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Cilekar S, Cosgun IG, Ogan N, Gunay S, Taskın V, Parspur SE, Balci A, Gunay E. Effectiveness of multimedia-assisted training on inhaler usage technique, which is the optimum technique? Eur Rev Med Pharmacol Sci 2023; 27:9499-9509. [PMID: 37916317 DOI: 10.26355/eurrev_202310_34123] [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: 11/03/2023]
Abstract
OBJECTIVE In this study, we aimed to investigate the most appropriate education method for patients to use their inhaler devices with the proper technique. PATIENTS AND METHODS The study had a cross-sectional, multicenter design. 525 consecutive patients who had never used an inhaler therapy before were included in the study. Seven different types of inhalers were evaluated. 75 patients were included for each device type. For each device type, 25 patients were trained by their own physicians who personally demonstrated the use of the device [verbal education with physical demonstration (VEWPD)], 25 were given multimedia-assisted training (MAT), and 25 received both types of training together (first VEWPD followed by MAT). After the patients were trained, inhaler medications were used under the supervision of a physician. Correct use of the inhaler devices and perceptions of convenience were scored. RESULTS For Ellipta inhaler device and Levered Diskus inhaler device, the proportion of patients using their devices properly was significantly higher in patients who were instructed with both of the methods together compared to other education groups (p = 0.011, p = 0.015). The effects of different types of training on learning in Sanohaler, Diskus inhaler, and Pressurized metered dose inhaler devices were the same. CONCLUSIONS We could not come to a conclusion that multimedia training was more beneficial than other training. As an unexpected result, in almost all of the devices, patients who received multimedia training in combination with verbal training did not develop better learning despite being shown the use of the device twice (except Ellipta inhaler, and Levered Diskus inhaler device).
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Affiliation(s)
- S Cilekar
- Department of Chest Diseases, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
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Balci A, Düz ME, Vurmaz A, Çilekar Ş, Kaya F. Comprehensive biomarker analysis of patients with idiopathic pulmonary fibrosis and interstitial lung disease with healthy individuals. Eur Rev Med Pharmacol Sci 2023; 27:5468-5479. [PMID: 37401283 DOI: 10.26355/eurrev_202306_32783] [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: 07/05/2023]
Abstract
OBJECTIVE Interstitial lung diseases (ILDs) are a group of diffuse parenchymal lung disorders that can be idiopathic [idiopathic pulmonary fibrosis (IPF)] or associated with other diseases and are characterized by varying degrees of inflammation and fibrosis with poor prognosis. Several indicators are essential in diagnosing these individuals and differentiating between IPF and ILD. PATIENTS AND METHODS The study involved 44 IPF patients, 22 ILD (non-IPF) patients, and 24 healthy people. We aimed to compare ILD (non-IPF) and IPF patient groups with each other and with healthy people in terms of interleukin (IL)-1, tumor necrosis factor-alpha (TNF-α), matrix metalloproteinase (MMP)-1, MMP-7, galectin (Gal)-3, IL-6, Krebs von den Lungen-6 (KL-6), total antioxidant status (TAS), total oxidant status (TOS), pyruvate kinase (PK), complete blood count (CBC), ferritin, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) features. Furthermore, it was intended to assess the patient groups in terms of visual semi-quantitative score (VSQS) (IPF alone), respiratory function tests (RFT), and 6-minute walk test (6MWT), also potential correlations between these tests and the previously indicated parameters. RESULTS MMP-1, MMP-7, Gal-3, IL-6, KL-6, forced vital capacity (FVC), % FVC, forced expiratory volume in 1 second (FEV1), % FEV1, TAS, TOS, and PK values significantly elevated in IPF and ILD. Weight, IL-1, MMP-1, MMP-7, Gal-3, IL-6, KL-6, % FVC, FEV1, % FEV1, eosinophil count, and % red blood cell distribution width (RDW) values differed between IPF and ILD. VSQS, 6MWT, and PK were substantially linked with MMP-1, MMP-7, Gal-3, IL-6, and KL-6 in IPF. CONCLUSIONS The factors investigated can be helpful in the diagnosis and distinction of IPF and ILD. In addition to focusing on the inflammatory environment in IPF and ILD patients, oxidant and antioxidant interactions must be studied.
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Affiliation(s)
- A Balci
- Department of Pulmonology, Medical Faculty, Afyonkarahisar University, Afyon, Turkey.
