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Biomedical subjects

Nural Kiper

Publications and source records attributed to Nural Kiper.

27 records · Page 2Linked to original sources
PubMed2002

[Isolation frequency of Burkholderia cepacia from cystic fibrosis patients].

Microorganisms such as Pseudomonas aeruginosa, Staphylococcus aureus and Haemophilus influenzae frequently cause colonization and infection in airways of patients with cystic fibrosis. Burkholderia cepacia has also been isolated in patients with cystic fibrosis since 1980. In this study, we aimed to determine the colonization rate of B. cepacia in 286 sputum samples obtained from 129 cystic fibrosis patients. Selective media for B. cepacia were used besides the routine microbiological media in order to increase the isolation rate. The colonies were identified by biochemical tests and the antibiotic susceptibilities of the strains were determined by disc diffusion method. Pathogenic bacteria (S. aureus, P. aeruginosa, Enterobacteriaceae, Streptococcus pneumoniae, H. influenzae) were isolated in 52 of 129 patients (40%) and 66 of 286 sputum samples (23%). In addition 2 B. cepacia strains were isolated from two different patients (1.55%). B. cepacia is now being considered as a pathogen isolated from sputum samples of patients with cystic fibrosis with an increasing frequency and causing severe clinical features. According to these results it can be concluded that, the use of selective media for B. cepacia isolation, should be taken into consideration especially by the clinical microbiology laboratories collaborating with the cystic fibrosis centers.

Adolescent↗
PubMedDate not supplied

Postinfectious bronchiolitis obliterans in children: clinical and radiological profile and prognostic factors.

BACKGROUND: Postinfectious bronchiolitis obliterans (BO) designates a clinical syndrome of chronic airflow obstruction associated with inflammatory changes in the small airways. OBJECTIVES: The aim of this study was to determine the etiology, clinical and radiological features and define prognostic factors of postinfectious BO in children. METHODS: We undertook a review of the medical records of 20 children with postinfectious BO, who were followed up between January 1994 and August 2001. RESULTS: Postinfectious BO was diagnosed in 11 boys and 9 girls with a median age of 21.5 months (6-69 months) who were followed up for a median of 23 months. Cough and wheezing persisted since the initial lung infection in all patients. Postinfectious BO was diagnosed in an average of 6 months (1-42 months) after the acute illness. Adenoviruses were the most common etiologic agents identified serologically. The diagnoses of postinfectious BO was made by thoracic high-resolution computed tomography and clinical features. Corticosteroid therapy was used in 17 patients and supportive treatment was applied in all patients. Age at initial lung infection, gender, time of starting corticosteroid treatment, presence of bronchiectasis or atelectasis and etiologic agents identified on presentation did not predict severity in our study. CONCLUSIONS: Despite the prominent role of inflammation in the pathogenesis of postinfectious BO, the use of anti-inflammatory agents remains controversial. We could not identify any prognostic factors related to disease severity. In order to minimize associated complications, patients with postinfectious BO should be closely followed up and receive meticulous lung care.

Administration, Inhalation↗
PubMedDate not supplied

BALF nitrite as an indicator of inflammation in children with cystic fibrosis.

BACKGROUND: A unique substance reflecting the degree of inflammation localized to the lower respiratory tract in patients with cystic fibrosis (CF) has been the concern of several investigators and nitric oxide has gained interest for this purpose in the last decades. OBJECTIVES: The aim of this study was to evaluate the cytokine and nitrite levels by showing the relationship between them in serum and bronchoalveolar lavage fluid (BALF) of patients with CF and patients in which flexible fiberoptic bronchoscopy (FFB) was applied because of indications other than infection. METHODS: 20 children with CF with mean age 8.2 years and 10 children as control group with mean age 4.2 years were included in the study. Cultures for aerobes, anaerobes, fungi and mycobacteria, cell differentials, cytokine and nitrite measurements were made from BALF specimens. White blood cell (WBC) count, erythrocyte sedimentation rate (ESR), quantitative C-reactive protein (QCRP), cytokine and nitrite levels were measured from serum samples. RESULTS: BALF neutrophil, TNF-alpha, IL-8 and nitrite levels were significantly higher in patients with CF than control patients. There was no correlation between serum and BALF cytokine and nitrite levels. However, there was a significantly positive correlation between BALF IL-8 and nitrite levels in patients with CF (r = 0.5) and also in control patients (r = 0.6). CONCLUSIONS: The results suggest that BALF nitrite levels reflect the degree of inflammation localized to lower respiratory tract and may be a useful indicator of airway inflammation for patients with CF.

Blood Sedimentation↗
PubMedDate not supplied

Tracheomalacia and bronchomalacia in 34 children: clinical and radiologic profiles and associations with other diseases.

We reviewed our experience on tracheomalacia (TM) and bronchomalacia (BM) in children who presented with chronic respiratory problems and evaluated their clinical and radiologic characteristics and their associations with other disorders. There were 26 males and 8 females with a median age of 9 months. The main symptoms were wheezing, persistent or recurrent pneumonia, and chronic cough. Atelectasis on chest radiograph was the most common sign. Of 23 children with TM, 1 had a double aortic arch, 1 had tracheoesophageal fistula, and 1 other had associated laryngomalacia. BM was found in 27 children and was predominantly seen on the right side. TBM was found in 16 cases (in an infant TBM was accompanied by pharyngeal dyskinesia and in another by laryngomalacia). Malacia disorders were associated with gastroesophageal reflux, cardiovascular anomalies, and tracheoeosophageal fistula. TM and BM should be considered in the differential diagnosis of children with chronic and recurrent respiratory symptoms. Early diagnosis of malacia disorders will prevent unnecessary use of antibiotics or antiasthmatic drugs, which are often abused to treat these children. In these patients, treatment for associated diseases should also be considered.

