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Hantal AO, Kayhan S, Sagmen SB, Soy M. Efficacy of pulmonary rehabilitation in patients with post-acute COVID-19. Eur Rev Med Pharmacol Sci 2023; 27:2117-2126. [PMID: 36930511 DOI: 10.26355/eurrev_202303_31583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE The most important cause of mortality and morbidity of COVID-19 is lung involvement. In this study, the effects of pulmonary rehabilitation (PR) in the post-acute COVID-19 period on lung functions, functional capacity, dyspnea, quality of life, and psychiatric state were investigated. PATIENTS AND METHODS Patients were admitted to a PR program after discharge when their general condition had stabilized. The patients' scores of forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, maximum vital capacity (VCmax), peripheral arterial oxygen saturation (PaO2), 6-minute walking distance (6MWD), Medical Research Council Dyspnea Scale (MRC), St. George Respiratory Questionnaire (SGSA), and Hospital Anxiety and Depression Scale (HADS) before and after pulmonary rehabilitation were compared. The patients were divided into three groups, mild, moderate, and severe, according to their thorax CT findings. RESULTS A total of 52 patients [mean age: 46.7 ± 12.5 (range: 19-76) years] were included in the study. Nineteen patients were in the mild group, 16 in the moderate group, and 17 patients comprised the severe group. Comparing the parameters before and after PR, significant improvement was observed in all three groups in the evaluation parameters after treatment including FVC, FEV1, FEV1/FVC, 6MWD, and MRSC; SGSA symptoms, activity, effects and total scores; HADS depression, anxiety, and total scores (p<0.05 for all). CONCLUSIONS PR is a beneficial treatment for patients with COVID-19 with lung involvement for improving lung functions, eliminating dyspnea, and improving functional capacity, psychological status, and life quality of the patient.
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Affiliation(s)
- A O Hantal
- Physical Therapy and Rehabilitation Department, Altınbaş University Medical Park Bahçelievler Hospital, Istanbul, Turkey.
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Kayhan S, Selcan Akyol B, Ergul M, Baysan C. The effect of type of fluid on disease severity in acute pancreatitis treatment. Eur Rev Med Pharmacol Sci 2021; 25:7460-7467. [PMID: 34919248 DOI: 10.26355/eurrev_202112_27443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE In this study, we aimed to investigate the effect of type of fluid (Normal Saline solution: NSS or Lactated Ringer's solution: LRS) to be selected in fluid replacement in acute pancreatitis (AP) treatment on disease severity. SUBJECTS AND METHODS This study is a prospective, single-center study. Patients diagnosed with acute pancreatitis in emergency service were included in the study and randomized to receive LRS or NSS. The severity of AP was determined regarding Revised Atlanta Classification. C-reactive protein (CRP) levels and serum pH and bicarbonate (HCO3) levels were measured to evaluate the systemic inflammatory response and to detect changes in acid-base balance, respectively. RESULTS Sixty-five and seventy-seven patients receiving NSS and LRS, respectively, were analyzed. Eighty-nine (67.4%) and 43 (32.6%) patients were with mild and moderate AP, respectively; however, there was no patient with severe AP. The frequency of moderate AP was significantly lower in the LRS group than the NSS group in terms of the severity of AP (p=0.011). Subjects that were randomized to receive LRS had lower CRP levels when compared to the participants in the NSS treatment arm 48 hours after resuscitation (p=0.010). In addition to these results, serum pH and HCO3 level in patients resuscitated with NSS reduced in comparison to LRS (p<0.001). CONCLUSIONS Resuscitation with LRS is associated with decreased severity of AP in patients with AP. It may derive from how it causes lower CRP levels.
