Several forms of cardiovascular involvement have been described in acute coronavirus disease-2019... more Several forms of cardiovascular involvement have been described in acute coronavirus disease-2019 (COVID-19) infection and also it has been shown that acute infection is responsible for cardiac symptoms. However, the data on cardiac involvement and associated symptoms in chronic phase remains unclear. Recent evidence have shown that the reason for persistent dyspnea can be persistent cardiac dysfunction in post COVID-19 infection. The aim of our study was to investigate the relationship between persistent dyspnea and cardiac involvement in post COVID-19 patients without pulmonary sequelae. Material and Methods: In our study, we recruited 30 post COVID-19 patients with dyspnea between January 2021 and July 2021. In all patients, the absence of pulmonary sequelae was detected with PFT and chest-CT. 2D-TTE, 2D-STE and MPS were performed for each case. Results: Left ventricular dysfunction was detected in 63.3% of patients and also 93.3% of patients had extensive abnormal GLS at 3 month follow-up. Of the patients, 33.3% had myocardial perfusion defect (MPD) and all MPDs were observed to be reversible defects. MPD was obviously seen in anterior wall (60%) and mid (20%) to apical (70%) segments. As compared with patients without MPD, patients with MPD had higher CK-MB (p: 0.016) and troponin I (p: 0.011), lesser PW thickness (p:0.020) and lower peak systolic strain rate at A2C view (p:0.031). Patients with NYHA III had more impaired GLS than patients with NYHA II (p:0.035). Conclusion: Our study suggests ischemic or nonischemic cardiac dysfunction may be associated with persistent dyspnea in post-COVID-19 patients without lung sequelae.
Sağlık hizmetlerinde hasta memnuniyeti ilk kez 1956 yılında Amerika Birleşik Devletleri&#... more Sağlık hizmetlerinde hasta memnuniyeti ilk kez 1956 yılında Amerika Birleşik Devletleri'nde hem-şirelik alanında değerlendirilmiştir. Son on yıldır ise özellikle ABD ve İngiltere gibi gelişmiş ülkeler-de hasta memnuniyeti sağlık bakım kalitesinin bir sonuç ölçütü olarak önemli bir ...
ÖZET Konvansiyonel transbronşiyal akciğer biyopsisinin tanısal başarısı çeşitli parankimal akciğe... more ÖZET Konvansiyonel transbronşiyal akciğer biyopsisinin tanısal başarısı çeşitli parankimal akciğer hastalıkları arasında değişkenlik gösterir. Sarkoidoz ve lenfanjitis karsinomatozada bu oran yüksek iken usual interstisyel pnömoni ve nonspesifik interstisyel pnömoni gibi kompleks histopatolojik özelliklere sahip olan hastalıklarda materyalin küçük olması ve ezilme artefaktları nedeniyle oldukça düşüktür. Son yıllarda, kriyoprobların kullanımı tanıda gittikçe önem kazanmaktadır. Yeterli doku örneklemesine olanak sağlaması yanında pnömotoraks ve kanama gibi kontrol edilebilir yan etkilere sahip olması sebebiyle transbronşiyal akciğer kriyobiyopsinin, yakın gelecekte cerrahi akciğer biyopsisine alternatif olabilecek umut verici yeni bir teknik olacağı düşünülmektedir.
Aim:We performed the current study to evaluate the effects of caspase-8 (CASP8), Mitogen-activate... more Aim:We performed the current study to evaluate the effects of caspase-8 (CASP8), Mitogen-activated protein kinase 1 (MAPK1) gene expression levels, and their products on preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods:40 individuals with SARS-CoV-2 infection were included in the current study. The patients were divided into four main groups mild (n=7), moderate (n=10), severe(n=14), and critical(n=9) levels of the disease. Individuals under the age of 18 and pregnant women were excluded. Patients were classi ed according to the WHO classi cation system (WHO/2019-nCoV/clinical/2021.1). Results: Totally 40 individuals (male: 15 (37.5%); female: 25 (62.5%) with SARS-CoV2 infection were included in the current study. When all groups were taken into consideration, statistically signi cant differences were detected among all groups for both CASP82-ΔΔCt(p=0.006) and MAPK1 2-ΔΔCtvalues (p=0.015). Also, statistically signi cant differences were detected between mild and moderate (p=0.013), moderate and critical (p=0.018), and severe and critical (p=0.023) groups for lymphocytes. Conclusions:The CASP8/MAPK1 expression levels and/or its products are essential in preventing injury caused by SARS-CoV-2 infection. They play crucial roles in maintaining cellular homeostasis and viability. Perhaps CASP8/MAPK1 levels can provide information about the severity of the disease.
