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Biomedical subjects

M Duman

Publications and source records attributed to M Duman.

At least 19 recordsLinked to original sources
PubMed2006

French peritoneal dialysis registry (RDPLF): outline and main results.

The Registre de Dialyse Péritonéale de Langue Française (RDPLF Registry) is a non-profit association that has been set up to assist physicians and nurses in evaluating their practical experience and results regarding peritoneal dialysis (PD). Five French-speaking and two Spanish-speaking countries have participated in this initiative (which includes 21 000 patients). In France, 82% of all PD patients are included in the registry and the main results for the period from 1995 to January 2006 form the basis of this report: of 11 744 incident patients with a median age of 71 years, 21.5% were over 80 years of age and 56% were not able to perform PD treatment at home without assistance. Eighty-six percent of the latter group received external assistance from a private nurse and 14% were aided by their family. The overall average rate of peritonitis was one episode every 29 months. The probability of being peritonitis-free appeared to be better for patients on automated PD (59.4% at 2 year) than for those on continuous ambulatory PD (55.3%), but this finding requires further validation. The average waiting time before transplantation was about 2 years. In patients who had undergone transplantation, the peritonitis rate was one episode per 42 months before transplantation compared to one episode per 29 months for patients who had not received a transplant. Eighty-three percent of patients had a hemoglobin level greater than 11 g%. Catheter survival was 92% at 2 years post-insertion and 85% at 5 years, with 94% being implanted by experienced surgeons. In conclusion, the RDPLF results demonstrate that PD may be successfully prescribed for older patients who receive assistance either from their family or from a nurse. Further, a larger number of younger patients should also be prescribed this technique in France. Patients eligible for transplantation and on short-term PD have the lowest risk of developing peritonitis; PD before transplantation may help prolong residual renal function, and initial treatment by PD may also help to preserve vascular access for the future.

Age Distribution↗
PubMed2005

Erythropoietin attenuates lipopolysaccharide-induced splenic and thymic apoptosis in rats.

Apoptosis of lymphoid tissues during sepsis is well documented and linked to the pathobiology of organ failure and death. In this study, we evaluated the effect of a single dose of recombinant erythropoietin (EPO) on thymic and splenic apoptosis in an endotoxic sepsis model. Young male Wistar rats were divided into 3 groups and administered intraperitoneally (IP) either normal saline; lipopolysaccharide (LPS) 10 mg/kg; or EPO (5000 U/kg) 30 min before lipopolysaccharide. Six hours following LPS administration animals were sacrificed. Apoptosis was assessed by hematoxylin-eosin staining, terminal deoxynucleotide transferase-mediated fluorescein-dUTP nick end labeling (TUNEL), and caspase-3 immunostaining. When compared with animals given LPS, animals pretreated with EPO displayed reduced splenic and thymic TUNEL positivity of 44+/-3 (p<0.05) and 143+/-4 (p<0.05) nuclei per high power field (hpf), respectively. Caspase-3 positivity was also significantly reduced in the spleen and thymus, with 31+/-4 (p<0.05) and 93+/-3 (p<0.05) positive stained nuclei per hpf, respectively. Serum nitrite levels were elevated in animals given lipopolysaccharide. Pretreatment with EPO attenuated the increase in nitrite levels; however, this did not reach statistical significance. We conclude that a single dose of recombinant erythropoietin can reduce thymic and splenic apoptosis associated with lipopolysaccharide administration.

Animals↗
PubMed2005

Specific immunotherapy-induced Sjögren's syndrome.

BACKGROUND: Allergen-specific immunotherapy (SIT) is a well-documented treatment for allergic rhinitis, asthma, and allergy to bee venoms. Side-effects of SIT in long-term have not been well documented yet. Herein, we report a case of Sjögren's syndrome following SIT. CASE: The patient, a 25-year-old Caucasian woman, was started on subcutaneous grass-pollen immunotherapy. The patient's autoantibodies before the SIT screening tests were negative. We determined that anti-extractable nuclear antigen (ENA) was positive (ENA = 98.4, normal range 0-25 U) on routine screening tests at 44 weeks of her treatment, and then SIT was discontinued. The patient complained of burning and itching in her eyes for 6 months. Schirmer's and salivary flow tests were positive. Although antinuclear antigen and rheumatoid factor were negative, anti-SS-A/Ro was positive. Viral hepatitis markers were negative. Minor salivary-gland biopsy was performed, which showed grade 4 sialoadenitis. The HLA type of the patient was B55 (B22), Bw6, Cw1 for class I and DR11, DR52, DQ7 (DQ3) for class II. After the immunotherapy had been stopped, there were no changes in the symptoms and laboratory findings of the patient during the 1st year of follow-up. CONCLUSION: This is the first case to be reported of Sjögren's syndrome following SIT. Patients undergoing SIT must be carefully followed up for the development of autoimmunity and an autoimmune disease.