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Affiliation(s)
- S Kayhan
- Department of Internal Medicine, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
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Özdemir AK, Kayhan S, Çakmak SK. Herpes zoster after inactivated SARS-CoV-2 vaccine in two healthy young adults. J Eur Acad Dermatol Venereol 2021; 35:e846-e847. [PMID: 34363257 PMCID: PMC8447007 DOI: 10.1111/jdv.17577] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/04/2021] [Indexed: 02/01/2023]
Affiliation(s)
- A K Özdemir
- Department of Dermatology, Ankara City Hospital, Ankara, Turkey
| | - S Kayhan
- Department of Dermatology, Ankara City Hospital, Ankara, Turkey
| | - S K Çakmak
- Department of Dermatology, Ankara City Hospital, Ankara, Turkey
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Kayhan S, Kocakoç E. Pulmonary Fibrosis Due to COVID-19 Pneumonia. Korean J Radiol 2020; 21:1273-1275. [PMID: 32729265 PMCID: PMC7462762 DOI: 10.3348/kjr.2020.0707] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 05/27/2020] [Accepted: 06/05/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- Servet Kayhan
- Department of Chest Disease, Bahcelievler Medicalpark Hospital, Altinbas University, Istanbul, Turkey
| | - Ercan Kocakoç
- Department of Radiology, Bahcelievler Medicalpark Hospital, Altinbas University, Istanbul, Turkey.
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Dogan D, Cinarka H, Gümüş A, Özyurt S, Karataş M, Gıakoup D, Cüre M, Kayhan S, Şahin Ü. Role of red cell distribution width in assessing response to treatment and prognosis in community-acquired pneumonia: A prospective study. Eurasian J Pulmonol 2019. [DOI: 10.4103/ejop.ejop_80_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Senturk A, Ozsu S, Duru S, Cakır E, Ulaslı SS, Demirdogen E, Kayhan S, Guzel A, Yakar F, Berk S. Prognostic importance of central thrombus in hemodynamically stable patients with pulmonary embolism. Cardiol J 2017; 24:508-514. [DOI: 10.5603/cj.a2017.0021] [Citation(s) in RCA: 8] [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] [Received: 09/17/2016] [Revised: 02/15/2017] [Accepted: 12/05/2016] [Indexed: 11/25/2022] Open
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Guzel A, Kayhan S, Tutuncu S, Guzel A, Duran L, Alacam H, Gunaydin M, Torun AC, Yilmaz MZ, Selcuk MY, Murat N. Attenuation of bleomycin induced lung fibrosis by erdosteine and inhibition of the inducible nitric oxide synthase. ACTA ACUST UNITED AC 2015; 116:196-202. [PMID: 25869570 DOI: 10.4149/bll_2015_039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES Despite advances in treatment modalities, the discovery of optimal medical therapies still remains a necessity in the management of pulmonary fibrosis. MATERIAL AND METHODS The experiments were performed in 35 adult Sprague Dawley rats, randomly allotted into one of five groups (n=7). The control group was treated with 1 ml/kg, 0.9 % saline; the BLM group was given a single dose of BLM (2.5 U/kg); the BLM+ER group was treated with ER (10 mg/kg/day po) for 14 days after BLM administration; the BLM+SMT group was treated with i.p injections of SMT (20 mg/kg/ day) for 14 days after BLM administration; the BLM+ER+SMT group was treated with ER and SMT for 14 days after BLM administration. At the end of day 14, the results of histopathological, biochemical, and immunohistochemical investigations were analyzed. RESULTS Serum TNF-α, nitrate/nitrite, and TBARS levels significantly increased in BLM group compared to control group (p < 0.001, p < 0.001 and p < 0.05 respectively). Lung tissue content of IL-6 was found to be lower in BLM+ER, BLM+SMT and BLM+ER+SMT groups compared to BLM group by immunhistochemical examinations (p < 0.01, p < 0.01 and p < 0.001, respectively). Similarly, the TNF-α reactions (p < 0.01 for each group) and NF-kB expressions were shown to be significantly different among the study groups (p < 0.05, p < 0.05 and p < 0.001, respectively). CONCLUSION Based on our study, ER and SMT attenuate BLM-induced pulmonary fibrosis; the combination of two agents has a greater protective efficacy against fibrosis than one alone, reducing the inflammatory markers (Tab. 2, Fig. 2, Ref. 31).
