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Kayalı A, Bora ES, Acar H, Yılmaz G, Erbaş O. Fisetin ameliorates methotrexate induced liver fibrosis. Eur Rev Med Pharmacol Sci 2024; 28:3112-3119. [PMID: 38708470 DOI: 10.26355/eurrev_202404_36027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
OBJECTIVE Methotrexate (MTX), a widely used chemotherapeutic and immunosuppressive agent, is associated with hepatotoxicity, leading to liver fibrosis and cirrhosis. This study explores the regenerative and reparative effects of fisetin, a flavonoid with known antioxidant and anti-inflammatory properties, on MTX-induced liver fibrosis in a rat model. MATERIALS AND METHODS Thirty-six male Wistar albino rats were divided into normal, MTX and saline, and MTX and fisetin. Liver injury was induced in the latter two groups using a single intraperitoneal dose of MTX (20 mg/kg). Fisetin (50 mg/kg/day) or saline was administered intraperitoneally for ten days. After sacrifice, liver tissues were subjected to histopathological evaluation and biochemical analyses, including Transforming Growth Factor-β1 (TGF-beta), sirtuins-1 (SIRT-1), malondialdehyde (MDA), cytokeratin 18, thrombospondin 1, and alanine transaminase (ALT) levels. RESULTS MTX administration significantly increased liver injury markers, including TGF-beta, MDA, cytokeratin 18, thrombospondin 1, and ALT, while reducing SIRT-1 levels. Fisetin treatment attenuated these effects, demonstrating its potential therapeutic impact. Histopathological analysis confirmed that fisetin mitigated MTX-induced hepatocyte necrosis, fibrosis, and cellular infiltration. CONCLUSIONS This study proves that fisetin administration can alleviate MTX-induced liver damage in rats. The reduction in oxidative stress, inflammation, and apoptosis, along with the histological improvements, suggests fisetin's potential as a therapeutic agent against MTX-induced hepatotoxicity. Further investigations and clinical studies are warranted to validate these findings and assess fisetin's translational potential in human cases of MTX-induced liver damage.
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Affiliation(s)
- A Kayalı
- Department of Emergency Medicine, Faculty of Medicine, Izmir Katip Çelebi University, Izmir, Türkiye.
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Ürün M, Bora ES, Acar H, Erbaş O. Evaluation of the healing and protective properties of adipose-derived mesenchymal stem cells from cisplatin-induced liver and kidney damage. Eur Rev Med Pharmacol Sci 2024; 28:1327-1339. [PMID: 38436166 DOI: 10.26355/eurrev_202402_35454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
OBJECTIVE The occurrence of nephrotoxicity and hepatotoxicity as a result of cisplatin administration is a major concern in clinical practice. This study examined the potential protective effects of administering mesenchymal stem cells (MSCs) on the renal and hepatic damage caused by cisplatin. Moreover, the study investigated the potential protective effects of administering Adipose-Derived Mesenchymal Stem Cells (ADMSC) to counteract the harmful effects of cisplatin-induced kidney and liver damage. MATERIALS AND METHODS Male Sprague-Dawley rats were divided into three groups: normal control, cisplatin + saline, and cisplatin + ADMSC. Cisplatin was administered to induce toxicity, and ADMSC was administered intravenously as a potential therapeutic intervention. Biochemical parameters and histopathological changes were assessed in the kidney and liver tissues. Statistical analyses were performed using a one-way ANOVA. RESULTS Cisplatin increased malondialdehyde (MDA), tumor necrosis factor alfa (TNF-alfa), IL-6, alanine transaminase (ALT), creatinine, Galectin-3, Tissue growth factor beta 1 (TGF-beta 1), compared to the normal control group. Cisplatin-MSC reduced these levels. Histopathology showed that cisplatin caused kidney tubular epithelial necrosis, luminal necrotic debris, tubular dilatation, interstitial inflammation, liver sinusoidal and central vein dilatation, congestion, necrosis, and cytoplasmic vacuolization. ADMSC administration significantly reduced histopathological changes. CONCLUSIONS These findings highlight the potential therapeutic benefits of mesenchymal stem cell (MSC) administration in mitigating cisplatin-induced nephrotoxicity and hepatotoxicity. MSC treatment demonstrated protective effects by reducing oxidative stress, inflammatory markers, and histopathological alterations. Further investigations are warranted to elucidate the precise mechanisms underlying these protective effects and evaluate their clinical implications for managing cisplatin-induced organ damage.
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Affiliation(s)
- M Ürün
- Oncology Department, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey.
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Çınaroğlu O, Bora E, Acar H, Arıkan C, Küçük M, Kırık S. Is near-infrared spectroscopy a promising predictor for early intracranial hemorrhage diagnosis in the Emergency Department? Braz J Med Biol Res 2024; 57:e13155. [PMID: 38265345 PMCID: PMC10802232 DOI: 10.1590/1414-431x2023e13155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/04/2023] [Indexed: 01/25/2024] Open
Abstract
Intracranial hemorrhage (ICH) is a serious medical condition that can lead to significant morbidity and mortality if not diagnosed and treated promptly. Early detection and treatment are essential for improving the outcome in patients with ICH. Near-infrared spectroscopy (NIRS) is a non-invasive imaging technique that has been used to detect changes in brain tissue oxygenation and blood flow in various conditions. The aim of this study was to investigate the predictive potential of NIRS for early diagnosis of ICH in patients presenting to the Emergency Department (ED) triage with headache. A total of 378 patients were included in the study. According to the final diagnosis of the patients, 4 groups were formed: migraine, tension-cluster headache, intracranial hemorrhage and intracranial mass, and control group. Cerebral NIRS values "rSO2" were measured at the first professional medical contact with the patient. The right and left rSO2 (RrSO2, LrSO2) were significantly lower and the rSO2 difference was significantly higher in the intracranial hemorrhage group compared to all other patient groups (P<0.001). The cut-off values determined in the receiver operating characteristics (ROC) analysis were RrSO2 ≤67, LrSO2 ≤67, and ΔrSO2 ≥9. This study found that a difference of more than 9 in cerebral right-left NIRS values can be a non-invasive, easy-to-administer, rapid, and reliable diagnostic test for early detection of intracranial bleeding. NIRS holds promise as an objective method in ED triage for patients with intracranial hemorrhage. However, further research is needed to fully understand the potential benefits and limitations of this method.