Adult↗
PubMed2005

Disseminated intravascular coagulation in pediatric patients: clinical and laboratory features and prognostic factors influencing the survival.

Although disseminated intravascular coagulation (DIC) has been a well-known disorder for many years, there is lack of sufficient number of clinical trials about incidence, frequency of underlying disorders, and prognosis of DIC in children. The aim of this study was to evaluate the frequency, etiologic factors, and clinical and laboratory findings of DIC and to determine the prognostic factors influencing the mortality in hospitalized pediatric patients. Medical records of 5535 children who were hospitalized were investigated. Sixty-two patients who were diagnosed as acute DIC were enrolled. The frequency of DIC was 1.12%. The underlying etiologic factors were infection in 59 patients (95.2%) and major trauma in 3 patients (4.8%). The frequency of bleeding and thrombosis was 48.8 and 4.8%. Respiratory, cardiovascular, hepatic, renal, neurologic, and gastrointestinal dysfunction was present in 71, 67.7, 35.5, 16.1, 16.1 and 11.3% of patients, respectively. Respiratory and cardiovascular dysfunctions were significantly associated with mortality. Multiorgan dysfunction syndrome (MODS) was present in 85.5% of the patients, and 54.8% of the patients had developed acute respiratory distress syndrome (ARDS). Mortality rate was significantly high in patients with MODS and ARDS. In multivariete logistic regression analysis, only ARDS and cardiovascular dysfunction had predictive and prognostic value on mortality. None of the diagnostic laboratory tests had predictive or prognostic value and the degree of abnormality of these tests did not show any correlation with mortality. In conclusion, DIC is not a rare disorder in hospitalized children, especially in patients with sepsis, and MODS, ARDS, and respiratory and cardiovascular system dysfunctions are poor prognostic factors.

Acute Disease↗
PubMed2005

Effect of melatonin on brain oxidative damage induced by traumatic brain injury in immature rats.

Progressive compromise of antioxidant defenses and free radical-mediated lipid peroxidation, which is one of the major mechanisms of secondary traumatic brain injury (TBI), has also been reported in pediatric head trauma. In the present study, we aimed to demonstrate the effect of melatonin, which is a potent free radical scavenger, on brain oxidative damage in 7-day-old rat pups subjected to contusion injury. Whereas TBI significantly increased thiobarbituric acid reactive substances (TBARS) levels, there was no compensatory increase in the antioxidant enzymes such as superoxide dismutase (SOD) and glutathione peroxidase (GPx) 24 hours after TBI in 7-day-old rats. Melatonin administered as a single dose of 5 mg/kg prevented the increase in TBARS levels in both non-traumatized and traumatized brain hemispheres. In conclusion, melatonin protects against oxidative damage induced by TBI in the immature brain.

Animals↗
PubMed2004

Serum-soluble selectin levels in patients with rheumatoid arthritis and systemic sclerosis.

Soluble forms of selectins may play a regulatory role in inflammatory responses that are key to the pathophysiology of rheumatic diseases such as rheumatoid arthritis (RA) and systemic sclerosis (SSc). The aim of this study was to examine whether the elevated serum-soluble (s) selectin levels are associated with RA or SSc. Serum sE-, sL- and sP-selectin levels were measured by sandwich enzyme-linked immunosorbent assay in 34 RA patients, 30 SSc patients and 16 healthy subjects. The levels of sE-selectin were significantly higher in RA and SSc patients than those in healthy subjects. The sL-selectin level was significantly lower in RA patients compared to healthy subjects. Serum sP-selectin levels were not significantly different among the study groups. The active RA patients had significantly higher serum sE- and sL-selectin levels compared to inactive RA patients. Also, some correlations were observed between the serum selectin levels and measures of disease activity such as erythrocyte sedimentation rate and C-reactive protein in RA patients. The higher levels of sE-selectin were found in SSc patients with pulmonary fibrosis, and there was also a negative correlation between diffusion capacity for carbon monoxide and serum sE-selectin. Serum levels of selectins may provide a useful additional marker for disease activity in RA patients and for disease severity in SSc patients.

