caglar cuhadaroglu | Acibadem University (original) (raw)
Papers by caglar cuhadaroglu
Computers & Operations Research, 2013
Journal of Cancer Research and Therapeutics, 2020
Background: Ghrelin plays a role in mechanisms related to cancer progression – including cell pro... more Background: Ghrelin plays a role in mechanisms related to cancer progression – including cell proliferation, invasion and migration, and resistance to apoptosis in the cell lines from several cancers. We investigated the role of ghrelin levels in cancer cachexia-anorexia in patients with locally advanced nonsmall-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT). Materials and Methods: This study involved 84 NSCLC patients who had received concomitant CRT. Blood ghrelin levels were compared before and 3 months after CRT. Meanwhile, changes in body weight of the patients were also investigated with changes in ghrelin levels before and after CRT. Results: Ghrelin levels were significantly decreased in line with changes in patients' weights in patients receiving CRT (P < 0.001). Serum albumin levels and inflammatory-nutritional index were significantly decreased after radiotherapy (RT) (3.01 ± 0.40 g/dL, 0.38 ± 0.20) when compared with its baseline levels (3.40 ± 0.55 g/dL,P < 0.001; 0.86 ± 0.71,P < 0.001, respectively). Serum C-reactive protein levels were significantly increased after CRT (7.49 ± 6.53 mg/L) when compared with its baseline levels (9.54 ± 3.80 mg/L,P = 0.038). After RT, ghrelin levels in patients were positively correlated with body mass index (r = 0.830,P < 0.001) and albumin (r = 0.758,P < 0.001). Conclusion: Ghrelin may play a role in the pathogenesis of weight loss in NSCLC patients. Ghrelin seems to be implicated in cancer-related weight loss. Ghrelin, cancer, and RT all together have a role in tumor-related anorexia-cachexia in patients with NSCLC. Results of this study need further evaluation as regards to its potential role as an adjuvant diagnostic or prognostic marker.
PubMed, Nov 5, 2002
Objectives: We evaluated the efficacy of laser-assisted uvulopalatoplasty in the treatment of sno... more Objectives: We evaluated the efficacy of laser-assisted uvulopalatoplasty in the treatment of snoring and obstructive sleep apnea syndrome (OSAS). Patients and methods: Laser-assisted uvulopalatoplasty was performed in 34 patients (30 males, 4 females; mean age 45.7 years; range 17 to 70 years) with simple snoring and mild OSAS. The patients were evaluated preoperatively and in the first and sixth months postoperatively with the use of the Epworth sleepiness scale, polysomnography, and snoring scores. A questionnaire was administered to assess patient satisfaction. Results: All patients had decreased snoring. The quality of sleep increased in 79%. The clinical improvement seen in the first month continued through the sixth postoperative month. Satisfaction rates for the patients and their families were 88% and 85%, respectively. Significant decreases were found in the Epworth sleepiness scale (p=0.000) and visual snoring scores (p<0.001). In addition, postoperative desaturation indices decreased and minimal desaturation levels increased. However, no significant decreases occurred in the apnea/hypopnea index. No complications were encountered during and after operation. Conclusion: Laser-assisted uvulopalatoplasty has high efficacy in the treatment of snoring and mild OSAS, with such additional advantages as ease, low complication rate, and no need for hospitalization.
Turkiye Klinikleri Cardiology - Special Topics, 2018
The European respiratory journal. Supplement, Feb 5, 1996
Frontiers in Medicine, Feb 9, 2023
Background: Oxidative stress plays an important role in the pathogenesis of many diseases. This s... more Background: Oxidative stress plays an important role in the pathogenesis of many diseases. This study aimed to investigate the relationship between nuclear factor kappa B (NF-κB) and oxidative stress and the severity of the disease in new COVID-19 patients, and, to compare the levels of NF-κB, oxidized LDL (oxLDL), and lectin-like oxidized-LDL receptor-1 (LOX-1) with oxygen saturation, which is an indicator of the severity parameters of the disease in COVID-19 patients. Methods: In this prospective study, 100 COVID-19 patients and 100 healthy subjects were selected. Results: LOX-1, NF-κB, and oxLDL were found to be higher in COVID-19 patients compared to the healthy subjects (p < 0.001 for all). According to the results of correlation analysis, it was found that there was no significant relationship between oxygen saturation and LOX-1, NF-κB and oxLDL parameters. There was significant relationship between oxLDL with LOX-1 and NF-κB in patients with COVID-19 disease. ROC analysis results of the highest discrimination power were oxLDL (AUC: 0.955, CI: 0.904-1.000; sensitivity: 77%, and specificity: 100%, for cutoff: 127.944 ng/l) indicating COVID-19. Conclusion: Oxidative stress plays an essential role in COVID-19. NF-κB, oxLDL, and LOX-1 seem to represent good markers in COVID-19. Our study also showed that oxLDL has the highest power in distinguishing patients with COVID-19 from the healthy subjects.
