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Biomedical subjects

M Başoğlu

Publications and source records attributed to M Başoğlu.

At least 19 recordsLinked to original sources
PubMed2006

Neurological complications of prolonged hunger strike.

We investigated neurological findings in 41 prisoners (mean age: 28.6) who participated in a hunger strike between 2000 and 2002. All cases were evaluated using neuropsychological, neuroradiological, and electrophysiological methods. The total duration of fasting ranged from 130 to 324 days (mean 199 days). All cases had 200-600 mg/day thiamine orally for 60-294 days (mean 156) during the hunger strike, and had neurological findings consistent with Wernicke-Korsakoff syndrome. All 41 patients exhibited altered consciousness which lasted from 3 to 31 days. All patients also presented gaze-evoked horizontal nystagmus and truncal ataxia. Paralysis of lateral rectus muscles was found in 14. Amnesia was apparent in all cases. Abnormal nerve conduction study parameters were not found in the patient group, but the amplitude of compound muscle action potential of the median and fibular nerves and sensory nerve action potential amplitude of the sural nerve were lower than the control group, and distal motor latency of the posterior tibial nerve was significantly prolonged as compared with the control group. The latency of visual evoked potential was prolonged in 22 cases. Somatosensory evoked potential (P37) was prolonged but not statistically significant. Our most significant finding was that the effect of hunger was more prominent on the central nervous system than on the neuromuscular system, despite the fact that all patients were taking thiamine. In our opinion, partial recovery of neurological, and neurocognitive signs in prolonged hunger could be a result of permanent neurological injury.

Adult↗
PubMed2003

A brief behavioural treatment of chronic post-traumatic stress disorder in earthquake survivors: results from an open clinical trial.

BACKGROUND: Natural disasters such as earthquakes affect large numbers of people. Given the extent of the mental health problem following earthquakes, brief, effective and cost-effective treatment interventions are urgently needed. The present study examined whether cognitive-behavioural treatment could be shortened to a minimum number of sessions without undermining its effectiveness in post-traumatic stress disorder (PTSD). METHOD: The study participants (N=231) were consecutive referrals to five project sites in the earthquake region in Turkey a mean of 13 months after the disaster. A modified behavioural treatment (BT) was used, which involved self-exposure instructions based on an enhancement of 'sense of control' rather than a habituation rationale and minimal cognitive interventions. The duration of treatment was variable, involving as many sessions as required for clinical improvement. Survival analysis was used to explore the minimum number of sessions required for clinical improvement, and multiple regression analysis to examine the predictors of outcome. RESULTS: The survivors received a mean of 4-3 sessions. Significant treatment effects and clinically meaningful effect sizes were noted on all measures. The treatment improved all PTSD and depression symptoms. The cumulative proportion of improved cases was 76% after one session and 88% after two sessions. No baseline variable predicted treatment outcome. CONCLUSIONS: The modified BT appears to be promising as an effective one- or two-session intervention for earthquake survivors. It may be particularly useful in large-scale disasters as a cost-effective treatment that can be relatively easily disseminated to mass populations. Further research is needed to clarify the possible role of a treatment focus on sense of control in rapid recovery from traumatic stress.

Adult↗
PubMed2003

Olanzapine efficacy in the treatment of essential tremor.

We investigated the anti-tremor effect of olanzapine, a novel atypical antidopaminergic drug, in 37 patients with essential tremor (ET) in an open-label and prospective study by clinical scoring and patient self-evaluation. Olanzapine monotherapy appears to be efficacious for the treatment of ET. Further clinical trials with control groups are indicated to establish the efficacy of olanzapine in patients with ET.

Aged↗
PubMed2001

A study of the validity of a screening instrument for traumatic stress in earthquake survivors in Turkey.

The validity of a Traumatic Stress Symptom Checklist (TSSC), which was developed as part of a Screening Instrument for Traumatic Stress in Earthquake Survivors (SITSES), was examined in 130 survivors of the recent earthquake in Turkey. Data were obtained on the TSSC, which consists of 17 DSM-IV posttraumatic stress disorder (PTSD) items and 6 symptoms of depression. The Clinician-Administered PTSD Scale and the Major Depressive Episode module of the Semistructured Clinical Interview for DSM-IV were used for comparison with the TSSC. The results indicated that the TSSC has high internal consistency and satisfactory sensitivity and specificity in predicting the diagnosis of PTSD and major depression. The SITSES appeared to be a useful instrument in screening earthquake survivors for PTSD, major depression, illness severity, and risk factors associated with traumatic stress responses.