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Affiliation(s)
- O.S. Çınaroğlu
- Department of Emergency Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - E.S. Bora
- Department of Emergency Medicine, Izmir Ataturk Training and Research Hospital, Izmir, Turkey
| | - H. Acar
- Department of Emergency Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - C. Arıkan
- Department of Emergency Medicine, Izmir Ataturk Training and Research Hospital, Izmir, Turkey
| | - M. Küçük
- Department of Emergency Medicine, Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Turkey
| | - S. Kırık
- Department of Emergency Medicine, Izmir Katip Celebi University, Izmir, Turkey
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Kayalı A, Bora ES, Acar H, Erbaş O. Evaluation of the Reparative Effect of Sinomenine in an Acetaminophen-Induced Liver Injury Model. Curr Issues Mol Biol 2024; 46:923-933. [PMID: 38275673 PMCID: PMC10814253 DOI: 10.3390/cimb46010059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Due to its rising global prevalence, liver failure treatments are urgently needed. Sinomenine (SIN), an alkaloid from sinomenium acutum, is being studied for its liver-repair properties due to Acetaminophen (APAP) overdose. SIN's effect on APAP-induced hepatotoxicity in rats was examined histologically and biochemically. Three groups of 30 adult male Wistar rats were created: control, APAP-only, and APAP + SIN. Histopathological and biochemical analyses were performed on liver samples after euthanasia. SIN is significantly protected against APAP damage. Compared to APAP-only, SIN reduced cellular injury and preserved hepatocellular architecture. The APAP + SIN Group had significantly lower ALT, MDA, and GSH levels, protecting against hepatocellular damage and oxidative stress. SIN also had dose-dependent antioxidant properties. When examining critical regulatory proteins, SIN partially restored Sirtuin 1 (SIRT1) levels. While BMP-7 levels were unaffected, histopathological evidence and hepatocyte damage percentages supported SIN's liver-restorative effect. SIN protected and repaired rats' livers from APAP-induced liver injury. This study suggests that SIN may treat acute liver damage, warranting further research into its long-term effects, optimal dosage, and clinical applications. These findings aid liver-related emergency department interventions and life-saving treatments.
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Affiliation(s)
- Ahmet Kayalı
- Department of Emergency Medicine, Faculty of Medicine, Izmir Katip Çelebi University, Izmir 35270, Turkey; (A.K.); (H.A.)
| | - Ejder Saylav Bora
- Department of Emergency Medicine, Izmir Atatürk Research and Training Hospital, Izmir 35360, Turkey
| | - Hüseyin Acar
- Department of Emergency Medicine, Faculty of Medicine, Izmir Katip Çelebi University, Izmir 35270, Turkey; (A.K.); (H.A.)
| | - Oytun Erbaş
- Department of Physiology, Faculty of Medicine, Demiroğlu Bilim University, Istanbul 34395, Turkey;
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Kernder A, Rohde M, Acar H, Düsing C, Fischer-Betz R, Haase I, Mucke J, Sander O, Richter JG, Filla T, Schneider M, Chehab G. Patient-reported outcomes in large vessel vasculitis: insights from a retrospective analysis of disease activity and associated factors. J Patient Rep Outcomes 2024; 8:4. [PMID: 38285076 PMCID: PMC10825095 DOI: 10.1186/s41687-023-00681-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Patient-reported outcomes (PROs) play a crucial role in assessing rheumatic diseases, offering insights into disease evaluation and treatment efficacy. This study focuses on PRO assessment in large vessel vasculitides, including Takayasu Arteritis and Giant Cell Arteritis (GCA). METHODS We retrospectively analyzed routine data from patients treated at our rheumatology clinic over a 10-year span. Patient and physician-rated global disease activity scale (G-DAS) scores, measured on a numeric rating scale (0-10 points), were collected at each visit. Clinical variables like age, sex, body mass index (BMI), disease duration, lab values, pain perception, and questionnaire responses were recorded. Linear regression and generalized additive linear regression (GAM analysis) examined associations between PROs and these factors. RESULTS The study included 138 patients, primarily diagnosed with GCA (94.4%). Mean follow-up was 2.5 years (0-7.7). Patient and physician G-DAS exhibited a moderate correlation (Pearson R 0.19, CI 0.14-0.24, p < 0.001). Higher patient G-DAS correlated with younger age (CI -3.4 - -1.5, p < 0.001), increased pain (CI 3.5-4, p < 0.001), functional limitations (HAQ, CI 0.5-0.6, p < 0.001), reduced physical (CI 2.3-2.7, p ≤ 0.001) and psychological well-being (CI 2.1-2.5, p < 0.001), and higher BMI (CI 1.3-2.4, p < 0.001). Physician G-DAS correlated with Birmingham Vasculitis Activity Score (V3.0; R 0.42, p 0.046) and were significantly linked to serum CRP elevations (β = 0.04, CI 0.0-0.08, p 0.028). CONCLUSIONS These findings underscore the need to integrate PRO measures into vasculitis disease management strategies, enhancing the understanding of disease activity from the patient's perspective.
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Affiliation(s)
- A Kernder
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany.
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany.