European journal of echocardiography, Dec 1, 2005
Purpose: Allhough responsible mechanisms are not lully known yel, obslructive sleep apnea is asso... more Purpose: Allhough responsible mechanisms are not lully known yel, obslructive sleep apnea is associated wilh increased risk for cardiovascular disease and evenls. Aorla is not only as a conduit delivering blood to the tissues but also as an imporlant modulalor of lhe entire cardiovascular system, its elastic properties also affect lelt ventricular lunction and coronary blood flow. The aim el this study was to determine left ventricular diastolic function and aortic elastic properties in patients with obstructive sleep apnea syndrome. Method: Fourteen male patients with obstructive sleep apnea and 14 age-and body mass index-matched healthy male controls took part in the study as a control group. All subjects underwent echocardiographic examination; lelt ventricular cavity dimension, standard and tissue Doppler parameters, and aortic diameter (3 cm above aortic valve) at systole and diaslole were measured. Results: While, the aorlic stillness index in palienls with obslruclive sleep apnea was significanlly higher than lhal el conlrol group (4.54-0.3 vs 2.14-0.1, p = 0.001), the aortic dislensibilily index was lound Io be lower in INs group compared wilh controls (2.44-1.2 vs 3.94-1.5 cm 2 dynes-1 10-6, p= 0.009). Furthermore, peak ve-Iocily el myocardial systolic wave and peak velocilies el myocardial diaslolic waves in palienls were lower than in conlrols. There was an associalion between aorlic stillness and apnea-hypopnea index (coelficient = 0.49, p=0.002). We also lound an inverse correlation between peak velocity el myocardial diastolic wave and aortic stillness (coellecient =-0.4.3, p=0.003) by using multiple linear regression. Conclusion: Increased aortic stigness which is associated with the severity el disease in patients with obstructive sleep apnea may lead to diastolic dyslunction of lelt ventricle. 907 Pulse wave reflections are associated with aortic dilatation and left ventricular diastolic dysfunction in AdamanUades-Behcat disease
Infectious diseases and clinical microbiology, Apr 30, 2020
This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License.
International Journal of General Medicine
Background: Acute pulmonary embolism (APE) is a common clinical condition. Its severity ranges fr... more Background: Acute pulmonary embolism (APE) is a common clinical condition. Its severity ranges from asymptomatic radiological findings to fatal obstructive shock. The potential circulating biomarkers have been studied to predict APE outcomes. This study aimed to explore their predictive power on prognosis in APE. Material and Method: It was a prospective observational study between March 2008 and April 2010. All consecutive patients diagnosed with APE were categorized as massive/high-risk, submassive/moderate-risk, and non-massive/low-risk. Cardiac troponin T (cTnT), myoglobin, N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP), growth differentiation factor-15 (GDF-15), and D-dimer levels were measured. Results: Of these patients, 14 (29.8%), 16 (34.0%), and 17 (36.2%) patients were categorized as low-risk, moderate-risk, and high risk-patients, respectively. There was no significant difference between the patient groups categorized based on the risk stratification in terms of demographic and clinical characteristics. The cTnT, myoglobin, HFABP, and D-dimer levels have also not differed significantly between the groups. There was a significant difference between the groups in respect of NT-proBNP and GDF-15 levels (p=0.009 and p=0.037, respectively). Nine (19.1%) patients had died by the 3rd-month follow-up. Adverse events were seen in 26 (55.3%) patients. GDF-15 had the highest area under the curve (AUC) value for predicting any adverse event (cut-off value=9.3 ng/ mL, AUC=0.796, CI (confidence interval) 95%: 0.653-0.899). NT-ProBNP was determined as the best predictor for mortality (cut-off value=229.2 pg/mL, AUC=0.889, CI 95%: 0.756-0.964). Conclusion: Higher levels of NT-proBNP and GDF-15 were found to be associated with more severe APE, worse outcomes, and mortality.
BMC Pulmonary Medicine
Background Pulmonary embolism (PE) is a common and potentially life-threatening disorder. Our stu... more Background Pulmonary embolism (PE) is a common and potentially life-threatening disorder. Our study was aimed to investigate whether oxidative stress markers can be used as clinical markers in the evaluation of acute PE (APE) severity. Methods 47 patients with objectively documented diagnosis of APE were recorded. Of these patients, 14 had low-risk PE, 16 had moderate-risk PE, and 17 had high-risk PE. 21 healthy subjects were also enrolled in this study. Ischemia-modified albumin (IMA), prooxidants-antioxidants balance (PAB), advanced protein oxidation products (AOPPs), and ferric reducing antioxidant power (FRAP) were measured as oxidative stress parameters to evaluate the role of oxidative stress. Results In the low-risk and moderate-risk APE groups, AOPPs and PAB levels were significantly higher and FRAP levels were significantly lower than those in the control group. AOPPs and IMA levels in the patients with high-risk PE were significantly higher than those in both the low-risk ...
