Sibel Doruk

Oxidative Stress Levels in Exhaled Breath Condensate Associated With COPD and Smoking

BACKGROUND: COPD is characterized by chronic air-flow limitation. Smoking is the most important factor in the pathogenesis of COPD. Smoking is associated with increased oxidative stress in the lungs. In this study our aim was to evaluate the differences in the burden of oxidative stress in patients with COPD, smokers, and non-smokers by measuring hydrogen peroxide (H2O2), malondialdehyde (MDA), and 8-isoprostane levels in the exhaled breath condensate (EBC) samples. METHODS: Eighty subjects were included in the study. Group I (no. = 25) had COPD, Group II (no. = 26) was smokers, and Group III (no. = 29) was nonsmokers. The severity of the COPD and dyspnea was assessed according to the results of pulmonary function tests (PFTs) and Medical Research Council (MRC) scale. RESULTS: The mean age of the subjects was 58 ± 8.9 years. While 8-isoprostane and H2O2 levels were significantly higher in subjects with COPD (44.8 ± 40.2 pg/mL and 1.9 ± 0.8 μmol/L) and smokers (41.3 ± 26 pg/mL and 1.7 ± 0.7 μmol/L) than non-smokers (15.8 ± 6.9 pg/mL and 0.8 ± 0.4 μmol/L), levels were similar between smokers and COPD subjects. MDA levels were similar between the 3 groups (P = .31). There was no correlation between 8-isoprostane and H2O2 levels and PFT parameters. There was a significant positive correlation between dyspnea grade on the MRC scale and 8-isoprostane levels (r = 0.805, P < .001). CONCLUSIONS: Even if respiratory function tests are within normal limits, oxidant burden in lungs of smokers is equivalent to that in COPD patients. 8-isoprostane could be useful in assessing symptom severity and health status of COPD patients.

Oxidative status in the lungs associated with tobacco smoke exposure.

Abstract Background: Oxidative stress has a critical role in inflammatory responce against tobacco smoke (TS). Testing exhaled breath condensate (EBC) samples is one of the methods used for assessment of airway inflammation caused by TS. We aimed to investigate oxidative stress in the lungs associated with TS and to evaluate the effect of this stress with pulmonary function tests (PFTs). Methods: We included 69 subjects as three groups into the study (Group I; 26 smokers, Group II; 21 passive smokers, Group III; 22 non-smokers without TS exposure). Levels of malondialdehyde (MDA), 8-hydroxydeoxyguanosine (8-OHdG), nitrite/nitrate ;ibindex of nitric oxide (NO) production;ic, vitamin C, superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) were measured in EBC samples collected using a condenser and PFTs were performed. Results: The levels of MDA, 8-OHdG, SOD and GSH-Px were higher in smokers. NO levels gradually increased from Group I to Group III. MDA levels were lower in Group III than Group II. The levels of vitamin C were similar in all groups. We determined negative correlation between 8-OHdG levels and forced expiratory volume in one second (FEV1), and maximum mean expiratory flow (MMEF), and a positive correlation between SOD levels and FEV1. Conclusions: TS exposure affected the balance between oxidative stress and antioxidant capacity of lungs. Preventing environmental TS exposure might decrease oxidative damage. Increased levels of 8-OHdG and SOD levels could be assessed as an early sign of airway damage.

The value of computed tomographic obstruction index in the identification of massive pulmonary thromboembolism

PURPOSE In this study, the pulmonary arterial computed tomography obstruction index ratio, which indicates the degree and extent of thrombotic arterial occlusion, was calculated in cases with pulmonary thromboembolism. Our objectives were to investigate the value of this index for the identification of cases with massive pulmonary thromboembolism and to search for correlations between this index and clinical parameters. MATERIALS AND METHODS Data from 68 patients were evaluated retrospectively. For the clinical evaluation, the Wells scoring system was used. Pulmonary computed tomographic angiography examinations were acquired using an eight-channel multidetector computed tomography. The presence of arterial filling defects was recorded, and the clot burden was quantified based on the degree and extent of thrombotic arterial occlusion. RESULTS According to the Wells scoring system, the patients were assigned to low (n = 14), moderate (n = 34), and high clinical (n = 20) possibility groups, and the difference among the mean pulmonary arterial computed tomography obstruction index ratios of the three groups was significant (P = 0.001). A positive correlation was observed between the pulmonary arterial computed tomography obstruction index ratio and the Wells score (r = 0.470, P < 0.001). The pulmonary arterial computed tomography obstruction index ratio cut-off point was determined to be 40% for the discrimination of massive and nonmassive cases (sensitivity, 72.7%; specificity, 91.4%). CONCLUSION We found that in cases where the pulmonary arterial computed tomography obstruction index ratio was above 40%, a diagnosis of massive pulmonary thromboembolism was demonstrated. Furthermore, a positive correlation between the obstruction index and the Wells score suggested the use of a clinical evaluation as a means of developing a recommendation regarding the thrombotic load.

