Publications by authors named "Mustafa Akin"

144 Publications

Differences in corpus callosum morphology between healthy adolescents and adolescents with migraine: a case control study.

Turk J Med Sci 2021 May 2. Epub 2021 May 2.

Background/aim: This study objected to compare the measurements of corpus callosum substructures of adolescents with migraine and healthy adolescents.

Materials And Methods: In a case-control design, adolescents aged 12-18 years with the diagnosis of migraine and healthy control group had brain magnetic resonance imaging examination. The CC dimensions including anteroposterior length, truncus, genu and splenium widths of the case and control groups were measured and compared.

Results: The sample consisted of 188 adolescents, 109 girls (58.0%) and 79 boys (42.0%). Of these 87 (46.3%) were in the migraine group and 101 (53.7%) were in the healthy control group. The mean genu and splenium width of the migraine group were significantly lower than the control group (p=0.024 and p=0.01 respectively).

Conclusion: The results of this study firstly demonstrated that CC splenium and genu widths were smaller in adolescents with migraine when compared to healthy adolescents. Our findings may contribute to enlighten migraine pathophysiology.
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http://dx.doi.org/10.3906/sag-2012-157DOI Listing
May 2021

Investigation of the biological and photophysicochemical properties of new non-peripheral fluorinated phthalocyanines.

Dalton Trans 2021 Mar;50(8):2736-2745

Department of Chemistry, Istanbul Technical University, Maslak 34469, Istanbul, Turkey.

This study presents the synthesis of a series of new tetra-substituted phthalocyanines bearing 3,5-bis(trifluoromethyl)phenoxy groups at non-peripheral positions. The resulting macromolecules were characterized by performing different spectroscopic methods including 1H NMR, UV-Vis, FT-IR, and mass spectroscopy. In this study, the synergistic effect of phthalocyanines used as colorants in ink formulas with other chemicals available was probed for the first time. The synergistic effect of methyl laurate on the biological and antioxidant activities of the compounds (2-5) was investigated. Moreover, the therapeutic properties of the complexes (3, 6, and 7) were investigated using photochemical methods. Upon comparison, complex 7 (ΦΔ = 0.42) was found to be more effective than complex 6 (ΦΔ = 0.40) and complex 3 (ΦΔ = 0.27) in terms of producing singlet oxygen. The results confirmed that the heavy atom effect improves the therapeutic effects.
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http://dx.doi.org/10.1039/d0dt04351fDOI Listing
March 2021

Adhesion molecules as diagnostic and severity biomarkers in pediatric community-acquired pneumonia.

Clin Respir J 2021 May 7;15(5):522-529. Epub 2021 Feb 7.

Pediatric Infectious Disease Department, Ihsan Dogramacı Children Hospital, Hacettepe University, Ankara, Turkey.

Background: Discrimination of the cases with severe and mild pneumonia is crucial due to the requirement of hospitalization, additional management, and treatment protocols. We aimed to analyze the role of IL6 (Interleukin), IL8, IL10, VCAM-1 (soluble Vascular Cell Adhesion Molecule), and sSELE (soluble E-selectin) in the diagnosis and prognostic evaluation of community-acquired pneumonia (CAP).

Methods: Pediatric patients with severe pneumonia (SP) were hospitalized and patients with mild disease (MP) were treated in the community. IL6, IL8, IL10, VCAM-1, and sSELE levels of the patients were investigated and compared with the age- and gender-matched healthy subjects.

Results: A total of 113 patients fulfilling the criteria for a diagnosis of CAP were enrolled in the study, 62 (54.8%) of which had SP and 51 (45%) had MP. MP and SP groups were significantly different in terms of IL8, IL10, and sSELE levels. Patients with SP and MP had significantly different WBC, ESR, and CRP values, as well.

Conclusions: Besides classical acute phase parameters, inflammatory response parameters such as IL6 and VCAM-1 levels may be helpful in diagnosis of pneumonia. In terms of determination of disease severity in pediatric CAP, systemic inflammatory markers like IL8 and IL10 and adhesion molecules like sSELE seem useful in clinical settings.
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http://dx.doi.org/10.1111/crj.13334DOI Listing
May 2021

Evaluation of radial artery endothelial functions in transradial coronary angiography according to different radial access sites.

Anatol J Cardiol 2021 01;25(1):42-48

Department of Cardiology, Faculty of Medicine, Ege University; İzmir-Turkey.

Objective: Radial endothelial dysfunction may occur after transradial coronary angiography (CAG). This study aimed to make a comparative evaluation of the radial endothelial functions before and after catheterization between three different radial access sites: left radial (LR) artery, left distal radial (LDR) artery, and right radial (RR) artery.

Methods: Seventy patients scheduled for elective transradial CAG and intervention from September 6, 2017 to March 6, 2018 were consecutively enrolled. Radial artery endothelial functions of the catheterization arm were measured by flow-mediated vasodilation (FMD) upon admission, at 24 hours, and 2 months following the procedure.

Results: LR access was used in 17 patients, whereas the LDR and the RR access were used in 27 and 26 patients, respectively. Basal radial diameters and FMD median values measured on the intervention arm were found to be similar between groups (LR 3.04±0.29 mm, 13.33%; LDR 2.79±0.31 mm; 13.64%; RR 2.74±0.29 mm; 12.52%, p=0.952). The radial vasodilation percentage change expressed as median decreased in all groups 24 hours after the procedure; however, the one with the LDR access was found to be significantly higher than with the LR (9.7% vs. 6.25% p=0.013) and the RR access (9.7% vs. 3.39 p<0.001). A partial recovery of endothelial functions was seen at 2 months after the procedure, approximating to basal values (11.11%; 12%; 10.62%, p=0.079, respectively).