| | - M Rohde
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - H Acar
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - C Düsing
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - R Fischer-Betz
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - I Haase
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - J Mucke
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - O Sander
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - J G Richter
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - T Filla
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - M Schneider
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
| | - G Chehab
- Department of Rheumatology, Medical Faculty of Heinrich, University Hospital Düsseldorf, Heine University, Moorenstr. 5, 40225, Düsseldorf, Germany
- Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University, Düsseldorf, Germany
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Efgan MG, Payza U, Çınaroğlu OS, Acar H, Kayalı A. A Comparison of BUN/Albumin Ratio with PSI and CURB-65 for Predicting Mortality in COVID-19 Pneumonia in the Emergency Department. Istanbul Med J 2022. [DOI: 10.4274/imj.galenos.2022.29794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Çakır A, Akyol PY, Acar H. The effect of stress hyperglycemıa seen ın acute ST-segment elevatıon ın myocardıal ınfarctıon on ın-hospıtal mortalıty. Ir J Med Sci 2022:10.1007/s11845-022-03182-9. [PMID: 36217074 DOI: 10.1007/s11845-022-03182-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/03/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The brief rise in blood glucose level during acute physiological stress in patients with no previous symptoms of diabetes mellitus is called stress hyperglycemia. METHODS This study is conducted with 1033 patients over the age of 18 who are diagnosed with STEMI and who did not meet the exclusion criteria for 1 year. Patients were divided into 2 groups as DM and non-DM and their blood glucose levels, demographic data (age, sex, cardiovascular risk factors, DM, HT presence/absence, history of smoking), vital signs, fatal arrhythmia requiring intervention (ventricular tachycardia and ventricular fibrillation), cardiac insufficiency development according to Killip score, length of hospital stay, mortality and cardiogenic shock conditions were evaluated. Statistical analysis was made using SPSS 23.0 for Windows® (IBM Inc. Chicago, IL, USA). Results were considered significant at p < 0.05, with a 95% confidence interval. RESULTS In non-DM group, BG has been found to be significantly higher in mortal cases compared to surviving cases (289.25 ± 106.35 mg/dL for mortal cases; whereas 156.99 ± 58.60 mg/dL for surviving cases; p < 0.001). Likewise, in DM group BG has been found to be higher in mortal cases compared to surviving cases. (328.38 ± 77.13 mg/dL for mortal cases while 237.16 ± 95.00 mg/dL for surviving cases; p < 0.001). CONCLUSIONS For patients who are admitted to the hospital with STEMI, stress hyperglycemia in the non-DM group and hyperglycemia in the DM group are associated with both mortality and adverse conditions; thereby, glucose levels of those patients must be evaluated.
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Affiliation(s)
- Adem Çakır
- Department of Emergency Medicine, Ministry of Health of Turkey Canakkale Mehmet Akif Ersoy State Hospital, Canakkale, Turkey.
| | - Pınar Yeşim Akyol
- Department of Emergency Medicine, Izmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Hüseyin Acar
- Department of Emergency Medicine, Izmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
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Acar H, Sorgun O, Yurtseve G, Bora ES, Erbaş O. Antifibrotic preventive effect of polyethylene glycol (PEG) 3350 in methotrexateinduced hepatoxicity model. Acta Cir Bras 2022; 37:e370507. [PMID: 35894304 PMCID: PMC9323303 DOI: 10.1590/acb370507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/20/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Liver damage caused by drugs and other chemicals accounts for about 5% of all cases. Methotrexate (MTX), a folic acid analogue, is a first-line synthetic antimetabolite agent routinely used in the treatment of rheumatoid arthritis and other autoimmune and chronic inflammatory diseases. Polyethylene glycol (PEG) has antioxidant activity. In this study, we evaluated biochemically and histopathologically the antifibrotic effect of PEG 3350 administered intraperitoneally to prevent methotrexate-induced liver damage in rats. METHODS A total of 30 male rats including 10 rats was given no drugs (normal group), and 20 rats received single-dose 20 mg/kg MTXfor induced liver injury in this study. MTX was given to 20 rats, which were divided in two groups. Group 1 rats was given PEG30 mg/kg/day (Merck) intraperitoneally, and Group 2 rats % 0.9 NaCl saline 1 mL/kg/day intraperitoneally daily for two weeks. RESULTS Transforming growth factor beta (TGF-β), plasma malondialdehyde (MDA), liver MDA, serum tumour necrosis factor alpha (TNF-α), alanine aminotransferase and plasma pentraxin-3 levels and, according to tissue histopathology, hepatocyte necrosis, fibrosis and cellular infiltration were significantly better in MTX+PEG group than in MTX+saline group. CONCLUSIONS PEG 3350 is a hope for toxic hepatitis due to other causes, since liver damage occurs through oxidative stress and cell damage, similar to all toxic drugs.
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Affiliation(s)
- Hüseyin Acar
- MD. Izmir Atatürk Training and Research Hospital - Department of Emergency Medicine - Izmir, Turkey
| | - Omay Sorgun
- MD. Ödemiş State Hospital - Department of Emergency Medicine - İzmir, Turkey
| | - Güner Yurtseve
- MD. Izmir Atatürk Training and Research Hospital - Department of Emergency Medicine - Izmir, Turkey
| | - Ejder Saylav Bora
- MD. Izmir Atatürk Training and Research Hospital - Department of Emergency Medicine - Izmir, Turkey
| | - Oytun Erbaş
- Associate professor. Demiroğlu Bilim University - Faculty of Medicine - Department of Physiology - Istanbul, Turkey
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Kernder A, Rohde M, Acar H, Sander O, Richter J, Fischer-Betz R, Schneider M, Chehab G. POS1488-HPR DETERMINANTS OF PATIENT AND PHYSICIAN GLOBAL ASSESSMENT OF DISEASE ACTIVITY IN LARGE VESSEL VASCULITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundFactors influencing disease activity assessment by patients and physicians are unknown, but are highly relevant in the context of PROs development.ObjectivesTo compare the patients’ and physicians’ global assessment of disease activity in large vessel vasculitis and investigate factors influencing the assessment of disease activity.MethodsBetween 2010 and 2020, patients with large vessel vasculitis and their routine caring physicians assessed a global disease activity score (numerical rating scale 0 – 10) in our outpatient clinic. We compared these global scores of disease activity. In a multiple linear regression analysis we examined the influence of potential demographical and clinical factors on the disease activity assessment.Results138 Patients with 866 assessments were available for analysis. At timepoint of assessment they had a mean age of 76 (± 9) years and a mean disease duration of 5 years (± 5). The median global score of patient-reported disease activity was 3 points, the median physicians’ disease activity assessment was 2 points.In 28,2% (n=244) there was a deviation of more than 2 points between the patients’ and physicians’ assessment of disease activity. Only 5 times the physicians, but 232 times the patients rated their disease activity higher than 5 points.In this group the patient-reported disease