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Kara N, Arman D, Seymen Z, Eratlı G, Gül A, Cömert S. The effects of mydriatic eye drops on cerebral blood flow and oxygenation in retinopathy of prematurity examinations. Eur J Pediatr 2023; 182:4939-4947. [PMID: 37606703 DOI: 10.1007/s00431-023-05161-3] [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: 05/17/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 08/23/2023]
Abstract
Mydriatic eye drops used during retinopathy examination have been associated with cardiovascular, respiratory, and gastrointestinal side effects. The aim of our study was to investigate the effects of the drops used for pupil dilatation on cerebral blood flow and cerebral oxygenation. The study included 62 infants who underwent retinopathy screening exams. Vital signs, heart rate (HR), arterial oxygen saturation (SpO2), and mean arterial pressure (MAP) were recorded. Cerebral oxygenation and middle cerebral artery blood flow velocity were evaluated using near-infrared spectroscopy (NIRS) and Doppler ultrasonography, respectively, and the cerebral metabolic rate of oxygen (CMRO2) was also calculated. The mean gestational age of the infants included was 31.29 ± 1.42 weeks, and the mean birth weight was 1620 ± 265 g. Heart rate was found to be significantly decreased after mydriatic eye drop instillation; however, there were no significant differences regarding blood pressure and oxygen saturation levels (HR: p < 0.001; MAP: p = 0.851; SpO2: p = 0.986, respectively). After instillation while cerebral regional oxygen saturation (rScO2) measurements were significantly decreased at the 60th minute (p = 0.01), no significant difference was found in Vmax and Vmean of MCA before and after mydriatic eye drop instillation (p = 0.755, p = 0.515, respectively). Regarding CMRO2 measurements, we also did not find any statistical difference (p = 0.442). Conclusion: Our study has shown that although eye drops may affect heart rate and regional cerebral oxygen saturation, they do not alter cerebral blood flow velocities and metabolic rate of oxygen consumption. Current recommendations for mydriatic eye drop use in retinopathy exam appear to be safe. What is Known: • Mydriatic eye drop installation is recommended for pupil dilatation during ROP screening exams. • It's known that mydriatics used in ROP examination have affects on the vital signs, cerebral oxygenation and blood flow. What is New: • This is the first study evaluating the changes in cerebral oxygenation and blood flow velocity after mydriatic drop instillation using NIRS and Doppler US concomitantly. • While the eye drops may affect heart rate and regional cerebral oxygen saturation, they do not alter cerebral blood flow velocities and metabolic rate of oxygen consumption.
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Affiliation(s)
- Nursu Kara
- Division of Neonatology, Department of Pediatrics, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Didem Arman
- Division of Neonatology, Department of Pediatrics, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zeynep Seymen
- Department of Ophthalmology, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gökçen Eratlı
- Department of Ophthalmology, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Adem Gül
- Division of Neonatology, Department of Pediatrics, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Serdar Cömert
- Division of Neonatology, Department of Pediatrics, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
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Kara N, Arman D, Seymen Z, Gül A, Cömert S. Effects of fentanyl and sucrose on pain in retinopathy examinations with pain scale, near-infrared spectroscopy, and ultrasonography: a randomized trial. World J Pediatr 2023; 19:873-882. [PMID: 36976515 DOI: 10.1007/s12519-023-00705-x] [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: 08/04/2022] [Accepted: 02/12/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND This study aimed to compare the efficacy of intravenous, intranasal fentanyl and oral sucrose in reducing the pain response during retinopathy of prematurity examinations using premature infant pain profile (PIPP) scores. METHOD The study included 42 infants who underwent retinopathy screening examinations. The infants were divided into three groups: oral sucrose, intranasal fentanyl, and intravenous fentanyl. Vital signs (heart rate, arterial oxygen saturation, and mean arterial pressure) were recorded. The PIPP was used to determine pain severity. Cerebral oxygenation and middle cerebral artery blood flow were evaluated using near-infrared spectroscopy and Doppler ultrasonography, respectively. The data obtained were compared between groups. RESULTS There was no significant difference between the three groups regarding postconceptional and postnatal ages or birth weights and weight at the time of examination. All babies had moderate pain during the examination. No correlation was observed between analgesia method and pain scores (P = 0.159). In all three groups, heart rate and mean arterial pressure increased, whereas oxygen saturation decreased during the exam compared with pre-examination values. However, heart rate (HR), mean arterial pressure (MAP) and arterial oxygen saturation (sPO2) values did not differ between groups (HR, P = 0.150; MAP, P = 0.245; sPO2, P = 0.140). The cerebral oxygenation (rSO2) values between the three groups were found to be similar [rSO2: P = 0.545, P = 0.247, P = 0.803; fractional tissue oxygen extraction (FTOE): P = 0.553, P = 0.278]. Regarding cerebral blood flow values, we also did not find any difference between the three groups [mean blood flow velocity (Vmean): P = 0.569, P = 0.975; maximum flow velocity (Vmax): P = 0.820, P = 0.997]. CONCLUSIONS Intravenous and intranasal fentanyl and oral sucrose were not superior to each other in preventing pain during the examination for retinopathy of prematurity (ROP). Sucrose may be a good alternative for pain control during ROP examination. Our findings suggest that ROP exam may not affect cerebral oxygenation or cerebral blood flow. Larger scale studies are needed to determine the best pharmacological option to reduce pain during ROP exams and evaluate the effects of this procedure on cerebral oxygenation and blood flow.
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Affiliation(s)
- Nursu Kara
- Department of Pediatrics, Division of Neonatology, University of Health Sciences Istanbul Research and Training Hospital, Istanbul, Turkey.
| | - Didem Arman
- Department of Pediatrics, Division of Neonatology, University of Health Sciences Istanbul Research and Training Hospital, Istanbul, Turkey
| | - Zeynep Seymen
- Department of Opthalmology, University of Health Sciences Istanbul Research and Training Hospital, Istanbul, Turkey
| | - Adem Gül
- Department of Pediatrics, Division of Neonatology, University of Health Sciences Istanbul Research and Training Hospital, Istanbul, Turkey
| | - Serdar Cömert
- Department of Pediatrics, Division of Neonatology, University of Health Sciences Istanbul Research and Training Hospital, Istanbul, Turkey
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Kara N, Arman D, Gül A, Şimşek T, Ceylan Ö, Cömert S. Evaluation of Critical Congenital Heart Disease Screening Results with Pulse Oximetry. Istanbul Med J 2022. [DOI: 10.4274/imj.galenos.2022.45793] [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: 12/01/2022] Open
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Umut Zübarioğlu A, Yıldırım Ö, Zeybek C, Balaban İ, Aliyev B, Yazıcıoğlu V, Tutak E, Dursun M, Türkoğlu Ünal E, Kara N. The Ideal Timing of Bedside Surgical Ligation of Patent Ductus Arteriosus in Premature Babies Less Than 30 Gestational Weeks. Turk Arch Pediatr 2021; 56:300-307. [PMID: 35929851 PMCID: PMC8890320 DOI: 10.5152/turkarchpediatr.2021.21010] [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] [Indexed: 11/22/2022]
Abstract
Objective: The aim of our study is to determine the relationship between exposure to hemodynamically significant patent ductus arteriosus and morbidities in premature babies, the optimal number of pharmacologic treatment cycles, and ideal ductus ligation timing. Materials and Methods: The study was a retrospective single-center study conducted in a 3-year period between July 2017 and June 2020. Premature babies, born ≤30 weeks of gestation and transferred to our unit for bedside ductus ligation, were included in the study. The subjects were divided into 2 groups; Group A consisted of the patients who received ≥3 pharmacologic treatment cycles, and group B consisted of the patients who received ≤2 cycles. The groups were compared according to preoperative and postoperative features. The main outcome of the study was the presence of severe bronchopulmonary dysplasia. The secondary outcomes were specified as the length of stay in the neonatal intensive care unit and the duration of invasive mechanical ventilation (MV). Results: The study group consisted of 24 patients. There were 10 patients in group A and 14 patients in group B. The mean gestational week and the mean birthweight were found to be 26,7 ± 2.2 weeks and 928 ± 190 g, respectively. The incidence of severe bronchopulmonary dysplasia was significantly higher in group A (70% vs. 14.3%; P = .019). Post-ligation invasive MV, duration, and length of stay in the intensive care unit were found to be significantly longer in group A. None of the patients had hemodynamic disturbances or complications during and after the operation. Conclusions: Bedside surgical ductus ligation is a safe procedure. Prolonging pharmacologic treatment in order to avoid surgery increases the risk of severe bronchopulmonary dysplasia and prolongs hospital stay.