Conclusion: Radial artery functions deteriorate early after transradial catheterization. The LDR access seems safer than the other conventional radial access sites in terms of preservation of radial endothelial functions.
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http://dx.doi.org/10.14744/AnatolJCardiol.2020.59085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803799PMC
January 2021

Applicability of left distal radial artery access site in ST-segment elevation myocardial infarction; A comparative evaluation with the conventional transfemoral approach.

J Vasc Access 2020 Dec 21:1129729820983138. Epub 2020 Dec 21.

Department of Cardiology, Ege University Medical School, Izmir, Turkey.

Background: Left distal radial artery (LDRA) has got high popularity as an alternative safe access site in coronary angiography. However, little is known about its applicability in primary percutaneous coronary intervention (PPCI) in ST-segment elevation myocardial infarction (STEMI) patients. We aimed to assess the convenience of LDRA access in STEMI patients and make the comparative evaluation with the transfemoral (TF) route.

Materials And Methods: A total of 91 consecutive STEMI patients who underwent PPCI from January to June 2019, were analyzed. Experienced operators, unaware of the study were left free of access site decision. Comparative demographic features and clinical outcomes were recorded during hospitalization.

Results: LDRA was used in 30 patients, whereas 61 patients underwent a TF approach. Successful PPCI was achieved in high rates in both groups (LDR: 90% vs TF: 91.8%:  = 0.795). On admission, KILLIP (II, III) class was higher in the LDRA group (23.3% vs 3.4%), whereas stent thrombosis, arhythmias were higher in the TF group (0% vs 6.6%  = 0.151; 6.7% vs 18%  = 0.355 respectively). Puncture time was relatively similar between groups (28.63 vs 28.93 s  = 0.767). Fluoroscopy time, total radiation exposure and hospital duration was found lower in the LDRA group (10.11 vs 13.75 min  < 0.001; 917.87 vs 1940.91 mGy  < 0.001; 4.2 vs 6.2 days  = 0.024 respectively). In-hospital mortality was found higher in the TF group (0% vs 18%  = 0.013).

Conclusion: In the acute management of STEMI, LDRA access site can be a convenient alternative to TF approach with shorter hospital duration and complication rates.
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http://dx.doi.org/10.1177/1129729820983138DOI Listing
December 2020

Investigation of tyrosinase enzyme (from mushroom) inhibitory activities and antioxidant properties of new fluorine-containing phthalocyanines.

Arch Pharm (Weinheim) 2021 Apr 10;354(4):e2000340. Epub 2020 Dec 10.

Department of Chemistry, Faculty of Science and Letters, Istanbul Technical University, Istanbul, Turkey.

A series of new peripherally or nonperipherally substituted phthalocyanines bearing 4-(trifluoromethoxy)thiophenyl groups was synthesized. In addition, a new metal-free phthalocyanine bearing 4-(trifluoromethoxy)phenoxy on the nonperipheral position was prepared. The resulting phthalocyanines were characterized using some spectroscopic techniques such as H nuclear magnetic resonance, Fourier-transform infrared spectroscopy, and UV-Vis spectroscopy, together with elemental analysis. When the tyrosinase enzyme inhibition activities of the synthesized phthalocyanines were examined, molecules 2b and 3b showed an inhibitory activity against the enzyme with IC values of 176.2 ± 0.65 and 284.4 ± 1.03, respectively. The inhibition types of the molecules and standard inhibitor kojic acid were found as competitive for 2b, mixed for 1b and kojic acid, and uncompetitive for 3b. Antioxidant activities were also assessed by using 1,1-diphenyl-2-picrylhydrazyl (DPPH) and reducing power assays, and the molecules showed moderate antioxidant activities.
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http://dx.doi.org/10.1002/ardp.202000340DOI Listing
April 2021

[A liver cycst hydatid case with widespread embolies to vena cava inferior].

Tuberk Toraks 2020 Sep;68(3):346-350

Clinic of Cardiac Surgery, T.C. Ministry of Health Ankara City Hospital, Ankara, Turkey.

Hydatid Cyst is a public health problem in Turkey. Although it can lead to cyst formation in all organs and systems, the most frequently affected organs are the liver and lungs. Here, we reported a 14-year-old girl who presented with low back pain and hydatid vomita symptoms and signs. The abdominal and thoracic CT examinations of the patient revealed that hydatid cyst found in the liver was opened to the inferior vena cava and it was determined that it caused multiple emboli in the right atrium, pulmonary arteries and lungs. Albendazole treatment was commenced and the hydatid cyst in the liver was excised by surgery, and surgery was planned for the hydatid cyst lesion in the right atrium. However, in the control thorax BT before the surgery, it was found that the cysts in the cardiovascular structures disappeared, causing widespread pulmonary embolism and spread to the entire pulmonary field. The most important complication of intense hydatid pulmonary embolization is the development of pulmonary hypertension and right heart failure. In our patient, pulmonary artery pressures and right heart functions were normal in repeated echocardiography. With this case, we wanted to emphasize that the cardiovascular involvement of hydatid cyst may not always require surgery.
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http://dx.doi.org/10.5578/tt.69499DOI Listing
September 2020

Recurrent angioedema in childhood: hereditary angioedema or histaminergic angioedema?

Pediatr Dermatol 2021 Jan 4;38(1):143-148. Epub 2020 Dec 4.

Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Background: Recurrent angioedema is a rare entity during childhood. This study aimed to clarify differences between hereditary angioedema (HAE) and histaminergic angioedema (HA) in children.

Methods: Fifty-seven children with HAE (male 36.8%, 8.9 years [5.4-12.5]) and 42 children with recurrent HA (male 42.9%, 11.5 years [8.1-16.8]) were analyzed.

