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    Alterations in platelet count and mean platelet volume as predictors of patient outcome in the respiratory intensive care unit
    (Wiley, 2015) Sezgi, Cengizhan; Taylan, Mahsuk; Kaya, Halide; Sen, Hadice Selimoglu; Abakay, Ozlem; Demir, Melike; Abakay, Abdurrrahman
    IntroductionThrombocytopenia is associated with increased mortality in intensive care unit (ICU) patients. Mean platelet volume (MPV) reflects platelet function and activation. Elevated MPV is associated with poor outcomes and increased mortality rate in diseases that are commonly encountered in the respiratory ICU. MethodsWe retrospectively enrolled 95 patients who died in the ICU (dead group), 80 patients who improved and were transferred from the ICU (survived group), and 80 healthy individuals as controls. Laboratory parameters including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin, and complete blood count (CBC) were recorded within 24h on admission and transfered from the ICU or died. White blood cell (WBC) count, hemoglobin (Hb), red cell distribution width, MPV, platelet distribution width (PDW), and platelet count (PC) were obtained from the CBC. ResultsAdmission PC and MPV levels were not different in the survived and dead groups. But in the survived group, admission WBC, MPV and PDW levels decreased, while PC increased when compared with admission levels. In the dead group, admission MPV and PDW levels increased, while PC decreased with respect to admission levels. The admission mean PC of the dead group was 182103, which was above the thrombocytopenia limit. The ratio of admission thrombocytopenia was 45.3% in the dead group, which was significantly higher than that of the survived group (13.8%) (P<0.001) ConclusionsIncreasing MPV and decreasing platelet count may alert intensivists to the worse course of disease in patients who had normal platelet counts at ICU admission. The development of thrombocytopenia may also be essential to assessing the outcome of ICU patients
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    Alterations of the neutrophil-lymphocyte ratio during the period of stable and acute exacerbation of chronic obstructive pulmonary disease patients
    (Wiley, 2017) Taylan, Mahsuk; Demir, Melike; Kaya, Halide; Sen, Hadice Selimoglu; Abakay, Ozlem; Carkanat, Ali Ihsan; Abakay, Abdurrrahman
    ObjectivesWe aimed to investigate the importance of neutrophil-lymphocyte ratio (NLR) in patients with chronic obstructive pulmonary disease (COPD) for identifying the severity of inflammation and recognition of acute exacerbation. MethodsWe retrospectively enrolled 100 patients with a diagnosis of COPD exacerbation who were admitted to our clinic. Complete blood count (CBC), measurement of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were determined within 2 h of hospital admission. Three months after an acute exacerbation, these measurements were obtained from the same patients during the stable period of COPD. The control group included 80 healthy subjects. NLR was calculated from CBC. ResultsNLR and other inflammatory markers, such as WBC, CRP and ESR were found to be significantly elevated in exacerbated COPD compared to stable COPD and control participants. There was a significant correlation of NLR with CRP (r=0.415, P<0.001), WBC (r=0.304, P=0.002) and ESR (r=0.275, P=0.035). For an NLR cutoff of 3.29, sensitivity for detecting exacerbation of COPD was 80.8% and specificity was 77.7% (AUC 0.894, P=0.001). Some patients presenting with acute exacerbation of COPD and CRP, WBC or ESR levels lower than the optimal cut-off value had high NLR values. ConclusionsElevated NLR can be used as a marker similar to CRP, WBC and ESR, in the determination of increased inflammation in acutely exacerbated COPD. NLR could be beneficial for the early detection of potential acute exacerbations in patients with COPD who have normal levels of traditional markers.
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    Analysis of YouTube as a source of information for restless leg syndrome
    (Associacao Arquivos de Neuro-Psiquiatria, 2020) Arıkanoğlu, Adalet; Demir, Melike; Aluçlu, Mehmet Ufuk
    Background: YouTube is one of the major resources for health related videos around the world. Objective: The aim of this study was to evaluate the quality of information available on YouTube about restless leg syndrome (RLS). Methods: A YouTube search was carried out on https://www.youtube.com for videos pertaining to “restless leg syndrome” by using the keyword “restless leg syndrome”. The first 100 relevant videos were included in the study. The videos were accepted as “useful” if they provided scientifically correct information about any aspect of RLS. The videos containing scientifically unproven information are defined as “misleading”. The overall quality of all videos was subjectively graded using the global quality scale (GQS), a 5-point Likert scale. Results: The median video length for the included videos was 3.39 (0.11-85) minutes, and the median views were 6,055 (32-2351490). The median GQS of useful videos was 3 (1-5). The median number of likes and the median number of comments of personal experience videos were significantly higher than that of the useful and misleading videos. Videos uploaded by the university hospitals frequently issued pharmacological treatment of the RLS; however, those uploaded by practitioners, individual users, and TV or social media accounts were about the non-pharmacological treatment of the RLS. Conclusions: This study demonstrates that 77% of the videos uploaded on YouTube regarding RLS are in the useful category, whereas only 16 videos were providing misleading information. However, even videos in the useful category do not provide a full and complete description of the RLS. © 2020 Associacao Arquivos de Neuro-Psiquiatria. All rights reserved.
