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Özmen K, Meral M, Kerget B, Yılmazel Uçar E, Sağlam L, Özmen M. Evaluation of Pulmonary Function Tests, Dyspnea Scores, and Antibody Levels at the Six-Month Follow-Up of Patients Hospitalized for COVID-19 Pneumonia. Cureus 2024; 16:e56003. [PMID: 38476506 PMCID: PMC10928457 DOI: 10.7759/cureus.56003] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) causes various signs and symptoms, especially lung involvement, during acute infection and in the long term. In this study, we evaluated the follow-up results of patients with chronic COVID-19 over a 24-week period. METHODS The study included a total of 100 post-COVID-19 patients (confirmed by real-time polymerase chain reaction (PCR) of a nasopharyngeal swab) who presented to the post-COVID-19 outpatient clinic with chronic COVID-19 symptoms 12 weeks after diagnosis, between April and June 2021. All of the patients in the study had a history of hospitalization and were grouped based on the severity of the acute COVID-19 infection (moderate: group 1, severe: group 2). RESULTS A comparison of pulmonary function test parameters at week 12 showed that forced expiratory volume (FEV1)%, forced vital capacity (FVC)%, diffusing capacity of the lungs for carbon monoxide (DLCO)%, and DLCO divided by the alveolar volume (DLCO/VA)% values were significantly lower in group 2 than in group 1 (p<0.001 for all). At week 24, only DLCO and DLCO/VA values were lower (<0.001 for both). The mean modified Medical Research Council (mMRC) dyspnea scores of groups 1 and 2 were 1.4 ± 0.9 and 2.8 ± 1.1 at 12 weeks and improved to 0.9 ± 0.6 and 1.6 ± 0.6 at 24 weeks, respectively. The groups' mMRC scores at 12 and 24 weeks differed significantly (p=0.001, p=0.02). There was no difference in levels of IgM and IgG antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein between the groups at 12 or 24 weeks (p>0.05 for all). CONCLUSION Improvement in pulmonary function parameters and mMRC scores may take longer than 24 weeks, especially in patients with severe COVID-19. Our results indicated that the levels of IgM and IgG neutralizing antibodies did not differ between patients with moderate and severe illness at 12 or 24 weeks.
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Affiliation(s)
- Kadir Özmen
- Department of Pulmonology, Erzurum Ci̇ty Hospi̇tal, Erzurum, TUR
| | - Mehmet Meral
- Department of Pulmonology, Faculty of Medicine, Ataturk University, Erzurum, TUR
| | - Bugra Kerget
- Department of Pulmonology, Faculty of Medicine, Ataturk University, Erzurum, TUR
| | - Elif Yılmazel Uçar
- Department of Pulmonology, Faculty of Medicine, Ataturk University, Erzurum, TUR
| | - Leyla Sağlam
- Department of Pulmonology, Faculty of Medicine, Ataturk University, Erzurum, TUR
| | - Murat Özmen
- Department of Cardiology, Erzurum City Hospital, Erzurum, TUR
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Meral M, Koc RK, Selcuklu A. The Effects of Regulating Increased Blood Glucose Levels on Plasma Endothelin-1 Levels After Severe Head Trauma in Rats. Turk Neurosurg 2024; 34:263-267. [PMID: 38497179 DOI: 10.5137/1019-5149.jtn.43318-23.2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
AIM To examine the effects of regulating increased blood glucose levels on plasma ET-1 levels after severe head trauma in rats. MATERIAL AND METHODS Traumatic diffuse brain injury-induced rats were followed for 7 days and were randomly divided into two groups of 36 rats. Pre- and posttraumatic blood glucose and ET-1 levels were measured in group 1 (control). Posttraumatic blood glucose levels were maintained at normal levels using insulin and both blood glucose and ET-1 levels were measured at 2, 6, 12, 24, and 48 h and 7 days posttrauma in group 2. The study excluded animals that died and had skull fractures. RESULTS Posttraumatic plasma ET-1 levels (n=36) were significantly higher than baseline values in group 1 (p < 0.05). ET-1 levels in group 2 at the 7-day follow-up after trauma were significantly higher than baseline values (n=36) (p < 0.05). However, the increased ET-1 levels were statistically significantly lower in group 2 than in group 1 (p < 0.05). CONCLUSION The increased ET-1 levels were significantly prevented by keeping blood glucose levels within normal limits with insulin after severe head trauma. Thus, secondary injury to cerebral blood flow can be prevented by reducing the occurrence of vasospasm that starts in the early posttraumatic period or by stimulating the release of nitric oxide. Therefore, further studies on the role of ET-1 and insulin in developing secondary injuries after severe head trauma would be beneficial.
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Affiliation(s)
- Mehmet Meral
- Erciyes Hospital, Department of Neurosurgery, Kayseri, Turkey
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Tumturk A, Meral M, Kucuk A, Ulutabanca H, Koc RK. Hemilaminectomy and Bilateral Decompression for Thoracic Spinal Stenosis. Turk Neurosurg 2020; 30:841-846. [PMID: 32865213 DOI: 10.5137/1019-5149.jtn.28093-19.2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM To assess the effectiveness and reliability of hemilaminectomy and bilateral decompression (HLBD) for the treatment of thoracic spinal stenosis (TSS) in selected patients. MATERIAL AND METHODS Clinical data of 21 consecutive adult patients who underwent HLBD were investigated. Patients diagnosed with TSS by computed tomography or magnetic resonance imaging, with stenosis secondary to posterior element hypertrophy, and who underwent HLBD for the treatment of narrow spinal canal were included in this study. Patients were evaluated based on their pre- and postoperative modified Japanese Orthopedic Association (JOA) scores using their medical records. Recovery rates were evaluated using the Hirabayashi?s method. RESULTS The mean follow-up period, age, and preoperative JOA score were 37.6 months, 61.6 years, and 5.0 (range: 1?10), respectively. The mean JOA score improved postoperatively, i.e., 10.0 (range: 7?11), during follow-up. The recovery rate was 83.3%. Operation-related transfusion, neurological deterioration, and postoperative instability did not occur during the follow-up examination. CONCLUSION HLBD is a suitable surgical technique for patients with stenosis primarily caused by posterior element hypertrophy, such as ligamentum flavum (LF) and facet joints because it has a relatively less complication ratio, protects the posterior anatomical structures, prevents post-laminectomy kyphosis and postoperative instability, and promotes successful clinical improvement.
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Affiliation(s)
- Abdulfettah Tumturk
- Erciyes University Medical Faculty, Department of Neurosurgery, Kayseri, Turkey
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Tabaru A, Gorguner M, Akgun M, Meral M, Sahin A. Helicobacter pylori infections in chronic obstructive pulmonary disease. Eurasian J Med 2015; 44:144-8. [PMID: 25610229 DOI: 10.5152/eajm.2012.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/17/2011] [Accepted: 06/13/2012] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE We aimed to investigate the prevalence of Helicobacter pylori (H. pylori) in patients with chronic obstructive pulmonary disease (COPD) using the C-14 urea-breath test (C14UBT) and to determine whether there is an association between H. pylori infection and the severity of COPD. This is the first report in the literature of the use of C14UBT to investigate the prevalence of H. pylori in patients with COPD. MATERIALS AND METHODS Fifty subjects with COPD (38 males and 12 females, aged 61±10 years) and 20 control subjects (10 males and 10 females, aged 55±11 years) were evaluated. C14UBT was used to determine H. pylori infection. RESULTS The prevalences of H. pylori infection in subjects with COPD and in controls were 72% and 65%, respectively (p=0.56). Forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) values were significantly higher in the H. pylori-infected subjects with COPD than in the uninfected subjects (p=0.008 and p=0.006, respectively). CONCLUSION The presence of H. pylori infection in COPD patients affects pulmonary functions, but the effects of H. pylori infection on the respiratory system and COPD are not clear.