Results: The median age at symptom onset (6 [3-10]; 7.8 [4.5-13] years), frequency of angioedema episodes within last year (3 [2-5]; 5 [2-10]), and duration of symptoms (48 [24-48]; 24 [12-48] hours) were similar in the HAE and HA group, respectively. Recurrent urticaria was observed in 7.3% (n = 3) of patients in the HAE group and in 45.2% (n = 19) of the HA group (P < .001). While angioedema episodes involving the lips (n = 30; 71.4%; P = .035) and eyelids (n = 28; 66.7%; P = .012) were observed more frequently in the HA group, gastrointestinal involvement/abdominal pain (n = 15; 36.6%) was more common in HAE (P < .001). Itching as a prodromal symptom was detected in 47.6% (n = 20) of HA patients versus 14.6% (n = 6) of those with HAE (P = .002). In the logistic regression analysis for the diagnosis of HAE, a family history of angioedema (OR = 58.289 [95% CI 10.656-318.853], P < 001) and trauma (OR = 35.208 [95% CI [4.368-283.794]], P = .001) as a triggering factor were determined to be independent variables.

Conclusion: A family history of angioedema, trauma as a triggering factor, and abdominal pain should suggest the diagnosis of HAE and the need for further investigation.
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http://dx.doi.org/10.1111/pde.14467DOI Listing
January 2021

Demographical and Clinical Features of Marginal Zone Lymphomas: A Retrospective Study of Turkish Oncology Group (TOG).

Indian J Hematol Blood Transfus 2020 Oct 22;36(4):640-645. Epub 2020 Feb 22.

Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey.

Marginal zone lymphomas (MZLs) are rare and indolent subtypes of non-Hodgkin lymphomas, and their clinical behaviours are heterogeneous. The aim of this study was to evaluate the clinical and prognostic characteristics of MZL. In this multicentre retrospective study, we analyzed demographical, clinical and prognostic features of 64 MZL patients. The median age was 54.0 and 78.1% of the patients had extra-nodal disease at presentation. Most of the patients were treated with chemotherapy. The 5 years and 10 years overall survival (OS) rates were 74.5% and 62.1%, respectively. The analysis of factors associated with OS showed that ECOG performance score was an important prognostic factor, with 133.0 months (95% CI 49.3-216.5) versus 18.0 months (95% CI 12.1-23.7) for ECOG 0-1 and 2-3, respectively (= 0.011). Prognosis of MZL is favorable and ECOG performance score was found associated with OS. Further detailed studies with large patient numbers are needed to clarify the clinical features and treatment management of MZLs.
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http://dx.doi.org/10.1007/s12288-020-01257-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573056PMC
October 2020

A Multicentered Study on Epidemiologic and Clinical Characteristics of 37 Neonates With Community-acquired COVID-19.

Pediatr Infect Dis J 2020 10;39(10):e297-e302

Gazi University School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey.

Background: Coronavirus disease 2019 (COVID-19) primarily affects adults and spares children, whereas very little is known about neonates. We tried to define the clinical characteristics, risk factors, laboratory, and imagining results of neonates with community-acquired COVID-19.

Methods: This prospective multicentered cohort study included 24 neonatal intensive care units around Turkey, wherein outpatient neonates with COVID-19 were registered in an online national database. Full-term and premature neonates diagnosed with COVID-19 were included in the study, whether hospitalized or followed up as ambulatory patients. Neonates without severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) via reverse transcriptase-polymerase chain reaction testing or whose mothers had been diagnosed with COVID-19 during pregnancy were excluded.

Results: Thirty-seven symptomatic neonates were included. The most frequent findings were fever, hypoxemia, and cough (49%, 41%, 27%, respectively). Oxygen administration (41%) and noninvasive ventilation (16%) were frequently required; however, mechanical ventilation (3%) was rarely needed. Median hospitalization was 11 days (1-35 days). One patient with Down syndrome and congenital cardiovascular disorders died in the study period. C-reactive protein (CRP) and prothrombin time (PT) levels were found to be higher in patients who needed supplemental oxygen (0.9 [0.1-8.6] vs. 5.8 [0.3-69.2] p = 0.002, 11.9 [10.1-17.2] vs. 15.2 [11.7-18.0] p = 0.01, respectively) or who were severe/critical (1.0 [0.01-8.6] vs. 4.5 [0.1-69.2] p = 0.01, 11.7 [10.1-13.9] vs. 15.0 [11.7-18.0] p = 0.001, respectively).

Conclusions: Symptomatic neonates with COVID-19 had high rates of respiratory support requirements. High CRP levels or a greater PT should alert the physician to more severe disease.
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http://dx.doi.org/10.1097/INF.0000000000002862DOI Listing
October 2020

Left Distal Radial Artery Access Site in Primary Percutaneous Coronary Intervention: Is It Safe?

Balkan Med J 2020 08 4;37(5):276-280. Epub 2020 Jun 4.

Department of Cardiology, Ege University School of Medicine, İzmir, Turkey

Background: Left distal radial artery access site has emerged as a new technique for coronary angiography procedures.

Aims: We aimed at assessing its applicability as an alternative way for primary percutaneous coronary interventions in ST-elevation myocardial infarction.

Study Design: Retrospective observational cohort study.

Methods: Left distal radial artery was used as an access site in 30 consecutive ST-elevation myocardial infarction patients for primary coronary intervention. It was used by experienced operators who were unaware of the study. All patients had a prominent pulse in their left forearm and distal radial artery. Each patient’s left arm was gently bent into his/her right groin with comfortable position of the hand. The operator/s stood at the right side of the patient where both could make the arterial puncture. Demographic features and complications were recorded during the hospital stay.

Results: Mean age of patients was 58 years with a male gender predominance of 87%. Fifteen patients were diagnosed of Inferior elevation myocardial infarction, 14 patients of Anterior, and one of Lateral elevation myocardial infarction. The most common culprit artery was the left anterior descending coronary artery (14 patients). Six patients were in KILLIP class II on admission and only one with Anterior elevation myocardial infarction was in severe pulmonary edema (KILLIP III) during intervention. All the procedures were successfully contemplated with 6 French Judkins catheters. Brachial spasm occurred in one patient which was resolved with intra-arterial nitrate. Transfemoral approach was changed to left distal radial access in 4 patients due to severe bilateral iliac artery disease. Mean puncture time was 37.36 seconds. There was no radial occlusion, hematoma, hand neurologic deficit or bleeding. Patients were discharged on an average duration of 4.2 days.