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    Artirit ile Başlayan Akut Sarkoidoz Olgusu: Löfgren Sendromu
    (2015) Karadeniz, Gülistan; Gündüz, Dilek; Yaşar, Zehra; Demir, Melike; İnce, Özlem
    Sarkoidoz etyolojisi bilinmeyen, dokularda nonkazei- fiye granülomatöz reaksiyon ile karakterize multisis- temik bir hastalıktır. Löfgren sendromu ise ateş, artrit ve/veya artralji, eritema nodozum ve bilateral hiler lenfadenopati ile karakterize akut sarkoidoz tablosu- dur. Klinik olarak akciğer bulguları tabloya hakim olsa da giderek artan sıklıkta romatolojik bulguların ön planda olduğu sarkoidoz olguları bildirilmektedir. Bu yazıda bilateral ayak bileklerinde artrit ile başla- yan Löfgren Sendromu tanısı konan bir bayan olgu sunulmuştur.
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    Bronchial atresia in an adult misdiagnosed as pulmonary mass
    (Turkish Assoc Tuberculosis & Thorax, 2017) Demir, Melike; Taylan, Mahsuk; Yilmaz, Sureyya; Dursun, Elif; Sezgi, Cengizhan; Isik, Recep
    [Abstract Not Available]
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    Differences in evaluation between geriatric and adult patients requiring pulmonary consultation
    (Springer Heidelberg, 2015) Karadeniz, Gulistan; Demir, Melike; Kaya, Halide; Yesil, Yusuf; Degerli, Semih; Yenibertiz, Derya
    The main aim of the study was to investigate the effects of age in pulmonary consultation and to evaluate differences between geriatric and adult patients. Consultation referrals to the clinic of chest diseases for patients from emergency, inpatient and outpatient clinics of a tertiary care general hospital between December 2010 and April 2011 were examined retrospectively. The patients were divided into two groups, namely those aged 65 years and over (geriatric patients) and those under the age of 65 years (adults). Out of 272 patients 135 (49.6 %) were geriatric patients and 137 (50.4 %) were adult patients. The mean age of the geriatric patients and adults was 75.6 +/- 7.1 years and 49.7 +/- 11.8 years, respectively. While the geriatric patients showed a significantly higher presence of pathologies in chest radiography, respiratory complaints and concomitant diseases compared to the adult group, the respiratory function test results were lower. The complaint of shortness of breath was higher in the geriatric group compared to the adult group (71 % in geriatric patients and 59.1 % in adults). The most common diagnosis was chronic obstructive pulmonary disease (COPD, 37 %) in the geriatric patients and asthma (27.7 %) in the adult patients. As to the results of consultations, treatment-oriented recommendations were given for 63 (46.6 %) geriatric patients and approval for operation was given for 75 (54.7 %) adult patients. Consultants should take the age of patients into consideration during evaluation in order to achieve the most appropriate treatment plan for these patients and reduce the potential postoperative complications to a minimum.