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Yörük C, Gulle S, Sari İ, Onen F, Balci A. POS0975 COMPARISON OF CLINICAL AND DEMOGRAPHIC FINDINGS OF PATIENTS DIAGNOSED AS WITH FULL SPINAL FUSION AND WITHOUT ANY SPINE DAMAGE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundErosions and sclerosis are early manifestations of radiographic progression, which can form syndesmophytes that bridge between the vertebrae and eventually lead to spinal fusion or the characteristic bamboo spine appearance in some patients.Bridging syndesmophytes in the spinal column plays a key role in the progression of AS.1 The development of ankylosis in the axial skeleton is considered to be the most important long-term outcome parameter for axial pondyloarthritis (axSpA).2ObjectivesIn this study, we aimed to evaluate patients with ankylosing spondylitis (AS) diagnosed with grade 4 sacroiliitis followed in our rheumatology clinic, without spinal column involvement and with complete spinal ankylosis (bamboo vertebra), together with their clinical, demographic and laboratory findings.MethodsA total of 202 patients with unilateral/bilateral grade 4 sacroiliitis, who were registered in the Dokuz Eylul University Hospital data system, diagnosed with AS according to the modified New York criteria, were included in the study. Cervical, dorsal and lumbar radiographs of all patients were evaluated for structural damage, in addition to lateral and anteroposterior aspects, as well as posterior and facet joint involvement. In the study, all radiographs were evaluated twice at separate times.ResultsIt was found that 19 (9.5%) patients had no involvement of the spinal column and 19 (9.5%) had spinal fusion appearance. It was determined that patients with spinal fusion were older (p<0.001) and the frequency of male gender was higher (p=0.042) than patients without any spinal involvement.(Table 1) In multivariate analysis; ≥45 years old [OR: 10.5, CI: 95%, 2.8-39.2; (p<0.001)] and male patients [OR: 10.5, CI: 95%, 1.14-96.56; (p=0.042)] was found to have an increased risk for the development of spinal fusion. TNFi retention rates (78.9% vs. 52.6%), TNF switch rates (53.3% vs. 45.5%) and TNF type distributions were similar in both groups (p>0.05).There was no significant difference between the patients with complete spinal fusion and no spinal involvement in terms of right and left hip BASRI scores (p>0.05).Table 1.DemographicsSpinal Involvement (-) (n=19)Full Spinal Involvement (+) (n=19)pn (%)n (%)Age<0.001 ≤4517 (89.5)0 (0)AUC (SH.): 0.945 (0.040) >452 (10.5)19 (100)10.5 (2.8-39.2) OOSex (Erkek)12 (63.1)18 (94.7)0.04210.5 (1.14-96.56) OOCRP11 (57.9)12 (63.2)0.999HLA-B2710 (64.3)9 (60.0)0.831Psoriasis1 (5.2)1 (5.3)-Family History4 (21)0 (0)-Alcohol1 (5.2)2 (10.5)-Cigarette7 (36.8)4 (21.1)0.475Dactylitis1 (5.2)0 (0)-Enthesitis0 (0)1 (5.3)-Uveitis3 (15.7)4 (21.1)0.234IBD3 (15.7)0 (0)-HT1 (5.2)7 (36.8)0.044DM1 (5.2)5 (26.3)0.182CHD0 (0)2 (10.5)-Aortic Failure1 (5.2)0 (0)-Mann-Whitney U Test (Monte Carlo), ROC (Receiver Operating Curve) Analysis (Honley&Mc Nell - Youden index J); AUC:Area under the ROC curve; OR: Odds Ratio; RC: ROC Curve Analyze, IBD: Inflammatory Bowel Disease, HT: Hypertension, DM: Diabetes Mellitus, CHD: Coronary Heart Disease, CRP: C-Reaktif Protein, n:Number, %: PercentConclusionIn our study, we reached four important clinical results: (1) Spinal fusion was observed in 9.5% of the patients with bilateral Grade 4 sacroiliitis diagnosed with AS, 9.5% had no spinal involvement and 81% had varying degrees of spinal injury. (2) Anti-TNF treatment responses were similar in patients with spinal fusion and no spinal involvement. (3) Except for being >45 years old and having a male gender, no other factor was found to predict the development of spinal fusion. (4) There was no difference in the degree of hip involvement between patients with complete spinal fusion and no spinal involvement.References[1]Siré E Van Der Heijde, D. et al. Modified stoke ankylosing spondylitis spinal score as an outcome measure to assess the impact of treatment on structural progression in ankylosing spondylitis.[2]Ramiro, S. et al. Spinal radiographic progression in early axial Spondyloarthritis: Five-year results from the DESIR cohort. Arthritis Care Res. (Hoboken).71, 1678–1684 (2019).Disclosure of InterestsNone declared