Conclusion: Left distal radial artery can be used as an alternative safe and feasible access site for successful primary coronary interventions provided that it is performed by experienced operators.
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http://dx.doi.org/10.4274/balkanmedj.galenos.2020.2020.4.49DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424190PMC
August 2020

Neonatal iliopsoas abscess presenting with transient cyanosis of a single extremity: a case report and review of the literature.

Turk J Pediatr 2020 ;62(1):160-164

Division of Neonatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

A newborn baby with an unusual complaint of transient left leg cyanosis during crying, who was diagnosed with a iliopsoas abscess is presented. Newborn cases diagnosed with an iliopsoas abscess in the English literature are summarized and differences in clinical presentations are discussed.
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http://dx.doi.org/10.24953/turkjped.2020.01.025DOI Listing
January 2020

Atypical mongolian spots as the initial manifestation of a lysosomal storage disorder.

Australas J Dermatol 2020 Aug 15;61(3):e371-e373. Epub 2020 Mar 15.

Department of Dermatology and Venereology, Hacettepe University, Ankara, Turkey.

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http://dx.doi.org/10.1111/ajd.13272DOI Listing
August 2020

A case of laryngeal atresia accompanied by persistent pharyngotracheal ductus.

Turk Pediatri Ars 2019 1;54(1):57-60. Epub 2019 Mar 1.

Neonatology Unit, Department of Pediatrics Kayseri Training and Research Hospital, Kayseri, Turkey.

Laryngeal atresia is generally a fatal congenital anomaly with an incidence of 1: 50,000 births. This congenital anomaly is a condition of multifactorial inheritance, in which the fetus has a dilated trachea, enlarged echogenic lungs, an inverted or flattened diaphragm, fetal hydrops, and ascites. Diagnosis is usually made when there is failure to perform endotracheal intubation in a neonate with severe respiratory distress and absence of audible cry. Here, we present a very rare case of a newborn with laryngeal atresia who had respiratory distress and was sustained for the first few minutes of life using partial ventilation via a persistent pharyngotracheal duct. We would like to draw the attention of all physicians to this issue by reporting a rare fatal case of a newborn with a congenital presentation.
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http://dx.doi.org/10.5152/TurkPediatriArs.2018.4619DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559978PMC
March 2019

Treatment outcomes of prostate cancer patients with Gleason score 8-10 treated with definitive radiotherapy : TROD 09-001 multi-institutional study.

Strahlenther Onkol 2019 Oct 29;195(10):882-893. Epub 2019 May 29.

Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, 06100, Ankara, Turkey.

Purpose: To validate the clinical outcomes and prognostic factors in prostate cancer (PCa) patients with Gleason score (GS) 8-10 disease treated with external beam radiotherapy (EBRT) + androgen deprivation therapy (ADT) in the modern era.

Methods: Institutional databases of biopsy proven 641 patients with GS 8-10 PCa treated between 2000 and 2015 were collected from 11 institutions. In this multi-institutional Turkish Radiation Oncology Group study, a standard database sheet was sent to each institution for patient enrollment. The inclusion criteria were, T1-T3N0M0 disease according to AJCC (American Joint Committee on Cancer) 2010 Staging System, no prior diagnosis of malignancy, at least 70 Gy total irradiation dose to prostate ± seminal vesicles delivered with either three-dimensional conformal RT or intensity-modulated RT and patients receiving ADT.

Results: The median follow-up time was 5.9 years (range 0.4-18.2 years); 5‑year overall survival (OS), biochemical relapse-free survival (BRFS) and distant metastases-free survival (DMFS) rates were 88%, 78%, and 79%, respectively. Higher RT doses (≥78 Gy) and longer ADT duration (≥2 years) were significant predictors for improved DMFS, whereas advanced stage was a negative prognosticator for DMFS in patients with GS 9-10.

Conclusions: Our results validated the fact that oncologic outcomes after radical EBRT significantly differ in men with GS 8 versus those with GS 9-10 prostate cancer. We found that EBRT dose was important predictive factor regardless of ADT period. Patients receiving 'non-optimal treatment' (RT doses <78 Gy and ADT period <2 years) had the worst treatment outcomes.
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http://dx.doi.org/10.1007/s00066-019-01476-zDOI Listing
October 2019

Resveratrol inhibits Src tyrosine kinase, STAT3, and Wnt signaling pathway in collagen induced arthritis model.

Biofactors 2019 Jan 29;45(1):69-74. Epub 2018 Nov 29.

Department of Rheumatology, Faculty of Medicine, Firat University, Elazig, Turkey.

Resveratrol, a phytochemical, acts several cellular signaling pathways and has anti-inflammatory potentials. The purpose of this study is to research the therapeutic effect of resveratrol in collagen-induced arthritis (CIA) model in rats and whether resveratrol affects the activities of signaling pathways those are potent pathogenic actors of rheumatoid arthritis. Arthritis was induced by intradermal injection of chicken type II collagen combined with incomplete Freund's adjuvant in Wistar albino rats. One day after the onset of arthritis (day 14), resveratrol (20 mg/kg/day) was given via oral gavage, until day 29. The paws of the rats were obtained for further analysis. Tissue Wnt5a, mitogen-activated protein kinase (MAPK), Src tyrosine kinase and signal transducer, and activator of transcription-3 (STAT3) mRNA expressions were determined by real-time polymerase chain reaction. Resveratrol ameliorated the clinical and histopathological (perisynovial inflammation and cartilage-bone destruction) findings of inflammatory arthritis. The tissue mRNA expressions of Wnt5a, MAPK3, Src kinase, and STAT3 were increased in the sham group compared to the control group. Resveratrol supplement decreased their expressions. The present study shows that Src kinase, STAT3, and Wnt signaling pathway are active in the CIA model. Resveratrol inhibits these signaling pathways and ameliorates inflammatory arthritis. © 2018 BioFactors, 45(1):69-74, 2019.
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http://dx.doi.org/10.1002/biof.1463DOI Listing
January 2019

Early Retinal Findings Following Cooling in Neonatal Encephalopathy.

