Feyza Erkan

Pulmonary complications of Behçet's disease

Our knowledge about pulmonary complications of Behçets disease continues to evolve, but we need controlled trials for the management of the disease. The main goal should be to elucidate the pathogenesis and standardize the management according to the underlying pathologic process.

Pulmonary artery aneurysm in Behcet's disease: a case report.

The pulmonary artery is the second most common site of arterial involvement in Behcet’s disease. A 32-year-old man presented with bilateral ankle edema, abdominal discomfort, and hemoptysis. He had a history of recurrent oral and genital aphthous ulcerations for 1 year. The diagnosis of Behcet’s disease was made on the basis of the criteria published by the International Study Group for Behcet’s Disease. His chest X-ray revealed left hilar enlargement. A helical computed tomography (CT) scan showed a pulmonary aneurysm with intramural thrombosis in the left pulmonary artery and enlarged hepatic veins. Treatment with colchicine and cyclophosphamide was given for 24 months, and helical thoracic CT was performed again. Helical CT showed that the pulmonary aneurysm was reduced by treatment. Helical CT could be used in Behcet’s disease for the diagnosis and follow-up of pulmonary involvement.

Health Problems of Garbage Collectors in Istanbul

Diseases from poisonous gases and micro-organisms in the air near garbage dumps and poisoning by polluted underground water and soil may result in serious health problems. The object of this study was to determine the negative impact of their occupation on full-time garbage collectors and to determine the microbiologic flora of their immediate environment. This study was performed with 228 selected individuals who worked daily in 5 different garbage collection units in several districts of Istanbul. The level of exposure to microbiologic flora was studied using a Merck Air Sampler MAS 100, and total bacteria, yeast and mildew concentrations per square metre and minute (cfu/m2/min) were calculated. Respiratory functions of all individuals in the study were evaluated with a computerised spirometer (MIR spirobank). Aspergillus and Penicillium spp. were the commonest species detected followed by Candida spp., Mycelia sterilia, Rhizopus spp. and Mucor spp. The study of respiratory functions showed that the FVC%, FEV1%, PEF% and FEF25–75% of the garbage collectors were below 80% compared to non-collectors: OR = 2.89 (95% CI 1.14–7.30) in FVC%, OR = 2.89 (95% CI 1.41–5.92) in PEF%, OR = 2.46 (95% CI 1.33–4.56) in FEF25–75% and OR = 4.48 (95% CI 1.90–10.58) in FEV1%. A long expirium period and ronchus symptoms were detected in 11 collectors (31.4%) and 4 drivers (11.4%) out of 32 collectors and 35 drivers whose respiratory function tests gave low values. Clinical findings between the two groups were statistically significant (p < 0.05), OR = 4.06 (95% CI 1.13–14.46). The exposure to airborne microbes could produce respiratory disorders, gastroenteritis, dermatitis and many other complaints.

Efficacy of Inhaled Budesonide and Oral Theophylline in Asthmatic Subjects

The aim of present study was to evaluate clinical, functional, and anti-inflammatory effects of inhaled budesonide and oral theophylline treatments in patients with mild to moderate asthma. The study included 38 patients. After a 10-day run-in period, the patients were randomly assigned into two groups. Group 1 received inhaled budesonide (Pulmicort Turbuhaler) 800 μg/day for 4 weeks. Group 2 received oral theophylline (Talotren tablets, 200 mg twice daily) for 4 weeks. Inhaled budesonide therapy was accompanied by a significant decrease in serum interleukin (IL)-5 levels (p < 0.0005) and blood, sputum, and nasal eosinophil counts (p < 0.005). It produced a significant reduction in daytime (p < 0.01) and nighttime (p < 0.005) symptom scores and an increase in morning (p < 0.005) and evening (p < 0.05) peak expiratory flow (PEF) and forced expiratory volume in 1 sec (FEV1) values (p < 0.01). Theophylline therapy was associated with a significant decrease in blood (p < 0.02) and nasal (p < 0.01) eosinophil counts and serum IL-5 levels (p < 0.01). It resulted in significant improvements in daytime and nighttime symptom scores (p < 0.05), and morning PEF and FEV1 values (p < 0.05). These changes were more significant in group 1 than in group 2. There was no statistically significant difference between the two groups with respect to post-treatment values. Our results confirm the role of inhaled corticosteroids in the treatment of asthma and are consistent with the recommendation that theophylline exerts an anti-inflammatory effect. Further studies should be conducted to determine long-term benefits of theophylline.