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    DİYARBAKIR YÖRESİNDE ALLERJİK SOLUNUM YOLU ŞİKAYETLERİYLE BAŞVURAN HASTALARDA UYGULANAN DERİ PRİCK TESTİ SONUÇLARININ DEĞERLENDİRİLMESİ
    (2015) Kaya, Halide; Selimoğlu, Hadice Şen; Taylan, Mahşuk; Demir, Melike; Yılmaz, Süreyya; Dallı, Ayşe; Abakay, Özlem
    Amaç: Atopik hastalıklarda deri prick testi (DPT), allerjenlerin saptanmasında oldukça hızlı, kolay ve ucuz bir yöntem olarak kullanılmaktadır. Bu çalışmada DPT ile tespit edilen allerjenler ile total serum IgE (T.IgE) düzeyleri arasındaki ilişkinin değerlendirilmesi ve bölgemizdeki allerjenlerin sıklığının incelenmesi planlandı. Gereç ve Yöntem: Ocak 2009 ile Aralık 2013 arasında Dicle Üniversitesi Göğüs Hastalıkları Polikliniğine allerjik astım ve/veya rinit tanısı ile başvurup DPT yapılan 1791 hastanın klinik özellikleri, deri prick testi sonuçları ve T.IgE düzeyleri geriye dönük olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen 1791 hastanın 1077si (%60.1) kadın, 714ü (%39.9) erkekti. Bu hastalardan 722ünde (%40.3) en az bir ya da daha fazla allerjene karşı pozitif yanıt saptandı. Erkeklerde (% 44.5) allerji testi pozitifliği kadınlara (%37.5) kıyasla daha yüksekti (p=0,002). DPTnde en sık saptanan allerjenler sırasıyla çayır polenleri (%70.3), buğday poleni (%46.5) ve ağaç polenleri (%46.1) idi. Kadınlarda erkeklere göre kedi ve köpek epiteline duyarlılık daha fazla idi (p=0.023, p=0.036). Total serum IgE seviyesi yüksek olan hastalarda DPT pozitifliği, T.IgE seviyesi normal olanlardan istatistiksel olarak anlamlı derecede daha fazlaydı (p < 0.001). Tartışma: Diyarbakır ilinde çayır ve buğday polenlerinin en sık karşılaşılan allerjenler olduğu saptandı.
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    Diyarbakır ilinin 2005-2010 yılları arasındaki tüberküloz kontrol durumu
    (Dicle Üniversitesi Tıp Fakültesi, 2015) Taylan, Mahşuk; Yılmaz, Süreyya; Kaya, Halide; Demir, Melike; Şen, Hatice Selimoğlu; Sezgi, Cengizhan; Abakay, Özlem; Tanrıkulu, Abdullah Çetin; Abakay, Abdurrahman
    Giriş: Tüberküloz (TB) kontrol programları, uluslararası ve ulusal düzeyde kabul gören standardize edilmiş tanı, tedavi ve korunma uygulamalarını içerir. Bir bölgenin TB verilerinin ülke verileriyle kıyaslanarak analizi, o bölgenin TB kontrol programlarına uyum düzeyini belirleyecek ve ileriye dönük doğru stratejileri belirlemeye yarayacaktır. Bu çalışmada Diyarbakır ilinin beş yıllık TB verileri ülke verileriyle kıyaslanarak irdelenmiştir. Yöntemler: Sağlık bakanlığı Verem Savaş Daire Başkanlığının yıllık TB raporları esas alınarak 2006–2010 yıllarına ait Diyarbakır ili TB verileri ve Ülke verileri iki grup olarak kaydedildi. TB olgularına ait, demografik, tanısal ve tedavi sonuçlarını içeren veriler, iki grup arasında karşılaştırmalı olarak analiz edildi. Bulgular: Diyarbakır TB verilerinden beş yıllık ortalama olgu hızı (22,8/100.000) ve akciğer TB için yayma yapılma oranı (%80,1) ülke ortalama olgu hızı (25,6/100.000) ve yayma yapılma oranının (%88,3) altında bulundu. Aynı olgularda kültür yapılma oranı (40,1), kültür pozitifliği (%45,5) ve kür oranı (%43,9), ülke ortalaması olan kültür yapılma oranı (%62,6), kültür pozitifliği oranı(%80,4) ve kür oranından (%58,5) daha düşük bulundu. Tedavi başarısı (86,5), tedavi terk (%5,7) ve ölüm oranı (%2,7) ile ülke verilerine benzer görüldü. Sonuç: Diyarbakır ilinde TB’un tanısal bakteriyolojik inceleme ve kür oranında ülke ortalamasının altında elde edilen sonuçlar, TB kontrolünü zorlaştıran sebepler olduğunu düşündürmektedir. Muhtemel sorunların aydınlatılmasında, sosyodemografik etmenlerin, sağlık hizmetlerinin ve donanım alt yapısının değerlendirildiği daha kapsamlı çalışmalara ihtiyaç olduğu düşünülmektedir.