Neuropediatrics 2019 02 20;50(1):15-21. Epub 2018 Sep 20.

Department of Neonatology, UCL EGA Institute for Women's Health (IfWH), University College London, London, United Kingdom.

Background And Aim: Perinatal HI (hypoxia-ischemia)-related visual defects including blindness are known to be associated with ischemic lesions in intracerebral visual pathways and ischemic retinal damage (IRD). Intraocular hemorrhages (IOH) such as retinal hemorrhage (RH), which may result from perinatal HI, can cause IRD by various mechanisms. We aimed to evaluate the early retinal findings in neonates with moderate-to-severe neonatal encephalopathy (NE) who underwent TH and its relationship between coagulation status, amplitude-integrated electroencephalography (aEEG) patterns, and magnetic resonance imaging-magnetic resonance spectroscopy (MRI-MRS) findings.

Method And Patients: A total of 31 newborn infants who underwent moderate-to-severe NE and TH included in the study. Coagulation parameters were taken immediately before starting TH, and daily during TH period. aEEG records were obtained during TH and rewarming period.Binocular indirect ophthalmoscopic examination (BIOE) and MRI-MRS scanning were performed when TH protocol completed.

Results: Total 13 (41.9%) patients had abnormal BIOE findings. Ten of them were (77%) IOH, other findings are as follows: RH ( = 7), optic disc hemorrhage ( = 2), and vitreous hemorrhage ( = 1). Initial coagulation status was not related to IOH. Worsened aEEG and MRI-MRS results were not related to BIOE findings.

Conclusion: Frequency of IOH is high in newborns with NE who underwent TH being independent from severity of MRS-MRI findings, aEEG pattern, and disturbed coagulation status.
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http://dx.doi.org/10.1055/s-0038-1669425DOI Listing
February 2019

DNA repair and apoptosis: Roles in radiotherapy-related acute reactions in breast cancer patients.

Cell Mol Biol (Noisy-le-grand) 2018 Mar 31;64(4):64-70. Epub 2018 Mar 31.

Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

Normal tissue reactions are therapy limiting factor for the effectiveness of the radiotherapy in cancer patients. DNA repair and apoptosis are estimated to be critical players of adverse effects in response to radiotherapy. Our aim was to define the association of DNA repair (ERCC1 and XPC) and apoptotic (BCL2, CASP3 and NFKB1) gene expression, DNA damage levels, apoptosis changes and DNA repair gene variations with the risk of acute side effects in breast cancer patients. The study included 100 women with newly diagnosed breast cancer; an experimental case group (n=50) with acute side effects and the control group (n=50) without side effects. Gene expression was analyzed by reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR). Micronucleus (MN) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) assays were performed to compare the DNA damage levels. Apoptosis was examined by TDT-mediated dUTP-biotin nick end-labeling (TUNEL) staining. ERCC1 rs3212986 and XPC rs3731055 polymorphisms were genotyped by real-time PCR technique. No significantly correlation of DNA repair and apoptosis gene expression and DNA damage levels with acute side effects in response to radiotherapy. Also, there was no association between apoptosis levels and acute effects. ERCC1 rs3212986 CC genotype showed a protective effect against radiotherapy-induced acute reactions (p<0.001; OR: 0.21; 95% CI= 0.08-0.52). Our results suggest that apoptosis and DNA damage levels are not associated with acute radiosensitivity. DNA repair may affect the risk of acute reactions. Further studies are needed to validate the current findings.
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March 2018

Coronary angiography using the left distal radial approach - An alternative site to conventional radial coronary angiography.

Anatol J Cardiol 2018 Apr 21;19(4):243-248. Epub 2018 Mar 21.

Department of Cardiology, Faculty of Medicine, Ege University; İzmir-Turkey.

Objective: To share our experience with the left distal radial approach for transradial coronary angiography and interventions. By performing the radial puncture in the fossa radialis or the so called anatomical "Snuffbox" we aimed to present the feasibility and complications of this new technique.

Methods: Left distal radial artery was used as an access site in 54 patients admitted to our clinic for coronary angiography and intervention between May 25th and October 20th 2017. All of them had pulse in their left distal radial artery. In the laboratory, they had their left arm gently flexed at the shoulder so that the hand was placed over their right groin. The operator stood on the right side of the patient and performed coronary angiography and interventions. During the hospital stay, demographic features and complications were recorded.

Results: Mean age of patients was 59.3 years and 80% were male. We used Judkins 6 French catheters for the procedures. Seventeen patients admitted with acute coronary syndrome. They all underwent successful left distal transradial coronary angiography and intervention. Primary angioplasty was performed in 10 patients. In total, 20 patients had coronary intervention. Left anterior descending artery was the artery requiring most intervention (11 patients). Two patients experienced brachial spasm requiring crossover to right femoral artery. There were no cases of radial artery occlusion, hematoma, or hand numbness. The radial sheath was removed at procedure termination. Hemostasis was achieved with manual compression.

Conclusion: Left distal radial approach is safe and feasible as a new technique for coronary angiography and interventions.
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http://dx.doi.org/10.14744/AnatolJCardiol.2018.59932DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5998856PMC
April 2018

Worth listening to the kidney: An uncommon cause of congestive heart failure.

