Selvi Asker

Assessment of corneal endothelial cell density in patients with keratoconus not using contact lenses

PURPOSE To assess the corneal endothelial cell density (ECD) in keratoconus patients with no history of contact lens use. SETTING Yuzuncu Yil University, School of Medicine and Van Training and Research Hospital, Department of Ophthalmology, Van, Turkey. DESIGN Cross-sectional controlled study. METHODS The eyes of 65 patients with the diagnosis of keratoconus with no history of contact lens wear and the eyes of 40 healthy controls were prospectively examined using the Heidelberg Retinal Tomography Rostock Cornea Module (HRT3/RCM). The average ECD from the two groups were then compared. RESULTS Of the cases with keratoconus, 44 (67.7%) were men and 21 (32.3%) were women. The mean age was 20.9±6.8 (range=10-41) years. Of the controls, 28 (70%) were men and 12 (30%) were women. The mean age was 23.9±5.8 (range=14-35) years. Of the 65 eyes with keratoconus, 19 (29.2%) had mild keratoconus, 21 (32.3%) had moderate keratoconus, and 25 (38.5%) had severe keratoconus. The mean ECD was 2731.6±303.2 cells/mm2 in cases with keratoconus and 2664.9±319.5 cells/mm2 in controls. There was no difference between the densities (unpaired t-test, P=0.4). No significant relationships were found between the ECD data and central corneal thickness or steepest keratometric. CONCLUSIONS Endothelial cell density was unaltered in keratoconic patients without a history of contact lens use when compared with healthy controls. Change in ECD is independent from the central corneal thickness and the stage of keratoconus.

The relationships among the levels of oxidative and antioxidative parameters, FEV1 and prolidase activity in COPD

Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by poorly reversible airflow limitations associated with an abnormal inflammatory response of the lung. Methods: We investigated whether prolidase levels in serum, total antioxidant status, total oxidative status (TOS), and the oxidative stress index (OSI) were associated with the etiopathogenesis of COPD, and whether there is a relationship between prolidase activity and oxidative parameters and carotid artery intima-media thickness (CIMT) in patients with COPD. This study included 91 patients with COPD and 15 control cases. Routine haematological and biochemical parameters were determined in all patients. All subjects were fully informed about the study and provided consent. Results: The mean age of the patients with COPD was 61.3 ± 10.5 years and that of the control group was 56.2 ± 12.1 years. The control group had a significantly higher plasma prolidase level than that in the COPD group. TOS and OSI levels in the control group were significantly lower than those in the COPD group. However, no significant differences were found in TALs or CIMT levels between the COPD and control groups. A negative correlation was detected between prolidase activity and age; however, no significant difference in age was observed between the two groups. Conclusion: These results indicate that prolidase activity decreases in patients with COPD.

Increased Asymmetric Dimethylarginine and Ischemia-Modified Albumin Levels in Obstructive Sleep Apnea

BACKGROUND: Asymmetric dimethylarginine and ischemia-modified albumin are new biomarkers that are used for evaluation of ischemia and oxidative stress. The present study aimed to investigate whether serum levels of asymmetric dimethylarginine and ischemia-modified albumin are altered in subjects with obstructive sleep apnea (OSA). METHODS: A cross-sectional, clinical study was implemented on data derived from 79 subjects who underwent polysomnography. Cases were allocated into 3 groups with respect to polysomnography results: Group 1 consisted of 22 subjects without apnea, whereas Group 2 comprised 29 subjects with mild to moderate OSA, and Group 3 included 28 subjects with severe OSA. These 3 groups were compared in terms of demographic datas and polysomnographic parameters, serum levels of asymmetric dimethylarginine and ischemia-modified albumin. RESULTS: Serum levels of ischemia-modified albumin were significantly higher in Groups 2 and 3 (P = .001). Mean SpO2 of Group 3 was notably lower than that of Groups 1 and 2 (P < .001), whereas times for SpO2 <90% were statistically significantly different from each other in all 3 groups (P < .001). Serum levels of asymmetric dimethylarginine in Group 3 were notably higher than those in Group 1 (P = .027). Levels of ischemia-modified albumin were correlated positively with AHI and time SpO2 <90% values (P = .008 and P < .001, respectively). CONCLUSIONS: Ischemia-modified albumin and asymmetric dimethylarginine were significantly higher in subjects with OSA. Furthermore, ischemia-modified albumin was independently associated with severity of OSA defined by AHI and severity of oxygen desaturation.

