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"Tanoglu, Ali"
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Healing Effects of Omalizumab in a Patient with Cholinergic Urticaria Associated Severe Dyspeptic Complaints
To the Editor： Cholinergic urticaria （CU） is a type of physical urticaria characterized by a number of short-lasting, highly pruritic weals. The underlying pathological mechanism of CU is not fully understood. Omalizumab is a humanized, monoclonal IgG anti-lgE antibody that binds specifically to circulating lgE molecules, thus interrupting the allergic cascade, The efficacy of anti-lgE treatment has been shown in many disorders with complex and unclear etiology, comprising physical urticarias, chronic idiopathic urticaria, angioedema and eosinophil-associated gastrointestinal disorders.
Journal Article
Investigation of doxorubicin combined with ciprofloxacin-induced cardiotoxicity: from molecular mechanism to fundamental heart function
This study was designed to investigate the impacts of Doxo alone and in combination with Cipro on the hepatic and cardiac CYP1A2, CYP2J3, and CYP3A1 mRNA levels. We also aimed to analyze the cardiac function by perfusing isolated rat hearts. Rats were given Doxo and/or Cipro in chronic (3-week) and acute (single-day) dosing schedules. Cardiac CYP2J3, CYP3A1, and CYP1A2 gene expression levels were measured by quantitative reverse transcription PCR. Cardiac functions of the isolated hearts were evaluated by using the Langendorff technique. Doxo alone (2.5 mg/kg) and Doxo + Cipro (2.5 mg + 20 mg/kg) significantly decreased hepatic CYP1A2 expression compared to saline, whereas Doxo (2.5 mg/kg) and Doxo + Cipro (2.5 mg + 20 mg/kg) showed significantly higher cardiac CYP1A2 expression in comparison to control. In the liver tissue, Doxo (2.5 mg/kg) and Doxo + Cipro (2.5 + 20 mg/kg) decreased the CYP2J3 expression than the control group. The Doxo (2.5 mg/kg) and Doxo + Cipro (2.5 + 20 mg/kg)-treated group had significantly higher cardiac CYP2J3 expression compared to control. Doxo (2.5 mg/kg; cumulative dose 15 mg/kg) and Doxo + Cipro (2.5 + 20 mg/kg) showed significantly higher cardiac CYP3A1 expressions than the control. Rate-pressure product (HR × LVDP)/1000) showed an overall decrease in cardiac functions of Doxo (2.5 mg/kg) and Doxo + Cipro (2.5 + 20 mg/kg)-treated group. We found considerable effects in chronic protocol; Doxo alone high dose and plus Cipro decreased hepatic CYP1A2 and CYP2J3 mRNA. On the other hand, these treatment groups exhibited an increase in the cardiac CYP1A2, CYP2J3, and CYP3A1 expression and likewise deteriorated the overall hemodynamic parameters.
Journal Article
Assessment and outcome of hospitalized patients during delta variant COVID-19 pandemic: A multicenter international study
Introduction: To date, the world has experienced four waves of the Coronavirus disease- 19 (COVID-19) pandemic. Patients infected during the era of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant were the subject of this study. The objectives were to describe their clinical manifestations, explain their laboratory and radiological findings, conclude factors contributing to clinical outcomes, and evaluate treatment protocols. Methodology: Relevant data were collected retrospectively from records of patients admitted to six referral centers in four countries. Data included sociodemographic patterns, symptoms, associated comorbidities, physical examination, laboratory and radiologic findings, treatment received, and patient outcomes. Results: Data analysis identified symptomatology and variables related to acquisition and infection outcome. The most prevalent symptoms were cough (81.5%), body aches (74.1%), and fever (71.6%). Independent risk factors for mortality were age, vomiting, epigastric pain, diabetes, obesity, oxygen saturation less than 90%, leukocytosis, neutrophilia, lymphopenia, thrombocytopenia, elevated creatinine, high glucose level, lung ground glass opacities with consolidation, affection of four lobes and bilateralism. Neither d-dimer nor lactate dehydrogenase nor ferritin foretells death possibility. The efficacy of the medications used was convenient. Conclusions: Assessing the clinical features of different COVID-19 waves, identifying predictors of outcomes, and concluding the efficacy of treatment protocols provide insight into patients’ responses and viral behaviors, which help in the proper diagnosis and treatment of subsequent surges.
Journal Article
RT- PCR testing of upper respiratory tract samples for diagnosis of SARS-CoV-2: Between justification and overestimation, a multi-center international study
It has been found that patients recovered from COVID 19 may still test Reverse Transcriptase- Polymerase Chain Reaction (RT- PCR) positive without being infectious; the reasons are unclear. The occurrence of false-negative results of RT- PCR interferes with a proper diagnosis. The objectives of that work were to determine factors associated with persistently detectable SARS-CoV-2 RNA among recovered hospitalized patients and to determine the incidence of false-negative RT-PCR results and associated factors.