Asian Pacific Journal of Tropical Medicine
This is an open access journal, and articles are distributed under the terms of the Creative Comm... more This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-Non Commercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Frontiers in Medicine
Background and objectivesAlthough several repurposed antiviral drugs have been used for the treat... more Background and objectivesAlthough several repurposed antiviral drugs have been used for the treatment of COVID-19, only a few such as remdesivir and molnupiravir have shown promising effects. The objectives of our study were to investigate the association of repurposed antiviral drugs with COVID-19 morbidity.MethodsPatients admitted to 26 different hospitals located in 16 different provinces between March 11–July 18, 2020, were enrolled. Case definition was based on WHO criteria. Patients were managed according to the guidelines by Scientific Board of Ministry of Health of Turkey. Primary outcomes were length of hospitalization, intensive care unit (ICU) requirement, and intubation.ResultsWe retrospectively evaluated 1,472 COVID-19 adult patients; 57.1% were men (mean age = 51.9 ± 17.7years). A total of 210 (14.3%) had severe pneumonia, 115 (7.8%) were admitted to ICUs, and 69 (4.7%) were intubated during hospitalization. The median (interquartile range) of duration of hospitalizati...
Infection, 2022
Objective Vaccination is the most efficient way to control the coronavirus disease 2019 (COVID-19... more Objective Vaccination is the most efficient way to control the coronavirus disease 2019 (COVID-19) pandemic, but vaccination rates remain below the target level in most countries. This multicenter study aimed to evaluate the vaccination status of hospitalized patients and compare two different booster vaccine protocols. Setting Inoculation in Turkey began in mid-January 2021. Sinovac was the only available vaccine until April 2021, when BioNTech was added. At the beginning of July 2021, the government offered a third booster dose to healthcare workers and people aged > 50 years who had received the two doses of Sinovac. Of the participants who received a booster, most chose BioNTech as the third dose. Methods We collected data from 25 hospitals in 16 cities. Patients hospitalized between August 1 and 10, 2021, were included and categorized into eight groups according to their vaccination status. Results We identified 1401 patients, of which 529 (37.7%) were admitted to intensive care units. Nearly half (47.8%) of the patients were not vaccinated, and those with two doses of Sinovac formed the second largest group (32.9%). Hospitalizations were lower in the group which received 2 doses of Sinovac and a booster dose of BioNTech than in the group which received 3 doses of Sinovac. Conclusion Effective vaccinations decreased COVID-19-related hospitalizations. The efficacy after two doses of Sinovac may decrease over time; however, it may be enhanced by adding a booster dose. Moreover, unvaccinated patients may be persuaded to undergo vaccination.
Infectious Diseases and Clinical Microbiology, 2021
Objective: Information on characteristics and outcomes of coronavirus disease 2019 (COVID-19) pat... more Objective: Information on characteristics and outcomes of coronavirus disease 2019 (COVID-19) patients in Turkey is limited. We aimed to describe the characteristics and outcomes of patients hospitalised with COVID-19 and compare patients who required intensive care unit (ICU) admission with those who did not require it. Materials and Methods: This retrospective cross-sectional study was conducted in a tertiary care hospital in Istanbul. A total of 215 patients hospitalised with COVID-19 between 9 March 2020 and 30 April 2020 were included. Demographic, clinical, laboratory and radiological data on admission and outcomes were analysed. The main outcomes were COVID-19 ward or ICU hospitalisation, invasive mechanical ventilation requirement, discharge, or death. Presenting characteristics were compared between patients who required ICU admission with those who did not require it. Results: Among 215 patients, 64% were male, and the median age was 53. The most prevalent comorbidity was hypertension, followed by diabetes mellitus and coronary artery disease. The prevalence of comorbidities and the median age was higher in patients in ICU. The most common presenting symptom was fever (%72). C-reactive protein (CRP), lactate dehydrogenase (LDH), neutrophil and lymphocyte count, ferritin, and d-dimer levels were significantly different between ICU and non-ICU patients. However, in the final logistic model, among presenting symptoms, initial radiographs and laboratory tests, having dyspnea, high CRP and LDH were significantly associated with ICU admission. Conclusion: Of 215 hospitalised patients with COVID-19, 17% of patients required ICU admission, and the mortality rate was 4.4%. Older age, having coronary artery disease, high levels of CRP, LDH, and presenting with dyspnea were significantly associated with ICU admission.