Adult↗
PubMed2001

[Thromboembolic prophylaxis after major abdominal surgery].

PURPOSE: To investigate the efficacy of prophylaxis modalities after major abdominal surgery. PATIENTS AND METHODS: Patients who underwent major abdominal surgery between October 1998 and October 1999 were randomly divided into 3 groups. The patients in Group 1 received compression stockings, in Group 2 0.3 ml low-molecular weight heparin (nadroparine calcium 0.3 ml, 2850 IU AXa LMWH) subcutaneously and in Group 3 compression stockings and 0.3 ml LMWH. All symptomless patients evaluated with low extremity deep venous Doppler ultrasonography (DUSG), and patients who had pulmonary embolus (PE) suspicion evaluated with pulmonary scintigraphy. RESULTS: There were 91 patients in Group 1, 91 patients in Group 2 and 92 patients in Group 3. The mean age was 57.25 +/- 13.12, 54.53 +/- 13.54, and 53.65 +/- 13.28 respectively. Male/female ratio was 51/38, 56/35 and 62/30, in Group 1, 2 and 3 respectively. Twenty-seven patients in Group 1, 26 patients in Group 2 and 37 patients in Group 3 had risk factors. DUSG showed deep venous thrombosis (DVT) on the 7th postoperative day in 10 patients in Group 1, in 8 patients in Group 2 and in 3 patients in Group 3. Pulmonary scintigraphy showed PE suspicion in 6 patients in Group 1, 1 patient in Group 2 and 1 patients in Group 3. Wound hematoma and hemorrhage from abdominal drains were developed in 1/0, 8/2 and 3/1 patients in Groups 1, 2 and 3 respectively. Four patients in Group 1 and 2 patients in Group 2 died during the treatment (2.2%). Satistical analysis showed significant differences in PE and wound hematoma between Groups 1 and 2, in DVT and PE between Groups 1 and 3, in risk factors between Groups 2 and 3 (p < 0.05). The differences in DVT and PE and hematoma between group 2 and 3 were not significant. CONCLUSION: All treatment modalities could not prevent all thromboembolic complications. In our study combined treatment was the most effective one.

Abdomen↗
PubMed2000

[Perforated peptic ulcers].

Two hundred forty-eight patients were operated for perforated peptic ulcer between 1983 and 1998. Of the patients 112 (45.1%) had chronic, 34 (13.7%) had acute ulcer history and 102 (41.2%) had no ulcer history. Of the patients 228 (92.0%) had duodenal, 9 (3.6%) had juxtapyloric, 6 (2.4%) had marginal, and 5 (2.0%) had antral ulcer. Forty two patients (16.9%) admitted within 12 hours and 206 patients (83.1%) between 12 hours and six days after perforation. Simple closure and omental patch was performed in 32 patients (12.9%) who had severe concomitant illness and 126 (50.8%) intraabdominal sepsis, truncal vagotomy + pyloroplasty in 32 (12.9%), simple closure + omental patch + truncal vagotomy + gastroenterostomy in 34 (13.7%), simple closure + omental patch + parietal cell vagotomy in 21 (8.5%), truncal vagotomy + antrectomy in 3 (1.2%). Patients who didn't have definitive procedure received H2 receptor blockers or proton pomp inhibitors. One hundred ninety-three patients (77.8%) underwent endoscopic control. Two of 53 patients with definitive procedure (3.8%) and 34 of 140 patients (24.3%) with simple closure had recurrence. Two patients in simple closure group underwent parietal cell vagotomy, the others received medical treatment. The recurrence rate was significantly higher in simple closure group (p < 0.01).

Acute Disease↗
PubMed1999

Surgical treatment of hydatid disease of the liver: review of 304 cases.

