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    Effect of Continuous Positive Airway Pressure Treatment on Mean Platelet Volume and Platelet Distribution Width in Patients with Sleep Apnea Syndrome
    (Aves, 2016) Cortuk, Mustafa; Simsek, Gokce; Kiraz, Kemal; Haytoglu, Suheyl; Zitouni, Burcak; Muluk, Nuray Bayar; Arikan, Osman Kursat
    Objective: Obstructive sleep apnea (OSA) syndrome is a common disorder that can cause hypercoagulation. Mean platelet volume (MPV) and platelet distribution width (PDW) are associated with hypercoagulability. This study aimed to investigate whether MPV and PDW values change in patients with OSA who were treated with continuous positive airway pressure (CPAP) device. Methods: A total of 43 adult patients with OSA who were treated with CPAP were included in this retrospective study. Patients who underwent CPAP treatment for <5 days/week and <4 h/day were excluded. Blood parameters, including MPV and PDW, were recorded before CPAP treatment and at the third month of CPAP treatment. All patients underwent polysomnographic evaluation with full night polysomnography and in the second night CPAP titration was performed together with full night polysomnography and MPV and PDW values were statistically compared before and after CPAP treatment. Results: Apnea hypopnea index was significantly reduced, whereas oxygen saturation was significantly increased at CPAP titration night (p<0.001). The third month of CPAP treatment resulted in significantly low PDW (p=0.004) values, but MPV values did not change. Conclusion: PDW value at the third month of CPAP treatment revealed a significant improvement compared with the values before treatment; moreover, no change was observed in MPV values. It was concluded that in patients with OSA who were treated with CPAP, activation of platelets may result in recovery.
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    Retrospective review of epidemic viral pneumonia cases in Turkey: A multicenter study
    (Spandidos Publ Ltd, 2017) Cortuk, Mustafa; Acat, Murat; Yazici, Onur; Yasar, Zehra; Kiraz, Kemal; Ataman, Sena Yapicioglu; Tanriverdi, Elif
    Influenza A (H1N1) caused its first pandemic in 2009 in USA and Mexico. Since then, clinicians have exercised great care in order to make an early diagnosis of viral pneumonias. This is due in part to pandemic influenza A infection having greater impact on populations <65 years old than other viral strains, including seasonal influenza. Chest radiographies of those affected displayed a rapid progression of patchy infiltrates, and a large proportion of individuals required admission to intensive care units (ICU). Despite efforts, patients infected with the virus had a high mortality rate. The present multicenter study aimed to retrospectively evaluate the clinical, demographic and prognostic characteristics of patients diagnosed with epidemic viral pneumonia in Turkey. A total of 92 patients were included in the study. The Student's t-test and Chi-square tests were performed to analyze quantitative data, assuming a normal distribution, and to analyze qualitative data, respectively. Stepwise logistic regression was used to evaluate the effects of demographic variables and laboratory values on the virus mortality rate. The male/female ratio was 42/50 and the mean age was 48.74 +/- 16.65 years. A total of 69 (75%) patients were unvaccinated against influenza. The most common symptoms were cough (87%) and fever (63%). Chest computed tomography showed peripheral patchy areas of the lungs of ground glass density in 38 patients (41.3%). A total of 22 (59.4%) patients had H1N1, 5 (12.5%) patients had influenza B, and 38 (41.3%) patients met the criteria for admission to the ICU. Of these patients, 20 (52.63%) were monitored with a mechanical ventilator, with a noninvasive ventilator being adequate for 10 (26.32%) of patients. The length of stay in the ICU was 6.45 +/- 5.97 days and the duration of mechanical ventilation was 5.06 +/- 4.69 days. A total of 12 (13.04%) patients in the ICU succumbed. Logistic regression analysis revealed that among the parameters possibly associated with mortality, being an active smoker increased the risk of mortality 7.08-fold compared to other groups (P=0.005). In conclusion, viral pneumonia remains a significant health problem during the winter period. Considering the high number of ICU admissions and high rate of mortality for patients in the present study, earlier initiation of antiviral therapy is necessary. Active smoking increased mortality in viral pneumonia.
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    A very rare side effect of amlodipine: non-cardiogenic pulmonary edema
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2017) Kiraz, Kemal; Cortuk, Mustafa; Quisi, Alaa; Akyol, Selahattin; Poyraz, Omer
    Calcium channel blockers are among the most widely used drugs in cardiovascular medicine. Amlodipine, which is both cost-effective and taken once daily, is one of the most commonly prescribed agents. Although peripheral edema is a well-known side effect of amlodipine, non-cardiogenic pulmonary edema associated with amlodipine is very rare. Herein, we describe a 24-year-old female case of non-cardiogenic pulmonary edema after ingestion of 300 milligram of amlodipine orally for a suicide attempt. The patient was successfully treated with fluid replacement, inotropic drugs, and mechanically ventilation. To the best of our knowledge, this is the first case reported in Turkey.