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Biomedical subjects

Orhan Cildag

Publications and source records attributed to Orhan Cildag.

7 recordsLinked to original sources
PubMed2004

Determinants of BMI in patients with COPD.

OBJECTIVE: COPD is characterized by significant chronic inflammation that is evident not only in the pulmonary compartment but also in the circulation. Peripheral blood features of COPD include markers of oxidative stress and altered circulating levels of inflammatory mediators and acute-phase proteins. The presence of a systemic inflammatory response may influence quality of life by giving rise to weight loss, muscle wasting and tissue depletion. The aim of the present study was to evaluate the determinants of body mass and the value of serum tumour necrosis factor alpha (TNF-alpha) as a marker of weight loss in COPD patients, and to correlate this with the burden of oxidative stress as measured by serum malonyldialdehyde (MDA) levels. METHODOLOGY: Fifty-two male COPD patients (mean age 62.55 +/- 6.81 years) were studied. After anthropometric measurements and standard spirometry, serum TNF-alpha concentration was measured by enzyme-linked immunosorbent assay using an hTNF-alpha kit, and MDA was studied spectrophotometrically using the Yoshioka-Kawada method. RESULTS: The mean BMI was 24.82 +/- 3.46. BMI was lower than normal (< 19) in six patients. Mean serum TNF-alpha concentration was 14.99 +/- 8.98 pg/mL and MDA was 0.93 +/- 0.13 nmol/L. There was no significant correlation between serum MDA and TNF concentrations (P = 0.140). Serum TNF-alpha and MDA concentrations were not correlated with severity of airflow obstruction or degree of hypoxaemia (P > 0.05 for all). BMI was negatively correlated with burden of smoking (pack-years) (r = -0.392, P= 0.004); but not with pulmonary function, degree of hypoxaemia, serum TNF-alpha or MDA levels. BMI was significantly lower in current smokers than ex-smokers (P = 0.041); however, serum MDA and TNF levels were similar in both groups. CONCLUSION: The results of this study indicate that body mass is related to smoking status (both pack-years and continuance of smoking) in COPD; however, serum TNF-alpha concentration does not seem to be a good marker of weight loss in these patients.

Aged↗
PubMed2004

Trace elements as a component of oxidative stress in COPD.

OBJECTIVE: The purpose of this study was to assess the serum concentrations of those trace elements that act as a component of oxidative stress in COPD patients. Clinically stable COPD outpatients (n = 26) and healthy controls (n = 24) were studied. METHODOLOGY: Serum concentrations of copper (Cu) and zinc (Zn) were determined using a Varian Spectra AA220 flame atomic absorption spectrophotometer. Serum concentration of iron (Fe) was measured by the ferene assay, using a commercially available kit (IL Test Iron) with the ILAb 900 autoanalyser. The lipid peroxidation product malondialdehyde (MDA) in serum samples was measured spectrophotometrically in terms of TBARS (thiobarbituric acid reactive substances). RESULTS: The serum MDA concentration in COPD patients was found to be similar to the control group (0.68 +/- 0.15 nmol/mL vs 0.62 +/- 0.13 nmol/mL, respectively; P= 0.163). The serum concentrations of the trace elements in both study groups were in the normal reference range. There was no difference in Fe concentration between COPD patients and the control group (0.81 +/- 0.38 micro g/mL vs 0.92 +/- 0.41 micro g/mL; P= 0.360). Copper concentrations were higher (1.06 +/- 0.26 microg/mL vs 0.92 +/- 0.19 microg/mL; P <0.040); while zinc was lower in the COPD group compared to the controls (0.83 +/- 0.25 microg/mL vs 1.03 +/- 0.23 microg/mL; P= 0.006). Serum Zn concentrations were lower in the severe COPD patients compared to mild-moderate COPD patients (P = 0.038). CONCLUSION: The results of this study indicate that there are alterations in serum concentrations of trace elements in COPD patients, suggesting that they may play a role in the pathophysiology of this disease by virtue of their role in oxidative stress. We recommend further studies on the role of trace elements in the pathophysiology of COPD, their association with markers of oxidant/antioxidant status and on the clinical significance of their deficiency.

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PubMed2004

Role of arterial blood gas abnormalities in oedema formation in COPD.

OBJECTIVE: Renal and hormonal abnormalities, manifesting as oedema or hyponatraemia, are often seen in patients with COPD. The aim of this study was to investigate the effect of airflow obstruction and arterial blood gas abnormalities on oedema formation in COPD patients. METHODOLOGY: A total of 58 COPD patients hospitalized for treatment of COPD exacerbation were admitted to the study. Of these, 38 patients had peripheral oedema (group 1) and 20 patients had no oedema (group 2). RESULTS: The mean age was 68 +/- 9 years in group 1 and 68 +/- 8 years in group 2. On the first day of admission, serum urea was 29.18 +/- 12.25 mg/dL and creatinine was 1.62 +/- 0.46 mg/dL in group 1, while urea was 15.50 +/- 4.59 mg/dL and creatinine was 1.07 +/- 0.10 mg/dL in group 2. Hyponatraemia occurred in five patients (13%) in group 1 and one patient (5%) in group 2. There was no difference in severity of airflow obstruction in the two groups; FEV1 was 44 +/- 15% of predicted and FEV1/FVC was 53 +/- 14 in group 1, while FEV1 was 45 +/- 16% of predicted and FEV1/FVC was 54 +/- 20 in group 2. There were statistically significant differences in pH (7.32 vs. 7.39; P= 0.013) and in PaCO2 (62 +/- 10 mmHg vs. 42 +/- 6; P= 0.048) for group 1 compared with group 2. PaO2 (62 +/- 17 mmHg vs. 82 +/- 27) and SaO2 (87 +/- 9%vs. 90 +/- 13) were found to be lower in group 1 compared with group 2 but the difference did not reach statistical significance. CONCLUSION: Alterations in pH and PaCO2 (respiratory acidosis and hypercapnia) appear to have more prominent roles than hypoxaemia in oedema formation in COPD patients.