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Çınarka H, Kayhan S, Karataş M, Yavuz A, Gümüş A, Özyurt S, Cüre MC, Şahin Ü. Copeptin: a new predictor for severe obstructive sleep apnea. Ther Clin Risk Manag 2015. [PMID: 25914540 DOI: 10.2147/tcrm.s80779.] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Copeptin which is the C-terminal fragment of antidiuretic hormone (ADH), is a biomarker that has been reported to be increased in various cardiovascular disorders, cerebrovascular diseases and associated with prognosis. Patients with obstructive sleep apnea syndrome (OSAS) have a tendency to develop coronary and cerebral atherosclerotic diseases. OBJECTIVES The aim of the present study was to study copeptin levels in patients with obstructive sleep apnea and in a control group in order to determine whether copeptin could be used as a biomarker predicting the severity of OSAS and possible complications in this group. METHODS A total of 116 patients with OSAS, diagnosed by polysomnography, and 27 controls were included in the study. Blood samples were collected after overnight fasting, and copeptin levels were measured with enzyme-linked immunosorbent assay. RESULTS Copeptin levels were significantly higher in the OSAS group compared to control group (2,156±502; 1,845±500 pg/mL, respectively, P=0.004). Mean copeptin level of the patients having apnea-hypopnea index (AHI) ≥30 was significantly higher than that of the patients having AHI <30 (2,392±415; 2,017±500 pg/mL, respectively, P<0.001). A multivariate regression analysis showed that copeptin level, (hazard ratio: 1.58; 95% confidence interval: 1.09-2.30) was a predictor of severe OSAS (P=0.016). Copeptin levels showed significant positive correlation with AHI (r=0.32; P<0.001), desaturation index (r=0.23; P=0.012), arousal index (r=0.24; P=0.010) and CRP (r=0.26; P=0.011) respectively. CONCLUSION Copeptin levels are high in OSAS patients and copeptin is a potential marker for identifying patients with a high risk of early cardiovascular complications of OSAS. Copeptin has modest sensitivity (84%) for discriminating severe OSAS patients who are candidates for severe cardiovascular complications.
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Affiliation(s)
- Halit Çınarka
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Servet Kayhan
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Mevlüt Karataş
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Asiye Yavuz
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Aziz Gümüş
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Songül Özyurt
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Medine Cumhur Cüre
- Department of Biochemistry, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Ünal Şahin
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
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Gümüş A, Çınarka H, Karataş M, Kırbaş A, Kayhan S, Şahin Ü. [Elevated pleural copeptin levels can distinguish to exudate from transudates]. Tuberk Toraks 2015; 62:267-72. [PMID: 25581690 DOI: 10.5578/tt.8690] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Copeptin is released simultaneously along with arginine-vasopressine as a result of different stimuli from the neurohypophysis. Physiological function of copeptin is still unclear. Increased blood copeptin levels is associated with poor prognosis in many diseases. Pleural effusion is a common clinical condition. The most common causes of pleural effusions are heart failure, parapneumonic effusion, pulmonary embolism and malignacy.Tuberculosis is one of the other major causes of pleural effusion in developing countries. In this study, we aimed to assess whether pleural copeptin level may be a new discriminative biomarker for exudates and transudates pleural effusions. MATERIALS AND METHODS Research was done at Recep Tayyip Erdogan University School of Medicine in the Department of Chest Diseases. The concentrations of pleural copeptin and typical pleural and serum marker levels were measured in 76 subjects with pleural effusions including 22 transudates caused by congestive heart failure (CHF), and 54 exudates including 18 parapneumonic (PPE), 18 tuberculous pleural effusions (TBPEs), 18 malignant effusions (MPEs). RESULTS Median pleural fluid copeptin levels were higher in exudates than in transudates (1936 ng/mL and 1313 pg/mL, p value < 0.001). There was no statistical significancy for pleural fluid copeptin levels with in-group exudates (n= 54). Pleural copeptin levels of exudates, with a cut off value of 1469 ng/mL, yielded a 79.6% sensitivity, 81.8% specificity, with an are a under the curve of 0.851. CONCLUSION Pleural copeptin level is a new biomarker to separate exudates from transudates. Pleural effusion discriminative effect of copeptin is lower than plasma protein level and plasma lactat dehydrogenase (LDH). Pleural copeptin measurement is not recommended for routine clinical use. Pleural copeptin level is not contribute to different iate exudative pleural fluids from each other like PPE, TBPE and MPE.
