Browsing by Author "Sungur, Mehmet Ali"
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Item Erythropoietin May Attenuate Lung Inflammation in A Rat Model of Meconium Aspiration Syndrome(2016) Turhan, Ali Haydar; Atici, Aytug; Muslu, Necati; Polat, Ayse; Sungur, Mehmet Ali; 27266360Background: Inflammation is believed to play a key role in the pathophysiology of meconium aspiration syndrome (MAS). Purpose of the Study: The objective was to determine whether the recombinant human Erythropoietin (rhEPO) pretreatment could attenuate meconium-induced inflammation. Materials and Methods: In this study, 24 ventilated adult male rats were studied to examine the effects of recombinant human EPO (rhEPO) onmeconium-induced inflammation. Seventeen rats were instilled with human meconium (1.5 mL/kg, 65 mg/mL) intratracheally and ventilated for 3 hours. rhEPO (1000 U/kg) (n = 9) or saline (n = 8) was given to the animals. Seven rats that were ventilated and not instilled with meconium served as a sham-controlled group. Analysis of the blood gases, interleukin (IL)-1 beta, IL-6, IL-8, and tumor necrosis factor (TNF)-alpha in blood and bronchoalveolar lavage (BAL) fluid samples, and lung tissue myeloperoxidase levels were performed. Results: Intrapulmonary instillation of meconium resulted in the increase of TNF-alpha (p = 0.005 and p < 0.001, respectively) and IL-8 concentrations (p < 0.001 and p < 0.001, respectively) in BAL fluid in the EPO + meconium and saline + meconium groups compared with the sham-controlled group. rhEPO pretreatment prevented the increase of BAL fluid IL-1 beta, IL-6, and IL-8 levels (p < 0.001, p = 0.021, and p = 0.005, respectively), and serum IL-6 levels (p = 0.036). Conclusion: rhEPO pretreatment is associated with improved BAL fluid and serum cytokine levels. Pretreatment with rhEPO might reduce the risk of developing of meconium-induced derangements.Item Evaluating clonidine response in children and adolescents with attention-deficit/hyperactivity disorder(2018) Kutuk, Meryem Ozlem; Guler, Gulen; Tufan, Ali Evren; Sungur, Mehmet Ali; Topal, Zehra; Kutuk, OzgurAttention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood, which is generally treated with stimulant and non-stimulant medications. However, 10-30% of patients in clinical setting do not present with adequate response to initial stimulant treatment. Thereby, clonidine may be considered for those patients who have failed to respond to psychostimulant/atomoxetine monotherapy or as an augmentation for inadequate response/comorbidity. This observational study evaluated its effectiveness as a single drug in ADHD cases unresponsive to previous treatment trials. Seventeen ADHD cases that were non-responders to stimulant, non-stimulant and combination therapy for the primary symptoms of ADHD were included in the study. Four cases dropped out before follow up, leaving thirteen cases who were administered immediate release clonidine treatment alone with a mean dose of 0.2 +/- 0.05 mg/day at baseline. The trial lasted for 12 weeks, and treatment outcomes were evaluated by the Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S) and the Clinical Global Impressions-Severity (CGI-S) and Improvement (CGI-I) scales. Mean age of the sample was 12.5 years (SD = 3.0) and eleven of the subjects had another comorbid psychopathology. Only two cases were evaluated as "very much improved", while another patient was judged to be "minimally improved" after 12 weeks of clonidine treatment. Attrition during follow-up was associated with higher median scores on the hyperactivity and impulsivity subscales (Mann-Whitney U test, p = 0.02). According to the T-DSM-IV-S, CGI-S, and CGI-I scales, clonidine treatment by itself had minimal benefits in this sample of treatment of refractory cases with ADHD evaluated at the study center. Clonidine is not available in Turkey pharmaceutical marketing system and patients' access to drug is limited. Our results provide first data regarding the use of clonidine in Turkish ADHD patients.