West Indian Medical Journal, Aug 31, 2015
Objective: Elevation of pregnancy-associated plasma protein-A (PAPP-A), a pro-atherosclerotic mol... more Objective: Elevation of pregnancy-associated plasma protein-A (PAPP-A), a pro-atherosclerotic molecule, has been shown to be an independent risk factor for acute coronary syndrome. Smoking is also an important risk factor for acute coronary syndrome (ACS). However, the molecular mechanism of this relationship is not clear. In the present study, we aimed to determine the association between smoking and serum PAPP-A levels in men and non-pregnant women. Method: The study population consisted of 112 smokers and 58 age-matched non-smoking healthy subjects as a control group. Blood samples were drawn from the antecubital vein of all subjects and serum PAPP-A levels were measured using an ELISA kit (ultrasensitive ELISA). Results: The serum PAPP-A level was significantly high in male smokers (smokers: 9.11 ng/mL (3.10 ng/mL, 18.55 ng/mL)); controls: 7.44 ng/mL (< 0.023 ng/mL, 16.54 ng/mL); p < 0.05)) but not in female smokers (smokers: 4.49 ng/mL (< 0.023 ng/mL, 11.92 ng/mL); controls: 5.95 ng/mL (< 0.023 ng/mL, 15.61 ng/mL); p > 0.05)). In male smokers, the correlations between serum PAPP-A levels and age, body mass index (BMI), duration of smoking (years), and number of cigarettes smoked per day were not statistically significant (p > 0.05). Conclusion: Serum PAPP-A levels are higher in male smokers, and this may indicate a higher risk for ACS among men.
International Journal of Chronic Obstructive Pulmonary Disease, 2019
Background: Antimicrobial peptides are effectors of host defence against infection and inflammati... more Background: Antimicrobial peptides are effectors of host defence against infection and inflammation and can encourage wound repair. Objectives: The objectives of this study were to investigate the plasma antimicrobial peptide LL-37 and nuclear factor-kappaB (NF-κB) levels in patients with stable COPD compared with a control group and to highlight their importance in immune inflammation. Methods: One hundred and thirty-eight stable COPD patients and 33 control subjects were enrolled in the study. The COPD patients were classified into four groups based on FEV 1 (groups I-IV) and also divided into "low-risk and high-risk" groups (groups A-B [low risk], C-D [high risk]). Results: Plasma LL-37 levels were significantly lower while plasma NF-κB levels of the COPD patients were significantly higher than those of the control subjects (P,0.001, both). LL-37 levels were significantly lower in group IV than in groups I, II, and III (P,0.01, all). NF-κB levels were significantly higher in groups III and IV than in groups I and II (P,0.05, both). There was a positive correlation between FEV 1 and FEV 1 /FVC in all COPD patients (r=0.742, P,0.001) and in group D (r=0.741, P,0.001). Furthermore, there was an inverse correlation between LL-37 and NF-κB in both the groups C (r=-0.566, P,0.001) and D (r=-0.694, P,0.001) and group C+D combined (r=-0.593, P,0.001). Furthermore, in group C, LL-37 and FEV 1 were positively correlated (r=0.633, P,0.001). Conclusion: Our study indicated that plasma LL-37 and NF-κB may play an important role in chronic immune inflammation. Decreased LL-37 levels may be particularly high risk for patients in stage IV disease. The role of LL-37 as a target for treatment of the immune system and COPD must be widely evaluated.
Respiration, 2005
Background: The obstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by repetitive ... more Background: The obstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by repetitive upper airway obstructions during sleep, and it might cause cardiovascular complications such as myocardial infarction, arrhythmias, and systemic and pulmonary hypertension. Objectives: We investigated the acute effects of automatic continuous positive airway pressure (automated CPAP) on blood pressure in patients with OSAHS and hypertension. Methods: Polysomnography was used and ambulatory blood pressure measurements were done in 12 patients with OSAHS. Blood pressure and heart rate were measured at night (10 p.m. to 6 a.m.) and during the day (6 a.m. to 10 p.m.). During these periods systolic, diastolic and mean blood pressure and heart rate of the patients on the diagnostic day were compared with those on the treatment day. Results: Patients had moderate or severe OSAHS; their mean age was 52.8 ± 4.2 years. Systolic, diastolic and mean blood pressure and heart rate between the diagnost...
toraks.dergisi.org
... Erelel Mustafa, Kıyan Esen, Çuhadaroğlu Çağlar, Ece Turhan, Arseven Orhan. İstanbul Üniversit... more ... Erelel Mustafa, Kıyan Esen, Çuhadaroğlu Çağlar, Ece Turhan, Arseven Orhan. İstanbul Üniversitesi İstanbul Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, İstanbul. Anahtar Kelimeler: KOAH akut atak, DVT, akciğer embolisi. ...