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Affiliation(s)
- Ali Tabaru
- Department of Chest Diseases, Aziziye Hospital, Suleyman Demirel Medical Centre, Ataturk University, Erzurum, Turkey
| | - Metin Gorguner
- Department of Chest Diseases, Aziziye Hospital, Suleyman Demirel Medical Centre, Ataturk University, Erzurum, Turkey
| | - Metin Akgun
- Department of Chest Diseases, Aziziye Hospital, Suleyman Demirel Medical Centre, Ataturk University, Erzurum, Turkey
| | - Mehmet Meral
- Department of Chest Diseases, Aziziye Hospital, Suleyman Demirel Medical Centre, Ataturk University, Erzurum, Turkey
| | - Ali Sahin
- Department of Nuclear Medicine, Yakutiye Hospital, Suleyman Demirel Medical Centre, Ataturk University, Erzurum, Turkey
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Araz O, Yilmazel Ucar E, Yalcin A, Kelercioglu N, Meral M, Gorguner AM, Akgun M. Predictive value of serum Hs-CRP levels for outcomes of pulmonary embolism. The Clinical Respiratory Journal 2014; 10:163-7. [DOI: 10.1111/crj.12196] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 08/01/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Omer Araz
- Department of Pulmonary Diseases; Ataturk University School of Medicine; Erzurum Turkey
| | - Elif Yilmazel Ucar
- Department of Pulmonary Diseases; Ataturk University School of Medicine; Erzurum Turkey
| | - Aslıhan Yalcin
- Department of Pulmonary Diseases; Marmara University; İstanbul Turkey
| | - Nazli Kelercioglu
- Department of Pulmonary Diseases; Ataturk University School of Medicine; Erzurum Turkey
| | - Mehmet Meral
- Department of Pulmonary Diseases; Ataturk University School of Medicine; Erzurum Turkey
| | - Ali Metin Gorguner
- Department of Pulmonary Diseases; Ataturk University School of Medicine; Erzurum Turkey
| | - Metin Akgun
- Department of Pulmonary Diseases; Ataturk University School of Medicine; Erzurum Turkey
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Araz O, Ucar EY, Akgun M, Aydin Y, Meral M, Saglam L, Kaynar H, Gorguner AM. Is atmospheric pressure change an Independent risk factor for hemoptysis? Pak J Med Sci 2014; 30:596-600. [PMID: 24948987 PMCID: PMC4048514 DOI: 10.12669/pjms.303.5063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 04/29/2013] [Revised: 02/10/2014] [Accepted: 03/06/2014] [Indexed: 11/15/2022] Open
Abstract
Objective: Hemoptysis is one of the most important and challenging symptoms in pulmonary medicine. Because of the increased number of patients with hemoptysis in certain periods of the year, we aimed to investigate whether atmospheric changes have an effect on the development of hemoptysis with or without a secondary cause. Methods: The data of patients presenting with hemoptysis between January 2006 and December 2011 were analyzed. Data on the daily atmospheric pressure (hectopascal, hPa), relative humidity (%), and temperature (o C) during that time were obtained. Results: A total of 232 patients with hemoptysis, 145 male (62.5%) and 87 female (37.5%) with an average age of 48.1(±17.6), were admitted to our hospital between 2006 and 2011. The highest admission rates were in the spring season, the highest in May (n=37, 15.9%), and the lowest admission rates were in December (n=10, 4.3%). A statistically significant negative correlation was found between the number of hemoptysis cases and mean atmospheric pressure but no relative humidity or outdoor temperature. Conclusion: Hemoptysis is very much influenced by weather factors; in particular, low atmospheric pressures significantly affect the development of hemoptysis. Fluctuations in atmospheric pressure may also play a role in hemoptysis.
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Affiliation(s)
- Omer Araz
- Dr. Omer Araz, Assistant Professor, Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Turkey
| | - Elif Yilmazel Ucar
- Dr. Elif Yilmazel Ucar, Assistant Professor, Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Turkey
| | - Metin Akgun
- Dr. Metin Akgun, Professor, Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Turkey
| | - Yener Aydin
- Dr. Yener Aydin, Assistant Professor, Department of Thoracic Surgery, Ataturk University School of Medicine, 25240, Erzurum, Turkey
| | - Mehmet Meral
- Dr. Mehmet Meral, Professor, Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Turkey
| | - Leyla Saglam
- Dr. Leyla Saglam, Professor, Ataturk University School of Medicine, 25240, Erzurum, Turkey
| | - Hasan Kaynar
- Dr. Hasan Kaynar, Professor, Ataturk University School of Medicine, 25240, Erzurum, Turkey
| | - Ali Metin Gorguner
- Dr. Ali Metin Gorguner, Professor, Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Turkey
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Ucar EY, Ozkaya AL, Araz O, Akgun M, Meral M, Kaynar H, Saglam L, Aksoy H, Akcay F. Serum and bronchial aspiration fluid HE-4 levels in lung cancer. Tumour Biol 2014; 35:8795-9. [PMID: 24879624 DOI: 10.1007/s13277-014-2134-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 05/21/2014] [Indexed: 12/21/2022] Open
Abstract
Human epididymis 4 (HE-4) protein has been proposed as a tumor marker for lung and ovarian cancer. This study was designed to measure HE-4 levels in bronchial aspiration fluid (BAF) of patients with lung cancer and to describe the relationship of BAF HE-4 with known systemic increase in serum HE-4 levels. Sixty-four patients with lung cancer, 38 with benign lung disease and 19 healthy subjects, were enrolled in our study. The BAF was obtained during routine bronchoscopic procedure in patient groups. HE-4 levels in serum and BAF were measured with the commercially available kit by an enzyme-linked immunosorbent assay. Serum HE-4 levels were significantly higher in patients with lung cancer group (204.2 ± 22.9 pmol/L) than in benign lung disease group (135 ± 26.9 pmol/L, p = 0.001) and healthy subjects (14.8 ± 7.0 pmol/L, p < 0.0001). No significant difference was observed in terms of BAF HE-4 values in two patient groups. BAF HE-4 levels were significantly higher than those of serum levels in both patient groups (p < 0.0001). Serum HE-4 level was correlated with tumor stage (p = 0.001) and age (p < 0.0001) in the lung cancer group. The areas under the receiver operating characteristic (ROC) curve of serum HE-4 was 0.784 (95 % confidence interval (CI), 0.701-0.867) and that of BAF HE-4 was 0.496 (95 % CI, 0.382-0.610). This study shows that a systemic increase in serum of HE-4 is more prominent than a local increase of HE-4 (BAF), so this may suggest the feasibility of using serum instead of BAF samples for HE-4 measurements in lung cancer cases.