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Affiliation(s)
- Aziz Gümüş
- Department of Chest Diseases, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
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10
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Abstract
INTRODUCTION Copeptin which is the C-terminal fragment of antidiuretic hormone (ADH), is a biomarker that has been reported to be increased in various cardiovascular disorders, cerebrovascular diseases and associated with prognosis. Patients with obstructive sleep apnea syndrome (OSAS) have a tendency to develop coronary and cerebral atherosclerotic diseases. OBJECTIVES The aim of the present study was to study copeptin levels in patients with obstructive sleep apnea and in a control group in order to determine whether copeptin could be used as a biomarker predicting the severity of OSAS and possible complications in this group. METHODS A total of 116 patients with OSAS, diagnosed by polysomnography, and 27 controls were included in the study. Blood samples were collected after overnight fasting, and copeptin levels were measured with enzyme-linked immunosorbent assay. RESULTS Copeptin levels were significantly higher in the OSAS group compared to control group (2,156±502; 1,845±500 pg/mL, respectively, P=0.004). Mean copeptin level of the patients having apnea-hypopnea index (AHI) ≥30 was significantly higher than that of the patients having AHI <30 (2,392±415; 2,017±500 pg/mL, respectively, P<0.001). A multivariate regression analysis showed that copeptin level, (hazard ratio: 1.58; 95% confidence interval: 1.09-2.30) was a predictor of severe OSAS (P=0.016). Copeptin levels showed significant positive correlation with AHI (r=0.32; P<0.001), desaturation index (r=0.23; P=0.012), arousal index (r=0.24; P=0.010) and CRP (r=0.26; P=0.011) respectively. CONCLUSION Copeptin levels are high in OSAS patients and copeptin is a potential marker for identifying patients with a high risk of early cardiovascular complications of OSAS. Copeptin has modest sensitivity (84%) for discriminating severe OSAS patients who are candidates for severe cardiovascular complications.
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Affiliation(s)
- Halit Çınarka
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Servet Kayhan
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
- Correspondence: Servet Kayhan, Department of Chest Diseases, Recep Tayyip Erdoğan University, 53200 Rize, Turkey, Tel +90 46 4213 0491, Fax +90 46 4217 0364, Email
| | - Mevlüt Karataş
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Asiye Yavuz
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Aziz Gümüş
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Songül Özyurt
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Medine Cumhur Cüre
- Department of Biochemistry, Recep Tayyip Erdogğan University, Rize, Turkey
| | - Ünal Şahin
- Department of Chest Diseases, Recep Tayyip Erdogğan University, Rize, Turkey
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Duran L, Kayhan S, Guzel A, Ince M, Kati C, Akdemir HU, Yavuz Y, Zengin H, Okuyucu A, Murat N. The prognostic values of GDF-15 in comparison with NT-proBNP in patients with normotensive acute pulmonary embolism. Clin Lab 2014; 60:1365-71. [PMID: 25185423 DOI: 10.7754/clin.lab.2013.130827] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND An early prediction of prognosis in pulmonary embolism (PE) is a crucial clinical entity. The aim of the study is to investigate whether growth differentiation factor-15 (GDF-15) or N-terminal pro-brain natriuretic peptide levels (NT-proBNP) can better predict the 30 day overall mortality in patients with normotensive acute PE. METHODS Patients with a high clinical probability of PE, or with low/intermediate probability and a positive D-dimer test, underwent contrast-enhanced computed tomography and ventilation/perfusion lung scan. Simplified pulmonary embolism severity index, the presence of echocardiographic right ventricular dysfunction, and ROC curve analysis by calculated cut-off value of serum GDF-15 and NT-proBNP levels were evaluated for each individual of study population. RESULTS The serum levels of GDF-15 and NT-proBNP were found to be significantly higher in patients with PE compared with controls (p < 0.0001). In this study, GDF-15 provided better results compared to NT-proBNP in predicting the short-term or 30 day mortality (p = 0.046 and p = 0.418, respectively). Serum GDF-15 with a cut-off value of > 2943 pg/mL yielded a 75% sensitivity, 68.7% specificity, 91.6% negative predictive value, and 90% accuracy for predicting 30 day overall mortality. The results of these tests were found as 62.5%, 40.6%, 81.2%, and 40% for NT-proBNP (with the cut-off value of > 1409 pg/mL), respectively. CONCLUSIONS High serum GDF-15 levels may provide better information than NT-proBNP for early death in the subjects with normotensive PE and these patients should be closely followed up.
