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Öğe Ameliorative Effects of Oleuropein on Lipopolysaccharide-Induced Acute Lung Injury Model in Rats(Springer/Plenum Publishers, 2021) Dikmen, Nursel; Cellat, Mustafa; Etyemez, Muhammed; Isler, Cafer Tayer; Uyar, Ahmet; Aydin, Tuba; Guvenc, MehmetAcute lung injury (ALI) is one of the most common causes of death in diseases with septic shock. Oleuropein, one of the important components of olive leaf, has antioxidant and anti-inflammatory effects. The objective of this study was to investigate the effects of oleuropein on lipopolysaccharide (LPS)-induced ALI in rats. Oleuropein was administered to rats at a dose of 200 mg/kg for 20 days and LPS was given through intratracheal administration to induce ALI. The study was terminated after 12 h. The results showed that in the group treated with oleuropein, inflammatory cytokines and oxidative stress decreased in serum, bronchoalveolar lavage fluid (BALF), and lung tissue, and there were significant improvements in the picture of acute interstitial pneumonia (AIP) caused by LPS in histopathological examination. Based on the findings of the present study, oleuropein showed protective effects against LPS-induced ALI.Öğe Asthma overlap syndrome: Concept and ventilatory modes(Nova Science Publisher Inc., 2023) Dikmen, NurselObstructive sleep apnea syndrome (OSAS) is a syndrome characterized by recurrent episodes of upper airway obstruction during sleep and often progresses with a decrease in blood oxygen saturation. OSAS patients have high mortality and morbidity rates. Asthma, on the other hand, is a heterogeneous disease, usually characterized by chronic airway inflammation, causing bronchial obstruction and secondary respiratory symptoms such as cough, shortness of breath, and wheezing, especially in the form of nocturnal attacks. The co-occurrence of obstructive sleep apnea-hypopnea syndrome (OSAS) and lung diseases such as chronic obstructive pulmonary disease (COPD), asthma, interstitial lung disease (ILD), and cystic fibrosis is called overlap syndrome. In this section, the co-existence of OSAS and asthma was considered an overlap syndrome. Recent data have shown that the presence of OSAS in asthma patients makes it difficult for patients to control their symptoms. Again, some studies have found an increased prevalence of OSAS in asthma patients. This section summarizes OSAS asthma overlap syndrome and treatment modalities considering the current literature. © 2023 Nova Science Publishers, Inc.Öğe A case of allergic bronchopulmonary aspergillosis with atypical clinical presentation(2012) Akoğlu Genç, Sebahat; Özer, Burçin; Babayiğit, Cenk; Balcı, Ali; Karazincir, Sinem; Dikmen, NurselAllerjik bronkopulmoner aspergilloz (ABPA) astım ya da kistik fibrozisli hastalarda görülen ve Aspergillus fumigatus ’a karşı gelişen yaygın bir hipersensitivite reaksiyonudur. Astımı olmayan hastalarda da nadiren bildirilmiştir. Burada atipik klinik bulgularla gelen ve “High attenuation mucoid impaction” saptanan bir ABPA olgusu sunulmaktadır. Amaç, ABPA’nın atipik klinik bulgularla ortaya çıkabileceğini vurgulamaktır.Öğe A Case of Secondary Narcolepsy Presenting with Obstructive Sleep Apnea Symptoms(Galenos Publ House, 2016) Genc, Sebahat; Bilgic, Hatice Kayim; Okuyucu, Emine Esra; Dikmen, Nursel; Duman, TaskinObstructive sleep apnea syndrome (OSAS) and narcolepsy are two diseases causing excessive daytime sleepiness (EDS). As they are often confused, these two disorders can also coexist. Therefore there is need to distinguish these disorders in patients with EDS. We would like to present a case on a patient who sent to our sleep laboratory with a preliminary diagnosis of OSAS and suspicion of narcolepsy in detailed history. The case is a 24 year-old male. He was diagnosed with OSAS and narcolepsy while being investigated for OSAS. Neurological examination revealed an additional diagnosis of multiple sclerosis. In this case report, we emphasize that in patients with EDS, particularly if EDS cannot be explained with OSAS, investigation for narcolepsy should also be done. In addition, when narcolepsy is detected; neurological examination is actually necessary considering the possibility of secondary narcolepsy.