Anatol J Cardiol 2018 Mar;19(3):226-227

Department of Cardiology, Faculty of Medicine, Ege University; İzmir-Turkey.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5864775PMC
http://dx.doi.org/10.14744/AnatolJCardiol.2018.06982DOI Listing
March 2018

Prevalence and seasonal distribution of viral etiology of respiratory tract infections in inpatients and outpatients of the pediatric population: 10 year follow-up.

Turk J Pediatr 2018 ;60(6):642-652

Division of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Aykaç K, Karadağ-Öncel E, Bayhan C, Tanır-Başaranoğlu S, Akın MŞ, Özsürekci Y, Alp A, Cengiz AB, Kara A, Ceyhan M. Prevalence and seasonal distribution of viral etiology of respiratory tract infections in inpatients and outpatients of the pediatric population: 10 year follow-up. Turk J Pediatr 2018; 60: 642-652. The aim of this study was to investigate the prevalence and seasonal distribution of respiratory viruses in pediatric patients. Nasopharyngeal swab specimens, demographic and clinical information were collected from 1240 pediatric patients aged < 18 years between 2006 and 2015 in Hacettepe University Children`s Hospital. Multiplex RT-PCR (multiplex reverse transcriptase polymerase chain reaction) was performed to detect viral pathogens. A total of 1240 pediatric outpatients and inpatients who had been admitted to the hospital with symptoms of upper and lower respiratory tract infections (RTIs) were enrolled. Viruses were identified in 339 (27.3%) of cases, with the leading three viruses being respiratory syncytial virus (RSV, 74/339; 21.8%), human rhinovirus (62/339; 18.3%), and multiple viruses (56/339; 16.5%). Most of the patients were diagnosed with lower RTI (264/339; 77.8%) and antibiotics were administered to three quarters of positive patients (254/339; 74.9%). With an overall viral agent detection rate of 27.3%, the findings of the present study suggest that other respiratory pathogens, whether viral or bacterial, may also lead to hospital visits due to respiratory tract symptoms in children.
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http://dx.doi.org/10.24953/turkjped.2018.06.004DOI Listing
January 2018

Evaluation of aortic intima-media thickness in newborns with Down syndrome.

Adv Clin Exp Med 2017 Nov;26(8):1253-1256

Department of Biochemistry, Faculty of Medicine, Acıbadem University, Istanbul, Turkey.

Background: Health care programs for children with Down syndrome (DS) help improve the overall outcome and quality of life of these children. It is therefore very important to focus on the most common and serious problems of these patients, such as congenital heart defects and cardiac problems, and to keep medical guidelines updated with regard to these problems.

Objectives: The aim of this study was to evaluate aortic intima-media thickness (aIMT), lipid profiles and blood pressure in DS patients in comparison with a control group of ageand gender-matched neonates without DS.

Material And Methods: Serum concentrations of lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride), blood pressure and abdominal aIMT were measured in newborns with DS, and compared with the measurements from ageand gender-matched newborns without DS.

Results: No statistically significant differences between the 2 groups of newborns were detected with respect to aIMT, lipid levels or blood pressure.

Conclusions: This study represents the first investigation of aIMT - one of the most important indicators of atherosclerosis - in DS patients, but neither a significantly increased aIMT, nor any significant changes in lipid profiles or blood pressure were detected in this group of patients. Whether aIMT differs according to the type of congenital heart defect (such as atrial septal defect, ventricular septal defect, patent ductus arteriosus, and atrioventricular septal defect) among DS patients remains to be determined in future studies.
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http://dx.doi.org/10.17219/acem/68677DOI Listing
November 2017

Platelet mass index can be a reliable marker in predicting the prognosis of retinopathy of prematurity in very preterm infants.

Pediatr Neonatol 2018 10 13;59(5):455-463. Epub 2017 Nov 13.

Erciyes University Medical Faculty, Department of Pediatrics, Division of Neonatology, Kayseri, Turkey. Electronic address:

Background: Retinopathy of prematurity (ROP) is a proliferative vitreoretinopathy resulting from vascular defect of the retina. The present study evaluates platelets, which are involved in VEGF storage, transport and release, and their functions with regard to the prognosis of the disease. The objective was to suggest a simple minimal invasive method that will facilitate the management of the disease and help clinicians in predicting the prognosis.

Methods: In this single center, retrospective, case-control study, we included a control group consisting of very preterm newborns (n = 83) at risk of ROP and a laser photocoagulation group including infants (n = 63) who received laser therapy during their follow-up examinations. The employed assessments included platelet counts and platelet mass index (PMI) which provide guidance in understanding platelet activity. In doing so, consideration was given to the first and second phases of ROP. The accuracy of prognostication was assessed with receiver operating characteristic analyses.

Results: The study groups did not differ statistically significantly by platelet count during the first and second phases of ROP (p > 0.05) nor were the PMI measurements statistically significantly different between the study groups during the first phase of the disease (p > 0.05). PMI values of the study groups, however, differed significantly in the second phase of ROP (p < 0.05).

Conclusion: The present study found a significant difference between the two groups in PMI measurements which reflect increased VEGF levels during the neovascularization phase, which underlies the disease. This conclusion demonstrated that monitoring the PMI values in newborns at risk of ROP can be considered to be a minimally invasive method that by changing the retinal examination procedure in use today which is rather troublesome for both the physician and the newborn, can provide facilities in monitoring the disease for both the physician and the newborn.
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http://dx.doi.org/10.1016/j.pedneo.2017.11.001DOI Listing
October 2018

Short-term Refractive Effects of Propranolol Hydrochloride Prophylaxis on Retinopathy of Prematurity in Very Preterm Newborns.

Curr Eye Res 2018 02 14;43(2):213-217. Epub 2017 Nov 14.

a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey.