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Affiliation(s)
- Adil Umut Zübarioğlu
- Department of Neonatalogy, İstanbul Yeni yüzyıl University School of Medicine, Istanbul, Turkey
- Corresponding Author:Adil Umut Zubarioglu
| | - Özgür Yıldırım
- Department of Pediatric Cardiovascular Surgery, İstanbul Yeni yüzyıl University School of Medicine, Istanbul, Turkey
| | - Cenap Zeybek
- Department of Pediatric Cardiology, İstanbul Yeni yüzyıl University School of Medicine, Istanbul, Turkey
| | - İsmail Balaban
- Department of Pediatric Cardiology, İstanbul Yeni yüzyıl University School of Medicine, Istanbul, Turkey
| | - Bahruz Aliyev
- Department of Pediatric Cardiology, İstanbul Yeni yüzyıl University School of Medicine, Istanbul, Turkey
| | - Volkan Yazıcıoğlu
- Department of Pediatric Cardiovascular Surgery, İstanbul Yeni yüzyıl University School of Medicine, Istanbul, Turkey
| | - Ercan Tutak
- Department of Neonatology, Istanbul Memorial Sisli Hospital, Istanbul, Turkey
| | - Mesut Dursun
- Department of Neonatology, İstanbul Biruni University School of Medicine, Istanbul, Turkey
| | - Ebru Türkoğlu Ünal
- Department of Neonatology, Istanbul Sarıyer Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Nursu Kara
- Department of Neonatology, Istanbul Suleymaniye Training and Research Hospital, Istanbul, Turkey
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Damri O, Asslih S, Shemesh N, Natour S, Noori O, Daraushe A, Einat H, Kara N, Las G, Agam G. Using mitochondrial respiration inhibitors to design a novel model of bipolar disorder-like phenotype with construct, face and predictive validity. Transl Psychiatry 2021; 11:123. [PMID: 33579900 PMCID: PMC7881114 DOI: 10.1038/s41398-021-01215-y] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/10/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022] Open
Abstract
We mimicked mild mitochondrial-distress robustly reported in bipolar-disorder (BD) by chronic exposure to uniquely low doses of inhibitors of mitochondrial-respiration complexes in vitro and in vivo. Exposure of the neuronal-originating SH-SY5Y cells to very low dose (10 pM) rotenone, a mitochondrial-respiration complex (Co)I inhibitor, for 72 or 96 h did not affect cell viability and reactive oxygen species (ROS) levels. Yet, it induced a dual effect on mitochondrial-respiration: overshooting statistically significant several-fold increase of most oxygen-consumption-rate (OCR) parameters vs. significantly decreased all OCR parameters, respectively. Chronic low doses of 3-nitropropionic acid (3-NP) (CoII inhibitor) did not induce long-lasting changes in the cells' mitochondria-related parameters. Intraperitoneal administration of 0.75 mg/kg/day rotenone to male mice for 4 or 8 weeks did not affect spontaneous and motor activity, caused behaviors associated with mania and depression following 4 and 8 weeks, respectively, accompanied by relevant changes in mitochondrial basal OCR and in levels of mitochondrial-respiration proteins. Our model is among the very few BD-like animal models exhibiting construct (mild mitochondrial dysfunction), face (decreased/increased immobility time in the forced-swim test, increased/decreased consumption of sweet solution, increased/decreased time spent in the open arms of the elevated plus maze) and predictive (reversal of rotenone-induced behavioral changes by lithium treatment) validity. Our rotenone regime, employing doses that, to the best of our knowledge, have never been used before, differs from those inducing Parkinson's-like models by not affecting ROS-levels and cell-viability in vitro nor motor activity in vivo.
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Affiliation(s)
- O Damri
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - S Asslih
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - N Shemesh
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - S Natour
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - O Noori
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - A Daraushe
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - H Einat
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel Aviv-Yafo, Israel
| | - N Kara
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel Aviv-Yafo, Israel
| | - G Las
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - G Agam
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel.
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Alatas I, Ozel K, Kara N, Canaz H. Urodynamic Study Findings Prior to Myelomeningocele Repair in Neonates. J Pediatr Neurosci 2020; 15:220-223. [PMID: 33531935 PMCID: PMC7847111 DOI: 10.4103/jpn.jpn_91_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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/18/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction Myelomeningocele (MMC) is the most common cause of neurogenic bladder dysfunction in children. Neurogenic bladder dysfunction is developed before birth due to autonomous nervous system affected prenatally in patients with MMC. The aim of this study was to share urodynamic study findings before MMC repair and to discuss the correlation with neurological evaluation. Materials and Methods We prospectively studied 37 patients who underwent surgery for MMC repair in our institution in the first 20 h of their lives between 2013 and 2016. All patients were evaluated by a neurosurgeon, neonatologist, and pediatric surgeon. Urodynamic study was performed in first 18h of life before MMC repair in all patients. Lesion level, occurrence of hydrocephalus, neurological functions, spinal deformities, and urodynamic study results were analyzed. Results The study included 18 female and 19 male patients. Overactive detrusor was detected in 22 patients, and hypoactive detrusor was detected in 5 patients. Overactive sphincter muscle was detected in 32 patients, and hypoactive sphincter was detected in 2 patients. Detrusor-sphincter dyssynergia was present in 34 patients. Conclusion Detailed analysis of urodynamic study findings in larger patient groups may be important to understand the physiopathology of prenatal damage in patients with MMC.
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Affiliation(s)
- Ibrahim Alatas
- Department of Neurosurgery, Florence Nightingale Hospital, Demiroglu Bilim University, Istanbul, Turkey
| | - Kerem Ozel
- Department of Pediatric Surgery, Medeniyet University, Istanbul, Turkey
| | - Nursu Kara
- Department of Neonatology, Istanbul Training and Education Hospital, Istanbul, Turkey
| | - Huseyin Canaz
- Department of Neurosurgery, Florence Nightingale Hospital, Demiroglu Bilim University, Istanbul, Turkey
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Kara N. Traumatismes du bas appareil urinaire lors des accidents de la route. Épidémiologie, présentation clinique, suivi à court et moyen terme de 591 cas. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.067] [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: 10/25/2022]
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Philpott CM, Smith R, Davies-Husband CR, Erskine S, Clark A, Welch A, Hopkins C, Carrie S, Ray J, Sunkaraneni V, Kara N, Kumar N, Robertson A, Anari S, Almeyda R, Wilson A. Exploring the association between ingestion of foods with higher potential salicylate content and symptom exacerbation in chronic rhinosinusitis. Data from the National Chronic Rhinosinusitis Epidemiology Study. Rhinology 2019; 57:303-312. [PMID: 31120456 DOI: 10.4193/rhin19.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Pharmacological salicylates are known to trigger respiratory exacerbations in patients with Non-Steroidal Exacerbated Respiratory Disease (N-ERD), a specific phenotype of Chronic Rhinosinusitis (CRS) and asthma. The impact of dietary sources of salicylates across subgroups of CRS is not well understood. The hypothesis is that in patients with nasal polyps present, there is likely to be a higher incidence of symptom exacerbation due to dietary salicylates regardless of any known response to pharmacological salicylate. METHODS The Chronic Rhinosinusitis Epidemiology Study (CRES) was a questionnaire-based case-control study which sought to characterise the UK CRS population in terms of sociological, economic and medical factors. Using specific questions to examine participant responses relating to symptom exacerbation from food groups thought to be high in salicylate content, this analysis of the CRES database sought to compare an estimate of the prevalence of dietary sensitivity due to food with higher potential salicylate content across patients with CRS with (CRSwNPs) and without nasal polyposis (CRSsNPs) and with allergic fungal rhinosinusitis (AFRS). RESULTS The CRSwNPs group were significantly more likely than controls to report symptom exacerbation due to ingestion of food groups with higher potential dietary salicylate content. The same trend was observed amongst CRSsNPs participants to a lesser degree. Reported response to the individual specific food groups wine, nuts, spicy foods, fruit and vegetables demonstrated that a statistically significant proportion of CRSwNPs and AFRS participants reported sensitivity to wine. CONCLUSIONS This analysis suggests that there is an association between symptom exacerbation in response to food products with higher potential salicylate content, specifically wine, in CRS patients both with and without nasal polyposis when compared to controls, but especially in the CRSwNPs and AFRS phenotypes. Further studies are needed to detail if this relationship represents a causal relationship to dietary salicylate. The data present the possibility that a wider group of CRS patients may elicit salicylate sensitivity than those with known N-ERD.