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Affiliation(s)
- Elif Yilmazel Ucar
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, 25240, Erzurum, Turkey,
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Yilmazel Ucar E, Araz O, Akgun M, Meral M, Saglam L, Kaynar H, Gorguner AM. Bronchial Anthracosis - Anthracofibrosis: Potential Causes and Clinical Characteristics. Eurasian J Pulmonol 2014. [DOI: 10.5152/ejp.2014.72681] [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] [Indexed: 11/22/2022] Open
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Araz O, Ucar EY, Meral M, Yalcin A, Acemoglu H, Dogan H, Karaman A, Aydin Y, Gorguner M, Akgun M. Frequency of Class I and II HLA alleles in patients with lung cancer according to chemotherapy response and 5-year survival. Clin Respir J 2014; 9:297-304. [PMID: 24720676 DOI: 10.1111/crj.12143] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 02/13/2014] [Accepted: 04/04/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Lung cancer is the most common cause of cancer death in the world, and the most common type is non-small-cell lung cancer (NSCLC). At present, surgical resection, chemotherapy, and radiation therapy are the main treatments for patients with NSCLC, but unfortunately outcome remains unsatisfactory. OBJECTIVES This study aimed to determine whether Class I and II histocompatibility leukocyte antigen (HLA) alleles are related with response to chemotherapy and survival of lung cancer. METHODS A total of 65 NSCLC patients (56 men and 9 women, mean age 58.4 ± 11 years) were included in the study. Patient groups were compared with a control group of 88 unrelated healthy kidney or bone marrow donors in order to clearly identify susceptible and protective HLA alleles in lung cancer. Target lesions and tumor response were assessed using the Response Evaluation Criteria for Solid Tumors (RECIST) guidelines. Results were classified into two groups: complete-partial response and stable-progressive disease. RESULTS We found that expression of HLA-A32, HLA-B41, HLA-B57, HLA-DRB1*13, and HLA-DQ5 were more frequent in the complete and partial response groups to chemotherapy than in the control group. The frequency of HLA-A11, HLA-A29, HLA-BW6, HLA-CW3, HLA-DR1*1, and HLA-DRB1*3 were determined to be higher in the stable and progressive disease groups taking chemotherapy than in the control group. Additionally, expressions of HLA-A2 and HLA-B49 were statistically related with 5-year survival. CONCLUSION Our results suggested that expressions of HLA-BW6 and HLA-DRB1*13 alleles may be predictable markers for response to chemotherapy in lung cancer patients.
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Affiliation(s)
- Omer Araz
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Elif Yilmazel Ucar
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Mehmet Meral
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Aslıhan Yalcin
- Department of Pulmonary Diseases, Marmara University, Istanbul, Turkey
| | - Hamit Acemoglu
- Department of Medical Education, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Hasan Dogan
- Department of Medical Biology, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Adem Karaman
- Department of Radiology, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Yener Aydin
- Department of Thoracic Surgery, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Metin Gorguner
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Metin Akgun
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
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Ucar EY, Araz O, Meral M, Sonkaya E, Saglam L, Kaynar H, Gorguner AM, Akgun M. Two different dosages of nebulized steroid versus parenteral steroid in the management of COPD exacerbations: a randomized control trial. Med Sci Monit 2014; 20:513-20. [PMID: 24675102 PMCID: PMC3976199 DOI: 10.12659/msm.890210] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 01/16/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The study aimed to compare the efficacy and safety of nebulized steroid (NS) with systemic corticosteroids (SC) and to determine optimal NS dose in the treatment of patients with COPD exacerbations requiring hospitalization. MATERIAL AND METHODS The study was a randomized, parallel design trial. Eligible patients (n=86) were randomly allocated to 1 of the 3 treatment groups: parenteral corticosteroid (PS) (n=33), 4 mg (NB) (n=27), or 8 mg NB (n=26). Partial pressure of arterial oxygen (PaO2), carbon dioxide (PaCO2), pH, and oxygen saturation (SaO2) were evaluated at baseline, 24 h, 48 h, and discharge. Airway obstruction (forced vital capacity [FVC] and forced expiratory volume 1 s [FEV1]) was evaluated at admission and discharge. RESULTS There were no significant differences between the groups for all parameters at all time periods, except for higher FEV1 value in the 8-mg NB group at baseline. In groups, significant differences were determined for FVC, FEV1, PaO2, and SaO2 (p<0.001), but not for PaCO2 and pH, in comparison to their baseline values. As adverse events, hyperglycemia and oral moniliasis were observed in the PS group (n=4) and in the NB groups (n=5), respectively, and treatment change was required in 9 patients (2 patients in the PS group and 7 patients in the NB groups) (p=0.57). CONCLUSIONS Nebulized budesonide may be used as an alternative to SC because of its equal effectiveness and lesser systemic adverse effects. The choice of optimal dosage needs to be evaluated carefully because adverse effect and dropout rates varied according to dosage. However, there is a need for further studies including more severe cases and evaluating long-term outcomes or relapses comparing the 3 arms.
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Yilmazel Ucar E, Araz O, Yilmaz N, Akgun M, Meral M, Kaynar H, Saglam L. Effectiveness of pharmacologic therapies on smoking cessation success: three years results of a smoking cessation clinic. Multidiscip Respir Med 2014; 9:9. [PMID: 24495744 PMCID: PMC3916028 DOI: 10.1186/2049-6958-9-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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: 11/28/2013] [Accepted: 01/15/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pharmacologic therapies have an important role in the success of interventions for smoking cessation. This study aims to determine the efficacy of several pharmacologic treatments in patients who applied to a smoking cessation clinic. METHODS This retrospective study includes 422 patients who presented to our smoking cessation clinic between January 2010 and June 2013, used the pharmacologic treatment as prescribed and completed the one-year follow-up period. All patients were assessed using the Fagerström Test for Nicotine Dependence (FTND) and received both behavioral therapy and pharmacotherapy. Patients' smoking status at one year was assessed by telephone interview. RESULTS The patients were 24.3% female (103/422) and 75.7% male (319/422) with a mean age of 38 ± 10 years. Patients were divided into three groups: varenicline (166 patients), bupropion (148 patients) and nicotine replacement therapy (108 patients).The smoking cessation rates of these groups were 32.5%, 23% and 52.8%, respectively, and were statistically significant (p > 0.001). The overall success rate was 35%. Further analysis revealed that pharmacologic therapy (p > 0.001) and gender (p = 0.01) were factors that showed statistically significant effects on smoking cessation rates. Males had higher success rates than females. The overall relapse rate was 21.6% and the bupropion group showed the highest relapse rate among treatment groups. Lack of determination emerged as the most important factor leading to relapse. CONCLUSION Nicotine replacement therapy was found to be more effective at promoting abstinence from smoking than other pharmacologic therapies.
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Affiliation(s)
- Elif Yilmazel Ucar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
- Yakutiye Medical Research Center, Chest Disease Department, Erzurum, Yakutiye 25240, Turkey
| | - Omer Araz
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Nafiye Yilmaz
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Metin Akgun
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Mehmet Meral
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Hasan Kaynar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Leyla Saglam
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
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Ucar EY, Araz O, Yilmaz N, Akgun M, Meral M, Kaynar H, Saglam L. Effectiveness of pharmacologic therapies on smoking cessation success: three years results of a smoking cessation clinic. Multidiscip Respir Med 2014. [DOI: 10.4081/mrm.2014.366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Pharmacologic therapies have an important role in the success of interventions for smoking cessation. This study aims to determine the efficacy of several pharmacologic treatments in patients who applied to a smoking cessation clinic.
Methods: This retrospective study includes 422 patients who presented to our smoking cessation clinic between January 2010 and June 2013, used the pharmacologic treatment as prescribed and completed the one-year follow-up period. All patients were assessed using the Fagerström Test for Nicotine Dependence (FTND) and received both behavioral therapy and pharmacotherapy. Patients’ smoking status at one year was assessed by telephone interview.
