardiol 2007; 118:203-5. [PMID: 16997399 DOI: 10.1016/j.ijcard.2006.06.051] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2006] [Accepted: 06/02/2006] [Indexed: 11/28/2022]
Abstract
Obstructive sleep apnea syndrome has been linked to cardiovascular complications. The diagnosis of effects of sleep apnea on heart may be difficult before apparent examination findings. The aim of the present study was to evaluate changes of myocardial contractile properties in patients affected by sleep apnea showing tissue Doppler imaging, in the face of quite normal myocardial contractility on standard echocardiography. Shortly, tissue Doppler imaging may represent an early stage of myocardial abnormality despite a preserved global function.
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Oflaz H, Cuhadaroglu C, Pamukcu B, Meric M, Ece T, Kasikcioglu E, Koylan N. Endothelial Function in Patients with Obstructive Sleep Apnea Syndrome but without Hypertension. Respiration 2006; 73:751-6. [PMID: 16804287 DOI: 10.1159/000094183] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2005] [Accepted: 03/30/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS) influences endothelial function and causes hypertension. OBJECTIVES Our aim was to evaluate the role of endothelial dysfunction in the pathogenesis of hypertension in OSAS. METHODS Twenty-three patients with OSAS but without hypertension and 15 healthy normotensive subjects were investigated. The presence or absence of OSAS was evaluated with a sleep study. Endothelial function was investigated with brachial artery ultrasound examination. RESULTS Baseline characteristics were equivalent between the two groups. Minimal oxygen saturation and apnea-hypopnea indexes in the OSAS and control groups were 62.9 +/- 16.5 versus 94.9 +/- 1.1% (p < 0.0001) and 53.1 +/- 20.3 versus 3.8 +/- 0.9 (p < 0.0001), respectively. There was not statistically significant difference between basal brachial artery diameters measured in the morning and in the evening in all groups. Flow-mediated dilation (FMD) values measured in the morning were lower than those measured in the evening in both OSAS patients and the control group: FMD of OSAS patients was 6.04 +/- 3.18% in the morning and 10.38 +/- 4.23% in the evening hours (p = 0.001), and FMD of control subjects was 10.9 +/- 2.6% in the morning and 13.9 +/- 2.32 in the evening hours (p = 0.002). Differences in FMD values measured both in the morning and evening hours in OSAS patients were lower compared with those in control subjects (p < 0.0001 in the morning hours and p = 0.003 in the evening hours). CONCLUSIONS We detected a prominent diurnal deterioration in endothelial function in normotensive OSAS patients compared with healthy subjects. This deterioration may occur due to ongoing hypoxemia during the night and it may be a possible cause of hypertension and atherosclerotic cardiovascular diseases in patients with OSAS.
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Affiliation(s)
- Huseyin Oflaz
- Department of Cardiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Kasikcioglu HA, Karasulu L, Durgun E, Oflaz H, Kasikcioglu E, Cuhadaroglu C. Aortic elastic properties and left ventricular diastolic dysfunction in patients with obstructive sleep apnea. Heart Vessels 2005; 20:239-44. [PMID: 16314904 DOI: 10.1007/s00380-005-0839-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2004] [Accepted: 04/15/2005] [Indexed: 11/25/2022]
Abstract
Although the responsible mechanisms are not yet fully known, obstructive sleep apnea is associated with an increased risk for cardiovascular disease and events. The aorta is not only a conduit delivering blood to the tissues but is also an important modulator of the entire cardiovascular system, its elastic properties also affecting left ventricular function and coronary blood flow. The aim of this study was to determine left ventricular diastolic function and aortic elastic properties in patients with obstructive sleep apnea syndrome. Fourteen male patients with obstructive sleep apnea and 14 age- and body mass index-matched healthy male controls took part in the study as a control group. All subjects underwent echocardiographic examination; left ventricular cavity dimension, standard and tissue Doppler parameters, and aortic diameter (3 cm above aortic valve) at systole and diastole were measured. While the aortic stiffness index in patients with obstructive sleep apnea was significantly higher than that of the control group (4.5 +/- 0.3 vs 2.1 +/- 0.1, P = 0.001), the aortic distensibility index was found to be lower in this group compared with controls (2.4 +/- 1.2 vs 3.9 +/- 1.5 cm2 dynes(-1) 10(-6), P = 0.009). Furthermore, peak velocity of myocardial systolic wave and peak velocities of myocardial diastolic waves in sleep apnea patients were lower than in controls. There was an association between aortic stiffness and the apnea hypopnea index (coefficient = 0.49, P = 0.002). We also found an inverse correlation between peak velocity of myocardial diastolic wave and aortic stiffness (coefficient = -0.43, P = 0.003), using multiple linear regression. Increased aortic stiffness that is associated with the severity of disease in patients with obstructive sleep apnea may lead to diastolic dysfunction of the left ventricle.