Journal of bronchology & interventional pulmonology, Oct 1, 2015
Hydatid cyst is a parasitic infestation caused by Echinococcus granulosus. Lungs are the second m... more Hydatid cyst is a parasitic infestation caused by Echinococcus granulosus. Lungs are the second most common site of involvement after liver. The diagnosis of complicated pulmonary hydatid cysts may not be easy because hydatid cyst disease mimics tuberculosis, lung cancer, empyema, or abscess. Fiberoptic bronchoscopy can be a valuable tool in the diagnosis of the infestation by visualization of hydatid cyst membrane. Here, we report the case of a 33-year-old woman who presented with hemoptysis and chest discomfort and was diagnosed with a hydatid cyst by fiberoptic bronchoscopy.
Objective: The objective of this study was to evaluate the effect of comorbid bronchiectasis on q... more Objective: The objective of this study was to evaluate the effect of comorbid bronchiectasis on quality-of-life in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: 103 patients were diagnosed with COPD were included in our study. Spirometric measurements were made. The following measurement tools were used to collect data: 6-Minute Walk Test (6MWT), Modified Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT), St. George Respiratory Questionnaire (SGRQ), and Short Form 36 (SF-36) quality-of-life questionnaire. Furthermore, all the patients' high Resolution Computed Tomography (HRCT) images for the last three years were included in the study. Results: 93.2% of the patients were male, with a mean age of 64.79 ± 9.35 years. It was found that SGRQ and SF-36 quality of life scores decreased to approximately half of the full score in all patients. The volume/forced vital capacity (FEV1/FVC) values in the first second of forced expiration were significantly lower in the group with bronchiectasis. A significant correlation was found to exist between the patients' mMRC dyspnea scale and CAT scores, 6MWT distances, and all subscales of SGRQ and SF-36. In addition, a significant correlation was also found to exist between FEV1 values and all subscales of SGRQ, and between subscales of SF-36. Conclusions: In our study, when we compared the quality-of-life scores of the patients with COPD and bronchiectasis with those with COPD alone, we found that the quality-of-life of both groups was impaired, but there was no significant difference between them.
Moxifloxacin related thrombocytopenia: A case report Drug-induced thrombocytopenia can be caused ... more Moxifloxacin related thrombocytopenia: A case report Drug-induced thrombocytopenia can be caused by various medications, most frequently, antibiotics. There have been reports of thrombocytopenia cases due to the usage of quinolone antibiotics, although moxifloxacin-related thrombocytopenia has been reported very rarely. The case is here presented of a 60-year old male with chronic obstructive pulmonary disease who presented with complaints of progressively worsening dyspnea. After hospitalization, progressive thrombocytopenia was detected which had started on the 3 rd day of moxifloxacin treatment. Other causes of thrombocytopenia were excluded and the thrombocyte count returned to normal after discontinuation of moxifloxacin.
Aim The current study aimed to evaluate the effects of caspase-8 (CASP8) and mitogen-activated pr... more Aim The current study aimed to evaluate the effects of caspase-8 (CASP8) and mitogen-activated protein kinase 1 (MAPK1) gene expression levels and their products on preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods A total of 40 patients (men, 15 [37.5%]; women, 25 [62.5%]) with COVID-19 infection were included in the current study. The patients were divided into four main groups based on disease severity: mild (n = 7), moderate (n = 10), severe (n = 14), and critical (n = 9). Individuals aged < 18 years and pregnant women were excluded. Patients were classified according to the World Health Organization (WHO) classification system (WHO/2019-nCoV/clinical/2021.1). Results Considering all groups, statistically significant differences were detected among all groups for both CASP8 2−ΔΔCt (p = 0.006) and MAPK1 2 −ΔΔCt values (p = 0.015). Moreover, statistically significant differences were detected between mild and moderate (p = 0.013), moderate and critical (p = 0.018), and severe and critical (p = 0.023) groups for lymphocytes. Conclusion The CASP8/MAPK1 expression levels and/or its products are essential in preventing injury caused by COVID-19 infection. They play crucial roles in maintaining cellular homeostasis and viability. Furthermore, CASP8/MAPK1 levels can provide information about disease severity.