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Abstract
Genetic and acquired thrombophilic risk factors may play role on developing venous thromboembolism (VTE). In many cases of pulmonary thromboembolism (PE) it can not be defined any explicit risk factor. In this study we aimed to identify the role of plasma viscosity level on PE. The investigation was planned prospectively and 33 patients with PE and 36 apparently healthy and nonsmoker volunteers as control group were enrolled in the study. The mean plasma viscosity levels were determined in patients with PE and in healthy volunteers as 1.42±0.30 cP and 1.29±0.22 cP respectively. The mean plasma viscosity levels was found to be different between PE and healthy group (p=0.009). The mean levels of triglyceride, fibrinogen and hematocrit were found different between patients with PE and control group (p<0.05). Variables including sex, age, smoking habits, levels of hematocrit, fibrinogen, total cholesterol and triglyceride were not associated with plasma viscosity values in patients with PE. Plasma viscosity levels were found higher in patients with PE compared with healthy indivudials. But it is needed to further studies to define the interactions between factors effecting blood rheology and development of thrombosis.
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Affiliation(s)
- Atilla Guven Atici
- Department of Pulmonary Medicine, Ondokuz Mayis University School of Medicine, Samsun Turkey
| | - Servet Kayhan
- Department of Pulmonary Medicine, Ondokuz Mayis University School of Medicine, Samsun Turkey
| | - Davut Aydin
- Department of Pulmonary Medicine, Ondokuz Mayis University School of Medicine, Samsun Turkey
| | - Yasemin Ari Yilmaz
- Department of Pulmonary Medicine, Ondokuz Mayis University School of Medicine, Samsun Turkey
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Affiliation(s)
- Mohsen Sokouti
- Department of Cardiothoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
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Abstract
Cerebral fat embolism syndrome is a lethal complication of long-bone fractures and clinically manifasted with respiratory distress, altered mental status, and petechial rash. We presented a 20-year-old male admitted with gun-shot wounds to his left leg. Twenty-four hours after the event, he had generalized tonic clonic seizures, decorticate posture and a Glascow Coma Scale of seven with localization of painful stimuli. Subsequent magnetic resonance imaging of the brain showed a star-field pattern defining multiple lesions of restricted diffusion. On a 4-week follow-up, he had returned to normal neurological function. Despite the severity of the neurological condition upon initial presentation, the case cerebral fat embolism illustrates that, cerebral dysfunction associated with cerebral fat embolism illustrates reversible.