Role of Zafirlukast on skin prick test

BACKGROUND Some anti-allergic and anti-asthmatic drugs should be discontinued before skin prick test. But there is no knowledge about zafirlukast effects on skin prick test. We investigate the effects of zafirlukast on cutaneous response to histamine and specific allergens. MATERIAL AND METHODS 9 patients suffering from allergic mild asthma or allergic rhinitis and 8 healthy individuals were recruited to the study. All of them took 20 mg zafirlukast twice daily for at least 5 days. Skin prick test was performed before and after treatment by histamine and specific allergens. There was no significant difference between pre- and post-treatment skin prick tests in spite of zafirlukast treatment. CONCLUSION Zafirlukast does not affect skin reactions against histamine and specific allergens. Diagnostic skin prick test can be performed under zafirlukast treatment.

The effectiveness of a pictorial asthma action plan for improving asthma control and the quality of life in illiterate women

Abstract Background: Written asthma action plans are an important part of asthma management, but cannot be used for illiterate people. Objective: The aim of this study was to establish the effectiveness of a pictorial asthma action plan on asthma control, health-related quality of life (HRQoL), and asthma morbidity in a population of illiterate women with asthma. Methods: Forty illiterate women with moderate-severe persistent asthma were assigned alternatively to receive either asthma education alone (control group) or asthma education and a pictorial asthma action plan (study group). Asthma control was assessed using the asthma control test (ACT), HRQoL was assessed using the St Georges Respiratory Questionnaire (SGRQ), and the frequency of non-scheduled hospital or emergency visits was monitored. Results: Thirty-four patients completed the study. The ACT and SGRQ scores of both groups improved at every follow-up time point compared with baseline (p < 0.001). The ACT scores at 1 month (22.44 versus 20.75, p = 0.034) and 2 months (23.28 versus 21.81, p = 0.010) were higher in the study group than in the control group, but this was not maintained at 6 months (24.00 versus 23.25, p = 0.069). The SGRQ scores at 6 months were better in the study group (18.12) than in the control group (23.96, p = 0.033). No hospital admissions were recorded for either group. Conclusion: Education provides a significant improvement in asthma control and HRQoL while managing illiterate asthma patients, additionally the pictorial asthma action plan can be a helpful tool for self-medication.

Evidence for the Efficacy of a Bioresonance Method in Smoking Cessation: A Pilot Study

Background: Since the 1970s, MORA bioresonance therapy has globally been applied in the context of complementary medicine for various indications. In this regard, practitioners also report successful application in smoking cessation. The present study aims to verify these reports in a controlled study setting. Methods: In order to achieve the aforementioned objective, we subjected the bioresonance method to a prospective, placebo-controlled, double-blind, parallel-group study involving 190 smokers. In both study groups (placebo n = 95; active bioresonance group; n = 95) the course of treatment and study conditions were standardized. Results: 1 week (77.2% vs. 54.8%), 2 weeks (62.4% vs. 34.4%), 1 month (51.1% vs. 28.6%), and 1 year (28.6% vs. 16.1%) after treatment, the success rate in the verum group differed significantly from the results in the placebo group. Also, the subjective health condition after treatment and subjective assessment of efficacy, polled after 1 week, were significantly more positive among participants in the active bioresonance therapy group than among those in the placebo group. Adverse side effects were not observed. Conclusion: According to the findings attained by this pilot study, bioresonance therapy is clinically effective in smoking cessation and does not show any adverse side effects.

Follow-up of 1887 patients receiving tumor necrosis-alpha antagonists: Tuberculin skin test conversion and tuberculosis risk

To evaluate the characteristics of patients who developed tuberculosis while receiving tumor necrosis factor‐alpha (TNF‐α) antagonists and the related factors with tuberculosis.

