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    Effects of the sibutramine therapy on pulmonary artery pressure in obese patients
    (Blackwell Publishing Ltd, 2004) Guven, A; Koksal, N; Cetinkaya, A; Sokmen, G; Ozdemir, R
    Aim: Obesity is a major global public health problem. Previous drugs (dexfenfluramine and fenfluramine) used for the treatment of obesity have been withdrawn due to various cardiac side effects. Sibutramine is an anti-obesity agent. The purpose of this study was to assess cardiac valve disease and pulmonary artery pressure (PAP) of the patients who used once daily doses of sibutramine. Methods: One hundred and six obese patients (51 men and 55 women) determined to have minimal tricuspid regurgitation (TR) on echocardiographic examination were included in the study. All patients had a complete physical examination, complete blood count and measurement of lipid parameters, and echocardiography was performed by which cardiac valves and PAP were evaluated. After the mean duration of 24-week of follow up, all examinations were repeated for each patient. Results: The drug was well tolerated by all patients for the follow-up period. A significant weight loss was recorded in all patients compared to the baseline values (93.1 +/- 9.6 kg vs. 85.8 +/- 7.7 kg, p < 0.001). Blood pressures and heart rate of the patients increased compared to the baseline measurements (systolic 122.3 +/- 8.5 vs. 124 +/- 10.2 mmHg, p = 0.128, diastolic 79.3 +/- 4.7 vs. 80 +/- 5.7 mmHg, p = 0.42 and heart rate 79.5 +/- 6.5 vs. 85 +/- 5.7 beats/min, p < 0.001). Echocardiographically determined aortic or mitral valve dysfunction appeared in none of the patients. PAP lightly increased after the treatment but the difference between pre and post-treatment values was not found statistically significant (14.7 +/- 1.8 vs. 16.3 +/- 1.6 mmHg, p = 0.06). Conclusions: A 24-week treatment with sibutramine does not affect heart valves and pulmonary artery pressure.
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    Organophosphate intoxication as a consequence of mouth-to-mouth breathing from an affected case
    (Elsevier, 2002) Koksal, N; Buyukbese, MA; Guven, A; Cetinkaya, A; Hasanoglu, HC
    We report three cases of organophosphate (OP) poisoning. One patient was a 19-year-old woman who drank OP compounds in an attempt at suicide. The other two patients became intoxicated on the way to the hospital during mouth-to-mouth breathing. The first patient died in the emergency department, and the other two were taken to the ICU. There, they were treated with atropine and pralidoxime. Three days later, all symptoms and signs had disappeared, and they, were discharged from the hospital satisfactorily.