Results: The patients were 24.3% female (103/422) and 75.7% male (319/422) with a mean age of 38 ± 10 years. Patients were divided into three groups: varenicline (166 patients), bupropion (148 patients) and nicotine replacement therapy (108 patients). The smoking cessation rates of these groups were 32.5%, 23% and 52.8%, respectively, and were statistically significant (p < 0.001). The overall success rate was 35%. Further analysis revealed that pharmacologic therapy (p < 0.001) and gender (p = 0.01) were factors that showed statistically significant effects on smoking cessation rates. Males had higher success rates than females. The overall relapse rate was 21.6% and the bupropion group showed the highest relapse rate among treatment groups. Lack of determination emerged as the most important factor leading to relapse.
Conclusion: Nicotine replacement therapy was found to be more effective at promoting abstinence from smoking than other pharmacologic therapies.
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Araz O, Yilmazer Ucar E, Aydın Y, Meral M, Bilen Y, Alper F, Gorguner AM, Akgun M. Effects of Lymphadenopathy on Pulmonary Function tests in Sarcoidosis. Turk Thorac J 2013. [DOI: 10.5152/ttd.2013.28] [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: 11/22/2022]
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Ucar EY, Araz O, Akgun M, Meral M, Kalkan F, Saglam L, Kaynar H, Gorguner AM. Low-molecular-weight heparin use with thrombolysis: is it effective and safe? Ten years' clinical experience. ACTA ACUST UNITED AC 2013; 86:318-23. [PMID: 23406693 DOI: 10.1159/000346203] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 11/25/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is no data on the use of subcutaneous low-molecular-weight heparin (SC LMWH) in cases that require thrombolysis. OBJECTIVE Having used SC LMWH with thrombolytics for more than 10 years, we aimed to review our data, share our experiences and find out whether the use of SC LMWH with thrombolytics had been effective and safe. METHOD This is a retrospective cohort study. Patients who were diagnosed as acute pulmonary embolism (PE) and received either SC LMWH treatment or SC LMWH with thrombolytics in our hospital (a tertiary hospital) between 2000 and 2010 were included in the study. For both treatments, the rates of mortality and complications were calculated. RESULTS A total of 392 patients, 210 female (53.5%) and 182 male (46.5%) with an average age of 60 years, ±16 SD, with acute PE, were included in the study. Of these patients, 107 (27.2%) were massive and 285 (72.8%) were nonmassive and were administered SC LMWH plus thrombolytics and only SC LMWH, respectively. The mortality rate was 16.8% (18 of 107) in patients who were massive and 3.5% (10 of 285) for those who were nonmassive (p < 0.001). Major hemorrhage occurred in 3.7% (n = 4) and 0.7% (n = 2) and minor hemorrhage in 12.1% (n = 13) and in 3.8% (n = 11) of the cases who received SC LMWH plus thrombolytics and SC LMWH, respectively. CONCLUSION SC LMWH use with thrombolytics seems to be feasible and safe. Prospective, large, randomized control trials are still required in order to confirm these results.
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Affiliation(s)
- Elif Yilmazel Ucar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
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15
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Kaynar H, Meral M, Ucar EY, Saglam L, Yildirim U, Gorguner M, Akgun M. Clinical value of detection of metastasis of carina in patients with non-small cell lung cancer. Respir Med 2011; 105:1537-42. [PMID: 21684730 DOI: 10.1016/j.rmed.2011.05.013] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 05/16/2011] [Accepted: 05/24/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Although the utility of blind biopsy in the detection of metastasis in the carina has been reported, submucosal fine needle aspiration (SMFNA) has not been evaluated. We investigated how SMFNA of the main carina and upper-lobe carina in addition to blind biopsy affect management of patients with NSCLC. METHODS Thirty-five patients were evaluated. During fiberoptic bronchoscopy (FOB), five blind biopsy and three SMFNA specimens were collected from normal-appearing main carina (n = 35) and/or upper-lobe carina (n = 18). Subjects were staged for operability using traditional staging system, without knowing the blind biopsy or SMFNA results. Then, patients were staged again after results were made known. RESULTS Thirty-five NSCLC patients were analyzed. The management of 12 patients (34%) was changed according to our results. Out of the patients, 8, 5 and one had microscopic metastasis in the main carina, ipsilateral upper-lobe carina and both, respectively. Although SMFNA were more diagnostic compared to blind forceps biopsy, there was no statistically difference between them. These procedures increased the success of detection of microscopic metastasis and the results changed management of those cases. CONCLUSION SMFNA adds valuable information to blind biopsy, and their combination changed the management in one quarter of our NSCLC patients.
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Affiliation(s)
- Hasan Kaynar
- Department of Pulmonary Medicine, Ataturk University, Erzurum, Turkey
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16
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Alp G, Meral M, Öztürk A, Bozdayi G, Dallar Y, Rota S, Nishizono A, Ahmed K. PVII-7 Electropherotyping of rotavirus detected by polyacrylamide gel electrophoresis (PAGE) in children aged <5 years, Turkey. J Clin Virol 2009. [DOI: 10.1016/s1386-6532(09)70187-8] [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: 11/26/2022]
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17
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Bulut I, Meral M, Kaynar H, Pirim I, Bilici M, Gorguner M. Analysis of HLA class I and II alleles regarding to lymph node and distant metastasis in patients with non-small cell lung cancer. Lung Cancer 2009; 66:231-6. [PMID: 19246116 DOI: 10.1016/j.lungcan.2009.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 12/31/2008] [Accepted: 01/20/2009] [Indexed: 10/21/2022]
Abstract
The aim of this study was to investigate the relation of HLA alleles in patients with non-small cell lung cancer (NSCLC). The incidence of class I and II HLA alleles of 63 patients with NSCLC were prospectively compared with the incidence of class I and II HLA alleles with 88 healthy controls. The number of cases with stage I and II (early stage) was 12 and there were 51 cases with stage III and IV (advanced stage). Metastasis rates of the regional lymph node in patients were as follow; N(0): n=10; N(1): n=13; N(2): n=26 and N(3): n=14. Lymph node metastasis was detected by pathological staging in 15 cases and by clinical staging in 48 cases. Lymph node metastasis was searched in all patients by a helical thorax CT. All distant metastasis were investigated by thorax CT, abdominal CT, brain CT or MRI and bone scintigraphy, and distant organ metastasis was detected in 25 cases. The patients and healthy controls were typed for HLA class I and II alleles. HLA-A2 was an independent risk factor for both critical lymph node (N(2 and 3)) involvement and distant metastasis. HLA-B44, -CW6 and -CW7 frequencies appear to be significant in controls compared to patients. HLA-A2 frequency was higher in patients with advanced stage than early stage, while HLA-A26, -B35 and -CW4 frequencies were more expressed in patients with early stage than in patients with advanced stage. Compared with controls, frequency of HLA-DRB1*07, -DQ02 and -DQ07 were lower expressed in patients. Compared patients with advanced stage, HLA-DRB1*07 was higher in patients with early stage. HLA-A2 was an independent risk factor for lymph node and distant metastasis, and the allele was significantly higher in patients with critical lymph node for surgery and distant metastasis. HLA-A26 appeared to be a significance protective allele against to metastases.
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Affiliation(s)
- Ismet Bulut
- Maresal Cakmak Military Hospital, Department of Chest Diseases, Ataturk University, School of Medicine, Erzurum - Turkey.