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Balci A, Erogul O, Dogan M, Gobeka HH, Akdogan M, Oral AY, Kasikci M, Eryigit Erogul L. Quantitative OCT angiography of the retina and choroid in non-ocular sarcoidosis. Eur Rev Med Pharmacol Sci 2022; 26:1906-1913. [PMID: 35363339 DOI: 10.26355/eurrev_202203_28336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate retinal and choroidal microvascular morphological changes in non-ocular sarcoidosis (NOS) patients using optical coherence tomography angiography (OCTA) and compare the results to age- and gender-matched healthy individuals. PATIENTS AND METHODS This study included 37 NOS patients (group 1, 37 right eyes) referred to the Ophthalmology Department between 2019 and 2021, as well as 31 healthy individuals (group 2, 31 right eyes). Non-ocular sarcoidosis was defined as sarcoidosis confirmed by a positive lung X-ray and biopsy without ocular manifestation. All participants underwent a comprehensive ophthalmic examination. The SPECTRALIS® OCT was used for both fundus photography and macular analysis. All OCTA procedures were performed in the Angio Retina mode (6.0x6.0 mm) to assess retinal and choroidal microvascular morphology. RESULTS Groups 1 and 2 had mean ages of 46.41±12.52 and 47.55±13.81 years, respectively (p=0.482). Group 1 had significantly increased superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel densities (VDs) in whole (p=0.059, 0.016), parafoveal (p=0.051, 0.015), and perifoveal (p=0.060, 0.010) regions relative to group 2. Group 1 was also associated with increased foveal avascular zone (FAZ) area (p=0.196), FAZ circumference (p=0.262), and foveal VD in 300 μm wide regions surrounding FAZ (p=0.003) relative to group 2. The outer retinal (p=0.712) and choriocapillaris (p=0.684) flows did not differ significantly between the two groups. CONCLUSIONS Quantitative OCTA analysis revealed a higher tendency for retinal and choroidal microvascular morphological changes in NOS patients, demonstrating the potential of this novel, non-invasive imaging technology, which may provide sensitive and reliable results without using contrast materials.
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Affiliation(s)
- A Balci
- Department of Chest Diseases, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey.
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Saydam O, Ozgen Saydam B, Adiyaman SC, Sonmez Ince M, Eren MA, Keskin FE, Bilen H, Dagdeviren M, Kaya S, Akinci G, Balci A, Altay C, Bayraktar F, Oral EA, Akinci B. Risk factors for diabetic foot ulcers in metreleptin naïve patients with lipodystrophy. Clin Diabetes Endocrinol 2021; 7:18. [PMID: 34593051 PMCID: PMC8485489 DOI: 10.1186/s40842-021-00132-9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/29/2021] [Indexed: 12/17/2022] Open
Abstract
AIM Patients with lipodystrophy are at high risk for chronic complications of diabetes. Recently, we have reported 18 diabetic foot ulcer episodes in 9 subjects with lipodystrophy. This current study aims to determine risk factors associated with foot ulcer development in this rare disease population. METHODS Ninety metreleptin naïve patients with diabetes registered in our national lipodystrophy database were included in this observational retrospective cohort study (9 with and 81 without foot ulcers). RESULTS Patients with lipodystrophy developing foot ulcers had longer diabetes duration (p = 0.007), longer time since lipodystrophy diagnosis (p = 0.008), and higher HbA1c levels (p = 0.041). Insulin use was more prevalent (p = 0.003). The time from diagnosis of diabetes to first foot ulcer was shorter for patients with generalized lipodystrophy compared to partial lipodystrophy (p = 0.036). Retinopathy (p < 0.001), neuropathy (p < 0.001), peripheral artery disease (p = 0.001), and kidney failure (p = 0.003) were more commonly detected in patients with foot ulcers. Patients with foot ulcers tended to have lower leptin levels (p = 0.052). Multiple logistic regression estimated significant associations between foot ulcers and generalized lipodystrophy (OR: 40.81, 95% CI: 3.31-503.93, p = 0.004), long-term diabetes (≥ 15 years; OR: 27.07, 95% CI: 2.97-246.39, p = 0.003), and decreased eGFR (OR: 13.35, 95% CI: 1.96-90.67, p = 0.008). CONCLUSIONS Our study identified several clinical factors associated with foot ulceration among patients with lipodystrophy and diabetes. Preventive measures and effective treatment of metabolic consequences of lipodystrophy are essential to prevent the occurrence of foot ulcers in these high-risk individuals.
