Yusuf İzzettin Bariş

Occurrence of allergic conditions in asthmatics with analgesic intolerance.

Background: The study aimed to determine whether allergic conditions accompany analgesic intolerance.

Prevalence of childhood asthma and allergic diseases in Ankara, Turkey

Kalyoncu AF, Selçuk ZT, Karakoca Y, Emri AS, Çöplü L, Şahin AA, Bariş YI. Prevalence of childhood asthma and allergic diseases in Ankara, Turkey.

Treatment of malignant pleural mesothelioma with cisplatin, mitomycin C and alpha interferon.

From October 1990 to September 1991, 20 consecutive patients with histologically proven malignant pleural mesothelioma (MPM), secondary to environmental exposure to asbestos or erionite, were treated with cisplatin, mitomycin C and alpha interferon (cisplatin 50 mg/m2 i.v. on day 1 of a 21-day cycle; mitomycin C 10 mg/m2 i.v. day 1 of cycles 1,3 and 5; alpha-2b-interferon 10 x 10(6) units i.m., 4 h prior to cisplatin and 10 x 10(6) units i.v. immediately prior to cisplatin day 1 of each cycle). Eighty-two treatment cycles were administered to 19 evaluable patients. Two patients attained a partial response. Eleven patients had stable disease and 6 had disease progression. Toxicities included interferon-related fever and flu-like symptoms, and vomiting. Actuarial median survival was 15 months. Three patients are alive at 20+, 21+ and 27+ months. We conclude that while the addition of alpha interferon to cisplatin and mitomycin C did not result in an objective response higher than previously reported with the cytotoxic agents alone, the trend towards an improvement in median survival as compared to a well-matched historical group suggests some benefit from the inclusion of interferon.

Survey of the allergic status of patients with bronchial asthma in Turkey: a multicenter study

Patients diagnosed with bronchial asthma (BA) were prospectively enrolled to assess their allergen spectra and atopic status. The patients came from five major cities (Ankara. Ízmir, Samsun. ElazíǵC, and Adana) in different regions of Turkey. Atopic status, total IgE levels, and allergen speelra were determined in 1149 patients and 210 controls who were spouses of the patients sharing the same environment hut not consanguinity with the patients. Total IgF. levels were significant higher in the asthmatic patients. For both groups, total IgE. levels were higher in both alopic and male subjects. Atopy rates were 42% in asthmatics and 26.1% in controls, declining notably by age in both groups. The most common allergen in both groups was house‐dust mite (RDM), which was more frequency detected in coastal regions (Samsun. Izmir, and Adana). Allergen spectra of the patients included HDM. pollens, cockroach, pet animals, and molds in decreasing order of frequency. Phleum praiensi: and Artemisia vulgam were the most common pollens in all regions, whereas Olea europaea was the most common in Izmir. Pollen sensitivity was least frequent in hlazig. For all of the regions, pet sensitivity was less common than, and mold sensitivity was comparable to, that of Western countries. In conclusion. BA patients in Turkey displayed significant differences in their allergen spectra and total IgE levels from control subjects and BA patients in Western countries.

Environmental Pleural Plaques due to Asbestos and Fibrous Zeolite Exposure in Turkey

There are many districts in central and south-eastern Anatolia where benign and malignant pleural diseases occur as a result of environmental exposure to mineral fibres. Tremolite asbestos is found in the region and, in addition, in certain areas, there is a unique non-asbestos fibre called erionite which is a fibrous zeolite and which causes pulmonary diseases similar to those produced by asbestos. In this article we would like to report the frequency of calcified pleural plaques in a large-scale epidemiological study in Turkey. The presence of such plaques is considered indicative of mineral fibre exposure. The miner alogy of the region, exposure characteristics of the population and frequency of detection by computerised tomography, thoracoscopy and thoracotomy are also given.