Cysteinyl leukotrienes in exhaled breath condensate of smoking asthmatics

Abstract Background: Cysteinyl leukotrienes (CysLTs) are among important inflammatory mediators in asthma pathogenesis. In this study, we aimed to determine leukotriene D4 (LTD4) and leukotriene E4 (LTE4) levels in exhaled breath condensate (EBC) in asthmatics and to evaluate the effect of smoking upon CysLTs levels and to speculate the importance of adding leukotriene receptor antagonists in smoking asthmatics. Methods: A total of 88 participants were included in the study. Of them, 59 were asthmatics; 30 of the 59 asthmatics were smokers (Group I) and the others were non-smokers (Group II). As a control group (Group III), 29 healthy non-smokers were enrolled. EBC samples were collected (EcoScreen, Jaeger, Hoechberg, Germany) and pulmonary function tests (PFTs) were performed in each case, and an asthma control questionnaire (ACQ) was completed by the asthmatics. LTD4 and LTE4 levels in EBC samples were analyzed by using ELISA. Results: LTD4 levels were found to be higher in Group I than other groups and similar in Group II and Group III. LTE4 levels were lower in Group III than other groups and similar in Group I and Group II. PFTs were different between Group I and Group III and there was a significant negative correlation between LTE4 levels and forced expiratory volume in one second and forced vital capacity ratio in Group I. Conclusions: LTD4, but not LTE4, concentrations in EBC were higher in asthmatic smokers than asthmatic non-smokers. LTE4 concentrations in EBC were higher in asthmatics than healthy non-smokers. In smoking asthmatics usage of agents that block the effects of LTD4 can be beneficial; however, new clinical studies are required.

Evaluation of visual field parameters in patients with chronic obstructive pulmonary disease

Purpose:  To evaluate the effects of chronic obstructive pulmonary disease (COPD) on retina and optic nerve.

Serum levels of gamma-glutamyl transferase are associated with cardiovascular disease in obstructive sleep apnea syndrome.

BACKGROUND AND OBJECTIVES Obstructive sleep apnea syndrome (OSAS) significantly increases the risk of cardiovascular disease (CVD). γ-glutamyl transferase (GGT) is a new marker for predicting CVD. The aim of this study was to evaluate the relationship of serum GGT levels with cardiovascular event, severity of OSAS, and polysomnographic parameters in patients with OSAS. DESIGN AND SETTINGS This was a retrospective, cross-sectional study conducted between January 2011 and March 2013 (Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey). METHODS We performed a retrospective study. Patients were divided according to their apnea-hypopnea index (AHI) scores into OSAS negative (AHI< 5, Group 1), mild OSAS (AHI: 5–15, Group 2), moderate OSAS (AHI=15–30, Group 3), and severe OSAS (AHI > 30, Group 4) groups. The presence of heart failure, coronary artery disease, or arrhythmia was defined as CVD. RESULTS A total of 320 patients, with a mean age of 50.2 (10.8) years, were included in this study. There were 47, 68, 58, and 147 patients in Groups 1, 2, 3, and 4, respectively. Serum GGT levels were significantly different between groups (Group 1: 25.24 [14.95]; Group 2: 28.03 [11.92]; Group 3: 32.82 [18.18], and Group 4: 40.41 [31.90] mg/dL, P<.001). Besides, serum GGT levels were significantly correlated with AHI, oxygen desaturation index, and average and minimum O2 saturation values (P<.05). Serum GGT levels were significantly higher in patients with CVD compared with those without (P<.05). Multiple regression analysis demonstrated that independent predictors of CVD were serum GGT and low-density lipoprotein-cholesterol levels, age, and body mass index in patients with OSAS. CONCLUSION GGT level is an important predictor for CVD in patients with OSAS. The effectiveness of continuous positive airway pressure therapy on CVD and GGT levels should be investigated.

Multidrug Resistance Among A. baumannii Isolates from Intensive Care Unit: A Four Years Retrospective Study

15 osocomial infections are related to prolonged hospitalization stays and increased mortality and morbidity.1 Among microorganisms, Acinetobacter ssp plays an important role, and in recent years its prevalence in intensive care unit (ICU) patients has risen.2,3 A. baumannii is an aerobic, Gram-negative, non-fermentative bacteria, which is the most Multidrug Resistance Among A. baumannii Isolates from Intensive Care Unit: A Four Years Retrospective Study

Antiinflammatory effect of telmisartan on chronic obstructive pulmonary disease: 8-isoprostane concentration in exhaled breath condensate

Amac. Kronik obstruktif akciger hastaligi (KOAH) kronik, ilerleyici, inflamatuar bir hastaliktir. Oksidatif stres ve havayolu inflamasyonu hastaligin ana patofizyolojik etkenleridir. Bu calismada bir anjiyotensin reseptor blokeri (ARB) olan telmisartan’in KOAH’daki antiinflamatuar etkisini arastirmayi amacladik. Yontem. Calismaya 25’i telmisartan kullanan 50 KOAH hastasi alindi. Hastalarin yogunlastirilmis soluk havasi (EBC) ornekleri EBC toplama cihazi kullanilarak toplandi (Ecoscreen, Jaeger, Germany). EBC ornekleri analiz edildi ve enzim immunoassay metodu (Cayman Chemical Co. Michigan, USA) kullanilarak 8-izoprostan duzeyleri olculdu. Bulgular. Her iki grup arasinda ortalama yas, cinsiyet ve sigara kullanimi acisindan fark yoktu. Telmisartan kullanan ve kullanmayan grupta 8-izoprostan duzeyleri sirasiyla 33,98 ve 35,91 pg/mL olarak olculdu, iki grup arasindaki fark istatistiksel olarak anlamli bulundu (p < 0,001). Sonuc. ARB’lerin oksidatif stres ve inflamasyonu azaltarak hastaligin patofizyolojisi ve ilerleyisine olumlu etkileri olabilir.