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Affiliation(s)
- O Saydam
- Division of Cardiovascular Surgery, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - B Ozgen Saydam
- Division of Endocrinology and Metabolism, Dokuz Eylul University Faculty of Medicine, Inciralti, Izmir, Turkey
| | - S C Adiyaman
- Division of Endocrinology and Metabolism, Dokuz Eylul University Faculty of Medicine, Inciralti, Izmir, Turkey
| | - M Sonmez Ince
- Department of Internal Medicine, William Beaumont Royal Oak Hospital, MI, Royal Oak, USA
| | - M A Eren
- Division of Endocrinology and Metabolism, Harran University Faculty of Medicine, Sanliurfa, Turkey
| | - F E Keskin
- Division of Endocrinology and Metabolism, Demiroglu Bilim University Faculty of Medicine, Istanbul, Turkey
| | - H Bilen
- Division of Endocrinology and Metabolism, Ataturk University Training and Research Hospital, Erzurum, Turkey
| | - M Dagdeviren
- Division of Endocrinology and Metabolism, Kecioren Training and Research Hospital, Ankara, Turkey
| | - S Kaya
- Department of Internal Medicine, Gulhane Training and Research Hospital, Ankara, Turkey
| | - G Akinci
- Division of Pediatric Neurology, Behcet Uz Children's Hospital, Izmir, Turkey.,Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - A Balci
- Department of Radiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - C Altay
- Department of Radiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - F Bayraktar
- Division of Endocrinology and Metabolism, Dokuz Eylul University Faculty of Medicine, Inciralti, Izmir, Turkey
| | - E A Oral
- Brehm Center for Diabetes Research and Division of Metabolism, Endocrinology and Diabetes, University of Michigan, 1000 Wall Street, 48105, Ann Arbor, MI, USA
| | - B Akinci
- Division of Endocrinology and Metabolism, Dokuz Eylul University Faculty of Medicine, Inciralti, Izmir, Turkey. .,Brehm Center for Diabetes Research and Division of Metabolism, Endocrinology and Diabetes, University of Michigan, 1000 Wall Street, 48105, Ann Arbor, MI, USA.
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Erez Y, Gulle S, Karakas A, Bekis R, Balci A, Birlik M, Can G, Onen F, Sari İ. POS0750 THE CHARACTERISTICS OF SYSTEMIC LUPUS ERYTHEMATOSUS WHO HAVE CONSTITUTIONAL SYMPTOMS AND LYMPHADENOPATHY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic lupus erythematosus (SLE) is the prototype of systemic autoimmune diseases. It may affect any organ system and may present with a variety of clinical symptoms. Lymphadenopathy (LAP) is a nonspecific finding of SLE and often associated to the active disease state. LAP associated SLE pose a significant diagnostic challenge especially in the presence of constitutional symptoms.Objectives:In this retrospective cohort study, we evaluated the clinical and imaging characteristics of SLE patients who presented with LAP and constitutional symptoms.Methods:SLE Patients with lymphadenopathy who had constitutional symptoms were reviewed retrospectively. The characteristics of the patients such as age, sex, disease duration, clinical features, and laboratory tests including autoantibodies against ANA, dsDNA and ENA were recorded. Imaging findings such as positron emission tomography–computed tomography (PET/CT), thoracal or abdominal CT or diagnostic lymph node biopsy were identified.Results:There were 28 patients in this study. The mean age at the time of LAP was 38.9±15.2 years, 22 (78.6%) were female. All patients were fulfilling SLICC 2012 classification criteria for SLE. LAP was the presenting feature of SLE in 15 (53.6%) patients. The most common clinical features associated with LAP were arthritis (42.8%), fever (35.7%), acute lupus rash (32.1%) and serositis (28.5%). There were 11 (39.2%) who had significant proteinuria and 4 (14.3%) had class III or IV renal histology. Anti-phospholipid antibodies were present in nearly one-third of the patients and 12 of them had venous or arterial thrombosis or pregnancy co-morbidity. Cervical LAP was present in 57.1%, axillary LAP in 82.1% and inguinal in 36%. On CT, the prevalence of thoracal and abdominal LAP and hepatomegaly and splenomegaly were 61.5%, 37,5%, 40% and 16% respectively. The pericardial and pleural effusion and intra-abdominal free fluid were 19.2%, 30.8% and 10.2% respectively. There were 19 (67.8%) patients who underwent PET/CT imaging and all were reported as reactive LAP. In terms of SUV max 7 (36.8%) of them had a threshold ≥2.5. 17 (60.7%) patients required lymph node biopsy; 2 did not include lymphoid tissue, 4 (30.7%) with atypical lymphoid hyperplasia suggestive of viral infection and remaining were reactive lymphoid hyperplasia. Autoantibody testing showed that anti-dsDNA was positive in 66.7% and the most common anti-ENAs were anti-nucleosome (35.7%) and anti-Sm-RNP (35.7%) followed by anti-SSA (25%), anti-ribosomal P (17.9%) and anti-histone (14%). The clinical and laboratory features of the clinical and laboratory features of the group is summarized in Table 1.Table 1.Data at the time of LAPAge, years38.9±15.2Disease duration, months3 (2- 300)SLE-DAI, median (min-max)9 (2-30)Sex, female n(%)22 (78.6)Clinical featuresn (%)Acute cutaneous9 (32.1)Arthritis12 (42.8)Fever10 (35.7)Other constitutional symptoms18 (64.2)Serositis8 (28.5)Renal involvement11 (39.2)Neurologic involvement1 (3.6)Leucopenia7 (25.0)Trombositopenia5 (17.8)Hemolitic anemia7 (25.0)ANA (+)>1/32028 (100)Anti-dsDNA (+)18 (66.7)Anti-Sm(+)5 (17.9)Anti-phospholipid antibody (+)9 (32.1)Low complement16 (88.5)Conclusion:We showed that SLE patients who had constitutional findings and LAP could be the presenting feature and may confer a significant diagnostic challenge in which the patients might require invasive procedures and advanced imaging modalities. PET/CT revealed reactive changes in lymph nodes in all patients but lymph node biopsy revealed atypical changes in some patients suggestive of viral infections. On the other hand, LAP patients with constitutional symptoms represents a severe phonotype of the SLE as there were significant renal and thrombotic disease.Disclosure of Interests:None declared