HYPOTHESIS: To review the results of different modalities of treatment of hydatid disease of the liver. DESIGN: Retrospective study of 304 patients. SETTING: A university hospital in Turkey. PATIENTS: Three hundred four patients with hepatic hydatid disease who underwent operation between 1981 and 1996. MAIN OUTCOME MEASURES: Mortality and morbidity. RESULTS: Two hundred thirty-eight patients had a cyst on the right lobe, 41 patients had a cyst on the left lobe, and 25 patients had a cyst on both lobes. Forty-five patients had multiple hepatic cysts and 18 patients had coexisting cysts in other intra-abdominal organs. Surgical procedures were tube drainage, capitonnage, omentoplasty, cystectomy, segmentectomy, and cystoenterostomy. Of the patients with tube drainage, 36 developed an infection of the remaining cavity, 10 developed long-lasting biliary fistula, 8 developed cholangitis, and 6 developed septicemia. Four patients died of unreleated complications. Of the patients with capitonnage, 7 developed cholangitis and 3 developed an infection of the remaining cavity. Of the patients with omentoplasty, 1 developed an infection of the remaining cavity and 1 developed cholangitis. One patient who underwent segmentectomy developed pulmonary complications. Of the patients with cystoenterostomy, 1 developed cholangitis, 1 developed septicemia, and 1 developed pulmonary complications. CONCLUSION: For management of hydatid disease of the liver, capitonnage, omentoplasty, cyst excision, segmentectomy, or cystoenterostomy are all superior to tube drainage.

Adolescent↗
PubMed1999

Long-term effects of alprazolam on memory: a 3.5 year follow-up of agoraphobia/panic patients.

BACKGROUND: Benzodiazepines (BZs) can impair explicit memory after a single dose and also when taken repeatedly for treatment of anxiety disorders. A previous study with agoraphobia/panic patients found that the BZ alprazolam impaired memory during an 8-week treatment and residual impairments were still manifest several weeks after drug withdrawal (Curran et al. 1994). The present study followed up the same group of patients 3.5 years after treatment to determine whether those memory impairments persisted. METHOD: Thirty-one patients, 15 who had originally been treated with alprazolam and 16 with placebo, were assessed on a battery of psychometric tests and self-rating scales. RESULTS: Ex-alprazolam patients performed at the same levels as ex-placebo patients on the memory task and on other objective tests. Performance levels of both groups were similar to pre-treatment baselines, however there were differences in subjective ratings whereby ex-alprazolam patients rated themselves as less attentive and clear headed and more incompetent and clumsy than ex-placebo patients. CONCLUSIONS: Explicit memory impairments found while patients were taking alprazolam and weeks after drug withdrawal did not persist 3.5 years later. We suggest that the memory impairments observed in our previous study weeks after withdrawal of alprazolam were not residual effects of alprazolam but rather were due to the drug's interference with practice effects on the tests and habituation of anxiety over repeated exposure to the test situation.

Adult↗
PubMed1997

Double-blindness procedures, rater blindness, and ratings of outcome. Observations from a controlled trial.

BACKGROUND: We determined whether blindness in a double-blind randomized controlled trial of alprazolam and exposure therapies in patients with panic disorder and agoraphobia was maintained in assessors and patients, what were the factors related to "unblinding," and whether unblinding was associated with clinical outcome. METHOD: In 129 patients with panic disorder and agoraphobia who were randomized to alprazolam-exposure, placebo-exposure, alprazolam-relaxation, or placebo-relaxation conditions, blindness was tested at the end of treatment by the independent assessors' and patients' classification of the treatment condition. RESULTS: Assessors' classifications were correct in 82% of the alprazolam group and 78% of the placebo group; corresponding figures for patients' classifications were 73% and 70%, respectively. Factors associated with unblinding included drug side effects but not assessors' ratings of treatment outcome. CONCLUSION: Judgment of the validity of the outcome of a randomized controlled trial is easier if the report notes not only the use of a double-blindness procedure but also details how blind the raters remained and how any unblinding affected their ratings of clinical outcome.

Agoraphobia↗
PubMed1997

Psychological preparedness for trauma as a protective factor in survivors of torture.

BACKGROUND: Although much research has focused on mechanisms of traumatization and factors related to post-trauma psychological functioning in survivors of trauma, there have been few studies of survivors of torture despite the widespread practice of torture in the world. The aim of this study was to examine the role of 'psychological preparedness' for trauma in post-traumatic stress responses in survivors of torture. METHOD: Thirty-four torture survivors who had no history of political activity, commitment to a political cause or group, or expectations of arrest and torture were compared with 55 tortured political activists, using structured interviews and measures of anxiety, depression, and post-traumatic stress disorder. RESULTS: Compared with tortured political activists, tortured non-activists were subject to relatively less severe torture but showed higher levels of psychopathology. Less psychological preparedness related to greater perceived distress during torture and more severe psychological problems, explaining 4% of the variance in general psychopathology and 9% of the variance in post-traumatic stress disorder symptoms. CONCLUSIONS: The study findings lend support to the role of prior immunization to traumatic stress and to unpredictability and uncontrollability of stressors in the effects of traumatization. Further research aimed at identifying the behavioural and cognitive components of psychological preparedness that play a role in traumatization may provide useful insights into effective treatment strategies for survivors of torture.