Arthritis, Rheumatoid↗
PubMed2004

Our sigmoid colon volvulus experience and benefits of colonoscope in detortion process.

BACKGROUND/AIMS: The sigmoid colon is the most frequent site for a volvulus. In this report, we review our experience with sigmoid colon volvulus. METHODOLOGY: We present our experience of 81 cases of sigmoid volvulus admitted to our department. RESULTS: Preoperative endoscopic volvulus detortion was attempted in all patients, and in 39 of them the procedure was successful. The success rate of endoscopic detortion for sigmoid colon volvulus with a flexible colonoscope (60%) was higher than with a rigid rectosigmoidoscope (42%). In 19 of these 39 non-operatively devolvulated patients, sigmoid resection with primary anastomosis was performed within 7-10 days after reduction, but 20 patients did not accept the elective operation after a non-operative treatment. Among the 61 patients undergoing urgent or elective operation for sigmoid volvulus, there were 17 laparotomies with only detortion, 19 resections with elective anastomosis, 6 resections with primary anastomosis, and 19 resections with a Hartmann's pouch. There were 9 deaths (21%) among 42 patients who underwent an emergency operation, and one (5.2%) among the 19 patients who had elective surgery died because of a cerebral embolus. CONCLUSIONS: Initial therapy with endoscopy affords decompression and an adequate preparation of patients for surgical resection, and a flexible colonoscope has notable advantages over rigid instruments for the detortion process.

Adult↗
PubMed2003

Dermal bilirubin kinetics during phototherapy in term neonates.

AIM: To investigate dermal bilirubin kinetics during phototherapy in the presence of neonatal indirect hyperbilirubinaemia. METHODS: 33 neonates with non-haemolytic indirect hyperbilirubinaemia, who required phototherapy, were included in the study. Phototherapy modules containing four normal and four blue fluorescent lamps were used during the study. The transcutaneous bilirubin index (TcBI) was measured in an area of the forehead covered by a 2.5 cm diameter opaque patch and a nearby exposed site. The TcBI obtained from patched and unpatched areas and simultaneous serum bilirubin (SB) concentrations were measured before the start of phototherapy and after 6, 12, 18, 30, 42 and 66 h of phototherapy. RESULTS: SB concentration and the TcBI from the unpatched area decreased significantly during the first 6 h of exposure, while the TcBI obtained from the patched area decreased significantly after 12 h. The TcBI from the unpatched area was consistently lower than that from the patched area during phototherapy. After the onset of phototherapy, there was a weak, non-significant correlation between SB concentrations and the TcBI from patched and unpatched areas. CONCLUSION: Phototherapy was effective for both patched and unpatched areas, but the rate of decline was slower in patched areas, only becoming significant in the second 6 h of treatment. There was no significant correlation between the levels of SB and TcBI after the onset of phototherapy, and therefore the use of TcBI cannot be recommended as a surrogate measure of SB.

Bilirubin↗
PubMed2002

Treatment outcome of adolescents with acute lymphoblastic leukemia.

Despite intensified chemotherapy, adolescents with acute lymphoblastic leukemia (ALL) still have lower rates of survival than younger children. The purpose of our study was to compare the treatment outcome and presenting clinical and laboratory features of adolescent and younger children with newly diagnosed ALL who were treated at our pediatric hematology department. Between April 1991 and February 2000, 42 children up to 18 years of age who were newly diagnosed with ALL and treated adequately with modified ALL Berlin-Frankfurt-Münster (BFM) 90 or 95 protocols were included in this study. The patients were examined in two groups according to their ages: the first group consisted of children who were <14 years old and the second group consisted of adolescents who were >14 years old. The median age of 42 patients was 6.5 years (range: 1-16.5 years); 26% of the patients were adolescents. The results of this study demonstrated that after a median observation time of 6 years the overall survival (OS) and event-free survival (EFS) of patients who were <14 and >14 years of age were 75% vs 49% and 70% vs 40%, respectively. When adolescent and younger patients were compared to each other according to gender, WBC count at administration, French-American-British (FAB) classification, immunophenotypes, risk groups, early deaths, and relapse rates, there were no statistically significant differences. Comparative data from other studies and data from this study indicate that adolescents with ALL still have shorter OS and EFS than younger children and a steady improvement in treatment outcome for adolescents with ALL over time suggests that more intensive therapy favorably influences prognosis.