Journal of Medical Updates, 2013
Allergy is a reaction with inflammatory cell infiltration in the target organ which allergen has ... more Allergy is a reaction with inflammatory cell infiltration in the target organ which allergen has been found to cause the pathology. [1,2] Allergens cause an immunoglobulin (Ig) E dependent reaction characterized by an early and late phase reaction. Histamine is released after 15 min of exposure to allergen, whereas leukotriene is increased in the Review / Derleme
Turkiye Klinikleri Journal of Internal Medical Sciences, 2006
Computers & Operations Research, 2013
Journal of Cancer Research and Therapeutics, 2020
Background: Ghrelin plays a role in mechanisms related to cancer progression – including cell pro... more Background: Ghrelin plays a role in mechanisms related to cancer progression – including cell proliferation, invasion and migration, and resistance to apoptosis in the cell lines from several cancers. We investigated the role of ghrelin levels in cancer cachexia-anorexia in patients with locally advanced nonsmall-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT). Materials and Methods: This study involved 84 NSCLC patients who had received concomitant CRT. Blood ghrelin levels were compared before and 3 months after CRT. Meanwhile, changes in body weight of the patients were also investigated with changes in ghrelin levels before and after CRT. Results: Ghrelin levels were significantly decreased in line with changes in patients' weights in patients receiving CRT (P < 0.001). Serum albumin levels and inflammatory-nutritional index were significantly decreased after radiotherapy (RT) (3.01 ± 0.40 g/dL, 0.38 ± 0.20) when compared with its baseline levels (3.40 ± 0.55 g/dL,P < 0.001; 0.86 ± 0.71,P < 0.001, respectively). Serum C-reactive protein levels were significantly increased after CRT (7.49 ± 6.53 mg/L) when compared with its baseline levels (9.54 ± 3.80 mg/L,P = 0.038). After RT, ghrelin levels in patients were positively correlated with body mass index (r = 0.830,P < 0.001) and albumin (r = 0.758,P < 0.001). Conclusion: Ghrelin may play a role in the pathogenesis of weight loss in NSCLC patients. Ghrelin seems to be implicated in cancer-related weight loss. Ghrelin, cancer, and RT all together have a role in tumor-related anorexia-cachexia in patients with NSCLC. Results of this study need further evaluation as regards to its potential role as an adjuvant diagnostic or prognostic marker.
PubMed, Nov 5, 2002
Objectives: We evaluated the efficacy of laser-assisted uvulopalatoplasty in the treatment of sno... more Objectives: We evaluated the efficacy of laser-assisted uvulopalatoplasty in the treatment of snoring and obstructive sleep apnea syndrome (OSAS). Patients and methods: Laser-assisted uvulopalatoplasty was performed in 34 patients (30 males, 4 females; mean age 45.7 years; range 17 to 70 years) with simple snoring and mild OSAS. The patients were evaluated preoperatively and in the first and sixth months postoperatively with the use of the Epworth sleepiness scale, polysomnography, and snoring scores. A questionnaire was administered to assess patient satisfaction. Results: All patients had decreased snoring. The quality of sleep increased in 79%. The clinical improvement seen in the first month continued through the sixth postoperative month. Satisfaction rates for the patients and their families were 88% and 85%, respectively. Significant decreases were found in the Epworth sleepiness scale (p=0.000) and visual snoring scores (p<0.001). In addition, postoperative desaturation indices decreased and minimal desaturation levels increased. However, no significant decreases occurred in the apnea/hypopnea index. No complications were encountered during and after operation. Conclusion: Laser-assisted uvulopalatoplasty has high efficacy in the treatment of snoring and mild OSAS, with such additional advantages as ease, low complication rate, and no need for hospitalization.
Turkiye Klinikleri Cardiology - Special Topics, 2018
The European respiratory journal. Supplement, Feb 5, 1996
Frontiers in Medicine, Feb 9, 2023
Background: Oxidative stress plays an important role in the pathogenesis of many diseases. This s... more Background: Oxidative stress plays an important role in the pathogenesis of many diseases. This study aimed to investigate the relationship between nuclear factor kappa B (NF-κB) and oxidative stress and the severity of the disease in new COVID-19 patients, and, to compare the levels of NF-κB, oxidized LDL (oxLDL), and lectin-like oxidized-LDL receptor-1 (LOX-1) with oxygen saturation, which is an indicator of the severity parameters of the disease in COVID-19 patients. Methods: In this prospective study, 100 COVID-19 patients and 100 healthy subjects were selected. Results: LOX-1, NF-κB, and oxLDL were found to be higher in COVID-19 patients compared to the healthy subjects (p < 0.001 for all). According to the results of correlation analysis, it was found that there was no significant relationship between oxygen saturation and LOX-1, NF-κB and oxLDL parameters. There was significant relationship between oxLDL with LOX-1 and NF-κB in patients with COVID-19 disease. ROC analysis results of the highest discrimination power were oxLDL (AUC: 0.955, CI: 0.904-1.000; sensitivity: 77%, and specificity: 100%, for cutoff: 127.944 ng/l) indicating COVID-19. Conclusion: Oxidative stress plays an essential role in COVID-19. NF-κB, oxLDL, and LOX-1 seem to represent good markers in COVID-19. Our study also showed that oxLDL has the highest power in distinguishing patients with COVID-19 from the healthy subjects.