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Affiliation(s)
- C M Philpott
- Norwich Medical School, University of East Anglia, Norfolk NR4 7TJ, United Kingdom; James Paget University Hospital NHS Foundation Trust, Gorleston, United Kingdom
| | - R Smith
- Norwich Medical School, University of East Anglia, Norfolk NR4 7TJ, United Kingdom; James Paget University Hospital NHS Foundation Trust, Gorleston, United Kingdom
| | | | - S Erskine
- Norwich Medical School, University of East Anglia, Norfolk NR4 7TJ, United Kingdom
| | - A Clark
- Norwich Medical School, University of East Anglia, Norfolk NR4 7TJ, United Kingdom
| | - A Welch
- Norwich Medical School, University of East Anglia, Norfolk NR4 7TJ, United Kingdom
| | - C Hopkins
- Guys and St Thomas Hospital, London, United Kingdom
| | - S Carrie
- Freeman Hospital, Newcastle, United Kingdom
| | - J Ray
- Sheffield University Teaching Hospitals, Sheffield, United Kingdom
| | - V Sunkaraneni
- Royal Surrey County Hospital, Guildford, United Kingdom
| | - N Kara
- Darlington Memorial Hospital, United Kingdom
| | - N Kumar
- Wrightington, Wigan and Leigh NHS Foundation Trust, United Kingdom
| | - A Robertson
- Southern General Hospital, Glasgow, United Kingdom
| | - S Anari
- Birmingham Heartlands Hospital, Birmingham, United Kingdom
| | - R Almeyda
- Royal Berkshire Hospital, Reading, United Kingdom
| | - A Wilson
- Norwich Medical School, University of East Anglia, Norfolk NR4 7TJ, United Kingdom
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Ceylan O, Arman D, Kara N. Noncompaction-like membranous structure in left ventricle. Echocardiography 2019; 36:813-814. [PMID: 30803005 DOI: 10.1111/echo.14294] [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] [Received: 12/05/2018] [Revised: 01/22/2019] [Accepted: 01/30/2019] [Indexed: 11/27/2022] Open
Abstract
A 22-day-old boy born to a 21-year-old gravida 1, para 1 mother was admitted to our hospital for routine newborn examination. On physical examination, any clinical abnormality or malformations were not observed except 1/6 systolic murmur. A well-demarcated membranous structure was confirmed by echocardiography which was starting from left ventricular apex, extending to the mitral chords including papillary muscles in apical four-chamber and parasternal long-axis examination. This structure was considered as a variant of left ventricular noncompaction. The patient is still being followed up in our pediatric cardiology department.
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Affiliation(s)
- Ozben Ceylan
- Department of Pediatric Cardiology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Didem Arman
- Department of Neonatology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Nursu Kara
- Department of Neonatology, Istanbul Education and Research Hospital, Istanbul, Turkey
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Kara N, Morel Journel N, Badet L, Ruffion A, Terrier J. 332 Management and outcomes of penile fracture: a ten year multicentric study. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.295] [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: 10/28/2022]
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Alatas I, Canaz G, Arslan G, Cevik S, Kacmaz B, Kara N, Canaz H. Analysis of Denver Neurodevelopmental Screening Test Results of Myelomeningocele, Hydrocephalus, and Microcephaly Patients. J Pediatr Neurosci 2018; 13:28-33. [PMID: 29899768 PMCID: PMC5982489 DOI: 10.4103/jpn.jpn_156_17] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Context: Spina bifida, hydrocephalus, and similar congenital central nervous system (CNS) anomalies take origin from embryologic stages weeks before birth, but assessment and follow-up of these patients are important to figure and predict the effects of these anomalies on child's neurodevelopment. Aims: To evaluate of multiple groups of congenital CNS anomalies in the neurodevelopment level. Settings and Design: The study was conducted at a research and treatment center for spina bifida patients. Materials and Methods: The study group included 348 patients with a mean age of 15.4 (±15.1) months, who had spina bifida aperta, hydrocephalus, and microcephaly. Patients with other known intracranial conditions were excluded. The subjects were evaluated into five groups: Group 1, 88 patients with congenital hydrocephalus; Group 2, 48 patients with congenital hydrocephalus and ventriculoperitoneal shunt; Group 3, 148 patients with microcephaly; Group 4, 30 patients who were operated for spina bifida aperta; and Group 5, 39 patients who were operated for spina bifida aperta and also had ventriculoperitoneal shunt implantation. Denver Developmental Screening Test II was used to assess patients’ neurodevelopment levels. Statistical Analysis Used: Pearson's chi-square and Fisher's exact tests were used for data analysis. Group comparisons were also made in pairs with chi-square test according to Bonferroni corrections. Frequency of abnormal findings was significantly correlated with age (P = 0.014). Results: Total score differences of five groups appeared to be statistically significant according to Pearson's chi-square test (P = 0.000). When we compared groups in pairs, abnormal results were significantly frequent in shunted groups (P < 0.01). Conclusions: Our results suggested that shunt-dependent hydrocephalus caused serious neurodevelopmental impairments in patients.
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Affiliation(s)
- Ibrahim Alatas
- Department of Neurosurgery, Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
| | - Gokhan Canaz
- Department of Neurosurgery, Bakirkoy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry, Istanbul, Turkey
| | - Gulseren Arslan
- Department of Pediatric Neurology, Avcilar Hospital, Istanbul, Turkey
| | - Serdar Cevik
- Department of Neurosurgery, Faculty of Medicine, Istinye University, Istanbul, Turkey
| | - Belgu Kacmaz
- Psychology Clinic, Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
| | - Nursu Kara
- Department of Neonatology, Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
| | - Huseyin Canaz
- Department of Neurosurgery, Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
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Alatas I, Canaz G, Kayran NA, Kara N, Canaz H. Shunt revision rates in myelomeningocele patients in the first year of life: a retrospective study of 52 patients. Childs Nerv Syst 2018; 34:919-923. [PMID: 29159427 DOI: 10.1007/s00381-017-3663-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 11/14/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Shunt placement indications are stringent and require confirmation of clinical and radiological evidence of hydrocephalus (HC). The aim of this study was to determine the rate of shunting and discuss the outcome in the first year of life in patients with myelomeningocele (MMC) on the basis of review of the literature. METHODS All patients who underwent postnatal repair of MMC at our institution between March 2014 and March 2015 were evaluated. Patients were only included if they underwent both MMC repair and ventriculoperitoneal (VP) shunt insertion at our institution and were followed up for at least 12 months. The mean ages for repair of MMC, MMC levels, timing of VP shunt placement, shunt revisions, and causes of shunt revisions were documented. RESULTS Fifty-two patients with MMC were included in this study. The average gestational age at birth was 38 weeks. The level of MMC was thoracolumbar in 13 cases, 11 times lumbar, 21 times lumbosacral, and 7 times sacral. Thirty-one patients (59.61%) suffered from hydrocephalus and required placement of a shunt. When we evaluate the lesion levels of patients who require shunting, 13 cases were thoracolumbar, 6 cases were lumbar, and 11 cases were lumbosacral. None of the sacral cases needed VP shunt. Seven patients (13.4%) had shunt revision within the first year of life. The cause of shunt revision was wound problem in one patient (1.9%), underdrainage in two patients (3.8%), infection in three patients (5.7%), and mechanical obstruction in another one patient (1.9%). CONCLUSION MMC closure and management of the associated HC are one of the most basic, but never simple, legs of the pediatric neurosurgery around the world. As clinicians and neurosurgeons, we are obligated to analyze recent evidences and evaluate present approaches to achieve optimization in this subject until further technologies or approaches became more advantageous for our patients.
