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Öğe Adherence and effectiveness of omalizumab treatment in severe allergic asthma patients: Do the patients like injectable treatment?(European Respiratory Soc Journals Ltd, 2013) Özşeker, Ferhan; Bulut, İsmet; Erdenen, Füsun; Gelincik, Aslı; Erdoğdu, Derya; Talay, FahrettinÖğe Association between varicocele and chronic obstructive pulmonary disease(Wiley, 2006) Erdoğmuş, Beşir; Yazıcı, Burhan; Balbay, Öner; Annakkaya, Ali Nihat; Özdere, Betül Ayça; Bulut, İsmetPurpose. To evaluate the relationship between varicocele and chronic obstructive pulmonary disease (COPD) via color duplex sonography. Materials and Methods. Forty-four male patients with COPD (age range, 50-89 years; mean +/- SD, 66 +/- 9) and 44 male healthy controls (age range, 47-75 years; mean +/- SD, 65 +/- 6) were evaluated with color duplex sonography for unilateral or bilateral varicocele. Results. The incidence of right, left, and bilateral varicocele was 47.7%, 65.9%, and 38.6% respectively, in the COPD group, versus 22.7%, 52.3%, and 13.6% in the control group. The incidence of right and bilateral varicocele in the COPD group was significantly higher than in the control group (p < 0.05). The incidence of varicocele also increased with increase in COPD severity. Conclusions. The incidence of varicocele in COPD patients is high. Varicocele might be one of the most important causes of scrotal pain and infertility in COPED patients.Öğe Does aspirin use prevent acute coronary syndrome in patients with pneumonia: multicenter prospective randomized trial(Lippincott Williams & Wilkins, 2013) Öz, Fahrettin; Gül, Şule; Kaya, Mehmet G.; Yazıcı, Mehmet; Bulut, İsmetObjectives The aim of this study was to test the hypothesis that aspirin would reduce the risk for acute coronary syndromes (ACSs) in patients with pneumonia. Backgrounds Pooled data suggest that pneumonia may trigger an ACS as a result of inflammatory reactions and the prothrombotic changes in patients with pneumonia. Hypothetically considering its antiaggregating and anti-inflammatory effects, aspirin might also be beneficial for the primary prevention of ACS in patients with pneumonia. Methods One hundred and eighty-five patients with pneumonia who had more than one risk factor for cardiovascular disease were randomized to an aspirin group (n = 91) or a control group (n = 94). The patients in the aspirin group received 300 mg of aspirin daily for 1 month. ECGs were recorded on admission and 48 h and 30 days after admission to assess silent ischemia. The level of high-sensitivity cardiac troponin T was measured on admission and 48 h after admission. The primary endpoint was the development of ACS within 1 month. The secondary endpoints included cardiovascular death and death from any cause within 1 month. Results The chi(2)-test showed that the rates of ACS at 1 month were 1.1% (n = 1) in the aspirin group and 10.6% (n = 10) in the control group (relative risk, 0.103; 95% confidence interval 0.005-0.746; P = 0.015). Aspirin therapy was associated with a 9% absolute reduction in the risk for ACS. There was no significant decrease in the risk of death from any cause (P = 0.151), but the aspirin group had a decreased risk of cardiovascular death (risk reduction: 0.04, P = 0.044). Conclusion This randomized open-label study shows that acetyl salicylic acid is beneficial in the reduction of ACS and cardiovascular mortality among patients with pneumonia. Coron Artery Dis 24:231-237 (c) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. Coronary Artery Disease 2013, 24:231-237Öğe Effect of symptom-to-treatment interval on prognosis in lung cancer(Sage Publications Ltd, 2007) Annakkaya, Ali Nihat; Arbak, Peri; Balbay, Öner; Bilgin, Cahit; Erbaş, Mete; Bulut, İsmetAims and background: To evaluate the relationship between delayed diagnosis and the degree of invasion and survival in lung cancer. Methods: One hundred and three patients (96 men) with lung cancer were included. Stages in the diagnosis of lung cancer were classified as follows: symptom-to-doctor interval, i.e., the interval from the first symptoms related to the presence of lung cancer to the first consultation with a medical professional; doctor-to-diagnosis interval, i.e., the interval between the first medical visit and confirmation of the diagnosis; and diagnosis-to-treatment interval, i.e., the interval between diagnosis and complete TNM staging and treatment. The symptom-to-treatment interval (STI) was the sum of the 3 intervals. The degree of invasion was determined by the TNM