activity was associated with the patients age (β 0.025), the patients BMI (β 0.071) and the extent of pain (β 0.19), p<0.05. The disease duration, CRP level and the psychological well-being of the patient showed no association.ConclusionIn our cohort, physicians and patients showed greater divergence in disease activity assessment with higher disease activity. Age, BMI and the extent of pain were associated with higher disease activity ratings by the patients. This results are relevant for the development and interpretation of PROs for activity assessment in large vessel vasculitides.Disclosure of InterestsAnna Kernder: None declared, Marius Rohde: None declared, Hasan Acar: None declared, Oliver Sander Speakers bureau: SOBI Pharma, EUSA Pharma, AbbVie Pharma, Consultant of: SOBI Pharma, EUSA Pharma, Boehringer Pharma, Jutta Richter: None declared, Rebecca Fischer-Betz: None declared, Matthias Schneider Speakers bureau: Astra-Zeneca; Biogen; BMS; Celgene; Chugai; GSK; Janssen-Cilag; Lilly; Pfizer; UCB, Paid instructor for: Lilly, Consultant of: Abbvie; Astra-Zeneca; Boehringer-Ingelheim; GSK; Lilly; Novartis; Pfizer; Protagen; Roche; Sanofi-Aventis; UCB, Grant/research support from: Abbvie; Astra-Zeneca; GSK; UCB, Gamal Chehab: None declared
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Acar H, Yamanoglu A. Rapid Shallow Breathing Index as a Predictor for Intubation and Mortality in Acute Respiratory Failure. Respir Care 2022; 67:562-571. [PMID: 35473843 PMCID: PMC9994252 DOI: 10.4187/respcare.09525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
BACKGROUND Noninvasive ventilation (NIV) is one of the most important therapeutic tools in patients with acute respiratory failure. However, in case of incorrect patient selection it can delay necessary intubation and is associated with complications and even mortality. Patient selection, therefore, plays a key role in therapeutic success. The purpose of this study was to determine the value of the rapid shallow breathing index (RSBI) in predicting the failure of NIV. METHODS This prospective observational study was conducted in the emergency department (ED) of a tertiary hospital. Adults presenting to the ED with acute respiratory failure were included in the study. The success of RSBI values measured initially (RSBI 1) and at 30 min (RSBI 2) and the difference between these 2 values (Δ RSBI) in predicting subjects' intubation requirement and survival was tested using multivariate logistic regression analysis. RESULTS Two hundred sixty-seven subjects were included in the study. RSBI 1, RSBI 2, and Δ RSBI values differed significantly between the intubated and non-intubated subjects. According to the multivariate model, RSBI 1 and RSBI 2 > 105, Δ RSBI < 19, heart rate > 100 beats/min, and SpO2 < 92% were significantly associated with intubation requirement. RSBI 1, RSBI 2, and Δ RSBI values also differed significantly between subjects with a fatal course and surviving individuals. According to the multivariate model, RSBI 2 > 105, Δ RSBI < 19, heart rate > 100, and increasing age were associated with in-hospital mortality. CONCLUSIONS RSBI can be a successful marker in predicting the failure of NIV and predicting in-hospital mortality in patients admitted to the ED with acute respiratory failure.
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Affiliation(s)
- Hüseyin Acar
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
| | - Adnan Yamanoglu
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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Karaali R, Çakir A, Bora ES, Akyol PY, Kavalci C, Acar H. The Evaluation of End Tidal Carbon Dioxide Values in Intubated Patients with COVID-19. Acta Biomed 2022; 93:e2022032. [PMID: 35315404 PMCID: PMC8972851 DOI: 10.23750/abm.v93i1.11989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/01/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of this study is to establish the value of PETCO2 in COVID-19 patients intubated in emergency department, and its effects on mortality. Objectives: Between May 15, 2020 and January 15, 2021, The patients aged ≥18 years and diagnosed COVID-19, scheduled for urgent intubation in the emergency department were included. METHOD Single-center, prospective and observational study. Age, gender, vital signs, laboratory findings are recorded. Immediately after intubation as measured by the capnography, the initial PETCO2_1 and at post-ventilation 15 min, PETCO2_2 and first, second arterial blood gas analysis are recorded. RESULTS The mean age of the 48 patients was 74 years. The PETCO2_1 and PETCO2_2 measurements were statistically significantly different between the patients who survived and those who died (p=0.014, p=0.015). The patients with a high first PETCO2_1 value and a decrease to the normal level survived, but those with a low PETCO2_1 value that could not increase to a normal value died (p=0.038, p=0.031). Increased levels of SpO2, PETCO2_1, PETCO2_2 and PaCO2_2 decreased the risk of mortality, while an increased level of PaO2_2 increased the risk of mortality. CONCLUSION Capnography is non-invasive and provides continuous measurement. Assessment of changes in PETCO2 value would contribute to patient survival.
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Affiliation(s)
- Rezan Karaali
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Turkey
| | - Adem Çakir
- Department of Emergency Medicine, Republic of Turkey, Ministry of Health Başakşehir Çam ve Sakura City Hospital, Istanbul, Turkey
| | - Ejder Saylav Bora
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Turkey
| | - Pınar Yeşim Akyol
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Turkey
| | - Cemil Kavalci
- Department of Emergency Medicine Republic of Turkey, Ministry of Health Antalya Research and Training Hospital, Turkey
| | - Hüseyin Acar
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Turkey
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Bilgin S, Kayali A, Yamanoğlu A, Acar H, Karakaya Z, Topal F, Yüksel ES, Topal FE. The value of conventional manometry in the identification of normal esophageal manometry. Medicine (Baltimore) 2021; 100:e28395. [PMID: 34967374 PMCID: PMC8718173 DOI: 10.1097/md.0000000000028395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/23/2021] [Indexed: 01/05/2023] Open
Abstract
In the last decade, high-resolution esophageal manometry (HREM) is the main device for the management of dysphagia replacing conventional manometry (CM). Conventional manometry still seems to have some space to diagnose major motility disorders and differentiate normal from abnormal esophageal motility. The long term outcomes of patients with normal CM were analyzed in our study.Participants (patients with dysphagia and normal CM) took a questionnaire via a phone call in February 2021. Impact Dysphagia Questionnaire (IDQ) was used as an assessment tool.Only 55% (83/151) the individuals with previous normal manometric findings were reached via telephone. The group who have completed the survey was representative of the cohort. 66.2% of the participants were female (P = .40). The mean age was 57.21, mean weight was 70.69 kg, mean height was 163.74 cm and mean body mass index was 26.41. More than 40% of patients were completely asymptomatic at follow up, reflected by an IDQ score of 0. Only 28 out of 83 (33.7%) patients reported significant symptoms as reflected by an IDQ score greater than or equal to 7. The rest of responders admitted as having moderate to mild symptoms.HREM is a valid technique with comparable precision to CM. HREM measurements differ considerably to CM. The identification of normal motor function in CM is not likely a positive prognostic indicator and must be interpreted precautiously.