Purpose: Retinopathy of prematurity (ROP) is one of the major problems of surviving premature infants with several ophthalmic morbidities such as increased risk of refractive errors, strabismus, and cortical visual impairment. Use of propranolol hydrochloride (PH) for the prevention of ROP is a new promising treatment modality. However, long-term effects are still to be defined. In our study, we aimed to investigate the short-term refractive effects of PH used for ROP prophylaxis in very preterm newborns.

Methods: This is a prospective, randomized, double-blind, placebo-controlled study. Very preterm newborns with a birthweight less than or equal to 1500 g and/or born prior to 32 gestational weeks were included in the study. The subjects were randomly divided into two groups: control group (CG, n = 37) given placebo and PH group (PHG, n = 34) given PH starting from 4 weeks after birth (27.1 ± 2.1 day). PHG patients received PH therapy for about 1 month (25.7 ± 7.8 day). Anthropometric measurements including weight, length, and head circumference were recorded before PH treatment (at birth) and during eye control (at corrected age). Cycloplegic refraction values were measured by retinoscopy at corrected age (CG: 10.3 ± 4.3 months, PHG: 11.4 ± 4.8 months).

Results: Anthropometric measurements including gestational age, weight, length, and head circumference were similar at birth and corrected age in both groups. The mean level of spherical refraction was significantly less hyperopic in the PHG than in the CG (CG: 1.37 ± 1.40 D, PHG: 0.37 ± 1.44 D) (p = 0.005).

Conclusion: PH may lead to myopic shift by affecting the beta-adrenergic receptors in the choroid or ciliary body of the developing eye. Long-term refractive follow-up is required in order to elucidate the effects of PH on emmetropization process of these very preterm infants.
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http://dx.doi.org/10.1080/02713683.2017.1390769DOI Listing
February 2018

Current epidemiology of resistance among Gram-negative bacilli in paediatric patients in Turkey.

J Glob Antimicrob Resist 2017 12 10;11:140-144. Epub 2017 Aug 10.

Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Objectives: The increasing incidence of infections caused by drug-resistant Gram-negative organisms has led to a re-emergence worldwide. This study attempted to investigate the changes in resistance of Gram-negative bacteria to different classes of antibiotics and the treatment options for invasive infections.

Methods: A retrospective study was performed between January 2012 and January 2017 in a Turkish tertiary care university hospital. A total of 302 patients with Gram-negative bacteraemia (n=274; 90.7%) or meningitis (n=28; 9.3%) were identified and their demographic, clinical and microbiological features were evaluated.

Results: A total of 302 patients with Gram-negative bacterial infection (bacteraemia or meningitis) were investigated. Klebsiella spp. was the most frequent causative agent (n=119; 39.4%), followed by Escherichia coli (n=67; 22.2%), Acinetobacter spp. (n=42; 13.9%), Pseudomonas spp. (n=41; 13.6%) and Enterobacter spp. (n=33; 10.9%). In total, 115 isolates (38.1%) were multidrug-resistant (MDR), 63 (20.9%) were extensively drug-resistant (XDR) and 6 (2.0%) were pandrug-resistant (PDR). Over the years, peak antibiotic resistance occurred in 2013, with an increase in the following years.

Conclusions: These data indicate that the resistance pattern of Gram-negative bacteria may change over the years in hospital settings. Therefore, active surveillance of the resistance patterns of micro-organisms is necessary for better management of infections caused by highly resistant bacteria.
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http://dx.doi.org/10.1016/j.jgar.2017.07.018DOI Listing
December 2017

Eosinophilic myocarditis presenting as acute coronary syndrome.

Turk Kardiyol Dern Ars 2017 Jun;45(4):358-361

Department of Cardiology, Ege University Faculty of Medicine, İzmir, Turkey.

Eosinophilic myocarditis (EM) is a rare condition that may result from several heterogeneous eosinophilic diseases, including parasite infection, hypersensitivity reaction, vasculitis, and hypereosinophilic syndrome. Regardless of etiology, the disease may present with various cardiac conditions, such as acute coronary syndrome, heart failure, or arrhythmia. Irreversible endomyocardial fibrosis, which causes restrictive cardiomyopathy, occurs in the late phase of the disease. Early diagnosis and treatment is crucial to prevent disease progression. Presently described is a case of EM presenting as acute coronary syndrome that was treated with steroids.
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http://dx.doi.org/10.5543/tkda.2016.49392DOI Listing
June 2017

Efficacies of vitamin D and omega-3 polyunsaturated fatty acids on experimental endometriosis.

Taiwan J Obstet Gynecol 2016 Dec;55(6):835-839

Department of Pathology, Firat University School of Medicine, Elazig, Turkey.

Objective: The aim of this study was to investigate the effects of 1,25-dihydroxyvitamin-D3 (vitamin D) and omega-3 polyunsaturated fatty acids (omega-3 PUFA) on experimentally induced endometriosis in a rat model.

Materials And Methods: A prospective, single-blind, randomized, controlled experimental study was performed on 30 Wistar female rats. Endometriosis was surgically induced by implanting endometrial tissue on the abdominal peritoneum. Four weeks later, a second laparotomy was performed to assess pre-treatment implant volumes and cytokine levels. The rats were randomized into three groups: vitamin D group (42 μg/kg/day), omega-3 PUFA group (450 mg/kg/day), and control group (saline 0.1 mL/rat/day). These treatments were administered for 4 weeks. At the end of treatment, a third laparotomy was performed for the assessment of cytokine levels, implant volumes (post-treatment) and implants were totally excised for histopathologic examination. Pre- and post-treatment volumes, cytokine levels within the groups, as well as stromal and glandular tissues between the groups were compared.

Results: The mean post-treatment volume was statistically significantly reduced in the omega-3 PUFA group (p=0.02) and the level of the interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), vascular endothelial growth factor (VEGF) in the peritoneal fluid were significantly decreased at the end of treatment in the omega-3 PUFA group (p=0.02, p=0.03, and p=0.03, respectively). In the vitamin D group, only IL-6 levels were significantly decreased. In the histopathologic examination, the glandular tissue and stromal tissue scores of the implants were significant lower in the omega-3 PUFA group (p=0.03 and p=0.02).