classification. Results: The patients were followed up for a mean period ( SD) of 7.4 +/- 8.7 months. Seventy-six (74%) patients were diagnosed with non-small cell lung cancer (NSCLC) and 27 patients (26%) with small cell lung cancer (SCLC). The mean length of STI was 120 +/- 101 days (median, 90). The mean length of the symptom-to-doctor interval was 63 +/- 62 days (median, 45), while the doctor-to-diagnosis and diagnosis-totreatment intervals were 41 +/- 82 days (median, 10) and 16 +/- 12 days (median, 12), respectively. When the STIs of the patients were correlated with tumor stage, tumor invasion, lymph node involvement and metastasis, no significant differences were found. Patients with an STI longer than 60 days had a significantly longer survival. Regarding the type of lung cancer and STI, the median survival was shorter in patients with an STI of less than 60 days both in NSCLC and SCLC, although this was not statistically significant in SCLC. Conclusions: The shorter the diagnostic interval, the shorter was the median survival in our study. The reason for the apparent discrepancy between poor prognosis of lung cancer patients in spite of early diagnosis might be much faster progression of the disease itself.Öğe Epiglottic tuberculosis in a patient treated with steroids for addison's disease(Tohoku Univ Medical Press, 2003) Egeli, Erol; Oğhan, Fatih; Alper, Murat; Harputluoğlu, Uğur; Bulut, İsmetIsolated epiglottic tuberculosis (TBC) is uncommon and has rarely been described. We report the case of a 40-year-old man with tuberculous involvement of the epiglottis and primary adrenal insufficiency. Endoscopic examination showed a severely swollen epiglottis with granulomatous and partially necrotic mucosa. The patient has been treated with glucocorticoids for four years due to primary adrenocortical. insufficiency. We therefore assume that tuferculous involvement of epiglottis is due to the reactivation of pulmonary TBC. We also discuss differential diagnosis and management of epiglottic TBC and Addison's disease.Öğe Evaluation of tumor markers in asthma patients(2006) Coşkun, Abdurrahman; Balbay, Öner; Yavuz, Özlem; Memişoğulları, Ramazan; Annakkaya, Ali Nihat; Bulut, İsmet; Bilgin, CahitBackground: Although tumor markers have been used as biomarkers for monitoring response to therapy and detecting early relapse in malignancies, it is well known that most tumor marker increases are not specific enough to be used for diagnosis of cancer. Aim: The aim of this study was to investigate the serum concentrations of α-fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen (CA) 19-9, CA 125, CA 15-3 and IgE in asthma patients. Materials and Methods: Thirty-five newly diagnosed asthmatic patients and 14 healthy subjects were included into the study. Blood samples were drawn from antecubital vein of asthma patients and control subjects. Serum AFP, CEA, CA 125, CA 15-3 and CA 19-9 levels were determined by chemiluminescent and IgE levels by electrochemiluminescent immunometric method on automatic hormone analyzers. Results: Serum levels of AFP, CEA, CA 19-9, CA 125, and CA 15-3 of asthma patients were not significantly different when compared with the control group. In asthma patients, there was a significant negative correlation between serum IgE and CA 125 (r = -0.401; p = 0.017) and a positive correlation between CA 125 and CA 15-3 (r = 0.368; p = 0.029). Conclusions: We concluded that in asthma patients’ sera, AFP, CEA, CA 125, CA 19-9 and CA 15-3 levels were not different from control subjects. Elevation in any of these tumor markers in asthma patients should be a sign for clinicians to evaluate patients for additional diseases.Öğe Pregnancy-associated plasma protein A (PAPT-A) and asthma(Elsevier Science Bv, 2005) Coşkun, Abdurrahman; Duran, Sadık; Balbay, Öner; Yavuz, Özlem; Bulut, İsmet; Kurt, Emel; Güler, SelverPAPP-A is produced in high concentration by trophoblasts during pregnancy. Except for IGF-dependent IGFBP-4 protease activity, the functional significance of PAPP-A is unclear. IGF-dependent IGFBP-4 protease activity has been described in a variety of cells, including fibroblasts, osteoblasts, endometrial stromal cells, decidual cells, and granulosa cells.