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Affiliation(s)
- Serkan Bilgin
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
| | - Ahmet Kayali
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
| | - Adnan Yamanoğlu
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
| | - Hüseyin Acar
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
| | - Zeynep Karakaya
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
| | - Firdevs Topal
- Department of Gastroenterology, İzmir Katip Çelebi University, İzmir, Turkey
| | - Elif Saritaş Yüksel
- Department of Gastroenterology, İzmir Katip Çelebi University, İzmir, Turkey
| | - Fatih Esad Topal
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
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Akyol PY, Acar H, Çakır A, Saraçoğlu G, Topal FE. Determining the level and causes of anxiety related to pandemic of healthcare professionals working in the emergency department. Am J Emerg Med 2021; 56:333-335. [PMID: 34565631 PMCID: PMC8425744 DOI: 10.1016/j.ajem.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/04/2021] [Accepted: 09/04/2021] [Indexed: 01/25/2023] Open
Affiliation(s)
- Pınar Yeşim Akyol
- Department of Emergency Medicine, Izmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey.
| | - Hüseyin Acar
- Department of Emergency Medicine, Izmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Adem Çakır
- Department of Emergency Medicine, The Ministry of Health Basaksehir City Hospital, Istanbul, Turkey
| | - Gülçim Saraçoğlu
- Muğla Sıtkı Koçman University Research and Training Hospital, Emergency Department, Muğla, Turkey
| | - Fatih Esad Topal
- Department of Emergency Medicine, Izmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
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Yamanoglu A, Akyol PY, Acar H, Celebi Yamanoglu NG, Topal FE, Kayalı A. How would you like your COVID-19? From a host with mild course disease, or from a severe one? Am J Emerg Med 2020; 38:2487.e7-2487.e12. [PMID: 32536478 PMCID: PMC7834627 DOI: 10.1016/j.ajem.2020.05.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/29/2020] [Indexed: 12/15/2022] Open
Abstract
The clinical course of COVID-19 presents a broad spectrum, being asymptomatic in some individuals while following a severe course and resulting in mortality in others. It is known that such factors as age and chronic diseases can result in a different clinical courses in individuals, however, variable clinical courses among the similar individuals in terms of age and chronic diseases are also seen. Other possible factors affecting the course of the disease that are mostly speculative or under investigation are genetic factors and the origin of transmission or possible subtype of novel coronavirus. Whether the source of transmission is important in the clinical course of the disease is unknown. A case series composed of seven individuals in a similar age group, with different lines of descent and different genetic structures, but who were infected from the same source is presented here. The similar and different clinical, laboratory and radiological findings of the cases residing in the same nursing home, who presented to the hospital altogether, were evaluated. The aim of the study was to analyze whether the source of transmission is influential in the clinical course of the disease.
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Affiliation(s)
- Adnan Yamanoglu
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
| | - Pinar Yeşim Akyol
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Hüseyin Acar
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | | | - Fatih Esad Topal
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Ahmet Kayalı
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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Richter JG, Chehab G, Tomczak M, Schwartz C, Ricken E, Acar H, Gappa H, Schneider M, Velasco C, Consortium TP. AB1189 PICASO - THE PLATFORM FOR IMPROVED PERSONAL AND COORDINATED CARE OF CHRONICALLY ILL – SIX MONTHS RESULTS FROM A PROOF-OF-CONCEPT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Cross-sectoral coordination of treatment plans and efficient management of patients with chronic diseases and co-morbidities are of great importance. In rheumatoid arthritis (RA) it is essential to orchestrate information available for a patient at various locations, to allow (cost) efficient data use, to optimize management processes and to avoid redundant diagnostics. The information and communication platform developed in the Horizon2020 funded PICASO project (www.picaso-project.eu) supports the management of patients and their data along the continuum of care, consisting of hospitals, outpatient departments, practices, other health service providers via remote health monitoring. The platform might empower patients to improve their self-management of their illnesses.Objectives:What technological expertise and resources do RA patients and physicians have, who are willing to participate in a proof-of-concept study using a modern ICT platform? What is the user satisfaction? What are platform`s clinical implications?Methods:PICASO pursued a user-centered design approach. Platform`s user requirements were determined through workshops and interviews with physicians from various disciplines, patients and other stakeholders in the health care system (e.g. data protection officers). The development was accompanied by so-called “expert walkthroughs” to ensure a user-friendly design. An evaluation concept assessing the usability of the applications, user satisfaction and clinical relevance of the platform was part of the 6-month proof-of-concept study with RA patients and their physicians (rheumatologists and family doctors). A positive ethics vote was obtained.Results:111 user requirements were identified and used to develop the platform. Conformity with the GDPR as well as national regulations were precisely adhered to. All developments are based on the new ‘Fast Healthcare Interoperability Resources’ standard enabling data exchange with other software systems in the healthcare sector. This offers many advantages, e.g. a semantic model for describing the smallest units in the health care system (e.g. medication intake times, diagnostic procedures). Thus information can be linked and made available across sectors. Data can remain with the data owner and role-specific data access is ensured.30 RA patients (80% female) participated, mean age was 58.6±10.8 years, disease duration 12.6±8.5 years, DAS28 2.6±0.9, average number of comorbidities 3.0±1.6. Patients’ IT-experience was heterogeneous. After 6 months evaluations showed a good platform acceptance with an overall rating of 2.3±1.1 (n=27, Likert scale (LS) 1-6) and evaluation of ‘ease of use’ at 2.3±1.2 (n=27, LS 1-6). Usability tests showed that for patients the presentation of (1) tasks to be performed for the management of their disease, (2) results from their remote health monitoring, and (3) patient-reported outcome instruments in a dashboard was clear and easy to understand. Time required for documentation and daily tasks was rated as appropriate by 75.9% of the patients. No major technical problems or impairments due to RA where experienced when using the dashboard. 8 physicians (37.5 % female) participated in the evaluation; overall the platform was rated at 2.2±0.5 (LS 1-6).Conclusion:The platform offers cross-sectoral orchestration of patient data and thus innovative capabilities for modern management processes (e.g. treat-to-target, tele-monitoring). The PICASO platform is available for RA patients as well as for other chronic diseases.Acknowledgments:This project received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 689209.Disclosure of Interests:None declared
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Kerimoglu O, Pekin A, Yılmaz S, İncesu F, Nergiz S, Doğan N, Acar H, Celik C. Effect of the FSH receptor polymorphism on the age at menarche. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4404.2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Genç A, Tutkun E, Güven D, Acar H. Investigation of the endometrial thickness and estrogen level in athletes and sedentaries. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4531.2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Acar H, Acar K. Posterior reversible encephalopathy syndrome in a pregnant patient without eclampsia or preeclampsia. Am J Emerg Med 2018; 36:1721.e3-1721.e4. [PMID: 29880411 DOI: 10.1016/j.ajem.2018.05.074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 05/29/2018] [Indexed: 11/25/2022] Open
Abstract
Posterior Reversible Encephalopathy syndrome (PRES) is a rare neurologic disorder characterised by vasogenic edema in occipital and parietal lobes on MR. Patients usually complain about headache, visual disturbance, seizure and altered mental status. We repot a case of PRES seen in a pregnant patient. Although pre-eclampsia and eclampsia are among the common causes of this syndrome in this case patient was normotensive and no proteinuria was present. To our knowledge this is the first PRES case presented of a pregnant patient without eclampsia or pre-eclampsia.
