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    The comparison of efficacy and tolerability of two bowel preparation agents in children: polyethylene glycol vs sodium phosphate
    (DergiPark, 2020) Aydemir, Yusuf; Baris, Zeren; Yurttas, Gozde Nur; Yavuz, Asli; Eren, Makbule
    Abstract: Adequate bowel cleansing with a good patient tolerability is important for high-quality and safe colonoscopy. We aimed to compare the efficacy and tolerability of an osmotic agent, polyethylene glycol (PEG) and a less frequently used stimulant agent, sodium phosphate (NP) for pediatric patients. We analyzed the records of pediatric patients who underwent colonoscopy and used either PEG or NP for bowel cleansing between January 2016 and December 2019. The patient tolerability of bowel preparation was assessed using a patient questionnaire that consisted of acceptance and adverse events, recording abdominal pain, nausea, vomiting, dizziness and severity of these symptoms. The quality of bowel preparation was assessed according to the Ottawa scale, including cleanliness and fluid quantity. The colonoscopic video records were retrospectively and blindly evaluated for Ottawa scale. There were a total of 145 patients (65 boys, 44.8%) with a mean age of 12.3±4.2 years. PEG was used in 93 patients (64.1%), while NP was used in 52 patients (35.9%). The mean age of the patients was significantly lower in PEG group (11.2±4.6 years) when compared to NP group (14.2±2.7 years) (p<0.0001). The patients who used PEG had significantly better tolerance without any complaints when compared to the patients who used NP (49/93 patients (52.7%) vs 14/52 patients (26.9%), respectively, p=0.003). Regarding the severity of symptoms in patients who had adverse events, the NP group had significantly more frequent moderate-severe side effects when compared to PEG group (15/52 patients (28.8%) vs 15/93 patients (16.1%), respectively, p=0.014). One of the children in NP group had severe hyperphosphatemia, which required fluid resuscitation. Regarding the efficacy of the preparations, 39/93 (41.9%) of the patients in PEG group had required wash and suctioning in any segments of the colon, this ratio was significantly lower in NP group (12/52 (23%)), (p=0.029). The Ottawa bowel preparation quality score in right colon and total Ottawa scale rating was significantly better in NP group when compared to PEG group (p=0.009 and 0.034, respectively). The Ottawa scores in mid and rectosigmoid colons were not significantly different between two groups. As conclusion, NP is more efficient in bowel cleansing when compared to PEG. But PEG had less frequent moderate-severe side effects compared to NP. Additionally, NP should be carefully used in selected cases where other bowel cleansing methods cannot be used, because of the severe side effects like hyperphosphatemia in children.
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    Comparison of oxidant/antioxidant balance in COPD and non-COPD smokers
    (Mosby-Elsevier, 2019) Aydemir, Yusuf; Aydemir, Özlem; Şengül, Aysun; Güngen, Adil Can; Çoban, Hikmet; Taşdemir, Canatan; Düzenli, Hasan; Şehitoğulları, Abidin
    Background/aim: Oxidative stress plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Smoking is the leading source of oxidants in lungs. However, it is currently unknown why some individuals are more resistant to the detrimental effects of smoking and do not develop COPD. The aim in this study is to measure and compare the oxidant/antioxidant balance between in non-COPD individuals who smoke and COPD patients who smoke. Materials and methods: Included in the study were 137 patients with COPD and 102 healthy individuals. Participants were divided into groups as COPD patients (former and current smokers), non-COPD individuals who smoke and non-smokers healthy persons. In the following stage, the total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) levels were measured in serum for all participants. Results: In the current-smoker COPD group, the level of oxidant status were significantly higher than the former-smoker COPD group (p < 0.001). Similarly, oxidant levels were significantly high in current-smoker healthy group than never smoker healthy group. According to these results TOS was associated with especially smoking status rather than COPD. Antioxidant status were similar between former-smoker COPD group and current-smoker COPD group. The antioxidant levels were found significantly low in current-smoker COPD patients, compared to the current-smoker non-COPD individuals (p = 0.007). Nevertheless, no significant difference was found in OSI levels between two groups. Briefly, high TOS and OSI values were correlated with only smoking, independently from COPD. Conclusion: It was concluded that there are complex pathogenetic mechanisms, including genetic and individual variations other than oxidant/antioxidant balance, involved in the development of smoking-related COPD. TOS and OSI values are not predictive parameters for the development of COPD, but high level of TAS in non-COPD smokers is promising for future studies. (C) 2019 Elsevier Inc. All rights reserved.
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    Evaluation of central and peripheral neuropathy in patients with chronic obstructive pulmonary disease
    (Dove Medical Press Ltd, 2018) Aras, Yesim Guzey; Aydemir, Yusuf; Doğan Güngen, Belma; Güngen, Adil Can
    Background: The aim of the study was to investigate the frequency and characteristics of peripheral nervous system (PNS) and central nervous system (CNS) involvement in COPD. Methods: The study included 41 COPD patients and 41 healthy volunteers. Electrophysiological studies were carried out: electromyography (EMG) and visual evoked potentials (VEPs). The median nerve, ulnar nerve, common peroneal nerve, and tibial nerve were evaluated for latency, amplitude, and conduction velocity. Results: The mean age of patients with COPD was 61.8 years and disease duration 10.3 years. There was no difference between patient and control groups in terms of age, BMI, smoking status, or biochemical parameters. Upon VEP examination, latencies were significantly prolonged and amplitudes shortened in the patient group compared to the control group. In EMG measurements, conduction velocity and amplitudes in all nerves were low in the patient group. Similarly, latencies in all nerves were higher in patients with COPD. Conclusion: Central and peripheral nervous system involvement could develop in patients with moderate-severe COPD, and these patients should be monitored for neuropathic changes in combination with neurological examination.