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18
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Yildirim A, Meral M, Kaynar H, Polat H, Ucar EY. Relationship between serum levels of some acute-phase proteins and stage of disease and performance status in patients with lung cancer. Med Sci Monit 2007; 13:CR195-200. [PMID: 17392651] [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] [Received: 06/23/2006] [Accepted: 12/12/2006] [Indexed: 05/14/2023] Open
Abstract
BACKGROUND Lung cancer is the leading cause of cancer death in both developed and developing countries. The aim of the present study was to compare serum levels of alpha1-acid glycoprotein, ceruloplasmin, transferrin, ferritin, and albumin with tumor stage, distant metastasis, lymphadenopa thy, and patient performance status in patients with non-small-cell lung cancer and those with small-cell lung cancer. MATERIAL/METHODS The study was carried out in 46 patients with primary lung cancer (39 men and 7 women) and 34 healthy subjects as the control group. RESULTS Serum ceruloplasmin and ferritin levels were higher and transferrin and albumin levels were lower both in non-small-cell and small-cell lung cancer patients than in controls. The levels of alpha1-acid glycoprotein and ferritin associated with both performance status and lymph node metastasis. CONCLUSIONS Measurement of alpha1-acid glycoprotein and ferritin levels could be a useful prognostic factor in addition to performance status in patient with primary lung cancer.
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Affiliation(s)
- Abdulkadir Yildirim
- Department of Biochemistry, School of Medicine, Ataturk University, Erzurum, Turkey.
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19
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Abstract
AIM Although liver injury due to cardiac, chronic respiratory and circulatory failure has been reported, this has yet to be studied in patients with pulmonary embolism (PE). We investigated liver injury in patients with acute PE. METHODS We retrospectively reviewed 107 acute PE patients over a two-year period. Patients were categorized as having: (1) severe (P(a)O(2) < 45 mmHg), moderate (45 mmHg </= P(a)O(2)</= 60 mmHg) or mild hypoxemia (60 mmHg < P(a)O(2) < 80 mmHg) groups; (2) massive and non-massive PE; (3) absence or presence of pre-existing cardiopulmonary disease; and (4) absence or presence of right ventricle dysfunction. Serum levels of liver enzymes were compared between groups. RESULTS Transaminase levels were higher in severe hypoxemia patients compared mild hypoxemia patients (p=0.045 and p=0.036). Albumin and bilirubin levels were lower and higher, respectively, in patients with severe and moderate hypoxemia compared to mild hypoxemia patients (p < 0.05 and p < 0.01). There was a negative correlation between hepatic markers and P(a)O(2) and %S(a)O(2): r=-0.212, p=0.032 between AST and %S(a)O(2); r=-0.243, p=0.013 and r=-0.241, p=0.014 between ALT and P(a)O(2) and %S(a)O(2); and r=-0.224, p=0.024 and r= -0.283, p=0.004 between direct bilirubin and P(a)O(2) and %S(a)O(2). AST and ALT levels were higher in massive PE than non-massive PE patients (p=0.0001). Albumin levels were lower in patients with right ventricle dysfunction than in those without (p=0.02). One (0.9%) had a clinical picture of hypoxic hepatitis. CONCLUSION Abnormal LFTs showed a mixed pattern in patients with acute PE.
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Affiliation(s)
- Sahin Aslan
- Department of Emergency Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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20
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Celik A, Tekis D, Saglam F, Tunali S, Kabakci N, Ozaksoy D, Manisali M, Ozcan MA, Meral M, Gülay H, Camsari T. Association of corticosteroids and factor V, prothrombin, and MTHFR gene mutations with avascular osteonecrosis in renal allograft recipients. Transplant Proc 2006; 38:512-6. [PMID: 16549163 DOI: 10.1016/j.transproceed.2005.12.062] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The mechanism of posttransplantation avascular osteonecrosis (AVN) is controversial. Besides an increased bone marrow pressure due to reduced blood supply, enhanced coagulation has been considered. We investigated the associations of factor V Leiden, prothrombin G20210A, and MTHFR C677T mutations as well as cumulative corticosteroid doses with AVN in renal allograft recipients. The records of 39 volunteer patients and 11 patients in whom osteonecrosis was previously identified were reviewed for cumulative corticosteroid dosages during the first year. All patients were screened for factor V Leiden, prothrombin G20210A, and MTHFR C677T mutations by direct sequencing of genomic DNA. The cumulative corticosteroid dosages at 3, 6, and 12 months in the osteonecrotic group (5033.5 +/- 1565.3, 7164.9 +/- 2063.1, 8835.1 +/- 2216.8 mg) were significantly higher than in the control group (3629 +/- 1504.1, 4784.5 +/- 1568.7, 6322.4 +/- 1686.6 mg; P = .013, P = .001, P = .001, respectively). No significant difference in factor V Leiden, prothrombin G20210A, and MTHFR C677T mutations was observed between the osteonecrotic and control groups (P > .05). In conclusion, an association between the first year (3, 6, and 12 month) cumulative corticosteroid dosages and AVN was demonstrated in renal transplant recipients. However, no correlation was determined between factor V Leiden, prothrombin G20210A, and MTHFR C677T mutations and osteonecrosis.
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Affiliation(s)
- A Celik
- Division of Nephrology, Dokuz Eylül University Medical School, Izmir, Turkey.
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21
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Akgun M, Meral M, Onbas O, Araz O, Koplay M, Aslan S, Mirici A. Comparison of clinical characteristics and outcomes of patients with COPD exacerbation with or without venous thromboembolism. Respiration 2006; 73:428-33. [PMID: 16636527 DOI: 10.1159/000092952] [Citation(s) in RCA: 20] [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] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Accepted: 02/20/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although some studies evaluated venous thromboembolism (VTE) prevalence in patients with chronic obstructive pulmonary disease (COPD), they contain no detailed description of the patients' characteristics. OBJECTIVES It was the aim of this study to investigate the frequency and clinical characteristics and outcomes of VTE in patients with COPD exacerbation. METHODS Between October 2004 and February 2005, 120 consecutive patients were included in the study. On admission, Doppler examination of lower extremities in all cases and spiral computed tomography of the thorax in cases with a suspicion of pulmonary thromboembolism were performed. A questionnaire was used to take a detailed history. In addition to routine laboratory tests, chest X-ray, postbronchodilator spirometry, arterial blood gas analysis and serum levels of D-dimer and C-reactive protein were evaluated, as well as dyspnea score and performance status before exacerbation. The hospitalization durations and mechanical ventilation requirements were also recorded. RESULTS VTE was determined in 16 cases (13.3%). In patients with VTE, the travel history was higher (p < 0.001), the dyspnea score worse (p = 0.005), the duration of hospitalization longer (p < 0.001) and the mechanical ventilation requirement increased (p < 0.001); a change in mental status was highly associated with the presence of VTE (p < 0.001). CONCLUSIONS It seems that VTE occurrence was higher in the presence of a risk factor causing immobility such as travel history and increased dyspnea. The cases with severe disease are more likely to have VTE. Preventive measures may be considered in such patients because their hospitalization stay and mechanical ventilation requirement are increased.
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Affiliation(s)
- Metin Akgun
- Department of Chest Disease, School of Medicine, Ataturk University, Erzurum, Turkey.
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22
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Akgun M, Saglam L, Kaynar H, Yildirim AK, Mirici A, Gorguner M, Meral M, Ozden K. Serum IL-18 levels in tuberculosis: comparison with pneumonia, lung cancer and healthy controls. Respirology 2005; 10:295-9. [PMID: 15955140 DOI: 10.1111/j.1440-1843.2005.00710.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 11/28/2022]
Abstract
OBJECTIVE The aim of the present study was to document the serum IL-18 levels in patients with pulmonary tuberculosis (P-TB), extrapulmonary tuberculosis (EP-TB), pneumonia, lung cancer and in healthy controls, and to investigate whether it may assist in the differential diagnosis of P-TB. METHODOLOGY A total of 116 patients were included in the study. The study population consisted of patients with P-TB, EP-TB, pneumonia and lung cancer and controls. P-TB patients were graded according to sputum positivity and extent of disease. Serum levels of IL-18 (ELISA) were compared between groups and with other clinical measures of disease. RESULTS Compared with the controls, all groups of patients had increased serum levels of IL-18. The highest mean concentration of IL-18 was observed in P-TB. Serum levels of IL-18 in the patients with P-TB correlated well with the extent of disease. CONCLUSIONS Although increased serum levels of IL-18 were not specific for TB, the increased levels may favour active TB in radiologically advanced disease where CXR findings are difficult to interpret, and sputum smears or cultures are not helpful.