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Affiliation(s)
- Ibrahim Alatas
- Department of Neurosurgery, Spina Bifida Center, Florence Nightingale Hospital, Istanbul Bilim University, Abide-i Hurriyet Cad. No:163, 34381, Sisli, Istanbul, Turkey
| | - Gokhan Canaz
- Department of Neurosurgery, Bakirkoy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry, Istanbul, Turkey
| | - Nesrin Akkoyun Kayran
- Department of Neurosurgery, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Nursu Kara
- Department of Neonatology, Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
| | - Huseyin Canaz
- Department of Neurosurgery, Spina Bifida Center, Florence Nightingale Hospital, Istanbul Bilim University, Abide-i Hurriyet Cad. No:163, 34381, Sisli, Istanbul, Turkey.
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13
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Kara N, Yao AC, Newton J, Deary V, O'Hara J, Wilson JA. General illness and psychological factors in patients with chronic nasal symptoms. Clin Otolaryngol 2017; 43:609-616. [PMID: 29150985 DOI: 10.1111/coa.13032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Only a minority of patients referred to specialists with sinonasal symptoms have clear evidence of chronic rhinosinusitis (CRS). This study aims to estimate the prevalence of and associations between (i) general illness factors (fatigue, autonomic dysfunction) and (ii) psychological factors (anxiety, depression, somatisation, personality traits) in patients presenting with sinonasal symptoms. DESIGN The following validated questionnaires were administered to patients: the Sino-Nasal Outcome Test-22 (SNOT-22) identifying symptom burden, Composite Autonomic Symptom Score-31 (COMPASS-31) measuring autonomic function, Chalder Fatigue Questionnaire, Patient Health Questionnaire-15 (PHQ-15) addressing somatisation symptoms, Hospital Anxiety and Depression Scale (HADS), and the International Personality Item Pool-50 (IPIP-50). Comparisons were made with normative and general population data, and relationships were analysed using nonparametric correlation. SETTING Secondary care ENT outpatients. PARTICIPANTS Adults referred with chronic sinonasal symptoms. MAIN OUTCOME MEASURES SNOT-22, COMPASS-31, Chalder, PHQ-15, HADS, and IPIP-50 questionnaire scores. RESULTS Sixty-one patients were included. There was a high prevalence of all general and psychological factors assessed compared with controls. Total SNOT-22 scores showed significant correlation with Chalder fatigue scores, total autonomic dysfunction score, anxiety, depression, somatisation tendencies and the emotionally unstable personality trait. Emotional instability and psychological dysfunction correlated significantly with sleep and psychological subscales of SNOT-22 but not the rhinological or ear/facial subscales. CONCLUSION Patients with sinonasal symptoms demonstrate high prevalence and complex associations of general illness factors, psychological distress and certain personality traits. The SNOT-22 is a valuable tool, but its utility is limited by correlations with these confounding factors (eg psychological factors) that may exaggerate the total score. The use of the SNOT-22 component subscales is likely to provide more clinically meaningful and discriminant information.
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Affiliation(s)
- N Kara
- ENT Department, County Durham & Darlington NHS Foundation Trust, Darlington, UK
| | - A C Yao
- ENT Department, Stockport NHS Foundation Trust, Stockport, UK
| | - J Newton
- Institute of Cellular Medicine, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle University, Newcastle upon Tyne, UK
| | - V Deary
- Psychology Department, Northumbria University, Newcastle upon Tyne, UK
| | - J O'Hara
- ENT Department, Institute of Health and Society, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle University, Newcastle upon Tyne, UK
| | - J A Wilson
- ENT Department, Institute of Health and Society, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle University, Newcastle upon Tyne, UK
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Philpott C, Erskine S, Smith R, Hopkins C, Kara N, Farboud A, Salam M, Robertson A, Almeyda R, Kumar B, Anari S, Ray J, Cathcart R, Carrie S, Ahmed S, Khalil H, Clark A, Thomas M. Current use of baseline medical treatment in chronic rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (CRES). Clin Otolaryngol 2017; 43:509-524. [DOI: 10.1111/coa.13012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2017] [Indexed: 11/29/2022]
Affiliation(s)
- C. Philpott
- James Paget University Hospital NHS Foundation Trust; Gorleston UK
- Norwich Medical School; University of East Anglia; Norfolk UK
| | - S. Erskine
- James Paget University Hospital NHS Foundation Trust; Gorleston UK
| | - R. Smith
- Norwich Medical School; University of East Anglia; Norfolk UK
| | - C. Hopkins
- Guys & St Thomas Hospital NHS Foundation Trust; London UK
| | - N. Kara
- County Durham & Darlington NHS Foundation Trust; Darlington UK
| | | | - M. Salam
- Ipswich Hospital NHS Foundation Trust; Ipswich UK
| | - A. Robertson
- Queen Elizabeth University Hospital Campus; Glasgow UK
| | - R. Almeyda
- Royal Berkshire NHS Foundation Trust; Reading UK
| | - B.N. Kumar
- Wrightington Wigan and Leigh NHS Foundation Trust; Wigan UK
| | - S. Anari
- Heart of England NHS Trust; Birmingham UK
| | - J. Ray
- Sheffield Teaching Hospitals NHSFT; Sheffield UK
| | | | | | - S. Ahmed
- University Hospitals Birmingham NHS Foundation Trust; Birmingham UK
| | | | - A. Clark
- Norwich Medical School; University of East Anglia; Norfolk UK
| | - M. Thomas
- Primary Care and population Sciences; University of Southampton; Southampton UK
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15
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Kara C, Selamet H, Gökmenoğlu C, Kara N. Low level laser therapy induces increased viability and proliferation in isolated cancer cells. Cell Prolif 2017; 51:e12417. [PMID: 29160001 DOI: 10.1111/cpr.12417] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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: 09/25/2017] [Accepted: 11/01/2017] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Low level laser therapy (LLLT), which stimulates natural biological processes in the application region, is frequently used in dental treatments. The aim of our study was to evaluate the effects of LLLT which could activate precancerous cells or increase existing cancerous tissue in case of clinically undetectable situations. MATERIALS AND METHODS Saos-2 osteoblast-like osteosarcoma cells and A549 human lung carcinoma cells were used. Twenty-four hours after preparation of cell culture plates, laser irradiation was performed 1, 2 and 3 times according to the test groups using Nd:YAG laser with the power output 0.5, 1, 2 and 3 W. Cell proliferation analysis was performed by MTT assay at the 24th hour following the last laser applications. RESULTS Generally, it was observed that the proliferation rates increased as the number of applications increased, when compared to the controls, especially in those cases in which the irradiation was performed 2 or 3 times more. CONCLUSION The findings of this study have led to the conclusion that LLLT increases cancer cell proliferation, depending on the power output level of the laser and the number of applications. In addition to the proliferation and mitotic activity of the cancer tissue cells, we concluded that LLLT, which is frequently used in dental practice, could activate precancerous cells or increase existing cancerous tissue.
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Affiliation(s)
- C Kara
- Department of Periodontology, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - H Selamet
- Department of Periodontology, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - C Gökmenoğlu
- Department of Periodontology, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - N Kara
- Department of Pedodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
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16
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Kara N, Badet L, Ruffion A, Terrier JE. Fracture des corps caverneux : présentation clinique, prise en charge et résultats. Étude multicentrique sur plus de 10 ans. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.061] [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: 11/29/2022]
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Affiliation(s)
- N. Karakus
- Department of Medical Biology, Section of Medical Genetics, Ondokuz Mayis University, Samsun, Turkey
| | - N. Kara
- Department of Medical Biology, Section of Medical Genetics, Ondokuz Mayis University, Samsun, Turkey
| | - S. Tural
- Department of Medical Biology, Section of Medical Genetics, Ondokuz Mayis University, Samsun, Turkey
| | - I. Kocak
- Department of Gynecology and Obstetrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - M. Elbistan
- Department of Medical Biology, Section of Medical Genetics, Ondokuz Mayis University, Samsun, Turkey
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18
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Perry W, Bagheri Nejad S, Tuomisto K, Kara N, Roos N, Dilip TR, Hirschhorn LR, Larizgoitia I, Semrau K, Mathai M, Dhingra-Kumar N. Implementing the WHO Safe Childbirth Checklist: lessons from a global collaboration. BMJ Glob Health 2017; 2:e000241. [PMID: 29082003 PMCID: PMC5656115 DOI: 10.1136/bmjgh-2016-000241] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 11/13/2016] [Accepted: 04/18/2017] [Indexed: 12/24/2022] Open
Abstract
The WHO Safe Childbirth Checklist (SCC) was developed to ensure the delivery of essential maternal and perinatal care practices around the time of childbirth. A research collaboration was subsequently established to explore factors that influence use of the Checklist in a range of settings around the world. This analysis article presents an overview of the WHO SCC Collaboration and the lessons garnered from implementing the Checklist across a diverse range of settings. Project leads from each collaboration site were asked to distribute two surveys. The first was given to end users, and the second to implementation teams to describe their respective experiences using the Checklist. A total of 134 end users and 38 implementation teams responded to the surveys, from 19 countries across all levels of income. End users were willing to adopt the SCC and found it easy to use. Training and the provision of supervision while using the Checklist, alongside leadership engagement and local ownership, were important factors which helped facilitate initial implementation and successful uptake of the Checklist. Teams identified several challenges, but more importantly successfully implemented the WHO SCC. A critical step in all settings was the adaptation of the Checklist to reflect local context and national protocols and standards. These findings were invaluable in developing the final version of the WHO SCC and its associated implementation guide. Our experience will provide useful insights for any institution wishing to implement the Checklist.