European journal of echocardiography, Dec 1, 2005
Purpose: Allhough responsible mechanisms are not lully known yel, obslructive sleep apnea is asso... more Purpose: Allhough responsible mechanisms are not lully known yel, obslructive sleep apnea is associated wilh increased risk for cardiovascular disease and evenls. Aorla is not only as a conduit delivering blood to the tissues but also as an imporlant modulalor of lhe entire cardiovascular system, its elastic properties also affect lelt ventricular lunction and coronary blood flow. The aim el this study was to determine left ventricular diastolic function and aortic elastic properties in patients with obstructive sleep apnea syndrome. Method: Fourteen male patients with obstructive sleep apnea and 14 age-and body mass index-matched healthy male controls took part in the study as a control group. All subjects underwent echocardiographic examination; lelt ventricular cavity dimension, standard and tissue Doppler parameters, and aortic diameter (3 cm above aortic valve) at systole and diaslole were measured. Results: While, the aorlic stillness index in palienls with obslruclive sleep apnea was significanlly higher than lhal el conlrol group (4.54-0.3 vs 2.14-0.1, p = 0.001), the aortic dislensibilily index was lound Io be lower in INs group compared wilh controls (2.44-1.2 vs 3.94-1.5 cm 2 dynes-1 10-6, p= 0.009). Furthermore, peak ve-Iocily el myocardial systolic wave and peak velocilies el myocardial diaslolic waves in palienls were lower than in conlrols. There was an associalion between aorlic stillness and apnea-hypopnea index (coelficient = 0.49, p=0.002). We also lound an inverse correlation between peak velocity el myocardial diastolic wave and aortic stillness (coellecient =-0.4.3, p=0.003) by using multiple linear regression. Conclusion: Increased aortic stigness which is associated with the severity el disease in patients with obstructive sleep apnea may lead to diastolic dyslunction of lelt ventricle. 907 Pulse wave reflections are associated with aortic dilatation and left ventricular diastolic dysfunction in AdamanUades-Behcat disease
Infectious diseases and clinical microbiology, Apr 30, 2020
This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License.
International Journal of General Medicine
Background: Acute pulmonary embolism (APE) is a common clinical condition. Its severity ranges fr... more Background: Acute pulmonary embolism (APE) is a common clinical condition. Its severity ranges from asymptomatic radiological findings to fatal obstructive shock. The potential circulating biomarkers have been studied to predict APE outcomes. This study aimed to explore their predictive power on prognosis in APE. Material and Method: It was a prospective observational study between March 2008 and April 2010. All consecutive patients diagnosed with APE were categorized as massive/high-risk, submassive/moderate-risk, and non-massive/low-risk. Cardiac troponin T (cTnT), myoglobin, N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP), growth differentiation factor-15 (GDF-15), and D-dimer levels were measured. Results: Of these patients, 14 (29.8%), 16 (34.0%), and 17 (36.2%) patients were categorized as low-risk, moderate-risk, and high risk-patients, respectively. There was no significant difference between the patient groups categorized based on the risk stratification in terms of demographic and clinical characteristics. The cTnT, myoglobin, HFABP, and D-dimer levels have also not differed significantly between the groups. There was a significant difference between the groups in respect of NT-proBNP and GDF-15 levels (p=0.009 and p=0.037, respectively). Nine (19.1%) patients had died by the 3rd-month follow-up. Adverse events were seen in 26 (55.3%) patients. GDF-15 had the highest area under the curve (AUC) value for predicting any adverse event (cut-off value=9.3 ng/ mL, AUC=0.796, CI (confidence interval) 95%: 0.653-0.899). NT-ProBNP was determined as the best predictor for mortality (cut-off value=229.2 pg/mL, AUC=0.889, CI 95%: 0.756-0.964). Conclusion: Higher levels of NT-proBNP and GDF-15 were found to be associated with more severe APE, worse outcomes, and mortality.
BMC Pulmonary Medicine
Background Pulmonary embolism (PE) is a common and potentially life-threatening disorder. Our stu... more Background Pulmonary embolism (PE) is a common and potentially life-threatening disorder. Our study was aimed to investigate whether oxidative stress markers can be used as clinical markers in the evaluation of acute PE (APE) severity. Methods 47 patients with objectively documented diagnosis of APE were recorded. Of these patients, 14 had low-risk PE, 16 had moderate-risk PE, and 17 had high-risk PE. 21 healthy subjects were also enrolled in this study. Ischemia-modified albumin (IMA), prooxidants-antioxidants balance (PAB), advanced protein oxidation products (AOPPs), and ferric reducing antioxidant power (FRAP) were measured as oxidative stress parameters to evaluate the role of oxidative stress. Results In the low-risk and moderate-risk APE groups, AOPPs and PAB levels were significantly higher and FRAP levels were significantly lower than those in the control group. AOPPs and IMA levels in the patients with high-risk PE were significantly higher than those in both the low-risk ...