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    THE EFFECT OF ABDOMINAL (DIAPHRAGM) RESPIRATORY TRAINING ON AERODYNAMIC PARAMETERS IN PATIENTS WITH MUSCLE TENSION DYSPHONIA
    (2020) Gül, Aylin; Özalp, Sevcan; Sizer, Bilal; Demir, Melike
    Objective: In this study, the effectiveness of abdominal (diaphragm) respiratory training on muscle tension dysphonia was investigated using aerodynamic parameters. Material-Method: 60 patients between the ages of 18-65 who were diagnosed with muscle tension dysphonia were included in the study. 60 healthy individuals were included in the control group. Maximum phonation time (/ a /), maximum (/ s /)duration, maximum (/ z /) duration, s / z ratio, vital capacity and phonification quotient were measured before respiratory training for all participants. Abdominal (diaphragm) respiratory training was given to the group with muscle tension dysphonia, and aerodynamic parameters were measured again after 4 weeks of respiratory training. The data of the control group were compared with the data of the patient group before abdominal (diaphragm) respiratory training. Then, the patient group"s aerodynamic parameters before the abdominal respiratory training were compared with the patient group"s aerodynamic parameters after the training. Results: The aerodynamic parameters of patients before abdominal (diaphragm) respiratory training; maximum phonation time, vital capacity, s / z ratio and phonation quotient were found to differ statistically significantly from the control group (p <0.05). When the patient data after four weeks of respiratory training were compared with the patient data before respiratory training, no significant change was observed in the other parameters (p <0.05), except for the s / z ratio (p <0.05). Conclusion: The main source of sound is air in the lungs. Therefore, correct and effective breathing is necessary for the effectiveness and continuity of phonation. Although, in our study, no statistically significant change was observed in relation to aerodynamic parameters, vital capacity, maximum phonation time and phonification quotient after 4 weeks, positive changes were observed in all the parameters mentioned. While it was thought that the four-week period might be short, it was observed that abdominal (diaphragm) respiratory training was effective on the s / z ratio of aerodynamic parameters.
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    Effect of human development index parameters on tuberculosis incidence in Turkish provinces
    (J Infection Developing Countries, 2016) Taylan, Mahsuk; Demir, Melike; Yilmaz, Sureyya; Kaya, Halide; Sen, Hadice Selimoglu; Oruc, Menduh; Icer, Mustafa
    Introduction: A country's development level is measured with a quantitative parameter called the human development index (HDI). The present study researched the effects of HDI parameters (such as healthcare standards, income, and education level) on the incidence of tuberculosis. Methodology: HDI data of 36 provinces of Turkey and the tuberculosis surveillance data were obtained from the Ministry of Development and the Ministry of Health, respectively. The associations between the incidence of tuberculosis and other HDI parameters were analyzed. Results: Higher population density (n/km(2)) (CI = 0.05 to 0.40) and higher relapse rate of tuberculosis (CI = 0.36 to 1.48) were identified to be independent predicting factors that increased the incidence of tuberculosis, whereas higher gross national product (CI =- 0.06 to 0.00), the population that holds a green Medicare card(CI=-0.58 to -0.04), increased general practitioners per 100,000 people (CI=-0.66 to -0.01), female population (CI = -0.70 to -0.06), married population (CI = -1.34 to -0.03), were found to be significant negative predicting factors that were relevant to the incidence (protective against tuberculosis). Conclusions: Tuberculosis is a disease that is affected by multiple factors, including the components of HDI. Improvement of income level, facilitation of access to health services via health insurance, urbanization with lower population density strategy, and provision of enough general practitioners may be useful in reducing the incidence of TB' in provinces of developing countries such as Turkey.