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Affiliation(s)
- Wrg Perry
- Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland
| | - S Bagheri Nejad
- Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland
| | - K Tuomisto
- Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland
| | - N Kara
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - N Roos
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - T R Dilip
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - L R Hirschhorn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - I Larizgoitia
- Evaluation Office, World Health Organization, Geneva, Switzerland
| | - K Semrau
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T H Chan School of Public Health, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - M Mathai
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland.,Centre for Maternal and Newborn Health, Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - N Dhingra-Kumar
- Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland
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19
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Gabor L, Canaz H, Canaz G, Kara N, Gulec EY, Alatas I. Foramina parietalia permagna: familial and radiological evaluation of two cases and review of literature. Childs Nerv Syst 2017; 33:853-857. [PMID: 27975139 DOI: 10.1007/s00381-016-3315-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 12/01/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Foramina parietalia permagna is a variable intramembranous ossification defect of the parietal bones. Foramina parietalia permagna have an autosomal dominant inheritance, and it is showed that mutations in chromosome 5 and 11 are causing this anomaly. Enlarged parietal foramina occurs extremely rare. They are usually asymptomatic, but occasional headache, vomiting, pain over unprotected cerebral cortex, and seizures may be experienced by the patients. In the literature, some associated congenital bony defects, soft tissue pathologies, underlying neuronal deficits, and vascular variations have been described. METHODS We report two cases of foramina parietal permagna with their pedigrees and genetic analysis. RESULTS In case 1, cytogenetic analysis revealed a mutation of the ALX4 gene and all of the members of the family diagnosed with FPP. MRI revealed inferior vermian cerebellar hypoplasia. Surgery was not considered. In case 2, cytogenetic analysis could not be obtained because of financial reasons. Cranial MRI revealed hypoplastic right transverse sinus and sigmoid sinus, with a persistent parafalcine sinus. Surgery was not considered. CONCLUSION Despite of its rarity, genetic background and some important associated anomalies make foramina parietalia permagna more than an uncommon insignificant genetic disorder.
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Affiliation(s)
- Larissa Gabor
- Department of Neurosurgery, Istanbul Bilim University, Sisli Florence Nightingale Hospital, Istanbul, Turkey
| | - Huseyin Canaz
- Department of Neurosurgery, Istanbul Bilim University, Sisli Florence Nightingale Hospital, Istanbul, Turkey
| | - Gokhan Canaz
- Department of Neurosurgery, Bakirkoy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry, 34147, Bakırkoy, Istanbul, Turkey.
| | - Nursu Kara
- Department of Neonatology, Istanbul Bilim University, Sisli Florence Nightingale Hospital, Istanbul, Turkey
| | - Elif Yilmaz Gulec
- Department of Medical Genetics, Kanuni Sultan Suleyman Training and Reseach Hospital, Istanbul, Turkey
| | - Ibrahim Alatas
- Department of Neurosurgery, Istanbul Bilim University, Sisli Florence Nightingale Hospital, Istanbul, Turkey
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20
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Gabor L, Canaz H, Canaz G, Kara N, Alatas I, Bozkus H. Russell-Silver syndrome associated with low conus medullaris. J Pediatr Neurosci 2017; 11:361-363. [PMID: 28217167 PMCID: PMC5314858 DOI: 10.4103/1817-1745.199482] [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] [Indexed: 11/30/2022] Open
Abstract
Russell–Silver syndrome is a rare heterogeneous disorder mainly characterized by intrauterine and postnatal growth retardation, craniofacial disproportion, clinodactyly, variation in urogenital development, and skeletal asymmetry. It is rare to come across tethered cord-associated Russell–Silver syndrome. We report a rare case of Russell–Silver syndrome associated with low conus medullaris in a 2-year-old patient with demonstrative phenotype. Magnetic resonance imaging indicated a low conus medullaris at the inferior border of the L3 vertebral body. Urodynamic study revealed detrusor-sphincter dyssynergia and detrusor overactivity. A decision to follow-up the patient was made because of the suspicion of tethered cord syndrome. Even though tethered cord syndrome is not a common finding in Russell–Silver syndrome, it is important to consider tethered cord syndrome to avoid scoliosis and other long-term complications.
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Affiliation(s)
- Larisa Gabor
- Department of Neurosurgery, Sisli Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
| | - Huseyin Canaz
- Department of Neurosurgery, Sisli Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
| | - Gokhan Canaz
- Department of Neurosurgery, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Nursu Kara
- Department of Neonatology, Sisli Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
| | - Ibrahim Alatas
- Department of Neurosurgery, Sisli Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
| | - Hakan Bozkus
- Department of Neurosurgery, Sisli Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey
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21
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Erskine S, Hopkins C, Kumar N, Wilson J, Clark A, Robertson A, Kara N, Sunkaraneni V, Anari S, Philpott C. A cross sectional analysis of a case-control study about quality of life in CRS in the UK; a comparison between CRS subtypes. Rhinology 2017; 54:311-315. [PMID: 27315942 DOI: 10.4193/rhino15.361] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Sinonasal Outcome Test (SNOT-22) has been used as a patient reported outcome measure to grade symptom severity before and after treatment for chronic rhinosinusitis (CRS). METHODOLOGY This analysis uses data from the CRS Epidemiology Study (CRES). The overarching aim of CRES was to determine factors that influence the onset and severity of CRS. A study-specific questionnaire including SNOT-22 was distributed to patients with CRS attending ENT clinics across 30 centres in the United Kingdom. The aim of this analysis was to compare SNOT-22 scores between those with different types of CRS to determine any differences present in the total score or the subdomains and to assess whether any differences varied according to gender. RESULTS There were a total of 1249 CRS participants in the following subgroups: CRS without nasal polyps (CRSsNPs) (n=553), CRS with nasal polyps (CRSwNPs) (n=651), allergic fungal rhinosinusitis (AFRS) (n=45). Since there were differing gender ratios in each subgroup, males and females were analysed separately. The mean and standard deviation for SNOT-22 was: males CRSsNP 41.1 (21.0), CRSwNP 41.7 (20.5); females CRSsNP 49.6 (19.7), CRSwNP 49.5 (22.9). In the nasal domain, those with CRSwNP scored more highly than those with CRSsNP; for males 18.1 (8.1) vs. 15.9 (7.9); for females 19.6 (8.0) vs 16.7 (7.5). CONCLUSIONS Patients with CRSwNPs report higher symptom scores in the nasal domain of SNOT-22 than those with CRSsNPs with women in both subgroups reporting higher total scores than men.
