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A Berna Dursun

Publications and source records attributed to A Berna Dursun.

5 recordsLinked to original sources

Safety of meloxicam in aspirin-hypersensitive patients with asthma and/or nasal polyps. A challenge-proven study.

BACKGROUND: The anti-inflammatory actions of acetylsalicylic acid (ASA)/non-steroidal anti-inflammatory drugs (NSAIDs) are thought to be due to inhibition of COX-2, whereas the side effects such as gastric damage and aspirin-induced asthma are mediated through inhibition of COX-1. Therefore, a new class of drugs with COX-2 selectivity may be well tolerated by patients with ASA/NSAIDs hypersensitivity. OBJECTIVE: We investigated whether subjects with asthma and/or nasal polyps (NP) and analgesic intolerance proven by oral ASA provocation test tolerated the selective COX-2 inhibitor, meloxicam. METHODS: All subjects were first challenged with ASA using a 2-day, single-blind, placebo-controlled oral provocation test. Thereafter, the subjects showing positive response to ASA provocation underwent a single-blind, placebo-controlled challenge with a cumulative dose of 7.5 mg of meloxicam on 2 separate days. One and three fourths of the divided doses of placebo and the active drug were given at 1-hour intervals. Clinical symptoms, lung function, and blood pressure were monitored during these challenge protocols. RESULTS: Twenty-one patients with asthma and/or NP (10 males and 11 females; mean age: 38.4 +/- 2.9 years) who reacted to ASA challenges were enrolled in the study. Response to ASA provocation was rhinitis + bronchospasm in 13, and extrabronchial reactions in 8 (isolated rhinitis in 3) patients. Mean PD(20) was 163.4 +/- 39.9 mg ASA among patients who reacted with bronchospasm to ASA. Only 1 patient reacted to meloxicam challenge at a cumulative dose of 7.5 mg. CONCLUSION: This study indicates that 7.5 mg of meloxicam is a safe alternative treatment for ASA-hypersensitive asthma and/or NP patients with proven hypersensitivity via oral ASA challenges.

Adolescent↗

[Tuberculosis prophylaxis].

Besides definition and treatment of index cases, prophylaxis plays an important role in battling tuberculosis that is still health problem in developing countries. But, in clinical practice, there are differences about prophylaxis between countries and even in our country. Approaches to prophylaxis of developed countries and current situation of our country were looked over for this purpose.

Antitubercular Agents↗

[Pott's disease and different clinical presentations Pott's disease and different clinical presentations].

Skeletal tuberculosis remains a potentially crippling disease in the developing world; particularly as it usually affects children and young adults. The spine is involved approximately 50% of bone and joint tuberculosis cases. The features of four spinal tuberculosis cases were looked over this article. Their ages were between 18 and 76 years. All of them were male and immunocompetent. Pain was the major complaint. There was no life-threatening neurological sign. Among them, a case who was admitted to the hospital with painful torticollis had upper cervical-lower thoracic spinal tuberculosis with psoas abscesses and peritoneal tuberculosis, but no pulmonary involvement. The other cases had thoracolumbal spinal tuberculosis with psoas abscesses and pulmonary tuberculosis of which miliary, chronic and new pulmonary tuberculosis. The whole diagnosis of spinal tuberculosis was made by radiographically-MRI and CT-. Specific antituberculous therapy with supportive care was begun and remarkable responses without surgical intervention were seen on them except miliary pulmonary tuberculosis case. The aim of this presentation was to emphasize the importance of early diagnosis so that adequate pharmacological treatment can be initiated to avoid serious complication.

Adolescent↗

Pulmonary tuberculosis in patients with rheumatoid arthritis (four case reports).

Pulmonary involvement is one of the most common extra-articular manifestations of rheumatoid arthritis (RA). We studied four smear-positivepulmonary tuberculosis patients who had had RA for 2.5-12 years. Three of them were using corticosteroids at the time of diagnosis. The clinical, radiological and bacteriological features of all the patients were examined. We conclude that when patients with RA have symptoms related to pulmonary involvement, tuberculosis should be considered, particularly in developing countries.

Aged↗

Clinical aspects of the link between chronic sinonasal diseases and asthma.

Chronic sinonasal diseases (CSDs) are common comorbidity of asthma. The aim of this study was to assess comprehensively CSD in a population of asthma patients and determine whether the clinical factors in both diseases were related to each other. Eighty adult stable asthmatic patients with sinonasal symptoms (SNSs) of 3 months and who were nonresponsive to aggressive medical treatment were prospectively investigated. All patients underwent a detailed ear, nose, and throat examination and were evaluated by paranasal sinus computed tomography (PNS-CT). The severity of asthma was compared with SNS scores (SNSSs) and sinonasal involvement on PNS-CT. Asthma was severe in 12.5%, moderate in 55%, and mild in 32.5% of cases. There were 15 (18.7%) patients in stage 0, 16 (20%) patients in stage 1, 21 (26.2%) patients in stage 2, and 28 (35%) patients in stage 3 according to PNS-CT scoring. There was no correlation between asthma severity and CT stages, total opacification scores (TOSs), anatomic variations, and SNSSs. Although SNSSs were similar in patients with nasal polyps (NPs) and without NPs, patients with NPs showed significantly higher TOSs and CT stages (p < 0.05). The presence of NPs and age and duration of disease were related to severity of asthma (p < 0.05). Nonatopic asthmatic patients had both more severe asthma (p = 0.05) and more extensive CT findings (p = 0.01). The use of clinical symptoms alone is not very reliable in predicting the presence or severity of CSD. Therefore, SNSs should be supported with objective criteria such as nasal endoscopy and PNS-CT scan. Furthermore, sinonasal involvement may exist independently from severity of asthma.

Adolescent↗