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Affiliation(s)
- Metin Akgun
- Department of Chest, Atatürk University, School of Medicine, Erzurum, Turkey.
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23
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Abstract
OBJECTIVES Reports in the literature suggest that weather changes may play a role in venous thrombotic disease. An increase in patients with pulmonary embolism (PE) during the spring season led us to investigate the relationship between atmospheric pressure (AP) and the incidence of PE, as diagnosed in most of the patients by helical CT angiography, and in the minority of patients by conventional pulmonary angiography and lung scanning. METHODS We retrospectively investigated the charts of 91 consecutive patients with a diagnosis of PE who were evaluated by the Department of Pulmonary Medicine between August 2000 and September 2004. We documented AP changes as recorded by the Erzurum Provincial Department of Meteorology. Of the 91 patients, the diagnosis of PE was made by helical CT angiography in 84 patients, isotope lung scan in 5 patients, and conventional pulmonary angiography in 2 patients. RESULTS More patients presented in the spring months (March, n = 15; April, n = 10; and May, n = 12) than during other seasons (p < 0.001). The frequency of PE was inversely related to general average AP (r = - 0.70; p < 0.01). When the average seasonal AP was correlated with the incidence of PE, however, the relationship was found to not be statistically significant (r = - 0.66; p = 0.34). There was no correlation between the severity of PE or mortality and AP. CONCLUSIONS The incidence of PE was significantly higher in the spring months, when AP was low. A regional study to capture all PE patients will need to be done to confirm our findings. Other meteorologic factors should be investigated regarding their effect on thromboembolic disease.
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Affiliation(s)
- Mehmet Meral
- Department of Pulmonary Medicine, Faculty of Medicine, Ataturk University, Erzurum 25240 Turkey.
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24
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Aslan S, Erol MK, Karcioglu O, Meral M, Cakir Z, Katirci Y. [The investigation of ischemic myocardial damage in patients with carbon monoxide poisoning]. Anadolu Kardiyol Derg 2005; 5:189-93. [PMID: 16140649] [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: 05/04/2023]
Abstract
OBJECTIVE Poisoning with carbon monoxide (CO) due to flash gas heater or stove being an important health problem in our region, causes significant pathologies in the body as well as death by decreasing oxygen-carrying capacity of blood. This study was planned to assess whether or not myocardial damage occurs in patients with CO poisoning. METHODS Forty consecutive adult patients with CO poisoning (30 females and 10 males) were included in this study. The mean age of the patients was 28.5+/-9.9 years (range: 15-56). The demographic characteristics, vital signs, the origin of CO gas, risk factors for coronary artery disease (CAD) and smoking habit of the patients were recorded. The evaluation of Glasgow Coma Scale score, electrocardiogram (ECG), peripheral arterial blood gases, complete blood count, creatine kinase (CK), creatine kinase-myocardial band (CKMB), troponin-T measurements were performed in all cases. Additionally, myocardial perfusion SPECT was performed in three cases with carboxyhemoglobin (COHb) levels over 50%. RESULTS Sinus tachycardia, was observed in 9 cases. Ventricular bigeminy was seen in a case with troponin-T positive test. Six of 40 cases (15%) had significantly increased CK and CK-MB levels with normal troponin-T measurements. High troponin-T levels (0.13 ng/ml) were detected only in 1 case with COHb level of 61.3%. Myocardial SPECT was performed in 3 cases with COHb levels higher than 50% and no images compatible with defects could be identified. CONCLUSION The results suggested that significant myocardial damage and life-threatening cardiac hemodynamic changes do not develop in CO-poisoned patients with COHb level below 60 % and without any known underlying CAD. It is not necessary to routinely measure CK, CK-MB and troponin-T, and perform myocardial perfusion SPECT in acute CO poisoning cases without any ECG abnormality, ischemic cardiac symptoms or known CAD.
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Affiliation(s)
- Sahin Aslan
- Department of Emergency Medicine, Medical Faculty, Atatürk University, 25090 Erzurum, Turkey.
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25
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Akgun M, Gorguner M, Meral M, Turkyilmaz A, Erdogan F, Saglam L, Mirici A. Silicosis Caused by Sandblasting of Jeans in Turkey: A Report of Two Concomitant Cases. J Occup Health 2005; 47:346-9. [PMID: 16096363 DOI: 10.1539/joh.47.346] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Metin Akgun
- Chest Disease, School of Medicine, Atatürk University, Erzurum, Turkey.
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26
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Akgun M, Mirici A, Meral M, Saglam L, Kaynar H, Gorguner M, Yilmazel Ucar E. A hypersensitivity pneumonitis case complicated with acute respiratory distress syndrome after bronchoscopy. Respir Med 2005; 99:1195-7. [PMID: 16085224 DOI: 10.1016/j.rmed.2005.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2004] [Indexed: 11/16/2022]
Affiliation(s)
- M Akgun
- Chest Disease Department, School of Medicine, Atatürk University, Erzurum, Turkey.
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27
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Acikel M, Yilmaz M, Gurlertop Y, Kaynar H, Bozkurt E, Erol MK, Köse N, Meral M, Senocak H. The effect of pulmonary hypertension on left atrial mechanical functions in chronic obstructive lung disease. Int J Cardiol 2005; 97:187-92. [PMID: 15458682 DOI: 10.1016/j.ijcard.2003.06.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 04/17/2003] [Revised: 06/02/2003] [Accepted: 06/29/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND Left atrial (LA) function is an important determinant of left ventricular (LV) filling. However, the effect of pulmonary hypertension (PH) on LA mechanical function in chronic obstructive lung disease (COLD) has not been studied, yet. METHODS 49 patients with COLD and 25 controls were included in this study. Patients were divided into two subgroups: patients without PH (group 1, n=21) and with PH (group 2, n=28). LA volumes were determined at mitral valve opening (Vmax), at onset of atrial systole (Vp) and at mitral valve closure (Vmin) according to biplane area-length method. The following LA parameters were calculated: passive emptying volume (PEV=Vmax-Vp), conduit volume [CV=LV stroke volume-(Vmax-Vmin)], passive emptying fraction (PEF=PEV/Vmax), active emptying volume (AEV=Vp-Vmin), active emptying fraction (AEF=AEV/Vp), total emptying volume (TEV=Vmax-Vmin), percent contribution of PEV, CV and AEV to LV stroke volume. RESULTS Vmax (p<0.01), PEV (p<0.001) and TEV (p<0.05) were lower in group 2 than in the controls, and the differences between group 1 and control group were insignificant (p>0.05). Vp, Vmin, CV and AEV did not differ among three groups. Percent contribution to LV filling of the PEV was decreased in group 2 when compared to group 1 (p<0.05) and the controls (p<0.01). Percent contribution to LV filling of the AEV was increased in group 2 when compared to the controls (p<0.05). There were inverse correlations between pulmonary artery pressure and the following parameters: LV stroke volume (r=-0.43, p<0.01), mitral E/A (r=-54, p<0.001), Vmax (r=-0.35, p<0.05), PEV (r=-40, p<0.01) and PEF (r=-0.43, p<0.01). CONCLUSION This study shows that the alterations of LA mechanical functions in patients with COLD are closely correlated to PH levels. Furthermore, these results underline the importance of maintaining a sinus rhythm in these patients.