Asian Pacific Journal of Tropical Medicine
This is an open access journal, and articles are distributed under the terms of the Creative Comm... more This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-Non Commercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Frontiers in Medicine
Background and objectivesAlthough several repurposed antiviral drugs have been used for the treat... more Background and objectivesAlthough several repurposed antiviral drugs have been used for the treatment of COVID-19, only a few such as remdesivir and molnupiravir have shown promising effects. The objectives of our study were to investigate the association of repurposed antiviral drugs with COVID-19 morbidity.MethodsPatients admitted to 26 different hospitals located in 16 different provinces between March 11–July 18, 2020, were enrolled. Case definition was based on WHO criteria. Patients were managed according to the guidelines by Scientific Board of Ministry of Health of Turkey. Primary outcomes were length of hospitalization, intensive care unit (ICU) requirement, and intubation.ResultsWe retrospectively evaluated 1,472 COVID-19 adult patients; 57.1% were men (mean age = 51.9 ± 17.7years). A total of 210 (14.3%) had severe pneumonia, 115 (7.8%) were admitted to ICUs, and 69 (4.7%) were intubated during hospitalization. The median (interquartile range) of duration of hospitalizati...
Infection, 2022
Objective Vaccination is the most efficient way to control the coronavirus disease 2019 (COVID-19... more Objective Vaccination is the most efficient way to control the coronavirus disease 2019 (COVID-19) pandemic, but vaccination rates remain below the target level in most countries. This multicenter study aimed to evaluate the vaccination status of hospitalized patients and compare two different booster vaccine protocols. Setting Inoculation in Turkey began in mid-January 2021. Sinovac was the only available vaccine until April 2021, when BioNTech was added. At the beginning of July 2021, the government offered a third booster dose to healthcare workers and people aged > 50 years who had received the two doses of Sinovac. Of the participants who received a booster, most chose BioNTech as the third dose. Methods We collected data from 25 hospitals in 16 cities. Patients hospitalized between August 1 and 10, 2021, were included and categorized into eight groups according to their vaccination status. Results We identified 1401 patients, of which 529 (37.7%) were admitted to intensive care units. Nearly half (47.8%) of the patients were not vaccinated, and those with two doses of Sinovac formed the second largest group (32.9%). Hospitalizations were lower in the group which received 2 doses of Sinovac and a booster dose of BioNTech than in the group which received 3 doses of Sinovac. Conclusion Effective vaccinations decreased COVID-19-related hospitalizations. The efficacy after two doses of Sinovac may decrease over time; however, it may be enhanced by adding a booster dose. Moreover, unvaccinated patients may be persuaded to undergo vaccination.
Infectious Diseases and Clinical Microbiology, 2021
Objective: Information on characteristics and outcomes of coronavirus disease 2019 (COVID-19) pat... more Objective: Information on characteristics and outcomes of coronavirus disease 2019 (COVID-19) patients in Turkey is limited. We aimed to describe the characteristics and outcomes of patients hospitalised with COVID-19 and compare patients who required intensive care unit (ICU) admission with those who did not require it. Materials and Methods: This retrospective cross-sectional study was conducted in a tertiary care hospital in Istanbul. A total of 215 patients hospitalised with COVID-19 between 9 March 2020 and 30 April 2020 were included. Demographic, clinical, laboratory and radiological data on admission and outcomes were analysed. The main outcomes were COVID-19 ward or ICU hospitalisation, invasive mechanical ventilation requirement, discharge, or death. Presenting characteristics were compared between patients who required ICU admission with those who did not require it. Results: Among 215 patients, 64% were male, and the median age was 53. The most prevalent comorbidity was hypertension, followed by diabetes mellitus and coronary artery disease. The prevalence of comorbidities and the median age was higher in patients in ICU. The most common presenting symptom was fever (%72). C-reactive protein (CRP), lactate dehydrogenase (LDH), neutrophil and lymphocyte count, ferritin, and d-dimer levels were significantly different between ICU and non-ICU patients. However, in the final logistic model, among presenting symptoms, initial radiographs and laboratory tests, having dyspnea, high CRP and LDH were significantly associated with ICU admission. Conclusion: Of 215 hospitalised patients with COVID-19, 17% of patients required ICU admission, and the mortality rate was 4.4%. Older age, having coronary artery disease, high levels of CRP, LDH, and presenting with dyspnea were significantly associated with ICU admission.
