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Engin Dursun

Publications and source records attributed to Engin Dursun.

6 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↗

The incidence of anatomic variations and sinus opacities in pediatric patients with chronic sinonasal symptoms.

OBJECTIVES: In this study, our purpose was to determine the incidence of paranasal sinus anatomic variations and their relationship with sinus opacities in pediatric patients. PATIENTS AND METHODS: A total of 44 children (age range 3 to 16 years) unresponsive to maximum medical therapy were evaluated with coronal paranasal sinus computed tomography. RESULTS: Computed tomographic evaluations revealed that 70.5% (31/44) of the patients had at least one anatomic variation, the most common being septal deviation, followed by concha bullosa and agger nasi cells. Sinus opacities were found in 81.8% (36/44) of the patients, of whom 9 had single and 27 had multiple involvement of sinus groups. The most commonly involved sinuses were anterior ethmoids and maxillary sinuses, followed by posterior ethmoids, sphenoid and frontal sinuses. Patients with single, multiple, and no anatomic variations had 78.9% (15/19), 83.3% (10/12), and 84.6% (11/13) opacities, respectively. CONCLUSION: The incidence of anatomic variations was found to be similar to that reported for adults in the literature except for nasal septal deformity which was found lower. Our results showed no correlation between bony anatomic variations and sinus opacities in children.

Adolescent↗

Clinical predictors of long-term success after endoscopic sinus surgery.

OBJECTIVE: Determining the clinical predictors of long-term success after endoscopic sinus surgery (ESS) would better guide the management of patients. METHODS: One hundred-thirty chronic rhinosinusitis (CRS) patients were evaluated retrospectively. Overall subjective improvement was 83% with a mean follow-up of 60 months. Eighty percent had anatomic variations; 36.2%, allergy; 55.4%, nasal polyps; and 26.9%, history of previous operation. The improvement was 100%, 94%, 79.5%, and 69.7% in stages 0, I, II, and III, respectively. With other parameters, the success rates were 68.1% and 91.6% with and without allergy, 73.6% and 94.8% with and without polyps, 54.3% and 93.7% with and without previous history of surgery, 84.4% and 82.7% with and without anatomic variations, and 23.8% and 94.4% with and without recurrent polyps. CONCLUSION: In multivariate Cox regression analysis, allergy (P < 0.05; relative risk, 4.6) and previous polypectomy (P < 0.05; relative risk, 9.9) were found to be predictors of poor prognosis in the long-term follow-up.

Adolescent↗

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↗

Is septoplasty alone adequate for the treatment of chronic rhinosinusitis with septal deviation?

BACKGROUND: The purpose of this study was to reveal the role of septoplasty in curing chronic rhinosinusitis (CRS) in patients with significant septal deviation. METHODS: This prospective study involved 26 patients with CRS and septal deviation. The patients were randomly divided into two groups according to the applied surgical procedures. In the first and second groups, septoplasty and septoplasty plus endoscopic sinus surgery were applied, respectively. Subjective (questionnaire) and objective (endoscopy and computerized tomography) success rates were used to analyze the results. RESULTS: Septoplasty alone and septoplasty plus endoscopic sinus surgery were applied in 57.7% (15/26) and 42.3% (11/ 26) of the patients, respectively. Success rates were 93.3% (14/15) and 81.8% (9/11), subjectively (p > 0.05), and 66.7% (10/15) and 54.5% (6/11), objectively (p > 0.05), respectively in each group. CONCLUSION: We suggest that septoplasty alone can be adequate for the treatment of CRS with septal deviation.

Adolescent↗