Evaluation of Airway Wall Thickness Via High-Resolution Computed Tomography in Mild Intermittent Asthma

INTRODUCTION: This study aims to evaluate bronchial thickness via thorax high-resolution computed tomography (HRCT) in subjects with mild intermittent asthma in comparison with healthy control subjects. METHODS: A total of 37 out-patients (mean ± SD age = 36.7 years (9.7 years); 54.8% males) with mild intermittent asthma and 13 healthy control subjects (mean ± SD age = 25.0 years (2.9 years); 61.5% males) were included in this case control study. Data on demographics, pulmonary function test results, and segmental and subsegmental thorax HRCT results were recorded. The ratio of bronchial wall thickness to bronchial lumen diameter (T/D) and bronchial wall area percentage (WA%) were calculated for all cases. RESULTS: Subject and control groups were similar in terms of pulmonary function test results, and total and subsegmental T/D values. Mean ± SD subsegmental WA% values at the level of inferior pulmonary vein (55.6% [16.8%] vs 41.7% [7.4%], P = .047) and 2 cm above the diaphragm (49.8% [15.8%] vs 38.6% [10.4%], P = .046) were significantly higher in subjects than control subjects. No significant correlation of overall and subsegmental T/D and WA% values to age in both groups, and to asthma duration in subjects. CONCLUSION: Our findings revealed an increase in bronchial wall thickness in peripheral airways in subjects with mild intermittent asthma regardless of the duration of asthma. This may indicate a need to also administer anti-inflammatory or bronchodilator therapy, which is effective in peripheral airways during the early period of the disease.

Is There a Relationship Between Obstructive Sleep Apnea (OSA) and Hearing Loss

Background Obstructive sleep apnea (OSA) is a common disorder with an estimated prevalence in the general population of 2–5%. Its main clinical features are loud snoring and breathing stoppage during sleep. Ischemia could be a consequence of noise-induced hearing loss because cochlear oxygen tension is reduced during and after noise exposure. In this study, we evaluated auditory function in patients affected by OSA and simple snoring. Material/Methods A total of 66 participants (male to female ratio: 40:26) were included in the study, of which 21 were in the control group, 18 were in the simple snoring group, and 27 were in the OSA patient group. Polysomnography and audiometric examination were performed in all participants. Results The mean ages of the participants in the control, simple snoring, and OSA groups were 39.14±9.9, 37.28±8.2, and 41.56±8.99 years, respectively. There were no statistically significant differences among groups regarding age or sex; however, there were statistically significant differences among groups in body mass index, apnea-hypopnea index scores, mean saturation, and duration under 90% saturation. In addition, statistically significant differences were found between the patient group and the control and simple snoring groups concerning the mean saturation, duration under 90% saturation, and the extended high frequency of hearing. Conclusions These data show that snoring may cause hearing loss at extended high frequencies.

Serum levels of trace minerals and heavy metals in severe obstructive sleep apnea patients: correlates and clinical implications

PurposeThe aim of the present study was to evaluate the serum levels of trace minerals and heavy metals in obstructive sleep apnea (OSA) patients and to investigate whether there is a correlation between levels of trace minerals and demographic and biochemical variables.MethodsThis clinical, case–control study was performed on 61 OSA patients and 36 healthy controls. Demographic, radiological, biochemical variables, as well as serum levels of trace minerals (magnesium, copper, iron, zinc, manganese, cobalt) and heavy metals (lead, cadmium) were compared in OSA and control groups. In addition, correlation of serum levels of these substances to demographic, biochemical, and radiological parameters was tested.ResultsNot only serum levels of cholesterol, triglycerides, cadmium, cobalt, copper, iron, magnesium, manganese, lead, and zinc were found to be higher, but also carotid intima-media thickness (CIMT) was increased in OSA patients. Increase in CIMT was found to be correlated with levels of cobalt, copper, iron, magnesium, manganese, and zinc.ConclusionOur results have shown that serum levels of trace minerals and heavy metals were higher in OSA. This difference may ensource from deterioration of the balance of these substances due to oxidative stress and inflammation. Significance of these findings with respect to the etiopathogenesis, diagnosis, and treatment of OSA warrants further trials.