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Affiliation(s)
- Mahmut Acikel
- Faculty of Medicine, Department of Cardiology, Ataturk University, Erzurum, Turkey.
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28
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Kaynar H, Meral M, Turhan H, Keles M, Celik G, Akcay F. Glutathione peroxidase, glutathione-S-transferase, catalase, xanthine oxidase, Cu-Zn superoxide dismutase activities, total glutathione, nitric oxide, and malondialdehyde levels in erythrocytes of patients with small cell and non-small cell lung cancer. Cancer Lett 2005; 227:133-9. [PMID: 16112416 DOI: 10.1016/j.canlet.2004.12.005] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.6] [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: 10/13/2004] [Revised: 11/30/2004] [Accepted: 12/05/2004] [Indexed: 11/29/2022]
Abstract
Lung cancer is a common pathology with high mortality due to late diagnosis. Glutathione peroxidase (GSH-Px), glutathione-S-transferase (GST), catalase (CAT), xanthine oxidase (XO), Cu-Zn superoxide dismutase (Cu-Zn SOD) activities, total glutathione (TGSH), nitric oxide (NO*), and malondialdehyde (MDA) levels were investigated in erythrocytes of patients with non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC), and healthy control group. We aimed to investigate serum GSH, GSH-dependent enzymes activities (GSH-Px and GST), XO, CAT, Cu-Zn SOD activity, and NO*, and MDA levels in patients with NSCLC and with SCLC and correlate with the cancer stage. Erythrocyte MDA, NO*, TGSH levels and erythrocyte SOD, CAT and XO activities were significantly higher in patients with NSCLC and SCLC than in controls. Slightly increased erythrocyte GSH-Px and GST activities were not significantly different from the controls. Erythrocyte MDA level positively correlated with erythrocyte NO* levels in patients with early stage (I+II) in NSCLC groups. Erythrocyte MDA level positively correlated with erythrocyte XO activity in patients with advanced stage (III+IV) in NSCLC groups. However, no other correlation could be found among the parameters in healthy controls and patients with NSCLC and with SCLC. Results obtained in this study indicate significant changes in antioxidant defence system in NSCLC and SCLC patients, which may lead to enhanced action of oxygen radical, resulting in lipid peroxidation.
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Affiliation(s)
- Hasan Kaynar
- Department of Chest Diseases, Ataturk University, Medical School, 25240 Erzurum, Turkey
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Kaynar H, Akgun M, Saglam L, Meral M, Gorguner M, Mirici A. The prevalence of exercise-induced bronchoconstriction among symptomatic sportsmen. Asian Pac J Allergy Immunol 2004; 22:191-6. [PMID: 15783131] [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: 05/02/2023]
Abstract
Exercise-induced bronchoconstriction (EIB) is a transient airflow obstruction that usually occurs 5 to 15 minutes after physical exertion. Although this condition is preventable, it is still underrecognized and affects the quality of life. The purpose of this study was to evaluate the prevalence of EIB, to find out whether self-reported symptoms were enough to establish the diagnosis of EIB and to define related symptoms and risk factors among symptomatic students of a Sports Academy in our city, which is situated at about 2,000 meters altitude and experiences a long winter period. A questionnaire was sent to students of the Sports Academy. After its evaluation, symptomatic students were invited to perform a pulmonary function test (PFT) before and after a six minute exercise test. Two hundred and seventy-seven students (205 males and 72 females, mean age: 20+/-4) from 12 different types of sport replied to the questionnaire. Of these subjects, 43% were symptomatic. Out of the 119 symptomatic students, 63 accepted our invitation. Three of them were excluded. After performing a six-minute exercise test, EIB was observed in 5 (8%) of them, whose symptoms were aggravated by cold weather. Our results suggest that EIB may be common among symptomatic sportsmen. Screening is important, since EIB could be prevented with appropriate diagnosis and treatment. Although respiratory symptoms during exercise may give important clues, only these symptoms are not sufficient to establish the diagnosis of EIB. Symptomatic patients should undergo further tests for EIB.
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Affiliation(s)
- Hasan Kaynar
- Atatürk University, School of Medicine, Chest Department, Erzurum, Turkey
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Aslan S, Karcioglu O, Bilge F, Meral M, Ozkurt Z, Uzkeser M. Post-interval syndrome after carbon monoxide poisoning. Vet Hum Toxicol 2004; 46:183-5. [PMID: 15303387] [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: 04/30/2023]
Abstract
Carbon monoxide (CO) exposure and toxicity is a potentially lethal disorder with immediate and delayed side effects. A 24-y-old driver was admitted to the University-based emergency department with altered mental status. He was found unconscious in the driver's seat of his vehicle in an indoor garage the morning before. An estimated 7 h later, he was comatose and taken to a nearby village clinic. Oxygen was administered immediately. Later, he was transferred to the university hospital. At the 12th h after exposure, the Glasgow Coma Scale score was 12/15 (E3, M5, V4). Co-oximetry disclosed a carboxyhemoglobin concentration of 10.5%. Normobaric oxygen was administered. He recovered completely the 3rd d after exposure; however, on the 7th d disorientation and agitation was noted, and the interval form of CO poisoning and leukoencephelopaty were suspected, for which he was readmitted the 10th d after exposure. Analysis of cerebrospinal fluid and blood revealed no abnormalities. Magnetic resonance imaging on the 11th d after exposure demonstrated an ischemic area in the posterior temporoparietal area. The patient continued improvement to discharge at 7th d of the second admission. Close follow-up should be scheduled for CO-poisoned patients to rule out the post-interval syndrome for at least 1 mo. This should also include those with apparent clinical and laboratory recovery.
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Affiliation(s)
- Sahin Aslan
- Department of Emergency Medicine, Ataturk University, School of Medicine, Erzurum, Turkey
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Akar S, Birlik M, Gurler O, Sari I, Onen F, Manisali M, Tirpan K, Demir T, Meral M, Akkoc N. The prevalence of rheumatoid arthritis in an urban population of Izmir-Turkey. Clin Exp Rheumatol 2004; 22:416-20. [PMID: 15301237] [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: 04/30/2023]
Abstract
OBJECTIVE To estimate the prevalence of rheumatoid arthritis (RA) in an urban area in Izmir, Turkey. METHODS The study was conducted in the Balcova and Narlidere districts of Izmir and a total of 2,887 people aged 20 years or older were contacted with a 98.2% acceptance rate. Nine medical doctors administered an RA questionnaire by face-to-face interview. Subjects reporting a history of swelling in at least 2 joints lasting more than 4 continuous weeks or a history of a diagnosis of rheumatoid arthritis, inflammatory joint rheumatism or joint rheumatism were considered as screening positive and they were invited to come in for an examination. RA cases were defined by the 1987 American College of Rheumatology (ACR) criteria modifiedfor use in population studies. RESULTS A total of 301 subjects (243 women, 58 men), or 10.6% of those who received the questionnaire were screening positive. 240 (79.7%) of these agreed to undergo a clinical examination either in the clinic or at home. Among these, 14 (12 female, 2 male) patients fulfilled the ACR criteria for RA. The prevalence of RA was 0.49% (95% CI 0.27-0.83) in the total population interviewed, 0.77% (95% CI 0.40-1.35) in women and 0.15% (95%CI 0.02-0.60) in men. The age- and sex-adjusted prevalence for the general population was estimated as 0.36%. Five of the 14 RA (36%) cases had not been diagnosed previously CONCLUSION These data are consistent with the results of other Mediterranean countries. A significant proportion of RA cases remain undiagnosed in the community.