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MESH Headings
- Adult
- Aged
- Aorta, Thoracic/diagnostic imaging
- Aorta, Thoracic/physiopathology
- Cardiac Volume/physiology
- Coronary Circulation/physiology
- Diastole/physiology
- Echocardiography, Doppler
- Elasticity
- Hemodynamics/physiology
- Humans
- Linear Models
- Male
- Middle Aged
- Muscle, Smooth, Vascular/diagnostic imaging
- Muscle, Smooth, Vascular/physiopathology
- Myocardial Contraction/physiology
- Reference Values
- Risk Factors
- Sleep Apnea, Obstructive/diagnostic imaging
- Sleep Apnea, Obstructive/physiopathology
- Systole/physiology
- Ventricular Dysfunction, Left/diagnostic imaging
- Ventricular Dysfunction, Left/physiopathology
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Affiliation(s)
- Hulya Akhan Kasikcioglu
- Siyami Ersek Cardiovascular Surgery Center, Resitpasa caddesi Salkim sokak No. 2/5, Avcilar (PK 9), 34840 Istanbul, Turkey.
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Erden S, Cagatay T, Buyukozturk S, Kiyan E, Cuhadaroglu C. Hashimoto thyroiditis and obstructive sleep apnea syndrome: is there any relation between them? Eur J Med Res 2004; 9:570-2. [PMID: 15689305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
Hashimoto thyroiditis (HT), which is an autoimmune disease of thyroid gland, has been declared to present with concomitant several systemic diseases. In this study, the coexistence of the Hashimoto disease with the sleep apnea syndrome has been examined. Seven female patients (33-66 year of age) with Hashimoto thyroiditis were evaluated for sleep apnea syndrome. The diagnosis of Hashimoto disease was based on the high titers of anti-thyroid antibodies and histological findings. None of the patients had any complaints of sleep disturbances. Seven healthy subjects with similar age and sex characteristics were taken as the control group. All the patients and the control subjects were undertaken a full polysomnography (PSG). Five patients with HT showed the characteristics of obstructive sleep apnea syndrome (one severe, one moderate and three mild OSAS), whereas no sleep breathing disturbance was found in the control group. These findings suggest that sleep related breathing problems may develop in the patients with autoimmune thyroiditis even if they are euthyroid.
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Affiliation(s)
- S Erden
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Abstract
Screening for cardiac health should involve relevant parameters or indices that are easy and inexpensive to obtain. Various cardiac adaptation mechanisms develop during regular exercise that are affected by many factors, and these are reflected on a surface electrocardiogram. QT dispersion has been considered a surrogate for heterogeneity of repolarization, leading to ventricular arrhythmias. We compared QT parameters between athletes and sedentary subjects. A total of 225 men were assessed, comprising a group of professional soccer players and sedentaries. Each subject underwent supine 12-lead electrocardiographic examinations and exercise testing by ergospirometry. QT parameters were taken at rest and at peak exercise. Peak oxygen consumption was considerably higher in the athletes than in the controls (59.3 +/- 5.6 vs. 44.3 +/- 2.4 ml/kg/min, mean +/- SD, p < 0.001). QT parameters at rest: There were significant differences in heart-rate-corrected rest maximal QT duration (413.9 +/- 50.5 vs. 445.3 +/- 45.7 ms, p < 0.001) and in heart-rate-corrected rest minimum QT duration (380.5 +/- 51.2 vs. 409.5 +/- 46.7 ms, p < 0.001). QT parameters at peak exercise: maximal QT duration at peak exercise (253.9 +/- 20.8 vs. 261.7 +/- 26.2, p = 0.02), QT dispersion at peak exercise (25.2 +/- 9.1 vs. 29.5 +/- 15.8 ms, p = 0.04), heart-rate-corrected QT dispersion at peak exercise (44.6 +/- 16.4 vs. 52.6 +/- 28.3 ms, p = 0.03) differed significantly between professional soccer players and controls. QT dispersion and corrected QT dispersion at peak exercise are lower in athletes than in controls. Athletes and other subjects identified with a long QT interval should be examined at regular intervals.
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Affiliation(s)
- E Kasikcioglu
- Istanbul University, Istanbul Medical School, Department of Sports Medicine, Istanbul, Turkey.
