Tulin Cagatay

Levels of tumour necrosis factor-alpha and IL-1alpha in newly diagnosed and multidrug resistant tuberculosis.

Background:  The pro‐inflammatory cytokines tumour necrosis factor (TNF)‐α and IL‐1α play key roles in host defence against tuberculosis (TB) but there is little knowledge of their levels in multidrug resistant TB (MDR‐TB). The aim of the present study was to investigate the levels of TNF‐α and IL‐1α and their relationship with the levels of T helper (CD4+), T suppressor (CD8+) and total lymphocytes (CD45+) in newly diagnosed TB (N‐TB) and MDR‐TB.

Can immune parameters be used as predictors to distinguish between pulmonary multidrug-resistant and drug-sensitive tuberculosis?

Introduction Despite the development and wide implementation of Directly Observed Therapy Strategies (DOTS), multidrug-resistant tuberculosis (MDR-TB) remains a serious global health threat. In this study, the role of host immune response in patients with MDR-TB is investigated and compared with that of patients with smear-positive drug-sensitive tuberculosis (SP-TB). Material and methods 27 patients with SP-TB, 20 patients with MDR-TB, and 20 healthy controls were included in the study. Immune parameters were determined by flow cytometry using monoclonal antibodies in order to compare the percentage values of these markers in the two study groups and the control group. Results The levels of lymphocyte subgroups in the gate of CD45(+)/CD14(–) lymphocyte: CD45(+), CD3(+), CD4(+), NK, CD3/HLA-DR, CD 95(+) cells were significantly lower; by contrast CD23(+), CD25(+), CD19(+), CD4(+)/CD8(+), HLA-DR cells were found to be lower, but not significantly so in patients with MDR-TB, compared to levels in patients in the SP-TB and control groups. Besides these findings, the levels of NKT cells and γδ TCR(+) cells were significantly higher in the MDR-TB than in the healthy control and SP-TB group. Conclusions The lower levels of CD3/ HLA-DR, CD4 (+), Fas (+), and NK, and the higher level of NKT together with γδ T cells in patients with MDR-TB compared to those in SP-TB may indicate a profound immune suppression in MDR-TB patients and thereby may denote an accumulation in the bacterial load. Our findings may shed light on the pathogenesis and prognosis of MDR tuberculosis, and may point towards the use of flow cytometry findings as an aid to early diagnosis in MDR-TB patients.

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.

The effect of montelukast sodium on serum arginase levels in patients with seasonal allergic rhinitis.

Background Nitric oxide (NO) imbalance appears to be important in the pathogenesis of allergic rhinitis. NO is synthesized from L-arginine by NO synthase (NOS). Competing with NOS for L-arginine is arginase, which catalyzes the hydrolysis of arginine to urea and ornithine. Therefore, increased serum arginase activity could potentially limit NO production catalyzed by inducible NOS, thus contributing to allergic rhinitis. This study was designed to investigate the effect of the cysteinyl leukotriene type 1 receptor antagonist, montelukast sodium on serum arginase levels in patients with seasonal allergic rhinitis. Methods Twenty-five patients with seasonal allergic rhinitis (SAR; treatment group) and 16 nonasthmatic patients without allergic rhinitis (control group) were included in the study. Serum arginase levels and the mean total nasal symptoms scores were measured before and after oral montelukast sodium (10 mg) was administered daily for 4 weeks to the treatment group. Results Serum arginase levels and the mean total nasal symptoms scores were significantly lower in the treatment group after montelukast sodium administration compared with the baseline levels (p = 0.001). Serum arginase levels were significantly lower in the treatment group compared with the control group (p = 0.01). There was no statistically significant difference between the serum arginase levels of the treatment group before treatment and the control group (p = 0.05). There was a weak correlation between the mean total nasal symptoms scores and serum arginase levels in the treatment group before montelukast sodium administration (rs = 0.40; p = 0.05. Conclusion Montelukast sodium may reduce serum arginase levels and total nasal symptoms scores of patients with SAR. Additional studies that compare the effectiveness of nasal corticosteroid and montelukast sodium on serum arginase levels should be conducted.

Analysis of HLA antigens in Turkish sarcoidosis patients.

Background: Sarcoidosis is a systemic granulomatous disorder associated with high CD4+cell activity, without any detectable pathogen. Clustering in families occurs, and the existence of a genetic predisposition to sarcoidosis is widely accepted. There are differences among different ethnic groups. Methods: We studied HLA polymorphisms in 64 Turkish patients with biopsy proven sarcoidosis. The control group was taken of 160 donor candidates of kidney transplantation within the same period. Results: Fifty-one patients were female, and 13 were male. The mean age was 39 ± 6.1 years. Frequency of HLA A2, A9, A24 (9), A25, A69 (28), B12, B22, B38, B49 (21), DR4, and DR14 antigens were significantly higher, and frequencies of HLA B7 and DR7 were significantly less in sarcoidosis patients. Clustering in some families were also noted in our study. Conclusions: This study implies a genetic predisposition to sarcoidosis in the Turkish population. Clustering in some families should be kept in mind.

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.

Does the 6-minute walk test predict nocturnal oxygen desaturation in patients with moderate to severe COPD?

Patients with chronic obstructive pulmonary disease (COPD) who have nocturnal oxygen desaturation (NOD) can be treated with nocturnal oxygen therapy (NOT) to avoid possible morbidity and mortality. Although there is no definite data recommending NOT alone, our aim is to evaluate the relationship between desaturation during the six-minute walk test (6MWT) and NOD in COPD. Fifty-five stable patients with COPD were enrolled in this study. The 6MWT and nocturnal oximetry were performed. Patients with comorbid diseases and respiratory failure were excluded. In total, 55 patients (49 males and 6 females, mean age: 65.8 ± 8.4 years) were analysed. Twenty-seven of the patients had moderate COPD and the remainder (n = 28) had severe COPD. Three patients (11%) with moderate COPD and 12 patients (42.9%) with severe COPD desaturated during 6MWT (p = 0.003). NOD was observed in five patients with severe COPD (17.9%). There were no patients with NOD in the moderate COPD group. Three (25%) of patients with severe COPD who desaturated during the 6MWT also had NOD. NOD was more common in patients with severe COPD and the patients with higher carbon dioxide levels (p = 0.02 and p = 0.001). Three patients (11%) with moderate COPD desaturated during the 6MWT; however they did not have NOD. Although the sample size in this study was too small to be conclusive, NOD was more common in desaturators during the 6MWT particularly in patients with severe COPD.

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.

Lung Cancer: Clinical and Surgical Specifications

Description: Lung cancer diagnosis worldwide has advanced considerably. Progress in diagnostic techniques and therapeutic methods has greatly improved life expectancy in lung cancer patients. Information on lung cancer diagnosis and treatment is therefore useful for all medical professionals especially those who work outside the realm of pulmonology or oncology. This book answers the needs of medical professionals seeking this information and includes both internal and surgical aspects of lung cancer as well as developments in molecular research on pulmonary oncology.