Öğe Chest CT in COVID-19 pneumonia: correlations of imaging findings in clinically suspected but repeatedly RT-PCR test-negative patients(Springer, 2021) Korkmaz, Inan; Dikmen, Nursel; Keles, Fatma Ozturk; Bal, TayibeBackground: To emphasize the importance of CT in the diagnosis of COVID-19 disease by comparing the thoracic CT findings of COVID-19 patients with positive RT-PCR results and patients with clinical suspicion of COVID-19 but with negative RT-PCR results. Results: In our study, COVID-19 patients with positive RT-PCR results (RT-PCR (+) group) and patients with clinical suspicion of COVID-19 but negative RT-PCR results (RT-PCR (-) group) were compared in terms of CT findings. In CT images, ground-glass opacity and ground-glass opacity + patchy consolidation were the most common lesion patterns in both groups. No statistically significant differences in the rates and types of lesion patterns were observed between the two groups. In both groups, lesion distributions and distribution patterns were similarly frequent in the bilateral, peripheral, and lower lobe distributions. Among the 39 patients who underwent follow-up CT imaging in the first or second month, a regression in lesion number and density was detected in 18 patients from both groups. Consolidations were completely resorbed in 16 of these patients, and five patients had newly developed fibrotic changes. The follow-up CT examination of 16 patients was normal. Conclusions: Due to the false-negative rate of RT-PCR tests caused by various reasons, clinically suspected COVID-19 patients with a contact history should be examined with CT scans, even if RT-PCR tests are negative. If the CT findings are positive, these patients should not be removed from isolation.Öğe Correlation Between the Carotid Artery Intima Media Thickness and Gamma Glutamyl Transferase Level in Maras Powder Users(2022) Bozkus, Fulsen; Dikmen, Nursel; Köylü, AhmetObjective: In this study, we evaluated carotid artery intima-media thickness (CIMT), an early marker of atherosclerosis in smokers and Maras\rpowder users, and serum gamma glutamyl transferase (GGT) levels, which is a marker of oxidative damage.\rMethods: The study included 27 men who do not smoke but use maras powder, 32 men who smoke but do not use maras powder and 30\rmen who neither smoke nor use Maras powder as the control group. Serum levels of GGT and lipid profiles were measured and the results\rwere compared between the groups. CIMT was measured by Doppler ultrasonography.\rResults: Mean CIMT was found as 0.79±0.09 mm, 0.74±0.08 mm and 0.55±0.08 mm in Maras powder, smoking and control groups; respectively.\rThe difference among the groups was statistically significant (p<0.001). Plasma levels of total cholesterol, low-density lipoprotein-cholesterol\rand triglyceride were significantly higher in the Maras powder and smoking groups than in the control group (p<0.001). Plasma levels of highdensity\rlipoprotein-cholesterol levels were significantly lower in the Maras powder and smoking groups than in the control group (p<0.001).\rSerum GGT levels were found significantly higher in the Maras powder and smoking groups compared to the control group (p<0.001).\rConclusion: This study reveals that Maras powder is as effective as cigarette smoking on increasing of oxidative stress, which plays a role in\rthe pathogenesis of many diseases. Our results suggest that CIMT is an important marker of cardiovascular complications in Maras powder\rusers and smokers as a non-invasive method.Öğe Does the neutrophil-to-lymphocyte ratio have any importance between subjects with obstructive sleep apnea syndrome with obesity and without obesity?