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Affiliation(s)
- Latif Duran
- Department of Emergency Medicine, University of Ondokuz Mayıs, School of Medicine, Samsun, Turkey
| | - Servet Kayhan
- Department of Pulmonology, University of Ondokuz Mayıs, School of Medicine, Samsun, Turkey
| | - Celal Kati
- Department of Emergency Medicine, University of Ondokuz Mayıs, School of Medicine, Samsun, Turkey
| | - Hizir Ufuk Akdemir
- Department of Emergency Medicine, University of Ondokuz Mayıs, School of Medicine, Samsun, Turkey
| | - Kemal Balci
- Department of Neurology, University of Ondokuz Mayıs, School of Medicine, Samsun, Turkey
| | - Yucel Yavuz
- Department of Emergency Medicine, University of Ondokuz Mayıs, School of Medicine, Samsun, Turkey
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Kayhan S, Guzel A, Duran L, Tutuncu S, Guzel A, Gunaydın M, Salis O, Okuyucu A, Selcuk MY. Effects of leflunomide on inflamation and fibrosis in bleomycine induced pulmonary fibrosis in wistar albino rats. J Thorac Dis 2013; 5:641-9. [PMID: 24255778 DOI: 10.3978/j.issn.2072-1439.2013.09.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 09/24/2013] [Indexed: 11/14/2022]
Abstract
PURPOSES Pulmonary fibrosis is a rare and progressive lung disease with a high mortality rate. The treatment regimens still fail to recover the disease. Leflunomide (LEF) is an immunomodulatory agent with antiproliferative activity that is used for the treatment of rheumatoid arthritis. The purpose of the study is to investigate the potential therapeutic efficacy of LEF in bleomycin (BLM) induced pulmonary fibrosis. METHODS A total of 21 male, adult wistar albino rats were used. The animals were divided into three groups as control, BLM and BLM plus LEF groups (n=7). In BLM group, mice were treated with intratracheal instillation of BLM (2.5 U/kg). Control group received the same volume of saline instead of BLM. In LEF group, in addition to BLM, LEF (10 mg/kg, daily) was administrated by oral gavage. The effect of LEF on pulmonary inflammation and fibrosis was studied by measurements of serum clara cell protein-16 (CC-16), thiobarbituric acid reactive substance levels (TBARS), superoxide dismutase (SOD) and advanced oxidation protein products (AOPP) levels and lung tissue contents of IL-6, TNF-α and NF-κB by immunhistochemical examinations. RESULTS LEF significantly increased the level of CC-16 and decreased the level of AOPP (P=0.042 and P=0.003 respectively). Lung tissue contents of IL-6, TNF-α and NF-κB significantly decreased in LEF group compared to BLM group by immunhistochemical examinations (P<0.001). CONCLUSIONS LEF reduces oxidative stress factors, alveolar inflammation and attenuates lung injury and fibrosis.
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Affiliation(s)
- Servet Kayhan
- Department of Chest Disease, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey
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Kayhan S, Gumus A, Cinarka H, Murat N, Yilmaz A, Bedir R, Sahin U. The clinical utility of pleural YKL-40 levels in diagnosing pleural effusions. J Thorac Dis 2013; 5:634-40. [PMID: 24255777 DOI: 10.3978/j.issn.2072-1439.2013.09.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 09/24/2013] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Recent evidence suggests that YKL-40 is a relatively new biomarker of inflammation and it is involved in the pathogenesis of several pulmonary diseases. Details of serum and pleural YKL-40 in pleural effusions however, remain unknown. We aimed to assess whether serum and pleural YKL-40 is an accurate biomarker of pleural effusions. METHODS This clinical study was prospective, observational and cross-sectional. The concentrations of serum and pleural fluid YKL-40 and conventional pleural marker levels were measured in 80 subjects with pleural effusions, including 23 transudates caused by congestive heart failure (CHF), and 57 exudates including 23 parapneumonic, 22 malignant and 12 tuberculous pleural effusions (TBPEs). RESULTS Median pleural fluid YKL-40 levels were higher in exudates than in transudates (219.4 and 205.9 ng/mL, respectively, P<0.001). High pleural YKL-40 levels, with a cutoff value of >215 ng/mL, yielded a 73% sensitivity, 73% specificity, likelihood ratio 2.8 for diagnosing exudate, with an area under the curve of 0.770 [95% confidence intervals (CI): 0.657-0.884]. Pleural YKL-40/serum YKL-40 ratio >1.5 yielded a 75% sensitivity, 72% specificity and likelihood ratio 2.6 for diagnosing TBPE, with an area under the curve of 0.825 (95% CI: 0.710-0.940). CONCLUSIONS High concentrations of pleural YKL-40 level may help to differentiate exudate from transudate and a high pleural YKL-40/serum YKL-40 ratio may be helpful in seperating TBPE from non-tuberculous effusions.