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Abstract
The pulmonary artery is the second most common site of arterial involvement in Behcet's disease. A 32-year-old man presented with bilateral ankle edema, abdominal discomfort, and hemoptysis. He had a history of recurrent oral and genital aphthous ulcerations for 1 year. The diagnosis of Behcet's disease was made on the basis of the criteria published by the International Study Group for Behcet's Disease. His chest X-ray revealed left hilar enlargement. A helical computed tomography (CT) scan showed a pulmonary aneurysm with intramural thrombosis in the left pulmonary artery and enlarged hepatic veins. Treatment with colchicine and cyclophosphamide was given for 24 months, and helical thoracic CT was performed again. Helical CT showed that the pulmonary aneurysm was reduced by treatment. Helical CT could be used in Behcet's disease for the diagnosis and follow-up of pulmonary involvement.
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Affiliation(s)
- Erdem Kasikcioglu
- Istanbul Faculty of Medicine and Ersek Cardiovascular Center, Istanbul University, Istanbul, Turkey.
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Kílícaslan Z, Oztürk F, Sarimurat N, Cuhadaroglu C, Caglar E, Erem A. Microscopic examination and treatment outcomes of new pulmonary tuberculosis cases in Istanbul dispensaries between 1998 and 2000. Int J Tuberc Lung Dis 2003; 7:1059-63. [PMID: 14598965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
SETTING Twenty-four public tuberculosis dispensaries in Istanbul. OBJECTIVE To investigate microscopic examination of new pulmonary tuberculosis (TB) cases and treatment outcomes of smear-positive cases. DESIGN A retrospective analysis of 12572 new pulmonary tuberculosis cases between 1998 and 2000. METHODS Microscopic examination of sputum smears of all patients and treatment outcomes of smear-positive cases were evaluated. RESULTS Of 12572 new TB cases registered between 1998 and 2000, 78.1% (n = 9822) were pulmonary and 21.9% (n = 2750) were extra-pulmonary TB cases. Of 9822 new pulmonary TB cases, 5438 (55.4%) were sputum smear-positive and 2154 (21.9%) had no sputum examination. In smear-positive pulmonary cases, treatment outcomes were classified as follows: 2521 (46.4%) cured, 1926 (35.4%) treatment completed, 128 (2.4%) treatment failure, 514 (9.4%) default, 260 (4.8%) transfer out and 72 (1.3%) died. Treatment success was 81.8% (n = 4447). Between 1998 and 2000, the smear-positive case rate improved from 47.5% to 61.5% and the cure rate improved from 41.8% to 51.1%. CONCLUSION The microscopic diagnosis and cure rates are low in Istanbul dispensaries. The laboratories should be re-organised and directly observed treatment should be performed.
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Affiliation(s)
- Z Kílícaslan
- Chest Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
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Abstract
In adults, influence of body position on the occurrence of respiratory events during sleep is recognized, and increased numbers of respiratory events occur when the supine position is assumed.1-4 In 1985, Orr et al. showed that body position did not influence respiratory events during sleep in children.5 Recently, Fernandes do Prado et al. showed that children had a lower obstructive apnea hypopnea index (AHI) in supine position.6 Results of these two studies are different from others performed on adults. Moreover, upper airway abnormalities were not considered in these studies. The aim of the present study was to evaluate the effect of body position on obstructive respiratory events in children with different upper airway findings.
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Affiliation(s)
- Caglar Cuhadaroglu
- Sleep Laboratory, Chest Department, Istanbul School of Medicine, University of Istanbul, Atakoy 11, Kisim, Menekse A, Daire: 6, Atskoy, Istanbul, Turkey.
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Tosun T, Karabuda C, Cuhadaroglu C. Evaluation of sleep bruxism by polysomnographic analysis in patients with dental implants. Int J Oral Maxillofac Implants 2003; 18:286-92. [PMID: 12705309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
PURPOSE The aims of the present study were to use polysomnographic analysis to confirm sleep bruxism (SB) and to evaluate clinical findings of dental implant treatment in SB patients. MATERIALS AND METHODS The present study comprised the retrospective analysis of 368 patients with a total of 838 endosseous implants. Nineteen patients who experienced mechanical complications, such as implant or abutment fractures, loosened gold screws, or occlusal surface wear or damage, were selected for polysomnographic analysis to monitor sleep symptoms. Six patients in the study group were identified as having SB, and this was confirmed by polysomnographic analysis. RESULTS The SB electromyographic episodes were at least 20% of the patients' maximum voluntary contractions while awake and were scored. Most of the bruxism episodes (80%) were seen in light sleep stages. Only 5% of bruxism episodes were detected during rapid-eye-movement sleep. Sleep stage recordings were similar in all individuals. Bruxism episodes did not cause arousals. Patients were unaware of their nocturnal parafunctional habits. Despite protection with night guards, all patients were reported to have continued bruxism. DISCUSSION Since possible occlusal parafunctional habits may be evident in any stage of dental treatment, treatment outcome risks must be considered. CONCLUSIONS Polysomnographic study was evaluated as an effective, low-cost method to confirm occlusal parafunctional habits during sleep. Precautions against SB in patients having dental implant treatment have not been properly clarified. However, night guard protection appears to have some validity in patients having sleep bruxism.