(Turkish Assoc Tuberculosis & Thorax, 2018) Bozkus, Fulsen; Dikmen, Nursel; Samur, Anil; Bilal, Nagihan; Atilla, Nurhan; Arpag, HseyinIntroduction: An increase in the incidence of OSAS (obstructive sleep apnoea syndrome) has been seen due to the reported association between OSAS and obesity. Subjects are predisposed to cardiovascular disease due to systemic inflammation caused by the interactions between obesity and OSA. Inflammatory markers could be used to predict the degree of systemic inflammation, which could be a prognostic factor for future adverse events such as metabolic risks. One marker that has recently started being used as an indicator of systemic inflammation is neutrophil-to-lymphocyte ratio (NLR). Materials and Methods: The aim is to evaluate NLR, which is a easily measured parameter of systemic inflammation in OSAS subjects with and without obesity. 155 subjects were assigned to four different groups according to their body mass indices. Comparisons of white blood cell, neutrophil, lymphocyte, NLR values and anthropometric measurements were done for each group. Results: The NLR and neutrophil counts of group 4 were statistically significant and higher than those of groups 1, 2 and 3. The lymphocyte counts of group 4 were the lowest amongst all groups, these values were lower than the lymphocyte counts of groups 1, 2 and 3 with statistically significant differences (p< 001). A positive correlation was found between the body mass index and lymphocyte count values of obese OSAS subjects (r= 0.027, p= 353). Conclusion: The NLR ratio was found to be increasing by obesity grade and reveals that the associated inflammatory response also increases. The NLR ratio might be used as an inflammatory marker in obese OSAS subjects.Öğe Dose-dependent effects of simvastatin, atorvastatin and rosuvastatin on apoptosis and inflammation pathways on cancerous lung cells(Ankara Univ, 2023) Dikmen, Nursel; Ozkan, Huseyin; Cimen Acikgul, Funda; Camdeviren, Baran; Ay, Emrah; Ambarcioglu, Pinar; Duran, NizamiThe aim of study was to investigate the anti-proliferative and inflammatory effects of atorvastatin, rosuvastatin, and simvastatin in lung cancer. The effects of statins were investigated in Vero, BEAS-2B, and A549 cell lines. In addition to expressions of BAX, BCL-2, TNF alpha, IL-10, IL-6, protein levels of TNF alpha, IL-10, IL-6 were determined. Cell viability and MDA were also measured. While the cell numbers in groups with low doses of statins were found to be approximately 1x106/mL, proliferation was inhibited at higher rates containing high doses. Simvastatin, rosuvastatin, and high dose atorvastatin upregulated the BAX, while high dose of atorvastatin and both doses of rosuvastatin caused downregulation in BCL-2. All statin groups had higher MDA. Simvastatin and high dose rosuvastatin upregulated TNF alpha. While low dose simvastatin and atorvastatin and high dose atorvastatin and rosuvastatin upregulated IL-10, IL6 was upregulated with a low dose of rosuvastatin. TNF alpha was higher in simvastatin and rosuvastatin groups. IL-10 was highest in rosuvastatin groups. Atorvastatin groups had lower IL-6. Although cell numbers have been reduced by all statins, rosuvastatin is more effective on studied genes.Öğe The effect of continuous positive airway pressure treatment on inflammatory parameters and periostin levels in patients with obstructive sleep apnea syndrome(Springer Heidelberg, 2023) Tosun, Fatma; Babayigit, Cenk; Dikmen, Nursel; Dogan, Serdar; Dirican, EmreBackground The purpose of the study was to examine the effects of continuous positive airway pressure (CPAP) treatment on inflammation parameters in patients with obstructive sleep apnea syndrome (OSAS). Methods Patients aged 18 to 65 years who underwent polysomnography (PSG) in the sleep clinic between January 1, 2019, and December 31, 2019, were included in the study. Patients with severe OSAS initiated treatment with CPAP. Patients and control subjects were assessed for levels of periostin, TNF-alpha, TGF-beta, and IL-6. Patients were re-evaluated 3 months later. Comparisons for the serum markers were made between controls and patients of different severity of OSAS. Comparisons of serum markers were also made between baseline and 3 month follow-up. Results A total of 92 patients were enrolled in the study, including 25 controls (apnea-hypopnea