Adaptation, Psychological↗
PubMed1997

Agoraphobia and panic disorder: 3.5 years after alprazolam and/or exposure treatment.

BACKGROUND: Long-term follow-ups after controlled studies of exposure therapy for agoraphobia/panic are few. Most of these studies found that improvement during treatment persists to the end of follow-up. METHODS: Out of 69 patients with panic disorder plus agoraphobia who had been in an 8-week controlled study of alprazolam and/or exposure, 31 were followed up at a mean of 3.5 years later (4 years after trial entry). The 31 patients followed up included more cases who had relapsed at week 43 than did the group which did not attend the 3.5-year follow-up. RESULTS: As a group, followed-up cases maintained their gains over the 3.5 years, more so among ex-exposure than ex-relaxation cases. Ex-exposure patients did significantly better than relaxation patients on disability and survival time. Ex-alprazolam and ex-exposure patients did not differ significantly on any variable at the 3.5-year follow-up. No baseline variable predicted outcome at follow-up. CONCLUSIONS: Present results modestly confirm those of previous studies finding lasting improvement years after exposure, though some residual symptoms were the norm.

Adult↗
PubMed1997

Glutathione and nitric oxide concentrations in glutamine-infused rabbits with intestinal ischaemia/reperfusion.

Intestinal ischaemia/reperfusion causes formation of reactive oxygen intermediates which lead to mucosal cell injury. Glutathione, a scavenger of reactive oxygen intermediates, protects tissues from reactive oxygen intermediate-mediated cell injury. Nitric oxide is a lipophilic gas and its synthesis is stimulated by ischaemic conditions. In this experimental study, we aimed to investigate the role of i. v. L-glutamine infusion on mucosal tissue glutathione and serum nitric oxide concentrations in intestinal ischaemia/reperfusion. External jugular vein of albino rabbits was cannulated with catheter and infused with normal saline at 4 ml/h. After 3 days, they were randomly divided into two main groups. Group 1 (n = 30) received i. v. normal saline alone, group 2 (n = 30) received normal saline + 205 mmol/l glutamine at 4 ml/h for 24 hours. Next, mucosal glutathione and serum nitric oxide concentrations were measured after 0, 30, 60 min of ischaemia/60 min of reperfusion. Basal glutathione concentrations were similar in normal saline alone and normal saline + 205 mmol/l glutamine infusion groups (p > 0.05). At 30 and 60 min of ischaemia/60 min of reperfusion, glutathione concentrations were significantly lower in normal saline-infused rabbits compared to the normal saline + 205 mmol/l glutamine-infused rabbits (p < 0.05). In addition, serum nitric oxide concentrations were found to be significantly increased in rabbits 30 and 60 min after ischaemia/reperfusion when compared to mean basal nitric oxide concentrations obtained from control animals. However, the normal saline + 205 mmol/l glutamine group had lower serum nitric oxide concentrations than did the normal saline alone group. In conclusion, this study revealed that intestinal mucosal glutathione concentrations were significantly higher in glutamine-receiving rabbits than in non-receiving ones. Additionally, it was shown that nitric oxide concentrations increased in ischaemia both in normal saline alone and normal saline + 205 mmol/l glutamine receiving groups, while this increase in nitric oxide was more prominent in the normal saline alone group (p < 0.01). These findings show that glutamine supplementation may protect the small intestine from ischaemia/reperfusion injury and may play a regulatory role in the biosynthesis of nitric oxide.

Animals↗
PubMed1997

Fournier's gangrene: review of fifteen cases.

Fournier's gangrene is a synergistic necrotizing fasciitis of the perineum and abdominal wall along with the scrotum and penis in men and the vulva in women. The process was believed to be idiopathic in initial descriptions. Fifteen patients were treated for Fournier's gangrene between 1990 and 1995 in the Departments of General Surgery and Urology, School of Medicine, Atatürk University, Erzurum, Turkey. The most common causes were perianal sepsis and urogenital diseases. Escherichia coli and Staphylococcus aureus were identified most commonly in cultures of necrotic tissue. The mortality rate was 20 per cent despite aggressive surgical debridement and broad-spectrum antibiotics.

Adult↗
PubMed1996

Appraisal of self, social environment, and state authority as a possible mediator of posttraumatic stress disorder in tortured political activists.