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Affiliation(s)
- Tosun Tosun
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Turkey
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Cuhadaroglu C, Erelel M, Tabak L, Kilicaslan Z. Increased risk of tuberculosis in health care workers: a retrospective survey at a teaching hospital in Istanbul, Turkey. BMC Infect Dis 2002; 2:14. [PMID: 12144709 PMCID: PMC122064 DOI: 10.1186/1471-2334-2-14] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2002] [Accepted: 07/26/2002] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) is an established occupational disease affecting health care workers (HCWs). Determining the risk of TB among HCWs is important to enable authorites to take preventative measures in health care facilities and protect HCWs. This study was designed to assess the incidence of TB in a teaching hospital in Istanbul, Turkey. A retrospective study of health records of HCWs in our hospital from 1991 to 2000. RESULTS The mean workforce of the hospital was 3359 + 33.2 between 1991 and 2000. There were 31 cases (15 male) meeting the diagnostic criteria for TB, comprising eight doctors, one nurse and 22 other health professionals. Mean incidence of TB was 96 per 100,000 for all HCWs (relative risk: 2.71), 79 per 100,000 for doctors (relative risk: 2.2), 14 per 100,000 for nurses and 121 per 100,000 (relative risk: 3.4) for other professionals. The mean incidence of TB in Turkey between 1991 and 2000 was 35.4 per 100,000. Incidence of TB was similar in the Departments of Chest Diseases and Clinical Medicine but there were no TB cases in the Basic Science and Managerial Departments. CONCLUSION HCWs in Turkey who work in clinics have an increased risk for TB. Post-graduate education and prevention programs reduce the risk of TB. Control programs to prevent nosocomial transmission of TB should be established in hospitals to reduce risk for HCWs.
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Affiliation(s)
- Caglar Cuhadaroglu
- Department of Chest Diseases, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey
| | - Mustafa Erelel
- Department of Chest Diseases, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey
| | - Levent Tabak
- Department of Chest Diseases, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey
| | - Zeki Kilicaslan
- Department of Chest Diseases, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey
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Cuhadaroglu C, Korular D, Erelel M, Kiyan E, Kiliçaslan Z. Respiratory distress with acitretin, reversal by corticosteroid. Dermatol Online J 2001; 7:5. [PMID: 12165221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
The retinoic acid derivatives are used for disorders of keratinization such as psoriasis. Acitretin, which is a synthetic, aromatic derivative of retinoic acid, is frequently used to treat psoriasis. The retinoic acid syndrome (RAS), described with all-trans-retinoic acid (ATRA) in patients with promyelocytic leukemia, is characterized by fever and respiratory distress. In this report we present a 32 year old male who developed high fever, dry cough and dyspnea while undergoing treatment with acitretin. During hospitalization, his acitretin was stopped and he was treated with corticosteroids. Significant improvement was observed within a few days.
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Affiliation(s)
- C Cuhadaroglu
- Respiratory Department, Faculty of Medicine, University of Istanbul
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Erdamar B, Suoglu Y, Cuhadaroglu C, Katircioglu S, Guven M. Evaluation of clinical parameters in patients with obstructive sleep apnea and possible correlation with the severity of the disease. Eur Arch Otorhinolaryngol 2001; 258:492-5. [PMID: 11769999 DOI: 10.1007/s004050100367] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Obstructive sleep apnea (OSA) is a complex disease whose etiology is multifactorial and incompletely understood. This article focuses on upper airway anatomy evaluation and the standardization of different physical findings in patients with OSA and on the possible correlation of these physical findings with the severity of the disease. All patients underwent a physical examination and polysomnography. The physical examination included tonsil size, modified Mallampati grade, neck circumference, lateral clinical craniofacial assessment and body mass index (BMI). The study group consisted of 85 patients. A statistically significant correlation between tonsil size and BMI and with the respiratory disturbance index (RDI) was detected (P = 0.004 and 0.03 respectively). Also patients with a craniofacial anomaly have a higher RDI level than the patients without this anomaly (P = 0.03). This study has identified some standardized physical findings for predicting the severity of OSA. We aim to benefit from these findings in the selection of a rational treatment modality selection for patients with OSA.