index or AHI < 5/h), 39 patents with mild to moderate OSAS who did not receive CPAP, and 28 patients with severe OSAS receiving CPAP treatment. When all three groups were compared, levels of periostin, TNF-alpha, TGF-beta, and IL-6, as inflammatory markers, were higher in the OSAS group, though not at a statistically significant level. In patients with severe OSAS, there were statistically significant decreases in the TGF-beta 1, TNF-alpha, and IL-6 values between baseline values and the same measures taken after 3 months of CPAP treatment. Periostin values also decreased after treatment, but this decrease was not at a significant level. Conclusion Inflammatory parameters of patients with OSAS were significantly higher compared with healthy participants. Regression of inflammation was detected after CPAP treatment.Öğe The effect of positive airway pressure therapy on intraocular pressure and retina in severe obstructive apnea syndrome(Springer Japan Kk, 2022) Dikmen, Nursel; Cakmak, Ayse Idil; Urfalioglu, SelmaTo identify and compare changes in intraocular pressure (IOP), macular, and peripapillary retinal nerve fiber layer (RNFL) thickness using optical coherence tomography (OCT) measurements before and after 3 months of positive airway pressure (PAP) therapy in patients with severe obstructive sleep apnea syndrome (OSAS). Twenty-five patients diagnosed with severe OSAS in the neurology sleep outpatient clinic were included in the study. Ophthalmologic examinations were performed at the time of diagnosis and after 3 months of PAP therapy. Statistical analysis of comparisons of pre-treatment and post-treatment measurements of IOP and OCT was performed. Before the PAP therapy, the correlations between central corneal thickness (CCT), body mass index (BMI), OCT, IOP, and sleep parameters were statistically analyzed. Compared to the pre-treatment measurements at the time of diagnosis, post-treatment measurements showed insignificant decrease in IOP, significant increase in mean macular thickness and significant thinning in superior nasal RNFL. There was no correlation found between pre-treatment measurements including IOP, OCT, CCT, BMI, and sleep parameters. The effect of intermittent hypoxia and hypercapnia on the IOP and macula may be reversible in severe OSAS patients receiving 3 months of PAP therapy, but the reversibility of the neurodegenerative effects of OSAS on RNFL with this treatment seems controversial. OCT can be considered to be a promising technique for monitoring disease progression under PAP therapy in patients with severe OSAS.Öğe Evaluation of hearing loss in patients with OSAS and the relationship between S100B and NSE(PLEKSUS BİLİŞİM TEKN. DANIŞ. TEMS. YAY. ORG. A.Ş., 2020) Arlı, Cengiz; Saraç, Elif Tuğba; Özcan, Oğuzhan; Babayiğit, Cenk; Dikmen, Nursel; Doğru, Sibel; Okuyucu, Emine EsraObjective: The aim of the current study was to determine the relationship between serum S100B levels, NSE levels and hearing function in patients with OSAS. Material and Methods: Thirty-five subjects and 30 controls were included in the study. The study group included 35 patients with moderate and severe apnoea (AHI > 15) who were diagnosed by polysomnography (PSG). Control subjects were selected with ESS (Epworth Sleepiness Scale). Serum S100B and NSE levels in the study and control groups were analyzed by ELISA (enzyme-linked immunosorbent assay) and high-frequency audiometry was done for all subjects. Results: Mean S100B levels and NSE levels of the OSAS group were significantly higher than that of the controls (p = 0.039; p = 0.002, respectively). The hearing thresholds between 125-1,000 Hz and between 4,000-12,000 Hz in the study group were found to be significantly higher than the control group. Conclusion: We suggest that hearing function should be evaluated in OSAS patients and a professional consultation should be sought for OSAS treatment. In addition, serum S100B and NSE measurements may be valued as biochemical indicators in determining hearing loss risk caused by OSAS.