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Kampman MAM, Siegmund AS, Bilardo CM, van Veldhuisen DJ, Balci A, Oudijk MA, Groen H, Mulder BJM, Roos-Hesselink JW, Sieswerda G, de Laat MWM, Sollie-Szarynska KM, Pieper PG. Uteroplacental Doppler flow and pregnancy outcome in women with tetralogy of Fallot. Ultrasound Obstet Gynecol 2017; 49:231-239. [PMID: 27071979 DOI: 10.1002/uog.15938] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/01/2016] [Accepted: 04/07/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Pregnancy in women with surgically corrected tetralogy of Fallot (ToF) is associated with cardiac, obstetric and neonatal complications. We compared uteroplacental Doppler flow (UDF) measurements and pregnancy outcome in women with ToF and in healthy women and aimed to assess whether a relationship exists between cardiac function and UDF in women with ToF. METHODS We evaluated prospectively pregnant women with ToF and healthy pregnant women from the ZAHARA studies. Clinical evaluation, standardized echocardiography and UDF measurements were performed at 20 and 32 weeks' gestation. RESULTS We included 62 women with ToF and 69 healthy controls. Cardiac complications, mostly arrhythmia, occurred in 8.1% of women with ToF. There was a higher incidence of small-for-gestational age (21.0% vs 4.4%, P = 0.004) and low birth weight (16.1% vs 2.9%, P = 0.009) in the group of women with ToF than in healthy controls. In women with ToF, early diastolic notching of uterine artery waveform at 20 and 32 weeks occurred more frequently (9.8% vs 1.5%, P = 0.034 and 7.0% vs 0%, P = 0.025, respectively) and the umbilical artery pulsatility index at 32 weeks was higher (1.02 ± 0.20 vs 0.94 ± 0.17, P = 0.015) than in healthy controls. Right ventricular function parameters prepregnancy and at 20 weeks' gestation were significantly associated with abnormal UDF. UDF parameters were associated with adverse neonatal outcome. CONCLUSION The majority of women with surgically corrected ToF tolerate pregnancy well. However, UDF indices are more frequently abnormal in these women, suggesting impaired placentation. The association of impaired right ventricular function parameters with abnormal UDF suggests that cardiac dysfunction contributes to defective placentation or placental perfusion mismatch and may explain the increased incidence of obstetric and neonatal complications. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- M A M Kampman
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- The Netherlands Heart Institute (ICIN), Utrecht, The Netherlands
| | - A S Siegmund
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - C M Bilardo
- Department of Obstetrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - D J van Veldhuisen
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A Balci
- Department of Cardiology, Isala, Zwolle, The Netherlands
| | - M A Oudijk
- Department of Obstetrics, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - H Groen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - B J M Mulder
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J W Roos-Hesselink
- Department of Cardiology, Erasmus Medical Center, University of Rotterdam, Rotterdam, The Netherlands
| | - G Sieswerda
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M W M de Laat
- Department of Obstetrics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - K M Sollie-Szarynska
- Department of Obstetrics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - P G Pieper
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Erkekoglu P, Zeybek N, Balci A, Yıldıztekin K, Yaman U, Asci A, Kizilgun M, Edebal O, Gumusel BK. The toxic effects of Aroclor 1254 on rat testis and modulatory effect of selenium status. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ziver T, Yuksel P, Balci A, Ergin S, Gode S, Kuskucu M, Torlak Z, Tokman HB, Ipek G, Tireli E, Midilli K, Yekeler I, Kiraz N, Kocazeybek B. The role of Porphyromonas gingivalis in the development of atherosclerosis and its relationship with fim A genotype. Int J Infect Dis 2014. [DOI: 10.1016/j.ijid.2014.03.1140] [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] Open
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Kampman MAM, Balci A, van Veldhuisen DJ, van Dijk APJ, Roos-Hesselink JW, Sollie-Szarynska KM, Ludwig-Ruitenberg M, van Melle JP, Mulder BJM, Pieper PG. N-terminal pro-B-type natriuretic peptide predicts cardiovascular complications in pregnant women with congenital heart disease. Eur Heart J 2013; 35:708-15. [DOI: 10.1093/eurheartj/eht526] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Balci A, Celik M, Balci DD, Karazincir S, Yonden Z, Korkmaz I, Celik E, Egilmez E. Patients with psoriasis have an increased amount of epicardial fat tissue. Clin Exp Dermatol 2013; 39:123-8. [PMID: 24164295 DOI: 10.1111/ced.12216] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND Psoriasis is associated with coronary artery disease, and ischemic heart disease is associated with increased amounts of epicardial fat tissue (EFT). There has as yet been no study published on the accumulation of EFT in patients with psoriasis. AIM To compare epicardial fat accumulation and coronary artery calcium score (CACS) in patients with psoriasis and controls. METHODS We enrolled 38 patients with psoriasis and 38 controls matched for age and gender. Epicardial fat area (EFA) and CACS were evaluated by multidetector computed tomography. RESULTS Mean EFA in patients with psoriasis was significantly higher than in controls (13.8 ± 8.4 vs. 9.7 ± 6.4 cm(2) , respectively, P = 0.02), but mean CACS did not differ significantly between the two groups (55.2 ± 65.4 vs. 27.8 ± 29.3; P > 0.05). Multiple linear regression analyses indicated that EFA was significantly associated with waist circumference and presence of coronary artery calcification in both patients and controls, whereas EFA was significantly associated waist circumference and age in patients only (P < 0.05). CONCLUSIONS Patients with psoriasis had a higher level of EFA compared with controls, and EFA was independently associated with the presence of CAC in all study subjects.