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PubMed2003

Should COPD patients be routinely evaluated for bone mineral density?

There are many factors that increase the risk of osteoporosis, including smoking, malnutrition, vitamin D deficiency, hypogonadism, limited physical activity due to chronic disease, and corticosteroid therapy in chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate bone mineral density (BMD) in COPD outpatients receiving regular therapy in order to clarify whether they were suitable candidates for bone mass screening. Twenty-eight male, clinically stable COPD patients (mean age, 63 +/- 9 years) and 20 male volunteer subjects with normal pulmonary function, as a control group (mean age, 63 +/- 5 years) were admitted to the study. The BMD of the COPD patients and control subjects was measured by dual X-ray absorptiometry (Hologic QDR-4000). Pulmonary function tests and arterial blood gas analyses of COPD patients revealed moderate-degree airway obstruction with mild hypoxemia and normal pH. Rates of 42% and 67% for lumbar and femoral osteopenia, respectively, and 35%, and 10% for lumbar and femoral osteoporosis, respectively, were detected in the COPD patients; whereas the rates of lumbar and femoral osteopenia were 40% and 50%, respectively, and the rates of lumbar and femoral osteoporosis were 40% and 15%, respectively, in the control subjects. There was no statistically significant difference between the BMD values of the COPD and control groups. Lumbar BMD was 0.871 g/cm(2) in the COPD patients and 0.853 g/cm(2) in the control group (P = 0.682); femoral BMD was 0.790 g/cm(2) in the COPD patients and 0.795 g/cm(2) in the control group (P = 0.909). Bone density was correlated with the degree of airway obstruction and arterial blood pH. In conclusion, the BMD values of COPD patients were not different from those of control subjects of the same age group. We conclude that the risk of osteoporosis is not increased in appropriately treated patients with moderate-degree COPD, and there is no indication for bone mass screening in this group.

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PubMed2003

Cavitary necrobiotic nodule imitating malignant lung disease in a patient without articular manifestations of rheumatoid arthritis.

Pulmonary involvement is a serious complication of rheumatoid arthritis (RA) and may be seen as airway disease, rheumatoid nodules, interstitial lung disease, and pleurisy. However, cavitary rheumatoid nodules without articular manifestations are rare. We describe a male patient presenting with pleurisy and multiple rheumatoid necrobiotic nodules in the absence of arthritis or subcutaneous nodules. One of the nodules was quite large (5 x 8 cm in diameter) and cavitary, imitating bronchial carcinoma radiologically and bronchoscopically. Definite histopathologic diagnosis was obtained by open lung biopsy. The patient was given methylprednisolone and methotrexate, and significant regression was observed in clinical and radiologic findings. He has been followed for 14 months with no articular manifestations yet, receiving 4 mg/d methylprednisolone and 20 mg/wk methotrexate. The diagnosis of rheumatoid pulmonary involvement without articular manifestations can be difficult. Rheumatoid nodules may imitate bronchial carcinoma, or bronchial carcinoma may coexist in RA patients. Open lung biopsy may be necessary for differential diagnosis of pulmonary lesions in RA.

Journal Article↗
PubMed2003

Should chronic obstructive pulmonary disease outpatients be routinely evaluated for trace elements?

We searched for serum concentrations of trace elements and correlated them to malondialdehyde (MDA), which is an indirect marker of oxidative stress, in order to clarify if routine evaluation is necessary in chronic obstructive pulmonary disease (COPD) outpatients. Serum concentrations of copper (Cu), zinc (Zn), and magnesium (Mg) were determined by atomic absorption spectrophotometry and iron (Fe) by a ILLab 1800 autoanalyzer with ILLab test kits. Serum MDA concentrations were detected in terms of TBARS (thiobarbituric acid reactive substances) spectrophotometrically. Serum Cu, Zn, Mg, Fe, and MDA concentrations in patient and control groups were all in the normal reference range. The results respectively were as follows: Cu:123 +/- 29.2 and 122.2 +/- 23.4 microg/dL; Zn: 87.8 +/- 17.8 and 96.9 +/- 12.9 microg/dL; Mg: 2.3 +/- 0,5 and 2.04 +/- 0.28 mg/dL; Fe: 73.8 +/-35.5 and 80.7+/-51.2 microg/dL; MDA: 1.09+/-0.11 and 0.95+/-0.06 nmol/L. MDA was not correlated to Cu, Zn, Mg, or Fe (p>0.05 for all). The serum Zn concentration of COPD group was lower than the control group (p=0.042), whereas the Mg concentration was higher (p=0.021). There was no statistical difference in other study parameters. Oxidative stress was not increased in clinically stable, regularly treated COPD patients. Although there was no deficiency in trace elements (Cu, Fe, Mg, and Zn), serum Zn was close to the lower limit of the reference value. There is no need for routine evaluation of trace elements in clinically stable, regularly treated COPD outpatients.

Adult↗