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Affiliation(s)
- S Akar
- Dokuz Eylul University School of Medicine, Division of Rheumatology, Dokuz Eylul University, Izmir, Turkey.
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Meral M, Akgun M, Kaynar H, Mirici A, Gorguner M, Saglam L, Erdogan F. Mediastinal lymphadenopathy due to mycobacterial infection. Jpn J Infect Dis 2004; 57:124-6. [PMID: 15218225] [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: 04/30/2023]
Abstract
Tuberculous lymphadenitis without pulmonary manifestation is an uncommon entity in developed countries, and the possibility of tuberculous infection is usually ignored in the differential diagnosis of lymphadenopathy. Therefore, appropriate treatment may be delayed. Paralysis of the recurrent laryngeal nerve caused by mediastinal lymphadenopathy due to tuberculosis is an extremely rare condition. In this paper, we present a patient who had vocal cord paralysis caused by tuberculous lymphadenopathy of the superior mediastinum. After anti-tuberculosis treatment, vocal cord function was only partially recovered, while the clinical, radiological, and laboratory abnormalities were completely recovered.
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Affiliation(s)
- Mehmet Meral
- Department of Chest Diseases, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
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Kaynar H, Yilmaz N, Sağlam L, Meral M, Altoparlak U, Görgüner M, Mirici A. [The pathogens and their antibiotic sensitivities in hospital-acquired pneumonia cases]. Tuberk Toraks 2004; 52:333-40. [PMID: 15558355] [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
Dynamic precautions in the early diagnosis and treatment of hospital acquired pneumonias are necessary because of their high mortality. In these patients, invasive diagnostic approaches may be needed since clinical and radiological findings and other non-invasive approaches frequently fail to establish the diagnosis. Thirty eight patients were prospectively included in the study. Average age of patients was 45.5 +/- 16.4 years; 31 were males (81.6%) and 7 (18.4%) were females. Pneumonia was detected in 9 (23.7%) cases during the first five days and in 29 (76.3%) cases after the fifth day of admission to the hospital. Bronchoscopic interventions diagnostic purpose were carried out in 25 (65.8%) patients. The culture results were negative in 7 (18.4%) cases. While more than one pathogen was determined on the cultures of 16 (42.1%) patients only one pathogen was isolated in the cultures of 15 (39.4%) cases. The frequently isolated pathogen on cultures was Staphylococci (45.4%). Other pathogens were Enterobacter spp., Pseudomonas spp., Escherichia coli, Serratia and Streptococcus pneumoniae according to their frequency on cultures. High resistance rates to the third generation cephalosporins were determined. Eleven of 17 deaths in 38 pneumonia cases were attributable to pneumonia. As a conclusion, isolation of pathogen and antibiotic resistance should be determined in the cases with hospital acquired pneumonia. Invasive diagnostic interventions were not avoided when necessary. Although pro-BAL and PSB methods were expensive, their use in selected cases may prevent unnecessary antibiotic use and contribute to a decrease in mortality rate.
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Affiliation(s)
- Hasan Kaynar
- Department of Chest Disease, Faculty of Medicine, University of Atatürk, Erzurum, Turkey.
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Mirici A, Meral M, Akgun M. Comparison of the Efficacy of Nebulised Budesonide with Parenteral Corticosteroids in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Clin Drug Investig 2003; 23:55-62. [DOI: 10.2165/00044011-200323010-00007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Koç RK, Kurtsoy A, Paşaoğlu H, Karaküçük EI, Oktem IS, Meral M. Lipid peroxidation and oedema in experimental brain injury: comparison of treatment with methylprednisolone, tirilazad mesylate and vitamin E. Res Exp Med (Berl) 1999; 199:21-8. [PMID: 10494671 DOI: 10.1007/s004330050129] [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: 10/28/2022]
Abstract
Trauma-induced lipid peroxidation (LP) is one of the most important factors that produces tissue damage in head trauma. In the present study, the protective effects of free radical suppression with methylprednisolone (MP), tirilazad mesylate (TM) and vitamin E on the development of cerebral LP and oedema resulting from head trauma have been investigated. Rats were divided randomly into four groups. Bolus injections of physiological saline, MP (initial 30 mg/kg for 1 h, continuing administration of 5.4 mg/kg per hour until 24 h), TM (10 mg/kg), or vitamin E (30 mg/kg) were given 1 h after the head trauma. The animals were killed 24 h after the weight-drop injury for removal of the brain, and the malondialdehyde (MDA) level and water content of the brain were determined. Rats treated with TM had MDA levels which decreased significantly in comparison with the control group (P<0.03), and none of the drugs had an effect on LP and water content of the brain (P>0.05) that was statistically different. These findings demonstrated the beneficial effect of TM in this model of experimental brain injury.
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Affiliation(s)
- R K Koç
- Department of Neurosurgery, Erciyes University, Faculty of Medicine, Kayseri, Turkey
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Abstract
Fourteen cases of an extradural hematoma of the posterior fossa (EDHPF), are presented and the clinical and radiological finds are described. The onset of symptoms was acute in 10 patients and subacute in the other 4. Hematomas occurred in the younger age groups with a clear male predominance. Nine cases had suffered a blow to the head. A fracture of the occipital bone was seen in 86% of the patients. The bleeder could be identified in 10 cases, and in 6 of these the source was a bleeding transverse sinus. The overall mortality was 14.2%, but only patients with an acute course died (20%). All subacute cases survived. This study revealed that the most important factors influencing mortality were late diagnosis and late treatment. Coexisting intracranial lesions had no influence on mortality. According to the literature, there has been a certain decrease in mortality in the acute and subacute course patients since the introduction of computed tomography (CT) scanning. Emphasis is placed on the importance of occipital soft-tissue swelling and occipital fracture as clues to the possible presence of extradural hematomas, and of using the CT in all such patients even if no clinical symptoms are present.
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Affiliation(s)
- R K Koç
- Department of Neurosurgery, Erciyes University, School of Medicine, Kayseri, Turkey
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Abstract
Patients with traumatic acute subdural hematoma were studied to determine the factors influencing outcome. Between January 1986 and August 1995, we collected 113 patients who underwent craniotomy for traumatic acute subdural hematoma. The relationship between initial clinical signs and the outcome 3 months after admission was studied retrospectively. Functional recovery was achieved in 38% of patients and the mortality was 60%. 91% of patients with a high Glasgow Coma Scale (GCS) score (9-15) and 23% of patients with a low GCS score (3-8) achieved functional recovery. All of 14 patients with a GCS score of 3 died. The mortality of patients with GCS scores of 4 and 5 was 95% to 75%, respectively. Patients over 61 years old had a mortality of 73% compared to 64% mortality for those aged 21-40 years. 97% of patients with bilateral unreactive pupil and 81% of patients with unilateral unreactive pupil died. The mortality rates of associated intracranial lesions were 91% in intracerebral hematoma, 87% in subarachnoid hemorrhage, 75% in contusion. Time from injury to surgical evacuation and type of surgical intervention did not affect mortality. Age and associated intracranial lesions were related to outcome. Severity of injury and pupillary response were the most important factors for predicting outcome.
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Affiliation(s)
- R K Koç
- Department of Neurosurgery, Erciyes University, Medical School, Kayseri, Turkey
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