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Affiliation(s)
- A Balci
- Department of Radiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Kampman MAM, Balci A, Mulder BJM, Van Dijk APJ, Roos-Hesselink JW, Sollie-Szarynska KM, Ludwig-Ruitenberg M, Van Melle JP, Van Veldhuisen DJ, Pieper PG. Nt-proBNP predicts cardiovascular complications in pregnant women with congenital heart disease. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2122] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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Celik T, Gunesacar R, Balci A, Unal S, Aldic G, Eskici H, Atilgan N, Elmaci S, Tutanc M, Can D. 355 The importance of the M470V polymorphism. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60495-6] [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: 11/24/2022]
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14
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Aksoy A, Solmaz D, Can G, Cetin P, Balci A, Akar S, Birlik M, Akkoc N, Onen F. THU0321 Increased Frequency of Hand Osteoarthritis in Patients with Primary Sjogren’s Syndrome: Is there a Relationship between Two Diseases? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.849] [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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15
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Guler H, Turhanoglu AD, Ozer B, Ozer C, Balci A. The relationship between anti‐cyclic citrullinated peptide and bone mineral density and radiographic damage in patients with rheumatoid arthritis. Scand J Rheumatol 2009; 37:337-42. [DOI: 10.1080/03009740801998812] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Dogramaci AC, Balci DD, Balci A, Karazincir S, Savas N, Topaloglu C, Yalcin F. Is androgenetic alopecia a risk for atherosclerosis? J Eur Acad Dermatol Venereol 2009; 23:673-7. [PMID: 19250324 DOI: 10.1111/j.1468-3083.2009.03137.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several studies have demonstrated the presence of an association between androgenetic alopecia (AGA) and cardiovascular disease. The aim of this study was to evaluate subclinical atherosclerosis in patients with AGA and healthy controls by the incorporation of carotid intima-media thickness (IMT) and high-sensitive C-reactive protein (hs-CRP) along with echocardiography (ECHO) and exercise electrocardiography (ExECG). METHODS We performed a case-control study in 50 male patients with AGA and 31 age-matched healthy male controls with normal hair status. Both the AGA patients and controls with a history of diabetes mellitus, cigarette smoking, hypertension, cardiovascular or cerebrovascular disease, and renal failure were excluded. AGA was classified according to the Hamilton-Norwood scale. Serum lipids, serum hs-CRP, total testosterone, and dehydroepiandrosterone sulphate were examined in all study subjects. Carotid ultrasonography was used to measure the IMT of the common carotid arteries (CCA). ECHO and ExECG were performed in all subjects. RESULTS IMT of the CCA was found to be significantly higher in patients with severe vertex pattern AGA when compared to patients with other patterns of AGA and healthy controls (P < 0.05). Hs-CRP in patients with any group of AGA was not significantly different from those healthy controls (P > 0.05). ECHO showed that cardiac structural and functional measures were in normal ranges. ExECG was also normal in all subjects. CONCLUSION Severe vertex pattern AGA should be considered to have an increased risk of subclinical atherosclerosis. For this reason, CCA IMT measurement can be recommended as a non-invasive and early diagnostic method.
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Affiliation(s)
- A C Dogramaci
- Department of Dermatology, Faculty of Medciine, Mustafa Kemal University, Hatay, Turkey.