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Affiliation(s)
- Servet Kayhan
- Department of Pulmonary Medicine, Recep Tayyip Erdogan University, Rize, Turkey
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Gumus A, Kayhan S, Cinarka H, Kirbas A, Bulmus N, Yavuz A, Sahin U, Ozkaya S. High serum YKL-40 level in patients with COPD is related to hypoxemia and disease severity. TOHOKU J EXP MED 2013; 229:163-70. [PMID: 23364142 DOI: 10.1620/tjem.229.163] [Citation(s) in RCA: 8] [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] [Indexed: 11/18/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a major health problem with increasing morbidity and mortality throughout the world. YKL-40 is a chitin-binding glycoprotein consisting of 383 amino acids, with a molecular mass of 40 kDa, and its serum level is elevated in inflammatory diseases. YKL-40 is a newly recognized biomarker of inflammation and has not been thoroughly investigated in COPD. The aim of the study is to investigate the relationship between serum YKL-40 levels and severity of COPD. The study population consisted of 52 patients with COPD with the mean age of 60.2 ± 10.1 years. The serum YKL-40 level increased significantly with increasing age (p = 0.022, r = 0.346). In COPD patients, high serum YKL-40 level is correlated to low forced expiratory volume at 1 second (FEV₁, percent of predicted) (r = -0.277, p = 0.047). Moreover, high serum YKL-40 level is correlated to low arterial oxygen pressure (PaO₂, mmHg) (r = -0.387, p = 0.005). The mean serum YKL-40 level was found as 243.1 ± 129.2 ng/ml in COPD patients with desaturation during 6-minute walk test (6MWT) and this value was higher than the mean serum YKL-40 level (155.8 ± 59.1 ng/ml) of COPD patients without desaturation during 6MWT (p = 0.004). This study demonstrated that high serum YKL-40 levels were correlated to severity of COPD. We propose that circulating YKL-40 levels could be a biomarker for hypoxemia and decline in lung function.
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Affiliation(s)
- Aziz Gumus
- Department of Chest Disease, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
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Kayhan S, Sahin U, Turut H, Yurdakul C. An unusual radiological presentation of a pulmonary hydatid cyst in a child. J Clin Imaging Sci 2013; 3:20. [PMID: 23814692 PMCID: PMC3690704 DOI: 10.4103/2156-7514.111238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 03/18/2013] [Indexed: 11/04/2022] Open
Abstract
Giant pulmonary hydatid cyst is usually encountered in adolescents and children who are older than 10 years. A relatively higher elasticity of the lung tissue allows rapid growth of cysts. We present a case of a 15-year-old male who was admitted with complaint of frequent and persistent dry cough for over a month. Computed tomographic scan revealed a giant cyst with thick enhancing rim and an "air bubble" sign. Diagnosis of giant hydatid cyst was confirmed by surgery and histopathological examination.
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Affiliation(s)
- Servet Kayhan
- Department of Pulmonary Diseases, University of Recep Tayyip Erdogan, School of Medicine, Rize, Turkey
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Cinarka H, Kayhan S, Gumus A, Durakoglugil ME, Erdogan T, Ezberci I, Yavuz A, Ozkaya S, Sahin U. Arterial Stiffness Measured Via Carotid Femoral Pulse Wave Velocity Is Associated With Disease Severity in COPD. Respir Care 2013; 59:274-80. [DOI: 10.4187/respcare.02621] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kayhan S, Celik B, Belet U, Aydin O. Intralobar pulmonary sequestratıon as an unusual cause of recurrent hemoptysis. J Clin Imaging Sci 2013; 2:71. [PMID: 23393628 PMCID: PMC3551497 DOI: 10.4103/2156-7514.104304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 09/02/2012] [Accepted: 09/25/2012] [Indexed: 11/06/2022] Open
Abstract
Pulmonary sequestration is an embryonic, cystic lung tissue that is supplied by systemic blood circulation. It is a nonfunctional lung parenchyma unconnected to normal tracheobronchial system. In cases of pulmonary sequestration, surgical interventions should be performed in order to prevent possible complications such as massive hemoptysis and infections. Preoperative imaging and treatment planning should be done carefully. We present an uncommon case of recurrent hemoptysis caused by intralobar pulmonary sequestration located in the left lower lobe.