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Affiliation(s)
- B Erdamar
- Department of Otolaryngology, Faculty of Medicine, Istanbul University, Turkey.
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Cuhadaroglu C, Korular D, Erelel M, Kiyan E, Kiliaslan Z. Respiratory distress with acitretin, reversal by corticosteroid. Dermatol Online J 2001. [DOI: 10.5070/d36xw860xk] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Abstract
BACKGROUND Some anti-allergic and anti-asthmatic drugs should be discontinued before skin prick test. But there is no knowledge about zafirlukast effects on skin prick test. We investigate the effects of zafirlukast on cutaneous response to histamine and specific allergens. MATERIAL AND METHODS 9 patients suffering from allergic mild asthma or allergic rhinitis and 8 healthy individuals were recruited to the study. All of them took 20 mg zafirlukast twice daily for at least 5 days. Skin prick test was performed before and after treatment by histamine and specific allergens. There was no significant difference between pre- and post-treatment skin prick tests in spite of zafirlukast treatment. CONCLUSION Zafirlukast does not affect skin reactions against histamine and specific allergens. Diagnostic skin prick test can be performed under zafirlukast treatment.
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MESH Headings
- Adrenergic beta-Agonists/therapeutic use
- Adult
- Allergens
- Anti-Asthmatic Agents/pharmacology
- Anti-Asthmatic Agents/therapeutic use
- Asthma/drug therapy
- Asthma/immunology
- Case-Control Studies
- False Negative Reactions
- Female
- Histamine
- Humans
- Hypersensitivity, Immediate/diagnosis
- Indoles
- Leukotriene Antagonists/pharmacology
- Leukotriene Antagonists/therapeutic use
- Male
- Middle Aged
- Phenylcarbamates
- Receptors, Adrenergic, beta-2/drug effects
- Rhinitis, Allergic, Perennial/drug therapy
- Rhinitis, Allergic, Perennial/immunology
- Rhinitis, Allergic, Seasonal/drug therapy
- Rhinitis, Allergic, Seasonal/immunology
- Skin Tests
- Sulfonamides
- Tosyl Compounds/pharmacology
- Tosyl Compounds/therapeutic use
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Affiliation(s)
- C Cuhadaroglu
- Department of Chest, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey. or
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Ziylan HO, Ander AH, Alp T, Kadioğlu TC, Esen T, Beşişik TA, Cuhadaroglu C. Latex allergy in patients with spinal dysraphism: the role of multiple surgery. Br J Urol 1996; 78:777-9. [PMID: 8976778 DOI: 10.1046/j.1464-410x.1996.20021.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate whether multiple surgery is responsible for the high prevalence of latex hypersensitivity in patients with spinal dysraphism by comparing the results of a skin-prick test in three groups of patients with different surgical histories. PATIENTS AND METHODS An in vivo diagnostic kit was used to determine the sensitivity to latex using a skin-prick test in three groups of patients, 23 with spinal dysraphism who had undergone surgery, 20 patients who had undergone non-urological surgery and urological patients who had not undergone surgery (control). There was no history of latex allergy in any individual from the three groups. RESULTS The skin-test was positive in six patients with spinal dysraphism, in one who had undergone previous non-urological surgery and in none of the control patients. The prevalence of latex hypersensitivity was significantly higher in patients with spinal dysraphism than in the other groups (non-urological surgery P < 0.05 and control P < 0.01). This difference occurred despite the patients in each surgical group having undergone a mean of less than two operations. There was no significant difference in latex sensitivity between control patients and those undergoing non-urological surgery. CONCLUSION Despite having no history of latex hypersensitivity, about a quarter of patients with spinal dysraphism were sensitive to latex. Repeated surgery alone cannot be responsible for the greater incidence of latex hypersensitivity in these patients. Despite multiple surgery being accepted as playing a major role in the development of latex hypersensitivity, relatively fewer surgical episodes than reported previously seem to be sufficient to elicit latex allergy.
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Affiliation(s)
- H O Ziylan
- Department of Paediatric Urology, University of Istanbul Medical Faculty, Turkey
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