Adolescent↗
PubMed2001

Autoimmune hemolytic anemia occurring with myelodysplastic syndrome: report of a pediatric case and review of the literature.

In this case report, we present a child who was admitted to hospital with the features of autoimmune hemolytic anemia (AIHA) and was diagnosed with myelodysplastic syndrome (MDS)-related AIHA. A 14-year-old female patient was admitted to our hospital with the chief complaints of palpitation, icterus, and fatigue for 2 months. She was pale and icteric. Diffuse hepatosplenomegaly was palpated. Hematological examination revealed a hemoglobin of 3.4 g/dl, red blood cell count of 2x10(12)/l, white blood cell count of 3x10(9)/l, platelet count of 14x10(9)/l, and reticulocyte count of 1.7%. Blood smear examination revealed significant anisocytosis, poikilocytosis, and tear drop cells. The direct Coomb's test was positive. Bone marrow aspirate showed hypercellularity, micromegakaryocytes, dyserythropoiesis, and dysmyelopoiesis with 2% blasts. The patient was diagnosed with MDS-refractory anemia and AIHA secondary to MDS. Rarely, AIHA can occur secondary to MDS. To our knowledge, this patient is the first pediatric case with MDS and AIHA reported in the literature.

Adolescent↗
PubMed2001

Patient information leaflets for medicines: using consumer testing to determine the most effective design.

Comprehensive medicine information leaflets for patients are now mandatory across the European Union. In 1997, the European Commission (EC) proposed a prescriptive 'model' for the leaflets and a method for consumer testing. This exploratory study compared consumers' ability to use a leaflet based on the EC model leaflet and an alternative leaflet based on best practice in information design (Mark II). The leaflets were tested in two matched groups of 20 consumers, who were required to find, and understand, 15 pieces of information in the leaflets. The target that each question should be answered correctly by 16 out of 20 consumers, was achieved for three of the 15 points in the EC leaflet, compared with eight in the Mark II leaflet. Open questioning confirmed the problems with the EC leaflet, including a failure to understand key concepts about medicine interactions and contraindications. This research demonstrates the benefits of consumer testing, ensuring that leaflets are patient-orientated. A rigid model leaflet would prevent these benefits from being utilised.

Aged↗
PubMed2001

Mass education for obesity prevention: the penetration of the BBC's 'Fighting Fat, Fighting Fit' campaign.

The study aimed to evaluate the BBC's 'Fighting Fat, Fighting Fit' campaign's success in achieving public awareness of the need for obesity prevention, and putting over its message of healthy eating and increased physical activity. Demographic factors associated with awareness of the campaign were assessed. Data were collected from a national representative British sample as part of the ONS Omnibus survey in March 1999. Questions included weight and height, recognition of the campaign name, recall of the content of the campaign, and participation in the campaign registration scheme. More than half of the respondents had heard of the campaign and 30% recalled the healthy lifestyle messages, although fewer than 1% registered to participate in the scheme. Awareness of the campaign was high in all socio-economic groups, but memory for the healthy lifestyle message was significantly poorer in those with lower levels of education and from ethnic minority groups. Disappointingly, awareness was also no higher in overweight than normal weight respondents. The results strongly support the effectiveness of the campaign in publicizing the issue of increasing prevalence of obesity and the need for lifestyle change, but suggest that different approaches might be needed to maximize participation from groups most in need of lifestyle change.

Adolescent↗
PubMed2001

Using the mass-media to target obesity: an analysis of the characteristics and reported behaviour change of participants in the BBC's 'Fighting Fat, Fighting Fit' campaign.

The study aimed to assess the characteristics and reported behaviour change of participants in the BBC's 'Fighting Fat, Fighting Fit' (FFFF) campaign. A postal questionnaire survey was sent to a random sample of 6000 adults registering with the FFFF campaign at the start of the campaign and 5 months later. Demographic characteristics, weight, eating behaviour and activity patterns were assessed. In total, 3661 respondents completed the baseline questionnaire and 2112 (58%) of these completed a follow-up evaluation questionnaire 5 months later. The majority of evaluation participants were women and classified as 'overweight' or 'obese'. Participants reported significant reductions in weight, and in fat and snack intake, and significant increases in exercise levels, and in fruit, vegetable and starch intake during the 6 months of the campaign. These effects remained significant if non-responders were assumed to have made no change. These results show that mass-media campaigns might make a contribution to weight control at the population level, but particular subgroups such as men and people under 25 may require specifically targeted campaigns. In addition, whilst such campaigns may initially attract obese people, they may be more likely to drop out of the campaign than overweight and normal weight individuals.