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    Effect of Sleep Quality on Hemodynamic Response to Exercise and Heart Rate Recovery in Apparently Healthy Individuals
    (Canadian Soc Clinical Investigation, 2014) Yuksel, Murat; Yildiz, Abdulkadir; Demir, Melike; Bilik, Mehmet Z.; Ozaydogdu, Necdet; Aktan, Adem; Isik, Ferhat
    Purpose: Poor sleep quality has an unfavorable impact on autonomic nervous system activity, especially that of the cardiovascular (CV) system. The heart rate (HR) and blood pressure (BP) at rest and during exercise, along with the heart rate recovery (HRR), were examined in poor sleepers and compared with individuals with good sleep quality. Methods: A total of 113 healthy individuals were enrolled to the study. All participants performed treadmill stress testing. Sleep quality of participants was assessed by using the Pittsburgh Sleep Quality Index (PSQI) questionnaire: 48 subjects were categorized as 'poor sleepers' (PSQI score > 6 points), and the rest were grouped as 'good sleepers'. Results: The poor sleepers showed higher resting HR (p<0.001), higher diastolic BP (p=0.006), similar systolic BP (p=0.095), more frequent hypertensive response to exercise (p=0.046) and less HR increase with exercise (chronotropic incompetence) (p=0.002) compared with individuals who reported good sleep quality. In addition, the poor sleepers demonstrated reduced heart rate recovery at the 1st and 3rd minute of recovery (p=0.005 and 0.037, respectively) compared with good sleepers. Multivariate logistic regression analysis revealed that only resting diastolic BP was the independent predictor of HRE. The PSQI score was positively correlated with resting HR; while it was negatively correlated with HR response to exercise, HRR1 and HRR index-1. Conclusion: This cross-sectional study emphasizes the effect of poor sleep quality on unfavorable cardiovascular outcome indicators of the treadmill stress test.
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    Evaluation of mean platelet volume and platelet distribution width in patients with chronic obstructive pulmonary disease
    (European Respiratory Soc Journals Ltd, 2015) Karadeniz, Gulistan; Aktogu, Serir; Erer, Onur Fevzi; Kir, Serpil Bulac; Doruk, Sibel; Demir, Melike
    [Abstract Not Available]
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    Evaluation of New Biomarkers in the Prediction of Malignant Mesothelioma in Subjects with Environmental Asbestos Exposure
    (Springer, 2016) Demir, Melike; Kaya, Halide; Taylan, Mahsuk; Ekinci, Aysun; Yilmaz, Sureyya; Teke, Fatma; Sezgi, Cengizhan
    The purpose of this study was to investigate the potential value of certain biomarkers in predicting the presence of malignant pleural mesothelioma (MPM) in individuals environmentally exposed to asbestos. This prospective study investigated three groups; a control group composed of 41 healthy subjects, an asbestos exposure group consisting of 48 individuals, and a MPM group consisting of 42 patients. Serum levels of soluble mesothelin-related peptide (SMRP), thioredoxin-1 (TRX), epidermal growth factor receptor (EGFR), fibulin-3, syndecan-1 (SDC-1), and mesothelin were determined. Benign pleural plaques were present in 27 (58.3 %) of the individuals in the asbestos exposure group. The asbestos exposure group had significantly higher mean TRX, SMRP, and mesothelin levels compared to the control group (p = 0.023, p = 0.011, and p < 0.001, respectively). Compared to the asbestos exposure group, the MPM group had significantly higher mean EGFR, TRX, SMRP, and fibulin-3 levels (p = 0.041, p = 0.023, p = 0.002, and p = 0.001, respectively), and significantly lower mean SDC-1 levels (p = 0.002). Unlike the other biomarkers, SMRP and TRX levels increased in a graded fashion among the control, asbestos exposure, and MPM groups, respectively. Area under the curve values for SMRP and TRX were 0.86 and 0.72, respectively (95 % CI 0.79-0.92 and p < 0.001 for SMRP, and 95 % CI 0.62-0.81 and p < 0.001 for TRX). The cut-off value for SMRP was 0.62 nmol/l (sensitivity: 97.6 %, specificity: 68.9 %, positive predictive value (PPV): 56.2 %, and negative predictive value (NPV): 98.3 %) and for TRX was 156.67 ng/ml (sensitivity: 92.9 %, specificity: 77.6 %, PPV: 41.4 %, and NPV: 92.1 %). The combination of the biomarkers reached a sensitivity of 100 %, but had lower specificity (as high as 27.7 %). Serum biomarkers may be helpful for early diagnosis of MPM in asbestos-exposed cases. SMRP and TRX increased in a graded fashion from the controls to asbestos exposure and MPM groups. These two seem to be the most valuable biomarkers for the diagnosis of MPM, both individually and in combination.