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Affiliation(s)
- Hüseyin Acar
- Atatürk Eğitim ve Araştırma Hastanesi Basın Sitesi, Izmir 35360, Emergency Department, Turkey.
| | - Kadriye Acar
- Sakarya Üniversitesi, Sağlık bilimleri enstitüsü, Kemalpaşa Mahallesi Üniversite Caddesi, 54050 Serdivan, Sakarya, Turkey
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Kucukmorkoc E, Kucuk N, Doyuran M, Acar H, Canoglu D, Rashad R, Caglar H. EP-1587: feasibility investigation of prone position robotic radiosurgery treatment for dorsal metastasis. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32022-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Acar H, Yılmaz S, Yaka E, Doğan NÖ, Özbek AE, Pekdemir M. Evaluation of the Diagnostic Role of Bedside Lung Ultrasonography in Patients with Suspected Pulmonary Embolism in the Emergency Department. Balkan Med J 2017; 34:356-361. [PMID: 28443595 PMCID: PMC5615969 DOI: 10.4274/balkanmedj.2016.1181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Despite the existence of detailed consensus guidelines, challenges remain regarding efficient, appropriate, and safe imaging methods for the diagnosis of suspected pulmonary embolism. Aims: To investigate the role of the wedge sign, B-lines, and pleural effusion seen on bedside lung ultrasound in the diagnosis of pulmonary embolism. Study Design: Diagnostic accuracy study. Methods: During the first evaluation of patients with suspected pulmonary embolism, bedside lung ultrasound was performed, and the B-lines, wedge sign, and pleural effusion were investigated. Computed tomography angiography was used as a confirmatory test and was compared with the lung ultrasound findings. Results: Pulmonary embolism was detected in 38 (38%) patients. In the comparison of bedside lung ultrasound results, statistically significant differences were found between the groups in terms of the B-lines and wedge sign (p=0.005 and p<0.001, respectively). There were no significant differences in terms of effusion (p=0.234). Comparison of these findings with computed tomography angiography of the chest showed weak negative correlations between the groups in terms of B-lines (r=-0297) and a moderately positive correlation in terms of the wedge sign (r=0.523). The sensitivity, specificity, and positive and negative predictive values of lung ultrasound findings alone were low. In the logistic regression analysis, the wedge sign (p<0.01, OR=69.45, 95% CI=6.94-695.17) and B-line (p=0.033, OR=1.96, 95% CI=0.41-8.40) were found to be effective in the diagnosis of pulmonary embolism. Conclusion: Although the role of lung ultrasound has been increasing in the management of critically ill patients, its value is limited and cannot replace the gold standard tests in the diagnosis of pulmonary embolism.
