Browsing by Author "Topcu, N"

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A Case of Antiphospholipid Syndrome Presenting With Pulmonary Truncus and Main Pulmonary Artery Thrombosis
(Springer, 2005) Sayarlioglu, M; Topcu, N; Harman, M; Guntekin, U; Erkoc, R
In patients with antiphospholipid syndrome (APS), thromboembolism and pulmonary hypertension are the most common pulmonary manifestations. Thrombotic obstruction at the level of the main and/or proximal pulmonary arteries is rare. We report a 40-year-old woman without any history of previous arterial and/or venous thrombosis who presented with severe dyspnea and was found to have pulmonary hypertension and positivity for anticardiolipin antibodies. Computed tomography revealed pulmonary truncus thrombosis extending to both right and left pulmonary arteries. The patient and her family refused surgical treatment. She had a prolonged hospital course, was unresponsive to thrombolytic, anticoagulant, antiplatelet, and immunosuppressive treatments, and died of right ventricle and respiratory failure 5 weeks later. This is the first reported case with thrombosis of pulmonary truncus and main pulmonary arteries concurrent with APS.
Comparison of Argon Laser Photocoagulation Induced Cutaneous Inflammation and Skin Pathergy Test in Behcet's Disease
(B M J Publishing Group, 2003) Sayarlioglu, M; Calka, O; Cinal, A; Sayarlioglu, H; Akdeniz, N; Topcu, N; Gul, A
Effect of Infliximab on Refractory Uveitis in Behcet's Disease
(Harvey Whitney Books Co, 2004) Sayarlioglu, M; Cinal, A; Topcu, N; Demirok, A
Hematological Malignancy and Pregnancy
(Blackwell Publishing, 2006) Dilek, I; Topcu, N; Demir, C; Bay, A; Uzun, K; Gul, A; Ugras, S
The incidence of hematological malignancies during pregnancy is low, and treatment in this setting is problematic. This study observed 21 pregnancies in 18 patients with hematological malignancies. Patients' ages were between 19 and 43 (median 25) years. Two pregnancies ended with spontaneous abortion, one pregnancy ended with in utero death, three therapeutic abortions were carried out, and 15 infants were born alive but three of them died later. The median birth weight was 2.47 kg. Twelve babies survived to a median age of 36 (range 4-117) months. Eight babies were exposed to chemotherapy during the in utero period. One baby was exposed to chemotherapy during all the trimesters and was born prematurely and later died because of intracranial bleeding. Four babies were exposed to chemotherapy during the first trimester, one of them had low birth weight and floating thumb malformation, two of them had only low birth weight, and one was born healthy, but died at 3 months of age as a result of severe gastroenteritis. Two babies were exposed to chemotherapy during the second and third trimesters; one of them had low birth weight, and the other pregnancy ended in in utero death. One infant was exposed to chemotherapy during the third trimester and was born at term, but died because of pulmonary hemorrhage. We concluded that chemotherapy during all trimesters of pregnancy carries a significant risk for an unfavorable outcome.
Oral Ciprofloxacin Versus Intravenous Cefotaxime and Ceftriaxone in the Treatment of Spontaneous Bacterial Peritonitis
(H G E Update Medical Publishing S A, 2003) Tuncer, I; Topcu, N; Durmus, A; Turkdogan, MK
Background/Aims: Cefotaxime or ceftriaxone were considered the first-choice antibiotic for empirical treatment in cirrhotic patients developing spontaneous bacterial Peritonitis. It has that ciprofloxacin could be an alternative to cefotaxime or ciprofloxacin in cirrhotic patients developing spontaneous bacterial peritonitis. The aim of the present study was to compare oral ciprofloxacin with cefotaxime and ceftriaxone in the treatment of-spontaneous bacterial peritonitis in cirrhotic patients. Methodology: Fifty-three hospitalized cirrhotic patients with spontaneous bacterial peritonitis were prospectively included and randomized into three groups: group A (n = 16); received orally 500mg ciprofloxacin every 12 h, group B (n = 18); received intravenous cefotaxime. 2g every 8 h and group C (n = 19) received intravenous ceftriaxone 2g every 24h. Results: 15 patients from the ciprofloxacin group, 17 from the cefotaxime group and 17 patients from the ceftriaxone group were finally analyzed. Spontaneous bacterial peritonitis resolution in three groups was found to be 80%, 76%, and 83%, respectively (p = NS). Incidence of complications and hospital mortality was similar in the three groups. No adverse events were observed in any of the three groups. The cost of the treatment was statistically lower in the ciprofloxacin group than in the cefotaxime group and ceftriaxone group (p < 0.001). Conclusions: These results suggest that orally ciprofloxacin is as effective as cefotaxime and ceftriaxone in the empirical treatment of spontaneous bacterial, peritonitis in cirrhotic patients, and is also less expensive and can be administered orally.
Treatment of Recurrent Perforating Intestinal Ulcers With Thalidomide in Behcet's Disease
(Harvey Whitney Books Co, 2004) Sayarlioglu, M; Kotan, MC; Topcu, N; Bayram, I; Arslanturk, H; Gul, A
OBJECTIVE: To report the beneficial effects of thalidomide on recurrent perforating intestinal ulcers in a patient with Behcet's disease (BD). CASE SUMMARY: A 24-year-old Turkish woman with BD was admitted to our hospital because of severe abdominal pain and vomiting. She had been receiving colchicine 1.5 mg/day and azathioprine 150 mg/day for treatment of BD for 2 years. During emergency laparatomy, 2 perforating ulcers were detected in the anterior cecum, which were treated with debridement and primary repair. She experienced 2 more episodes of intestinal perforations during the second and fifth weeks despite intense immunosuppressive treatment with methylprednisolone and cyclophosphamide. New intestinal perforations were found in the posterolateral cecum and transverse colon during the second operation and in the terminal ileum during the third one. Thalidomide 100 mg/day was then started, and the symptoms disappeared within 2 weeks. The woman experienced no other intestinal perforation during the follow-up period of 4 months. DISCUSSION: The mode of action of thalidomide in BID is still unclear. In BID, various cytokines have been shown to be abnormally expressed and neutrophils are overactive. This is a possible mechanism of action with thalidomide reducing both tumor necrosis factor and the neutrophil migration. CONCLUSIONS: Thalidomide may be an effective alternative treatment for BID patients with recurrent and perforating intestinal ulcers despite intense immunosuppressive therapy.