CT findings in malignant pleural mesothelioma related to nonoccupational exposure to asbestos and fibrous zeolite (erionite)

Endemic malignant pleural mesothelioma (MPM) in Turkey is related to two mineral fibers, tremolite asbestos and fibrous zeolite (erionite). Thirteen cases of MPM from the Cappadocian area, where the soil is rich in erionite, and 29 cases of MPM, from villages whose occupants have high asbestos exposure, were examined by CT. The CT findings of the two groups of MPM were compared with respect to the configuration of the pleural lesions, stage of disease, fissural involvement, pleural effusion, presence of calcified pleural plaques, and chronic fibrosing pleuritis. In erionite-related MPM the pleural lesions were flat and smooth in 69.1%; in asbestos-related MPM the lesions were nodular in 55.1%. Stage IV disease, calcified pleural plaques, and chronic fibrosing pleuritis were more common in the erionite-related MPM. The rest of the findings were similar in both groups. The early radiological diagnosis of erionite-related MPM may be even more difficult because of the similarity of the pleural lesions to chronic fibrosing pleuritis.

Carbon monoxide poisoning related to the use of steam coal in poorly ventilated bucket stoves

During the years 1986 to 1990, an increasing number of cases of acute carbon monoxide (CO) poisoning were encountered in the Emergency Department Hacettepe University Hospital in Ankara, Turkey. Between January 1 and March 31, 1991, all the patients presenting with complaints compatible with CO poisoning were evaluated; the diagnosis was confirmed in 55 of the 5795 people who attended the Emergency Department during this period. In all cases the source of CO intoxication was determined. Among these patients, nausea or vomiting and headaches were the most common complaints (occurring in 100% and 85%, respectively). At least transient impairment of alertness was observed in 29% of cases. The carboxyhaemoglobin levels ranged from 3.80 to 48.1% (median 14.2%). Two comatose patients who developed a non-cardiogenic pulmonary oedema required mechanical ventilation. One of them was discharged from the hospital with mild cerebral disability. Another patient developed an acute myocardial infarction. In all the cases in this series, the source of CO poisoning was identified as improper combustion of recently marketed steam coal in inadequately ventilated bucket stoves.

'Biomass Lung': Primitive Biomass Combustion and Lung Disease

Domestic burning of biomass fuel is one of the most important risk factors for the development of respiratory diseases and infant mortality. The fuel which causes the highest level of disease is dung. In the rural areas of developing countries some 80% of households rely on biomass fuels for cooking and often heating as well and so suffer high indoor air pollution. Even when the fire or stove is outside the home those near it are still exposed to the smoke. In areas where the winters are long and cold the problem is aggravated since the fire or stove is indoors for many months of the year. The consequence of biomass burning is a level of morbidity in those exposed to the smoke as well as mortality. The rural areas of Turkey are among many in the world where biomass is the major fuel source. In this case report 8 patients from rural areas, particularly Anatolia, who used biomass are presented. Many of these are non-smoking, female patients who have respiratory complaints and a clinical picture of the chronic lung diseases which would have been expected if they had been heavy smokers. Typically patients cook on the traditional ‘tandir’ stove using dung and crop residues as the fuel. Ventilation systems are poor and they are exposed to a high level of smoke pollution leading to cough and dyspnoea. Anthracosis is a common outcome of this level of exposure and several of the patients developed lung tumours. The findings from clinical examination of 8 of these patients (2 M, 6 F) are presented together with their outcome where known.

Treatment of Echinococcus granulosus Cysts

dOSL,\. The major ohstack in the treatment of hydntid diseases in Turkey is the lack of patient compliance. Needless to say. the presence of only I00 mg tablet\ of mebendazole in Turkey and thc difficulty of swallowing 60 to 120 tablets at one time every day contrihutcs to the outcome. We have no experience with alhcndazole which is not ;tvailable in Turkey. We have observed complications rno\tly due to perforation of the cysts during treatment in these paticnts. Pneurnothorax. hemoptysis. fever and superimposed hacterial infection in the hydatid cyst caviiy have occurred in 11 small nurnher of patient\. Side effects due to mebendazole were infrcqucnt and consisted of throinhocytopeni;i. g;istrointestin;il irritation and alopecia. All these sidc effects were rever\ible. We have not observed allergic reactionc during treatment or after perforation of the cysts in any of the patients. Wc assume that thc follow-up of the patientc after cyst rupture is a very important part of the treatment schedule. It should he emphasized that rigid or flexible hronchoscopy may be valuable for extraction of the hydatid membrane in o ionnl patients (2 of the 43 patient.; in our series. unpublished data). Pcrcutancous aspiration of the hydatid cyst lesions in the liver and lung in conjunction with mclxml;rzolc chemotherapy is currently under investigation in our institution. Preliminary results suggest that it is ii rather simple. inexpensive and useful method Longterm results are awaited.