Öğe Prevalence and risk factors of allergies in Turkey : results of a multicentric cross-sectional study in children(Wiley, 2007) Kurt, Emel; Metintaş, Selma; Başyiğit, İlknur; Bulut, İsmet; Coşkun, EvşenThe Prevalence And Risk Factors of Allergies in Turkey (PARFAIT) study was planned to evaluate prevalence and risk factors of asthma and allergic diseases and also to find out which geographical variables and/or climatic conditions play a role determining the prevalence of allergic diseases in Turkish school children. Study was planned as cross-sectional questionnaire-based. About 25,843 questionnaires from 14 centers were appropriate for analysis. Parental history of allergy, having an atopic sibling and other atopic disease in index case was significant risk factors for all allergic diseases. Breast feeding decreased the risk of current asthma (OR: 0.92, CI: 0.86-0.99) and wheezing (OR: 0.93, CI: 0.87-0.99) but not allergic rhinitis and eczema. Respiratory infection in the past was an important risk factor for the occurrence of allergic diseases especially for asthma which was increased 4.53-fold. Children exposed to household smoke were significantly at higher risk of asthma, wheezing, and allergic rhinitis (OR: 1.20, CI: 1.08-1.33; OR: 1.21, CI: 1.09-1.34; and OR: 1.32, CI: 1.21-1.43, respectively). All allergic diseases were increased in those children living in areas which have altitude of below 1000 m and mean yearly atmospheric pressure above 1000 mb. The study has suggested that household and country-specific environmental factors are associated with asthma, wheezing, allergic rhinitis, and eczema risk during childhood in Turkey.Öğe The prevalence of venous insufficiency in patients with chronic obstructive pulmonary disease evaluated by color duplex ultrasonography(Springer Wien, 2006) Erdoğmuş, Beşir; Annakkaya, Ali Nihat; Yazıcı, Burhan; Bulut, İsmet; Özdere, Betül Ayça; Büyükkaya, RamazanObjectives: We hypothesized that in patients with chronic obstructive pulmonary disease (COPD) some extrapulmonary effects such as increase in intra-abdominal and intra-thoracic pressures, presence of cor pulmonale and pulmonary artery hypertension could cause venous insufficiency (VI) in the lower limbs. Our aim in this study was to assess the prevalence of VI in patients with COPD in comparison with healthy controls. Methods: Thirty-nine male patients with COPD and 36 healthy male controls were evaluated for VI. All the participants were in the same age group and their smoking intensities were similar. Patients with COPD were classified as having mild, moderate, severe or very severe disease according to criteria of the Global Initiative for Chronic Obstructive Lung Disease. All the patients and control group were examined for unilateral or bilateral VI of the common femoral vein, superficial femoral vein, deep femoral vein and popliteal vein using color duplex ultrasonography. Results: The prevalence of VI of the lower extremity in patients with COPD (69.2%) was significantly higher than in the healthy control group (41.7%). The prevalence increased as the COPD severity increased and VI was detected in all the patients with very severe COPD [mild COPD, 50.0% (2/4); moderate, 58.8% (10/17); severe, 75.0% (9/12); very severe, 100% (6/6)]. Conclusion: VI of the lower extremity appears more frequent in patients with COPD. We suggest ruling out COPD in patients with otherwise unexplained "primary" VI.Öğe The resistance to major antituberculous drugs of mycobacterium tuberculosis strains isolated from the respiratory system specimens of tuberculosis patients in Duzce, Turkey(Natl Inst Infectious Diseases, 2005) Öztürk, C. Elif; Balbay, Öner A.; Kaya, Demet; Ceyhan, İsmail; Bulut, İsmet; Şahin, İdrisThough generally curable, tuberculosis (TB) is becoming increasingly resistant to commonly used antibiotics. Drug-resistant and multidrug-resistant (MDR)-TB is a consequence of monotherapy, insufficient drug therapy and national TB control programs. The present study was designed to reveal the resistance to major antimicrobial drugs (isoniazid [INH], streptomycin [SM], ethambutol [EMB], and rifampicin [RIF]) of Mycobacterium tuberculosis isolated from the respiratory specimens of TB patients in Duzce, Turkey. A total of 62 TB patients (46 male, 16 female; age: 17-75 mean: 42 +/- 15.9) were included in the study; 52 (83.8%) were new cases and susceptible to all anti-TB drugs, while 10 (16.2%) were previously treated cases. Antimicrobial susceptibility tests were performed by the proportion method in Lowenstein-Jensen medium. Fifty-two of the 62 (83.8%) isolated M. tuberculosis strains were found to be susceptible to all drugs, and 7 (11.3%), 5 (8%), and 3 (4.8%) were resistant to SM, INH, and RIF, respectively; 3 (4.8%) were MDR. There were no EMB-resistant strains. The results of this study. show the presence of drug-resistant and MDR strains of TB at Duzce in the northwest part of Turkey.