Relevant data were collected from 482 COVID 19 patients hospitalized in six referral centers from four countries.
The median duration of RT- PCR conversion to negative was 20 days. Out of 482 studied patients, 8.7% tested positive after more than four weeks and were considered prolonged convertors. Binary logistic regression analysis revealed headache as an independent risk factor for short conversion time while fever, hypertension, chronic obstructive pulmonary disease, lymphopenia, elevated erythrocyte sedimentation rate, and the number of lobes affected, and bilateralism were found to be independent risk factors for prolonged positivity. Eighteen patients had initial negative results then turned positive after 24–48 h. Associated factors and outcomes were identified.
Identifying patients with a high likelihood of COVID-19 despite a negative RT-PCR is critical for effective clinical care. However, patient isolation resumption depending on positive RT-PCR despite clinical and radiological recovery is an overrating that greatly burdens the health sector.
Journal Article
Esomeprazole: a safe alternative to lansoprazole allergy?
Proton pump inhibitors (PPIs) are widely prescribed drugs in daily practice. Allergic reactions, even small number of anaphylactic reactions to PPIs have been reported. Omeprazole, lansoprazole, pantoprazole, rapeprazol and esomeprazole are classified in the same group. Despite the similarity of biochemical structures among these drugs, presence of cross-reactivity between PPIs is controversial.1,2 In this letter, we present 3 lansoprazole allergy cases, who were prescribed and took esomeprazole safely after allergic reactions to lansoprazole.
Journal Article
INCREASED MEAN PLATELET VOLUME IS ASSOCIATED WITH DURATION OF HOSPITALIZATION AND TRANSFUSION REQUIREMENT IN UPPER GASTROINTESTINAL BLEEDINGS
Upper gastrointestinal (GI) bleeding is one of the most common reasons for admission to the emergency department, and frequently leads to an important clinical problem because of high costs of diagnosis, treatment and hospitalization. In order to determine the severity of upper gastrointestinal bleeding, low cost and non-invasive parameters are needed. Red cell distribution width (RDW) and mean platelet volume (MPV) are the parameters which can be used for this purpose. In this study, we aimed to determine the levels of MPV, RDW and other whole blood parameters in patients with upper GI bleeding and moreover we planned to research likely association between these blood parameters and endoscopic diagnosis, erythrocyte transfusion requirements, length of hospital stay. 108 patients with upper gastrointestinal bleeding and 36 age and sex matched healthy controls were included in the study. The mean age of patients was 65.65 ± 21.58 years. 64 patients were (59.2%) male and 44 were (40.8%) female. Patients' hemoglobin (Hb) and hematocrit (Hct) levels were significantly lower than healthy controls (p<.001) and there was no significant change in the number of platelets. Among patients with upper GI bleeding, MPV and RDW levels were significantly increased compared to healthy controls (7.9±1.1 fL and 7.0±0.6 fL, p<.001 and 14.3±2.8% and 12.8±1.8%, p<.001). Increased MPV levels, but not increased RDW levels, were positively correlated with length of hospital stay (r=0.706) and need for transfusion of packed red blood cells (r=0.681). In the light of these results, increased MPV levels may indicate need for hospitalization and transfusion requirements in patients with upper GI bleeding who admitted to the emergency room.
Journal Article
A retrospective analysis of diseases with an erythrocyte sedimentation rate exceeding 100 mm per hour
Erythrocyte sedimentation rate is a time-honored, frequently used, simple and cheap, although not sensitive and specific, blood test which assesses the degree of erythrocyte aggregation mediated by acute phase proteins, such as fibrinogen and immunoglobulins. In our study, we aimed to retrospectively analyze diseases in which erythrocyte sedimentation rate exceeded 100 mm/hour in patients hospitalized at the Department of Internal Medicine of Gulhane Military Medical Academy between 1992 to 2005. There were 797 patients with an erythrocyte sedimentation rate higher than 100 mm/hour. Of these, 475 were male (59.6%) and 322 were female (40.4%). Mean age of the patients was 49.10±22.99 (14-96) years. Mean erythrocyte sedimentation rate was 119.30±16.43 (100-200) mm/hour (118.39±16.23 mm/hour in males and 120.64±16.65 mm/hour in females). There were 232, 2 and 2 patients with erythrocyte sedimentation rates between 100 to 109 mm/hour (29.1%), 170 to 179 mm/hour and 190 to 200 mm/hour, respectively. When the distribution of increased erythrocyte sedimentation rates was analyzed according to diseases, rheumatological diseases were the most common (22.5%), and cardiovasculary diseases were the least common (3.0%). The highest erythrocyte sedimentation rate was 200 mm/hour in a 77-year-old male with lung carcinoma in 1993. In female patients the highest erythrocyte sedimentation rate was 190 mm/hour in a 43-year-old woman with diabetes mellitus (complicated with diabetic foot and renal failure) and urinary tract infection in 1995.
Journal Article