Öğe Evaluation of long-term lung capacity using spirometry in patients who underwent bronchoscopy due to foreign body aspiration(Çukurova Üniversitesi, 2019) Atıcı, Ahmet; Dikmen, Nursel; Çelikkaya, Mehmet Emin; El, Çiğdem; Akçora, BülentPurpose: The purpose of the present study was to evaluate the long-term lung status using spirometry in patients who underwent rigid bronchoscopy in acute period due to foreign body aspiration. Materials and Methods: Records of 142 children who underwent bronchoscopy due to foreign body aspiration between March 2013 and April 2018 were retrospectively reviewed. The data of 20 patients who cooperated with the spirometry process were included in this study (Group 1). Twenty patients who were admitted to the routine pediatric surgeon polyclinic without any lung problem and pain complaints were included in the study as a control group (Group 2). Forced expiratory flow rate (FEV1), forced vital capacity (FVC), FEV1/FVC, and forced expiratory flow at 25-75% of forced vital capacity (FEF 25–75) parameters were recorded in the first second. Results: Based on the statistical analysis results, there was no significant effect of age, sex, and BMI on FEV1, FVC, and FEF 25–75 values. The effect of bronchoscopy procedure on the same values, the difference between FEV1 and FVC values was statistically significant, whereas the difference between FEV1/FVC and FEF 25–75 values was not statistically significant for Groups 1 and 2. Conclusion: There was no long-term negative effect on lung capacities assessed using spirometry in our patients who received early-diagnosis and intervention within 24 h.Öğe Evaluation of retinal microvasculature according to stable chronic obstructive pulmonary disease severity and the correlation of pulmonary parameters with optical coherence tomography angiography findings(Wolters Kluwer Medknow Publications, 2022) Kurtul, Bengi Ece; Cakmak, Ayse Idil; Kasapoglu Dilek, Ezgi; Dikmen, NurselPurpose: To evaluate the retinal and optic disc microvascular changes according to disease severity in patients with stable chronic obstructive pulmonary disease (COPD), and the correlation of pulmonary parameters with optical coherence tomography angiography (OCTA) findings. Methods: Forty patients with COPD and 30 age- and sex-matched subjects (control group) were included in this cross-sectional prospective study. The COPD group was then divided into two subgroups according to GOLD classification and disease severity as mild-to-moderate COPD group (group 1) and severe COPD group (group 2). OCTA was performed with 6 mm x 6 mm sections for the macula and 4.5 mm x 4.5 mm sections for the optic disc. Foveal retinal thickness (FRT), peripapillary retinal nerve fiber layer (RNFL) thickness, and vessel density in different sections of the retina and optic disc were analyzed. Results: The mean ages, gender, intraocular pressures, peripapillary RNFL thickness, FRT, and optic disc vessel densities were similar among the groups. Compared to the control group and group 1, group 2 showed significantly lower mean foveal vessel density measurements in superficial and deep capillary plexus (P = 0.014 and P = 0.007, respectively). Cigarette packets/year, exacerbation per year, and Modified Medical Research Council showed significant negative correlations, whereas forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity showed significant positive correlations with foveal vessel densities. Conclusion: COPD severity seems to have a negative effect on OCTA measurements. OCTA may reflect the severity of inflammation and hypoxia in COPD and may provide useful detailed information on the role of retinal vascular changes in the follow-up and progression of patients with COPD.