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Affiliation(s)
- Hüseyin Acar
- Clinic of Emergency, Tunceli State Hospital, Tunceli, Turkey
| | - Serkan Yılmaz
- Department of Emergency, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Elif Yaka
- Department of Emergency, Kocaeli University School of Medicine, Kocaeli, Turkey
| | | | - Asım Enes Özbek
- Clinic of Emergency, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Murat Pekdemir
- Department of Emergency, Kocaeli University School of Medicine, Kocaeli, Turkey
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Codel G, Serin E, Cebe M, Mabhouti H, Pacaci P, Sanli E, Doyuran M, Kucukmorkoc E, Altinok A, Canoglu D, Kucuk N, Acar H, Caglar H. Accuracy of the small field dosimetry using Acuros XB and AAA dose calculation algorithms of eclipse treatment planning system within and beyond heterogeneous media for Trubeam 2.0 unit. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Mabhouti H, Sanli E, Cebe M, Codel G, Pacaci P, Serin E, Doyuran M, Kucukmorkoc E, Altinok A, Canoglu D, Kucuk N, Acar H, Caglar H. The dosimetric comparison of Truebeam and Cyberknife treatment planning systems dose calculation accuracy for brain SRS treatment on Randophantom. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Serin E, Codel G, Cebe M, Mabhouti H, Pacaci P, Sanli E, Doyuran M, Kucukmorkoc E, Altinok A, Canoglu D, Kucuk N, Acar H, Caglar H. Accuracy of the small field dosimetry using the monte carlo and sequential dose calculation algorithms of Multiplan treatment planning system within and beyond heterogeneous media for Cyberknife M6 unit. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Sanli E, Mabhouti H, Cebe M, Codel G, Pacaci P, Serin E, Kucuk N, Kucukmorkoc E, Doyuran M, Canoglu D, Altinok A, Acar H, Caglar Ozkok H. SU-F-SPS-10: The Dosimetric Comparison of GammaKnife and Cyberknife Treatment Plans for Brain SRS Treatment. Med Phys 2016. [DOI: 10.1118/1.4955685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Mabhouti H, Sanli E, Cebe M, Codel G, Pacaci P, Serin E, Kucuk N, Kucukmorkoc E, Doyuran M, Canoglu D, Altinok A, Acar H, Caglar Ozkok H. SU-F-SPS-11: The Dosimetric Comparison of Truebeam 2.0 and Cyberknife M6 Treatment Plans for Brain SRS Treatment. Med Phys 2016. [DOI: 10.1118/1.4955686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Acar H, Cebe M, Mabhouti H, Codel G, Pacaci P, Serin E, Sanli E, Kucuk N, Kucukmorkoc E, Doyuran M, Canoglu D, Altinok A, Caglar H. SU-F-T-616: Comparison of Different Techniques Using RTOG0631 Guidelines in Spine SBRT. Med Phys 2016. [DOI: 10.1118/1.4956801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Pacaci P, Cebe M, Mabhouti H, Codel G, Serin E, Sanli E, Kucukmorkoc E, Doyuran M, Kucuk N, Canoglu D, Altinok A, Acar H, Caglar Ozkok H. SU-F-SPS-04: Dosimetric Evaluation of the Dose Calculation Accuracy of Different Algorithms for Two Different Treatment Techniques During Whole Breast Irradiation. Med Phys 2016. [DOI: 10.1118/1.4955679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Cebe M, Pacaci P, Mabhouti H, Codel G, Sanli E, Serin E, Kucuk N, Kucukmorkoc E, Doyuran M, Canoglu D, Altinok A, Acar H, Caglar Ozkok H. SU-F-SPS-05: Experimental Validation of Peripheral Dose Distribution of Electron Beams for Eclipse Electron Monte Carlo Algorithm. Med Phys 2016. [DOI: 10.1118/1.4955680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Codel G, Serin E, Pacaci P, Sanli E, Cebe M, Mabhouti H, Doyuran M, Kucukmorkoc E, Kucuk N, Altinok A, Canoglu D, Acar H, Caglar Ozkok H. SU-F-SPS-01: Accuracy of the Small Field Dosimetry Using Acuros XB and AAA Dose Calculation Algorithms of Eclipse Treatment Planning System Within and Beyond Heterogeneous Media for Trubeam 2.0 Unit. Med Phys 2016. [DOI: 10.1118/1.4955676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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31
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Serin E, Codel G, Mabhouti H, Cebe M, Sanli E, Pacaci P, Kucuk N, Kucukmorkoc E, Doyuran M, Canoglu D, Altinok A, Acar H, Caglar Ozkok H. SU-F-SPS-02: Accuracy of the Small Field Dosimetry Using the Monte Carlo and Sequential Dose Calculation Algorithms of Multiplan Treatment Planning System Within and Beyond Heterogeneous Media for Cyberknife M6 Unit. Med Phys 2016. [DOI: 10.1118/1.4955677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Altinok A, Doyuran M, Caglar M, Canoglu D, Kucukmorkoc E, Acar H, Kucuk N, Caglar H. EP-1190: Boost volume assessment in breast cancer: preop tumor volume vs clips used in oncoplastic surgery. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32440-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Acar H, Yavas G, Yavas C. The impact of dose calculatıon algorıthms for perıpheral dose dıstrıbutıons of enhanced dynamıc and physıcal wedges. INT J RADIAT RES 2016. [DOI: 10.18869/acadpub.ijrr.14.1.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Cebe M, Acar H, Kucuk N, Kucukmorkoc E, Doyuran M, Caglar M, Altinok A, Yilidir G, Mabhouti H, Caglar H. SU-E-T-726: The Analysis of Different Percentage Depth Dose Curves Used for Commissioning in Eclipse. Med Phys 2015. [DOI: 10.1118/1.4925090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Mabhouti H, Acar H, Kucuk N, Kucukmorkoc E, Doyuran M, Caglar M, Altinok A, Cebe M, Yilidir G, Caglar H. SU-E-T-725: The Analysis of Different Diagonal Profiles Used for Commissioning in Eclipse. Med Phys 2015. [DOI: 10.1118/1.4925089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Yilidir G, Acar H, Kucuk N, Kucukmorkoc E, Doyuran M, Caglar M, Altinok A, Cebe M, Mabhouti H, Caglar H. SU-E-T-731: The Effect of Thermoplatic Mask to the Surface Dose in Sterotactic Brain Treatments with Flattening Filter Free Beams with EBT3 Gafchromic Film and OSL Dosimeter. Med Phys 2015. [DOI: 10.1118/1.4925095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kucukmorkoc E, Doyuran M, Caglar M, Kucuk N, Acar H, Altinok A, Caglar H. EP-1414: The effect of depth and control point number for MLC transmission and dosimetric leaf gap. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41406-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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38
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Acar H, Ozbay I. PO-1033: Dosimetric comparison of dose distributions in episcleral plaque brachytherapy. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41025-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Caglar H, Kucukmorkoc E, Kucuk N, Altinok A, Acar H, Doyuran M. EP-1335: Deformable MRI fusion for intracranial SRS: Can we trust? Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41327-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Altinok A, Acar H, Rizazade R, Kucuk N, Kucukmorkoc E, Doyuran M, Mabhouti H, Caglar H. EP-1253: Evaluation of interfractional bladder doses for two different patient positioning methods in prostate cancer. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41245-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Demirci O, Yavuz T, Arisoy R, Pekin O, Acar H, Aydin H, Cetinkaya A, Karaman A, Erdoğdu E, Kumru P. AGENESIS OF THE DUCTUS VENOSUS--A CASE WITH NOONAN SYNDROME. Genet Couns 2015; 26:373-376. [PMID: 26625673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Caglar HB, Altinok AY, Kucukmorkoc E, Acar H, Kucuk N. O2.06 * USE OF MRI FUSION FOR CT BASED INTRACRANIAL STEREOTACTIC RADIOSURGERY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Acar H, altinok A, kucukmorkoc E, kucuk N, caglar H. SU-E-T-548: How To Decrease Spine Dose In Patients Who Underwent Sterotactic Spine Radiosurgery? Med Phys 2014. [DOI: 10.1118/1.4888883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chehab G, Sander O, Richter J, Acar H, Vordenbäumen S, Brinks R, Schneider M, Fischer-Betz R. Validation and evaluation of the German Brief Index of Lupus Damage (BILD)--a self-reported instrument to record damage in systemic lupus erythematosus. Lupus 2014; 22:1050-5. [PMID: 23963433 DOI: 10.1177/0961203313500369] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Damage is a very important predictor for outcome in systemic lupus erythematosus (SLE) and should be routinely documented. Patient-reported assessments for damage are rare and neither the Lupus Damage Index Questionnaire (LDIQ) nor the Brief Index of Lupus Damage (BILD) is validated in German language. Our aim was to validate the BILD in German language and evaluate its use as a patient-administered instrument. METHOD We translated and adapted the BILD questionnaire to use it as a self-administered questionnaire for German-speaking SLE patients. It was applied to SLE outpatients at an academic centre and compared to the SLICC/SDI and other lupus outcome parameters. RESULTS The German BILD showed as strong a correlation with the SLICC/SDI as the original version of the BILD and a superior correlation compared to the LDIQ. It scored significantly higher with an increase of age, disease duration or disease activity, with a lower functional status or overall health and a higher probability of receiving an incapacity pension. CONCLUSION The German version of the BILD shows a comparable validity to the original BILD with even higher correlation to physician-reported damage even when used as a self-administered questionnaire. Hence it represents a promising instrument to survey damage in clinical routine as well as in clinical and epidemiological studies.