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17
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Abstract
Pregnancy in women with mechanical valve prostheses has a high maternal complication rate including valve thrombosis and death. Coumarin derivatives are relatively safe for the mother with a lower incidence of valve thrombosis than un-fractionated and low-molecular-weight heparin, but carry the risk of embryopathy, which is probably dose-dependent. The different anticoagulation regimens are discussed in this review. When valve thrombosis occurs during pregnancy, thrombolysis is the preferable therapeutic option. Bioprostheses have a more favourable pregnancy outcome than mechanical prostheses but due to the high re-operation rate in young women they do not constitute the ideal alternative. When women with native valve stenosis need pre-pregnancy intervention, mitral balloon valvuloplasty is the best option in mitral stenosis, while the Ross operation or homograft implantation may be the preferable surgical regimen in aortic stenosis. (Neth Heart J 2008;16:406-11.).
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Affiliation(s)
- P.G. Pieper
- Thorax Centre, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - A. Balci
- Thorax Centre, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
| | - A.P. Van Dijk
- Department of Cardiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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18
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Balci DD, Balci A, Karazincir S, Ucar E, Iyigun U, Yalcin F, Seyfeli E, Inandi T, Egilmez E. Increased carotid artery intima-media thickness and impaired endothelial function in psoriasis. J Eur Acad Dermatol Venereol 2008; 23:1-6. [PMID: 18702627 DOI: 10.1111/j.1468-3083.2008.02936.x] [Citation(s) in RCA: 145] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Psoriasis is associated with an increased risk of atherosclerosis. This study compared subclinical atherosclerosis of the carotid and brachial arteries in psoriasis vulgaris patients and healthy controls using high-resolution ultrasonography. METHODS We studied 43 psoriasis patients and 43 healthy controls matched for age and sex. Flow-mediated dilatation (FMD) and nitroglycerin-induced dilatation (NTD) of the brachial artery and intima-media thickness (IMT) of the common carotid arteries (CCA) were measured ultrasonographically. Diabetes mellitus, hypertension, renal failure, a history of cardiovascular or cerebrovascular disease were exclusion criteria. Subjects who were receiving lipid-lowering therapy, antihypertensive or anti-aggregant drugs, nitrates or long-term systemic steroids were also excluded. RESULTS The mean IMT values of the right, left and averaged CCA of the psoriasis patients were significantly higher, compared with the controls (0.607+/-0.144 mm vs. 0.532+/-0.101 mm, 0.611+/-0.157 mm vs. 0.521+/-0.117 mm, and 0.609+/-0.146 mm vs. 0.526+/-0.104 mm; P=0.006, P=0.003 and P=0.003, respectively). The mean FMD and NTD values of the psoriasis patients were significantly lower, compared with the controls (13.36+/-6.39 mm vs. 19.60+/-11.23 mm and 21.08+/-8.38 mm vs. 26.85+/-12.38 mm; P=0.002 and P=0.013, respectively). Multiple linear regression analysis revealed a significant association between psoriasis and the IMT, FMD and NTD. Moreover, the FMD in psoriasis patients was associated with disease duration. CONCLUSION Psoriasis patients had impaired endothelial function and thicker IMT of the CCA, compared with the healthy control subjects. The presence of psoriasis was an independent risk factor for subclinical atherosclerosis.
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Affiliation(s)
- D D Balci
- Department of Dermatology, Mustafa Kemal University Faculty of Medicine, Antakya, Turkey.
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19
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Inandi T, Ozer C, Balci A, Karazincir S. Effects of a fixed-payment method on demand for imaging tests in a university hospital. J Public Health (Oxf) 2008; 30:322-6. [DOI: 10.1093/pubmed/fdn038] [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: 11/12/2022] Open
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20
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Ulkü R, Eren S, Balci A, Ozçelik C, Eren MN. [Penetrating heart wounds. An analysis of 29 cases]. Ulus Travma Derg 2001; 7:172-5. [PMID: 11705219] [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: 02/22/2023]
Abstract
Twenty-nine cases, penetrating wounds to the heart, who were operated in the thoracic and cardiovascular surgery department of our University during January 1995-August 2000 were reevaluated. Twenty nine patients were men and the mean age was 22.6 (min 12, max 45). The cause of injury was stab wounds in 28 cases and gunshot wounds in 1 case. Besides the clinical findings; teleradiography, echocardiography were valuable for the diagnosis. Surgery was applied in emergent conditions for all cases. Interventions were performed 28 anterolateral thoracotomy, 1 bilaterally anterolateral thoracotomy and additionally 4 laparatomy were performed. The most frequent side of injury was right ventricule. Our mortality ratio was 17.2%, morbidity ratio 17.2%. We think that fast transportation, urgent diagnostic study and immediate surgical intervention important parameters which decrease of the mortality.