Adolescent↗
PubMed2000

Effect of socioeconomic status on the blood pressure in children living in a developing country.

BACKGROUND: Lower socioeconomic status has been reported to favor higher blood pressure both during childhood and adulthood, because obesity is more prevalent among this population. The aim of the present study was to evaluate the effect of socioeconomic status on blood pressure and prevalence of obesity among children living in a developing country. METHODS: Prepubertal primary school children (total number 1024, male/female ratio 513/511, mean age 10.32 +/- 0.60 years) living in Izmir, a metropolis of Turkey, were enrolled in the present study. The children were classified into three groups according to the locations of their schools as those from the well-developed (WD; n = 290), moderately developed (MD, n = 356) and underdeveloped (UD, n = 378) areas. Body mass index (BMI), ratio of BMI to the 50th percentile value of BMI for that age (BMI%) and systolic (SBP) and diastolic blood pressures (DBP) were determined in all children. Each socioeconomic group was subdivided into three subgroups with respect to BMI% as those with less than 90% (SG(< 90)), 90-110% (SG(90-110)), and more than 110% (SG(> 110)). Then, mean SBP and DBP in each subgroup of the WD, MD and UD groups were compared with the corresponding blood pressure values of each other to evaluate the effect of socioeconomic status on the blood pressure. In addition, the SBP and DBP of each subgroup were compared with other subgroups within that group to evaluate the effect of BMI on blood pressure. RESULTS: The BMI and BMI% of the UD group were significantly lower than that of the WD and MD groups (P < 0.05). In addition, the number of children with a BMI of more than 95% for their age was significantly lower in the UD group compared with the WD and MD groups (1.7, 1.9 and 0.5% in the WD, MD and UD groups, respectively, P < 0.05). The SBP and DBP were positively correlated with BMI% in each group and in all of the subjects cumulatively (r = 0.26, P < 0.001 for SBP and r = 0.34, P < 0.001 for DBP). The SBP and DBP were significantly higher in SG(> 110) than in SG(90-110) and were also higher in SG(90-110) than in SG(< 90) in each group. Mean DBP values in all subgroups of the MD and UD groups were significantly lower than the respective subgroups of the WD group. The SBP of SG(< 90) and SG(90-110) of the UD group were significantly lower than those of the corresponding subgroups of the WD and MD groups. CONCLUSION: Obesity is not more prevalent among the children of lower socioeconomic classes in Turkey as a developing country. In addition, independent of anthropometric structure, DBP and SBP were shown to be related to the socioeconomic status in childhood age groups and both values were determined to decrease in accordance with a decrease in the socioeconomic level.

Child↗
PubMed1999

Vinorelbine and carboplatin in recurrent and/or metastatic squamous cell carcinoma of the head and neck.

A phase II trial was performed to assess the safety and efficacy of the semisynthetic vinca alkaloid vinorelbine (VNR) when combined with carboplatin in recurrent and/or metastatic squamous cell carcinoma of the head and neck. Treatment consisted of VNR 30 mg/m2 in 250 ml saline, infused over 30 min on days 1 + 8, and carboplatin 300 mg/m2 in 1,000 ml saline, infused over 2 h on day 1. Treatment was continued in patients achieving objective response or stable disease for a total of 6 courses. 24 patients entered this trial, 12 of whom had received prior induction chemotherapy and radiation, 2 had palliative chemotherapy and 10 had only radiation and/or surgery. We observed 2 partial response (9.5%), stable disease in 6 patients (28.5%) and progressive disease in 13 (62%). The dose-limiting toxicity was myelosuppression with grade 3 or 4 leukocytopenia in 11 patients (46%). Thrombocytopenia was seen in only 2 patients. The most frequent nonhematological toxicity was an acute pain at the tumor site. None of the patients experienced neurological symptoms or chemically induced phlebitis. VNR combined with carboplatin does not appear to improve the therapeutic armentarium in recurrent squamous cell carcinoma of the head and neck.

Adult↗
PubMed1997

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Humans↗