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Affiliation(s)
- S Erskine
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - C Hopkins
- ENT Department, Guy s and St Thomas NHS Foundation Trust, London, UK
| | - N Kumar
- ENT Department, Writington, Wigan and Lee NHS Foundation Trust, Wigan, UK
| | - J Wilson
- Head and Neck Surg. Institute of Health and Society, Newcastle University, Newcastle, UK
| | - A Clark
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - A Robertson
- ENT Department, Southern General Hospital, Glasgow, UK
| | - N Kara
- ENT Department, Darlington Memorial Hospitals NHS Foundation Trust, Darlington, UK
| | - V Sunkaraneni
- ENT Department, Royal Surrey County Hospital, Surrey, UK
| | - S Anari
- ENT Department, Heart of England NHS Foundation Trust, Birmingham, UK
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
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22
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Philpott C, Erskine S, Hopkins C, Coombes E, Kara N, Sunkareneni V, Anari S, Salam M, Farboud A. A case-control study of medical, psychological and socio-economic factors influencing the severity of chronic rhinosinusitis. Rhinology 2016. [DOI: 10.4193/rhin15.272] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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23
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Erskine S, Hopkins C, Kumar N, WIlson J, Clark A, Robertson A, Kara N, Sunkaraneni V, Anari S, Philpott C. A cross sectional analysis of a case-control study about quality of life in CRS in the UK; a comparison between CRS subtypes. Rhinology 2016. [DOI: 10.4193/rhin15.361] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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24
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Kara N, codas RD, Badet L, fehri HF. Vapo-énuclation prostatique au laser Thulium selon la « Mushroom technique » : résultats préliminaires. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.239] [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: 11/25/2022]
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Erskine S, Hopkins C, Clark A, Anari S, Kumar N, Robertson A, Sunkaraneni S, Wilson J, Carrie S, Kara N, Ray J, Smith R, Philpott C. SNOT-22 in a control population. Clin Otolaryngol 2016; 42:81-85. [DOI: 10.1111/coa.12667] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 11/27/2022]
Affiliation(s)
- S.E. Erskine
- Norwich Medical School; University of East Anglia; Norwich UK
- ENT Department; James Paget University Hospital NHS Foundation Trust; Great Yarmouth UK
| | - C. Hopkins
- ENT Department; Guy's and St Thomas’ NHS Foundation Trust; London UK
| | - A. Clark
- Norwich Medical School; University of East Anglia; Norwich UK
| | - S. Anari
- ENT Department; Heart of England NHS Foundation Trust; Birmingham UK
| | - N. Kumar
- Otolaryngology, Head & Neck Surg; ENT Department; Writington, Wigan and Lee NHS Foundation Trust; Wigan UK
| | - A. Robertson
- ENT Department; Southern General Hospital; Glasgow UK
| | - S. Sunkaraneni
- ENT Department; Royal Surrey County Hospital; Guildford UK
| | - J.A. Wilson
- Otolaryngology, Head & Neck Surgery; Institute of Health & Society; Newcastle University; Newcastle upon Tyne UK
| | - S. Carrie
- ENT Department; Freeman Hospital; Newcastle upon Tyne UK
| | - N. Kara
- ENT Department; Royal Hallamshire Hospital; Sheffield UK
| | - J. Ray
- ENT Department; Darlington Memorial Hospitals NHS Foundation Trust; Darlington UK
| | - R. Smith
- Norwich Medical School; UEA; Norwich UK
| | - C.M. Philpott
- Norwich Medical School; University of East Anglia; Norwich UK
- ENT Department; James Paget University Hospital NHS Foundation Trust; Great Yarmouth UK
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Kara N, Terrier J, Ruffion A, Morel-journel N. Fracture des corps caverneux : présentations cliniques, apports radiologiques et résultats postopératoire sur 10ans d’activité. Prog Urol 2015; 25:772. [DOI: 10.1016/j.purol.2015.08.115] [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: 11/16/2022]
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Kara N, Descotes F, Terrier J, Ruffion A. Évaluation prospective de la prévalence des mutations du promoteur du gène TERT dans le cancer de la vessie. Prog Urol 2015; 25:759. [DOI: 10.1016/j.purol.2015.08.089] [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: 11/17/2022]
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28
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Kara N, Narayanan S, Belmaker RH, Einat H, Vaidya VA, Agam G. Chronic Lithium Treatment Enhances the Number of Quiescent Neural Progenitors but Not the Number of DCX-Positive Immature Neurons. Int J Neuropsychopharmacol 2015; 18:pyv003. [PMID: 25636892 PMCID: PMC4540105 DOI: 10.1093/ijnp/pyv003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 01/07/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The term adult neurogenesis constitutes a series of developmental steps including the birth, survival, differentiation, maturation, and even death of newborn progenitor cells within neurogenic niches. Within the hippocampus progenitors reside in the neurogenic niche of the subgranular zone in the dentate gyrus subfield. At the different stages, designated type-I, type-IIa, type-IIb, type-III, and granule cell neurons, the cells express a series of markers enabling their identification and visualization. Lithium has been shown to increase hippocampal cell proliferation in the subgranular zone of the hippocampal dentate gyrus subfield of adult rodents and to stimulate the proliferation of hippocampal progenitor cells in vitro, but data regarding lithium's ability to increase neuronal differentiation and survival is equivocal. METHODS To clarify the effect of lithium on adult hippocampal neurogenesis, we identified the effect of chronic lithium treatment on distinct stages of hippocampal progenitor development using adult Nestin-green fluorescent protein transgenic mice and immunofluorescent techniques. RESULTS The present observations confirm that lithium targets the initial stages of progenitor development enhancing the turnover of quiescent neural progenitors/putative stem-cells, corroborating previous reports. However, the enhanced quiescent neural progenitor-turnover does not translate into an increased number of immature neurons. We also observed a steep decline in the number of type-III immature neurons with complex tertiary-dendrites, suggesting that lithium alters the morphological maturation of newborn neurons. CONCLUSIONS Our results do not corroborate previous reports of lithium-induced enhanced numbers of newly generated neurons.
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Affiliation(s)
- N Kara
- Department of Clinical Biochemistry and Pharmacology (Ms Kara and Dr Agam), and Psychiatry Research Unit (Ms Kara and Drs Belmaker and Agam), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Mental Health Center, Beer-Sheva, Israel (Ms Kara and Dr Agam); Tel Aviv-Yaffo Academic College, Tel Aviv-Yaffo, Israel (Ms Kara and Dr Einat); Tata Institute of Fundamental Research, Mumbai, India (Ms Narayanan and Dr Vaidya); University of Minnesota, Minneapolis, Minnesota (Dr Einat)
| | - S Narayanan
- Department of Clinical Biochemistry and Pharmacology (Ms Kara and Dr Agam), and Psychiatry Research Unit (Ms Kara and Drs Belmaker and Agam), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Mental Health Center, Beer-Sheva, Israel (Ms Kara and Dr Agam); Tel Aviv-Yaffo Academic College, Tel Aviv-Yaffo, Israel (Ms Kara and Dr Einat); Tata Institute of Fundamental Research, Mumbai, India (Ms Narayanan and Dr Vaidya); University of Minnesota, Minneapolis, Minnesota (Dr Einat)
| | - R H Belmaker
- Department of Clinical Biochemistry and Pharmacology (Ms Kara and Dr Agam), and Psychiatry Research Unit (Ms Kara and Drs Belmaker and Agam), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Mental Health Center, Beer-Sheva, Israel (Ms Kara and Dr Agam); Tel Aviv-Yaffo Academic College, Tel Aviv-Yaffo, Israel (Ms Kara and Dr Einat); Tata Institute of Fundamental Research, Mumbai, India (Ms Narayanan and Dr Vaidya); University of Minnesota, Minneapolis, Minnesota (Dr Einat)
| | - H Einat
- Department of Clinical Biochemistry and Pharmacology (Ms Kara and Dr Agam), and Psychiatry Research Unit (Ms Kara and Drs Belmaker and Agam), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Mental Health Center, Beer-Sheva, Israel (Ms Kara and Dr Agam); Tel Aviv-Yaffo Academic College, Tel Aviv-Yaffo, Israel (Ms Kara and Dr Einat); Tata Institute of Fundamental Research, Mumbai, India (Ms Narayanan and Dr Vaidya); University of Minnesota, Minneapolis, Minnesota (Dr Einat)
| | - V A Vaidya
- Department of Clinical Biochemistry and Pharmacology (Ms Kara and Dr Agam), and Psychiatry Research Unit (Ms Kara and Drs Belmaker and Agam), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Mental Health Center, Beer-Sheva, Israel (Ms Kara and Dr Agam); Tel Aviv-Yaffo Academic College, Tel Aviv-Yaffo, Israel (Ms Kara and Dr Einat); Tata Institute of Fundamental Research, Mumbai, India (Ms Narayanan and Dr Vaidya); University of Minnesota, Minneapolis, Minnesota (Dr Einat)
| | - G Agam
- Department of Clinical Biochemistry and Pharmacology (Ms Kara and Dr Agam), and Psychiatry Research Unit (Ms Kara and Drs Belmaker and Agam), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Mental Health Center, Beer-Sheva, Israel (Ms Kara and Dr Agam); Tel Aviv-Yaffo Academic College, Tel Aviv-Yaffo, Israel (Ms Kara and Dr Einat); Tata Institute of Fundamental Research, Mumbai, India (Ms Narayanan and Dr Vaidya); University of Minnesota, Minneapolis, Minnesota (Dr Einat).