Bronchial Diseases↗
PubMedDate not supplied

Analysis of the modifying effects of TAP 1/2 genes on cystic fibrosis phenotype.

Phenotypic variability has been reported in cystic fibrosis (CF) patients. TAP1 and TAP2 genes are encoding "the transporter associated with antigen processing" proteins. The aim of the present study was to analyze the frequency of TAP 1/2 variants in the Turkish population and to investigate a possible modifying role of these variants in CF phenotype. Sixty-three CF patients of known genotypes and 100 healthy control subjects were analyzed. There was a significant difference in the frequencies at positions 333 and 637 of TAP 1 gene and at position 665 of TAP 2 gene between patients and controls. Comparison of TAP gene polymorphisms in 36 CF patients homozygous for AF508 mutation with control subjects revealed a significant difference at position 665 of TAP 2 gene. These findings may be useful to assess the predisposition and to predict severity of the disease. We demonstrated that TAP genes might have modifying effects on the CF phenotype.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMedDate not supplied

Hypercalciuria and nephrocalcinosis in cystic fibrosis patients.

The objective of this study was to determine the frequency of nephrocalcinosis and hypercalciuria in cystic fibrosis (CF) patients, and to search possible causes of this phenomenon. Forty-three CF children (24 boys, 19 girls; mean age 64.9 months, range 5 months-18 years) were included in this study. Plasma sodium, potassium, chloride, BUN, creatinine, calcium, phosphorus, magnesium, alkaline phosphatase; spot urine sodium, potassium, chloride, creatinine, calcium, magnesium; and serum 25-hydroxyvitamin-D levels were measured in all patients. Urine samples were examined for microscopic hematuria. Fractional sodium, potassium, chloride excretion and estimated glomerular filtration rate (GFR) were calculated. All patients underwent renal ultrasonography. Hypercalciuria, nephrocalcinosis and microscopic hematuria were detected in 15 patients (34.2%), 10 patients (23.2%) and two patients (5%), respectively. There was no significant but borderline correlation between 25-hydroxyvitamin-D levels and hypercalciuria (r: 0.308, p:0.05). There were no correlations between Shwachman clinical scoring system results and hypercalciuria (r: 0.221, p: 0.148) and age and hypercalciuria (r: -0.229, p: 0.135). Patients with chronic Pseudomonas colonization showed no hypercalciuria or nephrocalcinosis. There was no difference for plasma biochemical results, renal function tests, hypercalciuria and nephrocalcinosis between CF patients who had or had not experienced pseudo Bartter's syndrome (PBS) before. There was no relation between detected CF mutations of the patients and hypercalciuria and nephrocalcinosis. These results suggested that it is a primary abnormality of calcium metabolism in the kidney.

Adolescent↗
PubMedDate not supplied

Using computer based data acquisition and analysis system for nasal potential difference measurement in cystic fibrosis.

Nasal potential difference (PD) measurement has been used as a diagnostic test for cystic fibrosis (CF). It has been shown that large differences in reproducibility of nasal PD measurement can exist between different study sites. These differences reduce the validity of studies. In our study we tried to measure nasal PD values for a group of Turkish CF patients by using a computer based data acquisition system, which could eliminate the bias due to using different voltmeters. The CF group (n=40, mean age 9.3 years) value was -39.21+/-1.74 mV, and the control group (n=36, mean age 17.08 years) value was -18.24+/-1.48 mV (mean+/-SEM). Using the electronic data acquisition and analysis systems gave reliable results with high specificity (92%), sensitivity (79%), positive predictive value (95%) and negative predictive value (72%). Computer based data acquisition and analysis system provides suitable monitoring and continuous recording during measurements and facilitates repeat readings at the same distances along the nasal floor. Using electronic data acquisition may help to minimize the subjectivity in voltmeter measurements and hand analysis.

Adolescent↗
PubMedDate not supplied

Diagnostic value of flexible bronchoscopy in children with persistent and recurrent wheezing.

Episodes of wheezing are very common in infancy. In pediatrics, indications for flexible bronchoscopy include prolonged wheezing, where airway abnormalities such as malacia disorders, tracheobronchial abnormalities, and vascular ring may be found. The study was performed to determine the diagnostic use of flexible bronchoscopy in wheezy patients who were previously administered bronchodilators and steroids for asthma and whose symptoms recurred or were not improved at all. Infants with wheezing were identified and collected over a 3-year period at the pediatric pulmonology unit. Flexible bronchoscopy was performed for diagnostic purposes in 34 (24 boys and 10 girls) patients with wheezing who were previously treated for asthma. The mean age for the onset of the symptoms was 2.5 months (0-12 months), and the mean age of bronchoscopic assessment was 9 months (45 days-48 months). A definitive diagnosis was made by bronchoscopy in 29 (85%) patients. Functional abnormalities in 15 patients (malacia in 9, tracheal dyskinesia in 3, and both in 3 patients), structural abnormalities in 5 patients (bronchial abnormality in 2, subglottic stenosis in 2, and obliterative-like lesion at the orifice of right bronchus in 1), and coexistent structural and functional abnormalities in 9 patients were present. Bronchoscopy revealed normal findings in five patients. Structural and functional airway abnormalities are commonly found in children with wheezing and should be considered in the differential diagnosis of persistent and prolonged wheezing. Bronchoscopy should be performed in patients who remain symptomatic despite treatment for asthma.

Bronchi↗