Öğe Evaluation of right heart functions by echocardiography and tissue Doppler imaging echocardiography in obese and non-obese patients with obstructive sleep apnea(Cukurova Univ, Fac Medicine, 2020) Dikmen, Nursel; Genc, Sebahat; Akcay, Adnan BurakPurpose: The aim of our study was to compare the right ventricular systolic and diastolic functions and pulmonary artery pressure (PAP) in obese and non-obese patients with obstructive sleep apnea syndrome (OSAS) by tissue Doppler imaging (TDI) echocardiography. Materials and Methods: This study was conducted with 69 patients, 34 obese and 35 non-obese, diagnosed moderate or severe OSAS by an overnight polysomnographic sleep study. In all patients, LV (left ventricle) and RV (right ventricle) size, left atial (LA) and RA (right atrial) dimensions, LV and RV systolic and diastolic functions and systolic PAPs were measured by M-mode, two-dimensional analysis, color flow Doppler and TDI. Results: RV diastolic dysfunction was detected in both groups; this impairment was significantly higher in the obese group (lateral tricuspid late diastolic myocardial annular zone velocity A'a: 0.13 +/- 0.03 in non-obese patients and 0.11 +/- 0.04 in obese patients). The mean systolic PAP was significantly higher in obese patients (31.2 +/- 5.6, 27.1 +/- 5.8, respectively) Conclusion: Obstructive Sleep Apnea Syndrome increases cardiovascular morbidity and mortality. In our study,left ventricul and right ventricul diastolic dysfunction was determined by tissue Doppler imaging in patients with moderate and severe Obstructive Sleep Apnea Syndrome. Obesity contributes to this impairment regardless of Obstructive Sleep Apnea Syndrome.Öğe Genotyping, drug resistance and virulence factors of Candida species isolated from patients using long-term inhaled steroids(Wiley, 2021) Dikmen, Nursel; Duran, Nizami; Ay, Emrah; Cimen, Funda; Tek, ErhanAims In this study, it was aimed to determine the isolation frequency and species distribution of Candida species isolated from asthmatic patients using long-term inhaled steroids. It was also aimed to determine the drug resistance patterns and the frequency of erg11, HWP1, ALS1, INT1, SAP1 PLB1 genes in isolates. Methods Genotyping of Candida strains isolated from patients and healthy control group was performed by PCR-RFLP method. Drug resistance was investigated phenotypically, and the presence of erg11 resistance genes and HWP1, ALS1, INT1, SAP1 PLB1 virulence genes were investigated by PCR method. Results C albicans was the most isolated species in steroid-using patients and healthy control groups (patients: 44.2%; control group: 30.8%). C tropicalis and C glabrata were found to have the highest rates of non-albicans Candida in patients with 17.4% and 13.77%, respectively. Azole resistance was found to be significantly higher in isolates isolated from patients compared to the control group. Similarly, the presence of erg11 resistance gene was highest in C albicans (17.65%), C glabrata (12.5%) and C tropicalis (8.3%) strains in the control group, while C parapsilosis was highest in patients. (57.1%) and C glabrata (54.2%) strains. Compared to the control group, the virulence of Candida strains isolated from the patients was found to be higher. Presence of HWP1, ALS1, INT1, SAP1 and PLB1 genes in patients were determined as 72.1%, 63.9%, 68.9%, 57.38% and 54.5%, respectively. These rates were 29.4%, 35.3%, 25.5%, 17.7% and 23.5% in the healthy control group, respectively. Conclusions In asthma patients using long-term inhaled steroids, both Isolation rates of Candida species, drug resistance rates, presence of virulence genes were found to be significantly higher in patients than in the control group. We think that this may be due to the suppression of cellular immunity by long-term steroid use.Öğe Koroziv madde alımı olan çocukların uzun dönem akciğer kapasitelerinin spirometri ile değerlendirilmesi(2022) Atıcı, Ahmet; Dikmen, Nursel; Çelikkaya, Mehmet EminAmaç: Bu çalışmada korozif madde alımı sonucu özofagus striktürü gelişen ve mükerrer defa özofagus dilatasyonu işlemi yapılan hastaların uzun dönem akciğer durumlarının spirometri ile değerlendirilmesi amaçlanmıştır. Yöntem: Ocak 2014 – Mayıs 2021 tarihleri arasında merkezimize KMA nedeniyle başvuran hastalar retrospektif olarak incelendi. Hastalar; Grup 1: Kontrol grubu (n=23) Grup 2: Korozif madde alımı sonrası dilatasyon işlemine ihtiyacı olmayan ve kür sağlanmış hastalar (n=9) Grup 3: Korozif madde alımına bağlı özofagus striktürü