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Kara N, Urganci N, Kalyoncu D, Yilmaz B. The association between Helicobacter pylori gastritis and lymphoid aggregates, lymphoid follicles and intestinal metaplasia in gastric mucosa of children. J Paediatr Child Health 2014; 50:605-9. [PMID: 24925694 DOI: 10.1111/jpc.12609] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/24/2014] [Indexed: 12/23/2022]
Abstract
AIMS The aim of the study was to determine the topographic prevalence of lymphoid follicles, lymphoid aggregates, gastric glandular atrophy and intestinal metaplasia among children with chronic abdominal pain. The association between these lesions and age, type of gastritis and Helicobacter pylori density was also assessed. METHODS A total of 358 patients (mean age: 10, 18 ± 3, 26 years; male : female ratio: 0.92) with chronic abdominal pain who had upper gastrointestinal endoscopy were included in the study. The endoscopic and histopathological findings were documented. The prevalence of lymphoid follicles, lymphoid aggregates, atrophy and intestinal metaplasia according to the type of gastritis and their relation with H. pylori density were determined. RESULTS H. pylori was detected in 214 (59.8%) patients. H. pylori- positive patients were found to be significantly older than H. pylori-negative patients (P < 0.01). The endoscopy revealed that the most common finding observed was antral nodularity in H. pylori-positive patients and normal mucosal appearance in H. pylori-negative patients. Panmucosal gastritis both in the corpus and antrum and the prevalence of lymphoid follicles and lymphoid aggregates were more frequent in the H. pylori-positive group (P < 0.01). None of the patients had atrophy, whereas 11 patients had intestinal metaplasia. Although positive correlation was obtained between lymphoid lesions and H. pylori density, no significant relation was established between intestinal metaplasia, lymphoid lesions and H. pylori density. CONCLUSION Lymphoid follicles and lymphoid aggregates in gastric mucosa involving both antrum and corpus significantly correlated with H. pylori infection, H. pylori density and type of gastritis in children.
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Affiliation(s)
- Nursu Kara
- Department of Pediatrics, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
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Toker L, Kara N, Hadas I, Einat H, Bersudsky Y, Belmaker RH, Agam G. Acute intracerebroventricular inositol does not reverse the effect of chronic lithium treatment in the forced swim test. Neuropsychobiology 2014; 68:189-92. [PMID: 24157652 DOI: 10.1159/000355294] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 08/26/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Lithium has numerous biochemical effects but it is difficult to dissect which of these is responsible for its therapeutic action in bipolar disorder. In the current study we aimed to address one of the major hypotheses, the inositol depletion hypothesis. This hypothesis postulates that lithium's mood-stabilizing effect is mediated by the depletion of brain inositol levels and the subsequent effect on cellular signaling. METHODS We studied whether acute intracerebroventricular (ICV) administration of myo-inositol could reverse the antidepressant-like effect of chronic lithium treatment in the forced swim test (FST). RESULTS In contrast with our prediction, acute myo-inositol administration did not reverse the effect of chronic lithium to decrease immobility in the FST. CONCLUSIONS The results of the present study are limited due to the following: (1) inositol was given acutely while possible events downstream of inositol depletion might require a longer period and (2) ICV inositol may not have reached those areas of the brain involved in the FST.
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Affiliation(s)
- L Toker
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Mahdeb N, Bouzidi A, Kara N, Benouadah Z, Soufane S. Acute and Subacute Toxicity Studies of Alkaloids of Seeds and Synthetic Alkaloids of Datura stramonium in Female Rats. ACTA ACUST UNITED AC 2012. [DOI: 10.5567/pharmacologia.2012.598.604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Gunaldi M, Helvaci A, Demirel Yildirim N, Aydin D, Kara N. Multiple myeloma with serous membrane involvement and increased CA-125 and CA 15-3. J BUON 2011; 16:778. [PMID: 22331737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Travers B, Henderson S, Vasireddy S, SeQueira EJ, Cornell PJ, Richards S, Khan A, Hasan S, Withrington R, Leak A, Sandhu J, Joseph A, Packham JC, Lyle S, Martin JC, Goodfellow RM, Rhys-Dillon C, Morgan JT, Mogford S, Rowan-Phillips J, Moss D, Wilson H, McEntegart A, Morgan JT, Martin JC, Rhys Dillon C, Goodfellow R, Gould L, Bukhari M, Hassan S, Butt S, Deighton C, Gadsby K, Love V, Kara N, Gohery M, Keat A, Lewis A, Robinson R, Bastawrous S, Roychowdhury B, Roskell S, Douglas B, Keating H, Giles S, McPeake J, Molloy C, Chalam V, Mulherin D, Price T, Sheeran T, Benjamin SR, Thompson PW, Cornell P, Siddle HJ, Backhouse MR, Monkhouse RA, Harris NJ, Helliwell PS, Azzopardi L, Hudson S, Mallia C, Cassar K, Coleiro B, Cassar PJ, Aquilina D, Camilleri F, Serracino Inglott A, Azzopardi LM, Robinson S, Peta H, Margot L, David W, Mann C, Gooberman-Hill R, Jagannath D, Healey E, Goddard C, Pugh MT, Gilham L, Bawa S, Barlow JH, MacFarland L, Tindall L, Leddington Wright S, Tooby J, Ravindran J, Perkins P, McGregor L, Mabon E, Bawa S, Bond U, Swan J, O'Connor MB, Rathi J, Regan MJ, Phelan MJ, Doherty T, Martin K, Ruth C, Panthakalam S, Bondin D, Castelino M, Evin S, Gooden A, Peacock C, Teh LS, Ryan SJ, Bryant E, Carter A, Cox S, Moore AP, Jackson A, Kuisma R, Pattman J, Juarez M, Quilter A, Williamson L, Collins D, Price E, Chao Y, Mooney J, Watts R, Graham K, Birrell F, Reed M, Croyle S, Stell J, Vasireddy S, Storrs P, McLoughlin YM, Scott G, McKenna F, Papou A, Rahmeh FH, Richards SC, Westlake SL, Birrell F, Morgan L, Baqir W, Walsh NE, Ward L, Caine R, Williams M, Breslin A, Owen C, Ahmad Y, Morgan L, Blair A, Birrell F, Ramachandran Nair J, Zia A, Mewar D, Peffers GM, Larder R, Dockrell D, Wilson S, Cummings J, Bansal J, Barlow J. BHPR: Audit/Service Delivery [239-277]: 239. Arma-Based Audit of Rheumatology Service Delivered Predominantly Outside the Traditional Hospital Setting. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kara N, Hill J, Zammit-maempel I. West J Med 2010; 340:c1169-c1169. [DOI: 10.1136/bmj.c1169] [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]
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Gungel H, Kara N, Pinarci EY, Albayrak S, Baylancicek DO, Uysal HK. An uncommon case with intravitreal worm. Intravitreal Dirofilaria infection. Br J Ophthalmol 2009; 93:573-4, 697. [PMID: 19395628 DOI: 10.1136/bjo.2008.138842] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- H Gungel
- Beyoglu Eye Education and Research Hospital, 34001 Istanbul, Turkey
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Kara N, Watson C. The challenging sinus tympani. Clin Otolaryngol 2008; 33:295-6. [PMID: 18559054 DOI: 10.1111/j.1749-4486.2008.01683.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
The last decade has seen major changes in the working pattern of surgical trainees. This commenced with the introduction of the maximum 72-hour working week in 1991. The European Working Time Directive reduced the working hours to a maximum of 56 hours, with the intention to reduce it further to 48 hours by 2009. This is additionally affected by compliance with the SiMAP and Jaeger Rulings. The results of the Calman report coupled with those of the Confidential Enquiry into Perioperative Deaths (CEPOD) report have also had a significant effect on the amount and level of experience obtained during surgical training.