Conclusion: Omega-3 PUFA caused significant regression of endometriotic implants. Vitamin D has not been as effective as omega-3 PUFA on endometriosis.
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http://dx.doi.org/10.1016/j.tjog.2015.06.018DOI Listing
December 2016

The Efficacy of Propranolol in Retinopathy of Prematurity and its Correlation with the Platelet Mass Index.

Curr Eye Res 2017 01 3;42(1):88-97. Epub 2016 Jun 3.

a Division of Neonatology , Erciyes University Medical Faculty , Kayseri , Turkey.

Purpose: Retinopathy of Prematurity (ROP) is a proliferative vitreoretinopathy which is one of the most frequent causes of blindness in children. In an attempt to find a solution to this important problem in preterm children, the search for new, effective treatment modalities with fewer side effects is underway. In our study, which was planned for this reason, we aimed to investigate the effects of propranolol treatment applied to cases of ROP in various stages during the second phase (known as the neovascularization-hypoxia phase) and to determine the correlation of these effects with the platelet mass index (PMI).

Method: A total of 171 preterm infants at risk of ROP were selected randomly for inclusion in the study. All of the patients were classified according to their stage of ROP and were divided into control and treatment groups. While the cases in the control group were administered physiological saline solution, those in the treatment group were administered propranolol in the period that corresponded to the second stage of the disease. The thrombocyte and PMI values in the first and second stages of each study group were recorded.

Results: A significant difference was found between the control and treatment groups of the stage 2 ROP study subjects. In the stage 2 ROP study group, no significant difference was detected between the control and treatment cases in terms of platelet counts in phase 1 or in the PMI values and the thrombolytic counts in phase 2. On the other hand, in phase 2 of the stage 2 ROP study subjects significant differences were detected between the control and treatment group in terms of PMI values.

Conclusion: In the study, it was found in the stage 2 ROP study group that propranolol reduced the need for laser photocoagulation significantly. Also, in parallel to the efficacy of propranolol in this study group, a decrease was observed in PMI values.
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http://dx.doi.org/10.3109/02713683.2016.1158272DOI Listing
January 2017

Evaluation of treatment outcomes of triple-negative breast cancer.

J Cancer Res Ther 2016 Jan-Mar;12(1):150-4

Department of Radiation Oncology, Balikesir Public Hospital, Balikesir, Turkey.

Purpose: Breast cancer is the most common cancer in women. Treatment responses are variable depending on tumor morphological characteristics, clinical characteristics, and hormonal receptor levels. In current medical practice, estrogen receptor (ER), progesterone receptor (PGR), and human epidermal growth factor receptor 2 (HER2) levels have been identified as important prognostic factors; they can change prognosis and treatment modalities. In this study, the prognostic factors of patients with triple-negative breast cancer (TNBC) were examined retrospectively.

Materials And Methods: Some 110 cases with negative prognostic and predictive proteins (ER, PGR, and HER2) were included in this study. Median follow-up was 56 months. Recurrences, overall survival, and prognostic factors were evaluated.

Results: We revealed in our triple-negative series that nodal status, tumor size, whole breast radiation doses, and type of surgery are the most useful prognostic markers.

Conclusion: Triple-negative breast cancers, especially basal-like subtypes, have bad prognoses. They have high histopathological grades and high risk of invasion. This group can make early metastases and expected survival is usually short. We need to focus on new treatment strategy modalities on this group, and pretreatment values of different prognostic markers are well-identified, such as androgen receptors, basal cytokeratin expression, and BRCA gene status.
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http://dx.doi.org/10.4103/0973-1482.154000DOI Listing
December 2016

Evaluating functional capacity, and mortality effects in the presence of atrial electromechanical conduction delay in patients with systolic heart failure.

Anatol J Cardiol 2016 Aug 21;16(8):579-586. Epub 2015 Oct 21.

Department of Cardiology, Faculty of Medicine, Ege University, İzmir-Turkey.

Objective: Atrial functions are relatively suppressed in heart failure (HF). We aimed to investigate the associations of intra- and inter-atrial electromechanical conduction delay (EMCD) with functional class and mortality over a 12-month follow-up period.

Methods: The prospective study included 65 patients with systolic HF and 65 healthy subjects with normal sinus rhythm. Left ventricular (LV) systolic functions and left atrial (LA) dimensions and volumes were evaluated by transthoracic echocardiography. Tissue Doppler imaging (TDI) signals at the lateral border of the mitral annulus (lateral PA'), septal mitral annulus (septal PA'), and tricuspid annulus (tricuspid PA') were measured. Intra- and inter-atrial EMCD were calculated.

Results: Mitral inflow velocities were studied using pulsed-wave Doppler after placing the sample volume at the leaflets' tips. The peak early (E wave) and late (A wave) velocities were measured. The septal annular E/E' ratio was relatively higher and lateral, septal, and right ventricular S, E', and A' waves were significantly lower in the HF group than in the control group (12.49±6.03 - 7.16±1.75, pE/E' <0.0001). Intra-atrial EMCD was detected as 117.5 ms and inter-atrial EMCD as 127.5 ms in patients with prolonged atrial EMCD. A significant increase was found in prolonged intraand inter-atrial EMCD according to functional capacity increase (p=0.012 and p=0.031, respectively). The incidence of mortality was significantly higher in patients with prolonged atrial EMCD (p=0.025), and 5 patients in the HF group died during the study over the 12-month follow-up period.

Conclusions: In this study, we found a relationship between prolonged atrial conduction time and increased functional class and mortality in patients with systolic HF.
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http://dx.doi.org/10.5152/AnatolJCardiol.2015.6445DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368513PMC
August 2016