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Affiliation(s)
- Servet Kayhan
- Department of Pulmonary Medicine, University of Ondokuz Mayis, School of Medicine, Samsun, Turkey
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Kayhan S. Diagnostic value of mycobacteriophage based fast plaque technique for early detection of pulmonary tuberculosis. J Clin Exp Invest 2012. [DOI: 10.5799/ahinjs.01.2012.02.0142] [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: 11/23/2022] Open
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Kayhan S, Ünsal M, İnce Ö, Bakırcı M, Arslan E. Delays in Diagnosis of Acute Pulmonary
Thromboembolism: Clinical Outcomes and Risk Factors. ELECTRON J GEN MED 2012. [DOI: 10.29333/ejgm/82476] [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: 11/21/2022]
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Abstract
OBJECTIVE Hydatid cyst disease is caused by the metacestod form of Echinococcosis granulosus from cestods. Pulmonary hydatid cyst is the second most frequent form of the disease after the liver involvement and may open into the bronchial or pleural space by perforation and may cause complications. The aim of the study was to evaluate the clinical features and the frequency of the complicated pulmonary hydatid cyst disease. METHODS Fifteen hydatid cyst patients were evaluated according to socio-demographical, clinical and radiological findings between 2009 and 2011 retrospectively. Hydatid cyst diseases were diagnosed histopathologically after chest surgery. Diagnostic difficulties and clinical features were analysed in four complicated pulmonary hydatid cyst cases. RESULTS Pneumothorax, pleural effusion, lung abscess, and hemoptysis were observed in four complicated cases. The complicated cases were diagnosed after surgery. Eleven of lung cysts were intact, radiological and histopathological features were typical for images of hydatid cyst disease and reported as compatible with the clinical diagnosis. A synchronized liver and pulmonary hydatid cyst was evaluated as a morbidity factor. CONCLUSION Hydatid cyst should be considered in the differential diagnosis of uncertain chest pathologies, especially in rural areas where the disease is endemic.
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Affiliation(s)
- Servet Kayhan
- Samsun Göğüs Hastalıkları ve Göğüs Cerrahisi Hastanesi, Göğüs Hastalıkları Kliniği, Samsun, Türkiye.
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Kayhan S. Therapeutic monitoring of isoniazid, rifampicin, ethambutol and pyrazinamide serum levels in the treatment of active pulmonary tuberculosis and determinants of their serum concentrations. ACTA ACUST UNITED AC 2011. [DOI: 10.5897/ajpp11.511] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hamzaçebi H, Unsal M, Kayhan S, Bilgin S, Ercan S. Prevalence of asthma and respiratory symptoms by age, gender and smoking behaviour in Samsun, North Anatolia Turkey. Tuberk Toraks 2006; 54:322-9. [PMID: 17203417] [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: 05/13/2023] Open
Abstract
Asthma is a major health problem worldwide. This is the first study determining the prevalence of asthma among adults in Samsun which is situated in the centre of the Black Sea region of Turkey. The aim of our study was to assess the prevalence of asthma and asthmatic symptoms, and the relationships of these with age, gender and smoking behaviour in this region. A questionnaire interview adapted from the European Respiratory Community Health Survey (ERCHS) was performed by health centre officers with selected people between November-December, 2002. The study population included a total of 1.916 [810 men (42.3%) and 1.106 women (57.7%)] inhabitants of Samsun city center, aged 15 years of age or above. The mean age was 37.8 years+/-15.5, the prevalence of asthma was 2.7%, receiving asthma medicine was 2.2%, the prevalence of wheezing in the last 12 months was 15.5% and shortness of breath with wheezing was 11.6%. The frequency of symptoms was higher among the elderly population when compared to other groups (p<0.0001). Asthma diagnosis by a physician was more frequent among women (chi2=5.16, p<0.05). Morning cough, day time cough, chronic cough, phlegmy cough and waking up with cough symptoms were more frequent among the smokers (p<0.001). Asthma diagnosis and asthma treatment are at a very low level compared to reported asthma related symptoms.
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Affiliation(s)
- Hasan Hamzaçebi
- Department of Public Health, Hospital of Chest Diseases, and Department of Chest Diseases, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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