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    Evaluation of pulmonary function after radiotherapy using helical tomotherapy for breast cancer treatment: Prospective study
    (KARE yayıncılık, 2016) Teke, Fatma; Demir, Melike; Bucaktepe, Pakize Gamze Erten; Kaya, Mehmet Ali; Doğan, Mehmet Hakan; Küçüköner, Mehmet; Zincircioğlu, Seyit Burhanedtin; Teke, Memik
    Purpose of the present study was to investigate acute pulmonary changes using pulmonary function tests (PFTs) after breast cancer irradiation with helical tomotherapy (HT). METHODS Forty patients were included in this study. Pretreatment and 3 months after completion of radiotherapy (RT), values of forced vital capacity (FVC), forced expiratory volume in first second (FEV1), and FEV1/ FVC ratio were measured and recorded. RESULTS Restrictive pattern was seen in 4 patients in baseline PFTs and moderate deterioration was observed in their measurements of PFT at 3 months after RT. Obstructive pattern was defined in only 1 patient in baseline PFTs and it remained unchanged after RT. Mild obstructive pattern in 4 patients and mild restrictive pattern in 3 patients had developed at 3 months after RT. CONCLUSION Minimal changes that result in mild restrictive and obstructive pattern in PFTs can be seen in acute phase after RT with HT.
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    Evaluation of subclinical papilledema in patients with obstructive sleep apnea syndrome
    (Yüzüncü Yıl Üniversitesi Tip Fakültesi, 2019) Özkurt, Zeynep Gürsel; Demir, Melike; Yıldırım, Yusuf; Balsak, Selahattin; Karaalp, Ümit
    The aim of this study is to analyze optic nerve head total retinal thickness (TRT) in Obstructive Sleep Apnea Syndrome (OSAS) and demonstrate a possible subclinical papilledema Thirty-six patients with suspected OSAS underwent standard overnight polysomnography and were grouped into mild, moderate and severe. Seventy eyes of thirty six OSAS patients and seventy -two eyes of healthy controls were included. Retinal nerve fiber layer thicknesses (RNLF) and TRT s were measured by optic coherence tomography. RNFL segment values showed no difference between OSAS and control groups. RNFL superior segment and inferonasal segments of the mild OSAS subgroup were found to be thinner than the moderate and severe OSAS subgroups (p=0.034, p=0.025, respectively). RNFL point values also showed no difference between the two groups. The RNFL inferior point of the mild OSAS subgroup was found to be thinner than the moderate and severe subgroups (p=0.036). OSAS TRTs were thinner than the controls at inferior and temporal points (p=0.005, p=0.033, respectively). The TRT inferior point of the mild OSAS subgroup was found to be thinner than the moderate and severe subgroups (p=0.006). At all points RNFL values were subtracted from the TRT values and compared. At the temporal point the OSAS group’s TRT-RNFL was thinner than that of the control groups (p=0.029). TRT measurements could not demonstrate a possible subclinical papilledema. Thinning of RNFL thickness and TRT in OSAS patients could be the result of hypoxemia related chronic atrophy.
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    The evaluation of the factors that affects the smoking behaviours in a group of high school students in Turkey
    (European Respiratory Soc Journals Ltd, 2015) Demir, Melike; Karadeniz, Gulistan; Demir, Fikri; Karadeniz, Cem; Kaya, Halide; Yenibertiz, Derya; Aylan, Mahsuk T.
    [Abstract Not Available]
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    EVALUATION OF TPEAK-TEND INTERVAL AND TPEAK-END/QT RATIO IN PATIENTS WITH SARCOIDOSIS
    (Mattioli 1885, 2016) Ucsular, Fatma; Karadeniz, Gulistan; Karadeniz, Cem; Yalniz, Enver; Demir, Melike
    Background: Tp-e interval which represents the interval between the peak and the end of the T-wave on electrocardiogram (ECG), can be used as a marker of transmural dispersion of repolarization. Also, Tp-e/QT and Tp-e/QTc ratios are used as an index of arrhythmogenesis. Prolonged Tp-e interval and Tp-e/QT ratio was found associated with sudden cardiac death in different clinical conditions. Novel ventricular repolarization parameters, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios have not been evaluated in patients with sarcoidosis without cardiac symptoms previously. Therefore, we investigated Tp-e interval in patients with pulmonary sarcoidosis. Methods: Sixty-one consecutive patients diagnosed with biopsy-proven pulmonary sarcoidosis were retrospectively reviewed. The 12-lead ECG examinations were performed at speed of 25 mm/s while the patients were in supine position. QT dispersion, Tp-e intervals and Tp-e/QT ratio were measured. Results: Comparison of ECG parameters between two groups showed a significantly higher average heart rate (p<0.05) in the patients with sarcoidosis than controls. QT dispersion was higher in patients group. Tp-e interval was significantly prolonged in the study group compared to the control group (92+/-21 ms and 85+/-14 ms, respectively; p<0.05). Tp-e/QT and Tp-e/QTc ratios were significantly higher in patients with sarcoidosis compared to control subjects (all p values < 0.05). Conclusions: The novel repolarization parameters Tp-e interval, Tp-e/QT and Tp-e/QTc ratios are increased in patients with sarcoidosis without any cardiac symptoms. These parameters might be used as a marker for predicting the ventricular arrhythmias and sudden cardiac death in patients with sarcoidosis.