West Indian Medical Journal, Aug 31, 2015
Objective: Elevation of pregnancy-associated plasma protein-A (PAPP-A), a pro-atherosclerotic mol... more Objective: Elevation of pregnancy-associated plasma protein-A (PAPP-A), a pro-atherosclerotic molecule, has been shown to be an independent risk factor for acute coronary syndrome. Smoking is also an important risk factor for acute coronary syndrome (ACS). However, the molecular mechanism of this relationship is not clear. In the present study, we aimed to determine the association between smoking and serum PAPP-A levels in men and non-pregnant women. Method: The study population consisted of 112 smokers and 58 age-matched non-smoking healthy subjects as a control group. Blood samples were drawn from the antecubital vein of all subjects and serum PAPP-A levels were measured using an ELISA kit (ultrasensitive ELISA). Results: The serum PAPP-A level was significantly high in male smokers (smokers: 9.11 ng/mL (3.10 ng/mL, 18.55 ng/mL)); controls: 7.44 ng/mL (< 0.023 ng/mL, 16.54 ng/mL); p < 0.05)) but not in female smokers (smokers: 4.49 ng/mL (< 0.023 ng/mL, 11.92 ng/mL); controls: 5.95 ng/mL (< 0.023 ng/mL, 15.61 ng/mL); p > 0.05)). In male smokers, the correlations between serum PAPP-A levels and age, body mass index (BMI), duration of smoking (years), and number of cigarettes smoked per day were not statistically significant (p > 0.05). Conclusion: Serum PAPP-A levels are higher in male smokers, and this may indicate a higher risk for ACS among men.
International Journal of Chronic Obstructive Pulmonary Disease, 2019
Background: Antimicrobial peptides are effectors of host defence against infection and inflammati... more Background: Antimicrobial peptides are effectors of host defence against infection and inflammation and can encourage wound repair. Objectives: The objectives of this study were to investigate the plasma antimicrobial peptide LL-37 and nuclear factor-kappaB (NF-κB) levels in patients with stable COPD compared with a control group and to highlight their importance in immune inflammation. Methods: One hundred and thirty-eight stable COPD patients and 33 control subjects were enrolled in the study. The COPD patients were classified into four groups based on FEV 1 (groups I-IV) and also divided into "low-risk and high-risk" groups (groups A-B [low risk], C-D [high risk]). Results: Plasma LL-37 levels were significantly lower while plasma NF-κB levels of the COPD patients were significantly higher than those of the control subjects (P,0.001, both). LL-37 levels were significantly lower in group IV than in groups I, II, and III (P,0.01, all). NF-κB levels were significantly higher in groups III and IV than in groups I and II (P,0.05, both). There was a positive correlation between FEV 1 and FEV 1 /FVC in all COPD patients (r=0.742, P,0.001) and in group D (r=0.741, P,0.001). Furthermore, there was an inverse correlation between LL-37 and NF-κB in both the groups C (r=-0.566, P,0.001) and D (r=-0.694, P,0.001) and group C+D combined (r=-0.593, P,0.001). Furthermore, in group C, LL-37 and FEV 1 were positively correlated (r=0.633, P,0.001). Conclusion: Our study indicated that plasma LL-37 and NF-κB may play an important role in chronic immune inflammation. Decreased LL-37 levels may be particularly high risk for patients in stage IV disease. The role of LL-37 as a target for treatment of the immune system and COPD must be widely evaluated.
Respiration, 2005
Background: The obstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by repetitive ... more Background: The obstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by repetitive upper airway obstructions during sleep, and it might cause cardiovascular complications such as myocardial infarction, arrhythmias, and systemic and pulmonary hypertension. Objectives: We investigated the acute effects of automatic continuous positive airway pressure (automated CPAP) on blood pressure in patients with OSAHS and hypertension. Methods: Polysomnography was used and ambulatory blood pressure measurements were done in 12 patients with OSAHS. Blood pressure and heart rate were measured at night (10 p.m. to 6 a.m.) and during the day (6 a.m. to 10 p.m.). During these periods systolic, diastolic and mean blood pressure and heart rate of the patients on the diagnostic day were compared with those on the treatment day. Results: Patients had moderate or severe OSAHS; their mean age was 52.8 ± 4.2 years. Systolic, diastolic and mean blood pressure and heart rate between the diagnost...
toraks.dergisi.org
... Erelel Mustafa, Kıyan Esen, Çuhadaroğlu Çağlar, Ece Turhan, Arseven Orhan. İstanbul Üniversit... more ... Erelel Mustafa, Kıyan Esen, Çuhadaroğlu Çağlar, Ece Turhan, Arseven Orhan. İstanbul Üniversitesi İstanbul Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, İstanbul. Anahtar Kelimeler: KOAH akut atak, DVT, akciğer embolisi. ...
Journal of Medical Updates, 2013
Allergy is a reaction with inflammatory cell infiltration in the target organ which allergen has ... more Allergy is a reaction with inflammatory cell infiltration in the target organ which allergen has been found to cause the pathology. [1,2] Allergens cause an immunoglobulin (Ig) E dependent reaction characterized by an early and late phase reaction. Histamine is released after 15 min of exposure to allergen, whereas leukotriene is increased in the Review / Derleme
Turkiye Klinikleri Journal of Internal Medical Sciences, 2006