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Affiliation(s)
- R Ulkü
- Dicle Universitesi Tip Fakültesi Göğüs Kalp ve Damar Cerrahisi ABD Diyarbakir
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21
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Balci A, Ekmekci A, Cetin R. The expression of common fragile sites in peripheral blood lymphocytes of breast and colorectal cancer patients with aphidicolin. TOHOKU J EXP MED 1999; 189:107-16. [PMID: 10775054 DOI: 10.1620/tjem.189.107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/18/2022]
Abstract
The frequency and distribution of aphidicolin induced common fragile sites was evaluated on chromosomes of peripheral blood lymphocytes in 10 breast and 10 colorectal cancer patients, and 10 healthy controls to determine correlation between specific fragile sites and cancer breakpoints. Fifty complete metaphases were screened from each culture and the results were evaluated by Student's t-test. The total number of fragile sites was found as 933 in breast cancer patients, 950 in colorectal cancer patients and 501 in control group. Both the number of aberrations per cell and number of aberrations per damaged cell were significantly higher in the patient groups. These findings indicate that genetic instability in the breast and colorectal cancer patients increased and fragile sites may play a critical role in the pathogenesis of breast and colorectal cancer.
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Affiliation(s)
- A Balci
- Department of Medical Biology and Genetics, Faculty of Medicine, Gazi University, Ankara, Turkey
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22
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Abstract
In human promyelocytic leukemia cell line HL60, apoptosis was induced by treatment with gossypol that is an inhibitor of protein kinase C. Gossypol acetic acid was added to HL 60 cells at 50, 100, 150 and 200 microM concentrations for six hours. Morphological features of apoptosis as well as internucleosomal DNA fragmentation were evaluated by light microscope, agarose gel electrophoresis and spectrofluorometric quantitation. Our results indicated that with the effective concentrations of gossypol (50 and 100 microM), apoptosis was induced in HL 60 cells.
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Affiliation(s)
- A Balci
- Department of Medical Biology and Genetics, Faculty of Medicine, Gazi University, Ankara, Turkey
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23
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Balci A, Huusko P, Pääkkönen K, Launonen V, Uner A, Ekmekçi A, Winqvist R. Mutation analysis of BRCA1 and BRCA2 in Turkish cancer families: a novel mutation BRCA2 3414del4 found in male breast cancer. Eur J Cancer 1999; 35:707-10. [PMID: 10505028 DOI: 10.1016/s0959-8049(99)00014-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Since the identification of the BRCA1 and BRCA2 breast-ovarian cancer susceptibility genes, mutation analyses have been carried out in different populations. Here we screened 15 Turkish breast and breast-ovarian cancer families for mutations in both genes by conformation-sensitive gel electrophoresis (CSGE) and the protein truncation test (PTT), followed by DNA sequencing. Three families included a male breast cancer case, one without family history. Three germline mutations were identified, two in BRCA1 and one in BRCA2. The two BRCA1 mutations, 5382insC and 5622C-->T, were found in breast-ovarian cancer families. The BRCA2 3414delTCAG is a novel mutation detected in a site-specific breast cancer family that included 1 case of male breast cancer. These first results of Turkish families show that the frequency of germline BRCA1 or BRCA2 mutations appears to be high in families with at least 3 breast and/or ovarian cancer cases.
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Affiliation(s)
- A Balci
- Department of Medical Biology and Genetics, Faculty of Medicine, Gazi University, Ankara, Turkey
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24
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Bal F, Sahin FI, Yirmibes M, Balci A, Menevşe S. The in vitro effect of beta-carotene and mitomycin C on SCE frequency in Down's syndrome lymphocyte cultures. TOHOKU J EXP MED 1998; 184:295-300. [PMID: 9699245 DOI: 10.1620/tjem.184.295] [Citation(s) in RCA: 9] [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: 11/18/2022]
Abstract
Down's syndrome (DS) has the highest incidence among chromosomal disorders and is a predisposing factor in acute leukemia pathogenesis. DS patients are sensitive to both physical and chemical inducers at the DNA level. Studies on beta-carotene, an antioxidant, suggested the there is a relationship between high beta-carotene diet and reduced tumor incidence in humans indicating that beta-carotene is a chemopreventive agent against cancer. Sister chromatid exchange (SCE) is known as a sensitive parameter among the genotoxicity tests. In this study, we aimed to investigate the in vitro effect of beta-carotene on SCE frequencies in 7 DS patients and 7 healthy controls aged between 0-16 years. A direct leukomogenic agent Mitomycin-C (MMC) was used as a powerful SCE inducer. Addition of MMC to the cultures alone resulted in a significant enhancement of SCE frequencies in both groups when compared to the spontaneous values. In the study, beta-carotene seemed to decrease MMC induced mean SCE/cell values, but did not have an effect on unstimulated cells. As this is a limited study, it is hard to conclude that beta-carotene is a chemopreventive agent in DS patients, although our results seem to support other investigators' reports.
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Affiliation(s)
- F Bal
- Department of Medical Biology and Genetics, Faculty of Medicine, Gazi University, Ankara, Turkey
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