gelişen ve genel anestezi altında dilatsyon işlemi uygulanan hastalar (n=9) olarak üç gruba ayrıldı. Değerlendirme için; 1. Saniyedeki zorlu ekspiratuar akım hızı (FEV1), zorlu vital kapasite (FVC), FEV1/FVC ve zorlu ekspirasyon ortası akım hızı (FEF 25-75) parametreleri kaydedildi. Bulgular: Yapılan istatistik analizi sonuçlarına göre FEV1, FVC ve FEF 25-75 gibi değerlerin üzerinde dilatasyon işleminin etkisi incelendiğinde Grup 1-2 için FEV1 (p=0.02) ve FVC (p =0,01) değerleri arasındaki fark istatistiksel olarak anlamı, grup1-3 ve grup 2-3 arasında anlamsız (p>0,05) saptandı. FEV1/FVC (p>0.05) ve FEF 25-75 (p>0.05) arasında hiçbir grupta anlamlı fark saptanmadı. Sonuç: Hastalarımızın spirometre ile değerlendirilen akciğer kapasitelerinde uzun dönem olumsuz bir etkilenme tespit edilememiştir.Öğe Lack of association between obstructive sleep apnea syndrome and specular microscopic features of the corneal endothelium(Springer Heidelberg, 2021) Cakmak, Ayse Idil; Dikmen, Nursel; Eren, Ela; Atalay, ErayBackground Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of hypoxemia and hypercapnia during sleep. The aim of this study was to determine whether OSAS causes significant changes in corneal endothelium detectable by specular microscopy. Methods This prospective, cross-sectional study compared the specular microscopic features of the corneal endothelium of patients with OSAS and age-and gender-matched controls. Patients diagnosed with OSAS by polysomnography in the sleep unit were classified using apnea-hypopnea indexes into two groups as mild-moderate OSAS group and severe OSAS group. All participants were divided into three age groups: 30-45, 46-60, and > 60 years. Corneal endothelial cell density (ECD), percentage of hexagonal cells (Hex), and coefficient of variation of cell area (CV) were obtained using a non-contact specular microscope. The measurements of each group were compared statistically. Results A total of 66 patients (51.1 +/- 9.4 years) and 88 controls (49.2 +/- 10.5 years) were examined. The mild-moderate OSAS group and the severe OSAS group had no significant differences in measures of specular microscopy compared with the controls (ECD, p = 0.84; Hex, p = 0.18; CV, p = 0.41). The mean values of ECD, Hex, and CV were 2552.56 +/- 302.49 cells/mm(2), 54.13 +/- 8.13%, and 36.41 +/- 5.92, respectively, in the mild-moderate OSAS group; 2510.52 +/- 377.12 cells/mm(2), 54.85 +/- 8.68%, and 34.77 +/- 5.02, respectively, in the severe OSAS group; 2543.37 +/- 286.94 cells/mm(2), 51.89 +/- 9.09%, and 36.03 +/- 5.32, respectively, in the control group. Conclusions There were no significant differences in corneal endothelial features between patients and controls. Although OSAS causes systemic hypoxia, its effects do not appear to result in corneal endothelial alterations detectable by specular microscopy.Öğe Obez ve nonobez obstrüktif uyku apne sendromlu hastalarda sağ kalp fonksiyonlarının ekokardiyografi ve doppler ekokardiyografi ile değerlendirilmesi(Hatay Mustafa Kemal Üniversitesi, 2012) Dikmen, Nursel; Genç, SebahatGiriş ve Amaç: Obstrüktif Uyku Apne Sendromu (OUAS) sebep olduğu kardiyovasküler hastalıklar nedeniyle morbidite ve mortaliteye neden olabilen, sık görülen bir patolojidir ve obezite ile yakından ilişkilidir. OUAS'nun, pulmoner hipertansiyon ile ilişkisi veya sağ kalp fonksiyonları üzerine etkisi tartışmalıdır. Çalışmamızın amacı, obez ve nonobez OUAS hastalarında; doku doppler (DD) ekokardiyografi ile sağ ventrikül sistolik ve diyastolik fonksiyonlarının ve pulmoner arter basınçlarını (PAB) karşılaştırmaktı.Gereç ve Yöntem: Çalışmamıza Uyku Laboratuarında polisomnografik inceleme yapılmış ve orta ya da ağır OUAS tanısı konmuş 35 nonobez ve 34 obez olmak üzere 69 hasta alındı. Tüm hastalarda M-mode, iki boyutlu inceleme, renkli akım Doppler ve DD yardımıyla SV(sol ventrikül) ve RV (sağ ventrikül) boyutları, sol atrium (LA) ve RA(sağ atrium) boyutları, SV ve RV sistolik ve diyastolik fonksiyonları ve sistolik PAB' ları ölçüldü.Bulgular: Her iki grup yaş (Obez 46,6±8.9, nonobez 48,8 ±10,7, p>005) ve cins (K/E: nonobez