This study examined appraisal of self and others, as measured by semantic differential ratings of Police, State, Society, Family, Friend, Myself as a Man/Woman, and Myself as a Political Person, in 55 tortured political activists in Turkey, 55 nontortured political activists, and 55 nontortured, politically noninvolved controls. There were no remarkable differences between tortured and nontortured political activists; both groups differed from controls in having a more negative appraisal of the police and the state and stronger perceptions of danger, mistrust, and injustice in relation to state authority. Lack of beliefs concerning a "benevolent state" may have protected the survivors from the traumatic effects of state-perpetrated torture. Further research into the possible protective role of belief systems in posttraumatic stress disorder is needed.

Adult↗
PubMed1996

Does exposure to internal cues enhance exposure to external cues in agoraphobia with panic? A pilot controlled study of self-exposure.

BACKGROUND: The value of internal (interoceptive) cues for exposure is under debate and so was tested in a pilot controlled study. METHODS: Outpatients with panic disorder and severe agoraphobia were randomised to 10 weeks of self-exposure to either (1) both internal (interoceptive) and external cues (n = 12) or (2) external cues only (n = 14). Both groups were trained in slow deep breathing and asked to carry out daily self-exposure homework. Neither group had cognitive restructuring. RESULTS: By post-treatment and follow-up all outcome measures improved significantly in both treatment groups. The two groups did not differ significantly in outcome, though slightly more patients who had exposure to both internal and external cues improved 50% or more on phobic avoidance and fear. CONCLUSIONS: A larger controlled study is now worthwhile to tell if such small differences can be significant.

Adolescent↗
PubMed1994

Factors related to long-term traumatic stress responses in survivors of torture in Turkey.

OBJECTIVE: To examine factors related to long-term psychological functioning in political ex-prisoners who had been subjected to systematic torture. DESIGN: The psychological status of 55 tortured political activists, 55 nontortured political activists, and 55 subjects with no history of torture or political activism was assessed using Structured Clinical Interview for DSM-III for psychiatric assessment, Semi-structured Interview for Survivors of Torture, and other self-rated and assessor-rated measures of anxiety, depression, and posttraumatic stress disorder (PTSD). Correlational and multiple regression analyses were used to assess the independent effects of precaptivity, captivity, and postcaptivity variables as predictors of long-term psychological status among the torture survivors. SETTING: Istanbul, Turkey. MAIN OUTCOME MEASURES: Number of lifetime and current PTSD symptoms, and scores on the Beck Depression Inventory, Hamilton Depression Rating, Hamilton Anxiety Scale, and State-Trait Anxiety Inventory. RESULTS: Effect of captivity experience on various life areas (eg, family and social, economic, and employment status) and other postcaptivity psychosocial stressors were associated with PTSD symptoms, anxiety, and depression. Perceived severity of torture was related to PTSD symptoms but not to anxiety or depression. Lack of social support predicted anxiety and depression but not PTSD. Family history of psychiatric illness correlated with higher scores on most measures. Impact of captivity experience on family was the strongest predictor of PTSD symptoms. CONCLUSIONS: These findings point to three types of stressors related to different aspects of psychopathology in survivors of torture: perceived severity of torture, secondary effects of captivity experience on various life areas, and general psychosocial stressors following captivity. Different interventions may be needed for three components of survivors' traumatic experience: cognitive and behavioral strategies for treatment of PTSD symptoms, marital or family strategies for minimizing the impact of the trauma on the family, and strategies for enhancing social support to minimize postcaptivity depression and anxiety.

Adult↗
PubMed1994

A cross-cultural comparative study of depressive symptoms in British and Turkish clinical samples.

A cross-cultural comparison of the symptomatology of depression in Britain and Turkey was conducted in outpatient samples selected according to the same criteria, and matched for age, sex and severity; the same standardized rating instruments were also used with each sample. Comparison of the frequency and severity of individual symptoms showed higher mean ratings in the British sample for core depressive symptoms and higher ratings in the Turkish sample for symptoms reflecting somatization and a tendency to emphasize symptoms. Principal component analysis produced similar dimensions, confirmed after factor rotation, but the principal components emerged in a different order, reflecting differing contributions to the variance. In the Turkish sample, the first, general component, accounting for the greatest variance, was the somatization factor, while in the British sample it was the component that reflects core depressive symptoms. These findings indicate that there are some similarities in the symptoms of depression in the two cultures, but also differences in their predominant mode of expression.

Adult↗