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Affiliation(s)
- G Chehab
- Rheumatology, Heinrich-Heine-University, Duesseldorf, Germany.
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Ucar VB, Nami B, Acar H, Kilinç M. Is methylenetetrahydrofolate reductase (MTHFR) gene A1298C polymorphism related with varicocele risk? Andrologia 2014; 47:42-6. [PMID: 24456105 DOI: 10.1111/and.12229] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2013] [Indexed: 12/17/2022] Open
Abstract
Varicocele is one of the main reasons for male infertility the exact aetiology of which remains unclear. Methylenetetrahydrofolate reductase (MTHFR) is important for DNA synthesis and methylation, which has a key role during spermatogenesis. Numerous literature suggests that the MTHFR polymorphism may be genetic risk factors for male infertility. In this study, we evaluated C677T and A1298C MTHFR gene polymorphism frequency in patients with varicocele and normal men. A total of 107 varicocele patients and 109 fertile healthy individuals were included. Genotyping of the MTHFR gene in C677T and A1298C base pairs carried out by using real-time PCR technique and afterwards, the statistical analysis accomplished. There is a statistical difference for the frequency of 1298AA genotype in patients with varicocele compared with normal controls (P = 0.0051, OR = 2.2750). Instead, subsequently, 1298/A allel frequency in patient group was significantly higher in comparison with control group (P = 0.0174). According to our results, 1298AA genotype in MTHFR gene raises the risk of varicocele approximately 2.3 times more compared with men carrying other genotypes. The results show that genetic factors have an important role in the molecular basis of varicocele.
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Affiliation(s)
- V B Ucar
- Department of Medical Genetics, Selçuk University Medical School, Konya, Turkey
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Kucukmorkoc E, Acar H, Altinok A, Sertkaya H, Omurca A, Aydemir S, Caglar H. EP-1171: Repeat CT imaging and adaptive planning during radiotherapy for locally advanced lung cancer. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31289-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dundar M, Balta B, Bahadir O, Acar H, Baydilli N, Baltaci V, Ekmekcioglu O, Saatci C. An uncommon cause of infertility: Y;1 translocation and PGD trial. Genet Couns 2014; 25:353-355. [PMID: 25365861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Ülker HE, Ülker M, Botsalı MS, Dündar A, Acar H. Cytotoxicity evaluation of dentin contacting materials with dentin barrier test device using erbium-doped yttrium, aluminum, and garnet laser-treated dentin. Hum Exp Toxicol 2013; 33:949-55. [DOI: 10.1177/0960327113511476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: The effect of dentin contacting materials on three-dimensional cultures of pulp-derived cells was evaluated in a dentin barrier test device using erbium-doped yttrium, aluminum, and garnet (Er:YAG) laser-treated dentin. Methods: The test materials (iBond®, G-Bond™, and Vitrebond™) were applied on laser-treated or untreated dentin discs. After 24 h of exposure with perfusion of the test chamber, cell survival was evaluated by enzyme activity and related to a nontoxic control material. The mean values of control tissues were set to represent 100% viability. Data were analyzed using Kruskal–Wallis and Mann–Whitney U test. Results: Vitrebond was the most toxic material for both laser-treated and untreated dentin. On untreated dentin, G-bond was cytotoxic to the pulp-derived cells ( p < 0.05), and iBond was similar to the negative control group ( p > 0.05). However, G-Bond and iBond were not cytotoxic when they were applied to Er:YAG laser-treated dentin ( p > 0.05). Conclusion: Er:YAG laser treatment of dentin may protect the pulp cells from toxic substances of dentin contacting restorative materials; however, this effect is material related. Taking into consideration the limitations of this in vitro study, the Er:YAG laser treatment of dentin before restoration might be an option for decreasing the cytotoxic effects of the dental materials. Further research is required for clinical applications.
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Affiliation(s)
- HE Ülker
- Department of Restorative Dentistry, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - M Ülker
- Department of Restorative Dentistry, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - MS Botsalı
- Department of Pedodontics, Faculty of Dentistry, Selcuk University, Konya, Turkey
| | - A Dündar
- Department of Restorative Dentistry, Faculty of Dentistry, Abant İzzet Baysal University, Bolu, Turkey
| | - H Acar
- Department of Genetics, Faculty of Medicine, Selcuk University, Konya, Turkey
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Petek Balcı B, Günaydın S, Mutlu A, Çokar A, Acar H, Gürbüz D. The relationship between the internal capsule DTI parameters and cognition in relapsing remitting multiple sclerosis (RR MS) patients. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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