An overlooked cause of resistant hypertension: upper airway resistance syndrome - preliminary results

OBJECTIVE: Upper airway resistance syndrome is a sleep-disordered breathing syndrome that is characterized by repetitive arousals resulting in sympathetic overactivity. We aimed to determine whether upper airway resistance syndrome was associated with poorly controlled hypertension. METHODS: A total of 40 patients with resistant hypertension were enrolled in the study. All of the patients underwent polysomnographic examinations and 24-hour ambulatory blood pressure monitoring to exclude white coat syndrome and to monitor treatment efficiency. Among 14 upper airway resistance syndrome patients, 2 patients had surgically correctable upper airway pathologies, while 12 patients were given positive airway pressure therapy. RESULTS: All patients underwent polysomnographic examinations; 22 patients (55%) were diagnosed with obstructive sleep apnea and 14 patients (35%) were diagnosed with upper airway resistance syndrome, according to American Sleep Disorders Association criteria. The patients with upper airway resistance syndrome were younger and had a lower body mass index compared with other patients, while there were no difference between the blood pressure levels and the number of antihypertensive drugs. The arousal index was positively correlated with systolic blood pressure level (p = 0.034; rs = 0.746), while the Epworth score and AHI were independent of disease severity (p = 0.435, rs = 0.323 and p = 0.819, rs = -0.097, respectively). Eight patients were treated with positive airway pressure treatment and blood pressure control was achieved in all of them, whereas no pressure reduction was observed in four untreated patients. CONCLUSIONS: We conclude that upper airway resistance syndrome is a possible secondary cause of resistant hypertension and that its proper treatment could result in dramatic blood pressure control.

A Behcet's Disease Patient with Right Ventricular Thrombus, Pulmonary Artery Aneurysms, and Deep Vein Thrombosis Complicating Recurrent Pulmonary Thromboembolism

Intracardiac thrombus, pulmonary artery aneurysms, deep vein thrombosis, and pulmonary thromboembolism are rarely seen symptoms of Behcets disease. A 20-year-old female patient was admitted for complaints of cough, fever, palpitations, and chest pain. On the dynamic thorax computed tomograms (CT) obtained because of significantly enlarged hilar structures seen on chest radiograms, aneurysmal dilatation of the pulmonary artery segments bilaterally, chronic thrombus with collapse, and consolidation substances compatible with pulmonary embolism involving both lower lobes have been observed. It is learned that, four years ago, the patient had been diagnosed with Behcets disease and received colchicine treatment but not regularly. The patient was hospitalized. On the transthoracic echocardiogram, a thrombosis with a dimension of 4.2 × 1.6 cm was recognized in the right ventricle. On abdomen CT, aneurysmal iliac veins and deep vein thrombus on Doppler ultrasonograms were diagnosed. At the controls after three months of immunosuppressive and anticoagulant therapies, some clinical and radiological improvements were recognized. The patient suspended the treatment for a month and the thrombus recurred. We present our case in order to show the effectiveness of immunosuppressive and anticoagulant therapies and rarely seen pulmonary thromboembolism in recurrent Behcets disease.

Swyer-James-MacLeod syndrome with an anomalous origin of coronary artery: Case report.

Swyer–James (Macleod) syndrome was first defined in the 1950s by Swyer, James and Macleod in patients with unilateral hyperlucent lungs. Coronary artery anomalies are congenital anomalies that affect a small part of the population. They constitute about 1–2% of congenital heart diseases. The incidence of a left coronary artery arising from the right coronary sinus Valsalva has been reported as 0.017%, and 1.3% among coronary artery anomalies. We hereby present this case since the case was diagnosed in adult age and was accompanied by a rare congenital heart disease.

Serum levels of trace minerals and heavy metals in severe COPD patients with and without pulmonary hypertension

Aim The aim of the current study was to assess the serum levels of trace minerals/heavy metals in COPD patients with and without pulmonary hypertension (PH) and to investigate their correlations to demographic, clinical, and biochemical variables. Materials and methods This cross-sectional study was performed in Van Yuzuncu Yil University Medical Faculty between April 2013 and July 2013. Cases were allocated into three groups: Group 1 consisted of severe COPD patients; Group 2 was made up of COPD patients with PH; and healthy controls constituted Group 3. Demographic, radiological, and biochemical variables, as well as the serum levels of trace minerals and heavy metals, were noted and compared in these three groups. Results COPD patients were older and had higher rates of smoking habit, diabetes mellitus, and hypertension compared to the control group. Carotid intima-media thickness was increased bilaterally, and serum levels of Co, Cu, and Fe were higher in COPD patients. Left carotid intima-media thickness was increased, and serum levels of Cd, Co, and Fe were found to be higher in COPD cases with PH compared to COPD patients without PH. Conclusion Our results show that serum levels of trace minerals and heavy metals may be altered in COPD and PH.