Nebulized Lidocaine as an Alternative Therapy for Reactive Airway Dysfunction Syndrome

Reactive airway dysfunction syndrome (RADS) is a variant of irritant-induced asthma that develops in subjects without prior bronchoobstructive disease, following high-level exposure to nonimmunogenic irritants. Recommended maintenance treatment for RADS is not different from asthma. But in some cases, severe symptoms may persist despite the bronchodilators and corticosteroids. We describe the first case of a patient with RADS, unresponsive to all medical agents, who was successfully treated with lidocaine.

Daniel Kaiser - † Juli 2014

Daniel Kaiser ist nicht mehr. Im Juli setzte er seinem Leben ein Ende. Seine ganze Leidenschaft galt der Homöopathie. Von Studienzeiten an bis zu seinem Tod setzte er sich unermüdlich für diese Heilweise ein: für ihre Verbreitung unter den Medizinstudierenden, für die Verbesserung ihrer Lehre und ihrer praktischen Ausbildung, für die Fortbildungsliteratur – für jeden Aspekt, der die Homöopathie voranbringen konnte. Die Carstens-Stiftung «Natur und Medizin» hat ihm Großartiges zu verdanken. 1991/92 entwickelte er zusammen mit Bernhard Luft und der Stiftung das Konzept einer Kommunikationsund Fortbildungsplattform für die studentischen Arbeitskreise für Homöopathie, seit Herbst 1992 «Wilseder StudentInnen-Forum für Homöopathie» genannt, das bis heute zweimal im Jahr Vertreter der jeweils bestehenden studentischen Arbeitskreise um die Homöopathie versammelt. Diese Einrichtung, die ohne Daniel Kaiser nicht entstanden wäre, ist medizingeschichtlich längst als weltweit einzigartig gewürdigt worden. Die ersten Treffen lebten von seinem Schwung, seiner Leidenschaft, seiner frohen Ausstrahlung, seinen immer wieder neuen Impulsen. Gleich mit dem ersten Treffen im März 1992 gründete er die «Homöopathischen Flugblätter», ebenso neu und einmalig wie das Forum. Erst nach etwa 10 Jahren fielen sie dem elektronischen Zeitalter zum Opfer. Er war bescheiden genug, sich nach wenigen Treffen aus dem Forum zurückzuziehen und anderen den Vortritt zu lassen. Nun war jedoch ein Netzwerk junger leidenschaftlicher Homöopathen im Übergang vom Studium zum Arzt sein entstanden, das nach Kontinuität verlangte. So entstand auf Drängen Kaisers das «Alt-Wilseder Forum für Homöopathie», in dem sich bis heute einmal im Jahr diejenigen treffen, die dem Studentenforum entwachsen sind. Auch dieses Forum sucht seinesgleichen und wäre ohne Kaiser nicht entstanden. Im vergangenen Winter war er beim 20. Treffen dabei, das wegen des Jubiläums in Wilsede – dem namensgebenden Ursprungsort der ganzen Bewegung – in der Lüneburger Heide stattfand. Vollkommen neuartige Strukturen der Nachwuchsförderung in der Homöopathie, vom Studierenden bis zum Facharzt, gehen damit auf Kaiser zurück. Der Geist von Wilsede – Offenheit jenseits aller Schulen der Homöopathie, Offenheit für Wissenschaft und Forschung und ein freundschaftliches Miteinander – ist wesentlich durch ihn geprägt. Nicht nur die Carstens-Stiftung «Natur und Medizin», sondern die ganze homöopathische Gemeinschaft, insbesondere die mittlerweile mehreren Hundert Teilnehmer der Wilseder Foren, verneigen sich in Dankbarkeit vor Kaiser. Dem Entschluss, seinem Leben ein Ende zu setzen, kann man – bei aller Trauer – nur mit größtem Respekt begegnen. Sein schweres psychisches Leiden hat ihn schlussendlich in tiefer Verzweiflung zu Boden gedrückt.