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    Evaluation of ventricular arrhythmogenesis in patients with sarcoidosis
    (European Respiratory Soc Journals Ltd, 2015) Ucsular, Fatma; Karadeniz, Gulistan; Karadeniz, Cem; Yalniz, Enver; Demir, Melike
    [Abstract Not Available]
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    FACTORS ASSOCIATED WITH MORTALITY AMONG TUBERCULOSIS PATIENTS IN SOUTHEAST TURKEY
    (Carbone Editore, 2015) Yilmaz, Sureyya; Taylan, Mahsuk; Sen, Hadice Selimoglu; Abakay, Ozlem; Demir, Melike; Kaya, Halide; Yilmaz, Zulfukar
    Introduction: Tuberculosis (TB) is a disease caused by bacillus mycobacterium tuberculosis. Tuberculosis is a preventable and treatable disease that, despite the rapid advances in active therapy, continues to cause global mortality. In this study, we investigated the risk factors associated with mortality in patients undergoing treatment for TB. Materials and methods: Records of 2,450 tuberculosis patients who were followed-up with in tuberculosis dispensaries in the city of Diyarbakir, southeast Turkey, between January 2005 and December 2011 were reviewed retrospectively. Case definitions and treatment outcomes were classified according to WHO criteria. Results: Of the 2,450 registered TB patients, 1,339 were male (54.7%) and 1,111 were female (45.3%). Their mean age was 32.15 +/- 17.87 years, and 51 (2.1%) of them died. Mortality rates were higher in pulmonary TB (PTB) patients, males, relapse patients, category 2 patients, those >65 years old, TB meningitis patients, and patients who self-administered their therapy. According to Kaplan-Meier analysis, the mortality rates were significantly higher in patients aged >65 years, in those with Category II and in those TB meningitis. The significant independent risk factors for mortality during anti-TB treatment were advanced age, TB meningitis and gastrointestinal TB. Conclusion: Mortality was increased in the elderly, males, those with relapse, and in category II and extrapulmonary TB patients. Based on these data, we suggest that tuberculosis control programs should pay more attention to the high-risk groups determined in the current and previous studies. Treatment regimens for these risk groups should be considered for revision.
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    Histopathological and Biochemical Effects of Ecballium elaterium on Sepsis-Induced Lung Injury
    (Taylor & Francis Inc, 2016) Demir, Melike; Taylan, Mahsuk; Kaya, Halide; Ekinci, Aysun; Arslan, Demet; Aslan, Emel; Keles, Aysenur
    Purpose: The aim of this study was to investigate the role of Ecballium elaterium (EE) on sepsis-induced lung injury. Materials and Methods: A total of 30 male rats were divided into three groups as follows: control, sepsis, and treatment groups (sepsis + EE) with each group containing 10 rats. A rat model of sepsis induced by cecal ligation and puncture (CLP) was used. In the treatment group, rats were injected intraperitoneally with 2.5mg/kg EE after CLP. Interleukin-6 (IL-6), tumor necrosis factor (TNF)-, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values after a 24-hr period were measured via cardiac puncture. Animals were harvested after the procedure and biochemical analysis was done and histopathological changes of the tissue sections of lungs were examined thereafter. Results: A statistically significant decrease was observed in the IL-6 (p < .05), TNF- (p < .05), and TOS (p < .01) levels in the sera of the treatment group compared to those of the sepsis group. Following the treatment, the TOS (p = .01) and OSI (p < .05) levels in the lung tissue of rats indicated a statistically significant decrease compared to those of the sepsis group. The histopathological follow-up undertaken after the administration of the EE treatment to septic rats showed significantly lower values of alveolar wall thickness (p < .001), interstitial edema (p = .018), and neutrophil infiltration (p = .047). Conclusion: EE treatment may have beneficial effects on sepsis-induced lung injury, and therefore has potential for clinical use.