grupta 1/5, obezlerde; 1/4) açısından benzerdi. Her iki grupta da RV diyastolik fonksiyonlarında bozulma saptanmış olup, obez grupta anlamlı olarak daha fazla bozulma saptanmıştır. (lateral triküspit annuler bölge geç diyastolik miyokardial hız A'a: nonobez hastalarda 0,13 ±0,03 ve obez hastalarda 0,11±0,04, p=0,020). Nonobez grupta 25 (% 71,4), obez grupta ise 32 (%94,1) hastada sistolik PAB>25 mmHg olarak saptandı (p=0,04). Obez grupta ortalama sistolik PAB anlamlı olarak daha yüksek bulunmuştur (Sırasıyla 31,2±5,6 ve 27,1±5,8, p= 0,04).Sonuç: Çalışmamızda orta ve ağır OUAS hastalarında doku doppler incelemesi ile SV ve RV diyastolik fonksiyonlarında bozulma saptanmıştır. Obezite OUAS'tan bağımsız olarak bu bozukluğa katkıda bulunmaktadır.Öğe Oxidative stress index can be a new marker related to disease severity in COVID-19(Walter De Gruyter Gmbh, 2021) Dogan, Serdar; Bal, Tayibe; Cabalak, Mehmet; Dikmen, Nursel; Yaqoobi, Hasibullah; Ozcan, OguzhanObjectives: The aim of this study was to evaluate the relationship between systemic oxidative balance, and the severity of the disease in patients with COVID 19. Methods: Sixty-four patients were divided into three groups according to the severity of the disease: mild (n=28), moderate (n=11) and severe (n=25). Twenty-four healthy controls included to the study. Proinflammatory cytokines (IL-6 and TNF-alpha), D-dimer, fibrinogen, total oxidative status (TOS), total antioxidant status (TAS) were measured and oxidative stress index (OSI) was calculated. Results: The mean age of severe group was significantly higher than the other groups (p=0.001). TAS levels were significantly decreased in all patient groups compared to controls, while serum TOS and OSI levels were significantly different in all three stages of the disease. Serum IL-6 and TNF-alpha levels were significantly elevated in severe group compared to other groups. TOS and OSI levels were also significantly correlated with IL-6, CRP, ferritin, fibrinogen, LDH and D-dimer. Conclusions: TOS and OSI levels are an indicator of systemic oxidative balance in COVID-19 and related to the disease severity. They can be an important marker for evaluating the disease severity and used in the management of patients with COVID-19.Öğe Polisomographic Investigation of Sleep Disorders in Patients with Sickle Cell Anemia and Evaluation of the Effect on the Prognosis(Aves, 2022) Dikmen, Nursel; Okuyucu, Emine Esra; Guntel, Murat; Ucar, Edip; Ilhan, Gul; Babayigit, Cenk; Karadag, MehmetOBJECTIVE: The aim of this study is to identify sleep disorders in adults with sickle cell disease and to examine the effects of accompanying sleep disorders on the prognosis of sickle cell disease. MATERIAL AND METHODS: Twenty-eight patients followed up with a diagnosis of sickle cell disease and 22 healthy volunteers were included in our study. RESULTS: Both groups had similar characteristics in terms of age, gender, and body mass index. More obstructive sleep apnea syndrome was detected in the sickle cell group than in healthy volunteers. Statistically, the sickle cell patient group had higher apnea-hypopnea index and lower nighttime oxygen desaturation. As the degree of obstructive sleep apnea syndrome increased in the sickle cell group, it was found that there were more emergency admissions and hospitalization due to painful crises and/or acute chest syndrome in the last 1 year. Also, lower sleep efficiency was found in the sickle cell disease patient group. In the sickle cell group, it was found that the restless leg syndrome severity was statistically significantly more. CONCLUSION: As hypoxia deepens in sickle cell patients, mortality and morbidity due to the disease increase significantly. Comorbid sleep disturbances in sickle cell patients exacerbate nocturnal hypoxia and negatively affect the prognosis of the disease. Therefore, patients with sickle cell disease should be questioned in detail in terms of obstructive sleep apnea syndrome and, if necessary, polysomnographic evaluation should be performed to provide treatment for sleep disorders in the early period.