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Affiliation(s)
- N Kara
- Department of Surgery and Molecular Oncology, Ninewells Hospital and Medical School, Dundee
| | - PV Patil
- Department of Surgery and Molecular Oncology, Ninewells Hospital and Medical School, Dundee
| | - SM Shimi
- General and Upper Gastrointestinal Surgery, Department of Surgery and Molecular Oncology, Ninewells Hospital and Medical School, Dundee
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Gunes S, Okten G, Kara N, Saglam Y, Tasdemir HA, Kayacik OE, Tural S. De novo 18q deletion with mitral valve insufficiency. Genet Couns 2008; 19:261-265. [PMID: 18990980] [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: 05/27/2023]
Abstract
We report an 18-year-old Turkish girl with an 18q- deletion and abnormalities of face, mental and growth retardation, mitral deficiency and hypothyroidism. Mitral deficiency has not been reported in 18q deletion syndrome cases previously. We performed cytogenetic and molecular cytogenetic analysis, and brain MRI. Her karyotype was 46,XX,del(18)(q21.2-->qter). This report compares the symptoms and features of the present patient with previously reported cases with 18q syndrome.
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Affiliation(s)
- S Gunes
- Ondokuz Mayis University, Faculty of Medicine, Department of Medical Biology and Genetics, Samsun, Turkey.
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Aydin F, Kara N, Senturk N, Gunes S, Canturk MT, Bagci H, Bek Y, Turanli AY. Lack of association between leptin G2548A gene polymorphism and Behçet's disease. J Eur Acad Dermatol Venereol 2007; 21:68-71. [PMID: 17207170 DOI: 10.1111/j.1468-3083.2006.01868.x] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Behçet's disease is a chronic, multisystem, inflammatory disease characterized by the predominance of T-helper 1 cytokines. The disease is also characterized by infiltration of lymphocytes and neutrophils into the affected tissues. Because cytokines are involved in the regulation of lymphocyte and phagocyte functions, they may play an important role in the pathogenesis of Behçet's disease. Leptin, a member of the gp 130 family of cytokines, induces a strong T-helper 1 response and is regarded as a proinflammatory inducer. Recent studies have shown that serum leptin concentration was increased in patients with Behçet's disease and correlated with disease activity. OBJECTIVES We aimed to investigate the role of G2548A polymorphism of leptin gene in patients with Behçet's disease and compare the results with healthy controls. PATIENTS AND METHODS A total of 93 subjects with Behçet's disease and 125 healthy controls were included in this study. Analyses of G-2548A polymorphism of the LEP gene were performed using the PCR-restriction fragment length polymorphism technique. The genotypes (GG, GA, and AA of leptin G2548A) and alleles (G and A of leptin 2548) were scored and the frequency was estimated. The frequencies of the alleles and genotypes in patients and controls were compared. We analysed the correlation between leptin gene polymorphism and the clinical features of BD. RESULTS Both genotype and allele frequencies were not significantly different between controls and Behçet's disease patients [OR=0.67, 95% CI (0.35-1.29), P=0.197 and OR=0.77, 95% CI (0.52-1.15), P=0.184]. We did not find any significant relationship between leptin gene polymorphism and the clinical features of BD (P>0.05). CONCLUSION In the present case-control study, we found no evidence of an association between the G-2548A variant of the leptin gene and BD among Turks. Further studies are needed to investigate serum leptin level to explain the mechanisms behind the lack of association between leptin G2548A gene polymorphism and BD.
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Affiliation(s)
- F Aydin
- Ondokuz Mayis University, Department of Dermatology, Samsun, Turkey.
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Ozen S, Alikasifoglu M, Saatci U, Bakkaloglu A, Besbas N, Kara N, Kocak H, Erbas B, Unsal I, Tuncbilek E. Implications of certain genetic polymorphisms in scarring in vesicoureteric reflux: importance of ACE polymorphism. Am J Kidney Dis 1999; 34:140-5. [PMID: 10401028 DOI: 10.1016/s0272-6386(99)70120-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Polymorphisms of the renin-angiotensin system (RAS) have been shown to affect renal prognosis in a number of diseases. We examined the influence of deletion (D) and insertion (I) polymorphism in the angiotensin I-converting enzyme (ACE) gene and the other polymorphic markers of RAS, and that of plasminogen-activator inhibitor-1 (PAI-1) on renal scarring in reflux nephropathy. Ninety-four children with third- or fourth-degree reflux were the subject of the study. They were stratified into two groups according to the technetium-99m-dimercaptosuccinic acid (DMSA) findings: the first group consisted of 41 patients with no scar formation. In the second group (n = 53), there was significant scar formation in the refluxing units. ACE levels, ACE gene, angiotensin-1 receptor (AT1) A1166C, angiotensinogen (ATG) M235T, and PAI-1 4G/5G polymorphisms were studied. In the second group with scarred kidneys, 18 patients had decreased renal function. The frequency of patients homozygous for the D allele was significantly greater in the second group with scar formation in the refluxing units compared with the first group of patients (P < 0.005). On multivariate analysis, the DD genotype was the only factor that had a significant impact on renal scar formation, introducing a 4.9-fold risk (P < 0.05, 95% confidence interval). We were unable to find any correlation with the presence ofDD genotype and hypertension, decreased renal function, proteinuria, or sex of the patient. DDgenotype correlated with the serum ACE levels (P < 0.005). AT1and ATGpolymorphisms and PAI-1 polymorphism did not correlate with scar formation or any of the parameters. This study provides evidence that the DDgenotype of ACE may be a genetic susceptibility factor contributing to adverse renal prognosis in reflux nephropathy; namely, scar formation. The role of the synergism between the aforementioned genetic polymorphisms can be enlightened with larger patient groups, possibly through multicenter studies.
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Affiliation(s)
- S Ozen
- Departments of Pediatric Nephrology and Rheumatology, Genetics, Nuclear Medicine, and Clinical Biochemistry, Hacettepe University Faculty of Medicine, Turkey.
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Abstract
In order to obtain data on blood pressure (BP) distribution in Turkish children, a total of 5,599 Turkish children from birth to 18 years were studied. BP rises with age, and both systolic and diastolic BP showed a positive correlation with height and weight in both sexes. As the sampling was representative of Turkish children at different ages, the mean systolic and diastolic BP levels were compared for each age with the results reported in the study of the Second Task Force. The mean systolic and diastolic BP of Turkish children and the increase with growth and development were different from the Second Task Force study. Genetic, ethnic, and environmental factors were suggested to be responsible for this variation. In conclusion, normal BP curves should be applied with caution in childhood, and every population should use their own normal standards to define a measured BP level in children.
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Affiliation(s)
- N Tümer
- Department of Pediatrics, Ankara University Faculty of Medicine, Turkey
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Abstract
In this report, we evaluated the cardiac findings of 15 children with polyarteritis nodosa. The age range of the patients was 4-14 years; with a mean of 10 years. All have had systemic involvement of the disease. The most common findings in cardiac evaluation were diminished left ventricular systolic functions and mild mitral and/or tricuspid valve regurgitation. One patient had pericardial thickening with no effusion. One had sinus tachycardia. There were no signs of myocardial infarction or ischemia clinically or electro-cardiographically. In conclusion, we did not find cardiac complications, such as pericarditis or myocardial infarction, to be as frequent as in previous reports. However, even in asymptomatic patients, systolic dysfunction or valvular involvement were common findings in patients with polyarteritis nodosa, which were not reported previously. These findings may be due to the histological changes of the myocardium or atrioventricular valves. Although these were not severe and fatal lesions, long-term follow-up of these patients with echocardiography may help to determine the course of cardiac involvement.
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Affiliation(s)
- N Günal
- Department of Pediatric Cardiology, Social Security Hospital of Children, Ankara, Turkey
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Affiliation(s)
- M Elbistan
- Department of Medical Biology and Genetics, Ondokuz Mayis University, Samsun, Turkey
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Affiliation(s)
- M Elbistan
- Department of Medical Biology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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