AIM We aimed to investigate the effect of short-term pirfenidone treatment on prolonged COVID-19 ... more AIM We aimed to investigate the effect of short-term pirfenidone treatment on prolonged COVID-19 pneumonia. METHOD Hospital files of patients hospitalized with a diagnosis of critical COVID-19 pneumonia between November 2020 and March 2021 were retrospectively reviewed. Chest computed tomography images taken both before treatment and 2 months after treatment, demographic characteristics and laboratory parameters of patients receiving pirfenidone+methylprednisolone (n=13) and only methylprednisolones (n=9) were recorded. Pulmonary function tests were performed after the second month of the treatment. CT involvement rates were determined by machine learning. RESULTS A total of 22 patients, 13 of whom (59.1%) were using methylprednisolone + pirfenidone and 9 of whom (40.9%) were using only methylprednisolone were included. When the blood gas parameters and pulmonary function tests of the patients were compared at the end of the second month, it was found that the FEV1, FEV1%, FVC, and FVC% values were statistically significantly higher in the methylprednisolone + pirfenidone group compared to the methylprednisolone group (p=0.025, p=0.012, p=0.026, and p=0.017, respectively). When the rates of change in CT scans at diagnosis and second month of treatment were examined, it was found that the involvement rates in the methylprednisolone + pirfenidone group were statistically significantly decreased (p<0.001). CONCLUSION Antifibrotic agents can reduce fibrosis that may develop in the future. These can also help dose reduction and/or non-use strategy for methylprednisolone therapy, which has many side effects. Further large series and randomized controlled studies are needed on this subject.
İL-12, İFN-γ ve sİL-2 Düzeyleri IL-12, IFN-γ and sIL-2 Levels in Bronchoalveolar Lavage of Patien... more İL-12, İFN-γ ve sİL-2 Düzeyleri IL-12, IFN-γ and sIL-2 Levels in Bronchoalveolar Lavage of Patients with Pulmonary Tuberculosis ÖZ Amaç: Çalışmamızda lokal immün cevabı yansıttığı düşünülen sitokin seviyelerini (İL-12, İFN-γ ve sİL-2) bronkoalveolar lavaj sıvısında ölçerek balgamda yayma negatif saptanan hastalar ile balgam yayması pozitif olan hastaları karşılaştırmayı amaçladık. Gereç ve Yöntemler: Çalışma retrospektif olarak dizayn edildi. Çalışmaya Ekim 1998-Şubat 1999 arasında Yedikule Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi'nde tetkik ve tedavi edilen 24 tüberküloz hastası alındı. Kontrol grubu olarak diğer nedenlerle bronkoskopi yapılmış olan akciğer malignitesi veya tüberkülozu olmayan 15 hasta alındı. Bulgular: Hasta ve kontrol grupları İL-12, İFN-γ ve sİL-2 düzeyleri açısından karşılaştırıldığında İL-12 ve İFN-γ düzeylerinin anlamlı şekilde farklı olduğu tespit edildi (sırasıyla p: 0,02 ve p<0,001). Sonuç: Tüberküloz hastalarının bronkoalveolar lavaj sıvılarında İFN-γ düzeyinde belirgin artış tespit edilmesi önemli bir bulgudur. Bu İFN-γ artışına İL-12 düzeyi artışının da eşlik etmesi bu iki sitokinin lokal inflamasyon belirteci olarak da kullanılabileceğini düşündürmüştür. Bu sitokinlerin tanısal anlamda da kullanılabilirliğini araştıran daha kapsamlı çalışmalara ihtiyaç vardır.
Serum Total Thiol (TT), Native Thiol (NT), and Disulfide (SS) levels were found significantly low... more Serum Total Thiol (TT), Native Thiol (NT), and Disulfide (SS) levels were found significantly lower in benign proliferative pathologies and cancer disease compared to healthy subjects. We conducted this prospective study to investigate the possible predictive and prognostic significance of these markers in non-small cell lung cancer (NSCLC), which is one of the most associated cancers with oxidative stress. This was a non-randomized, prospective, and case-control study of 120 subjects, including 60 patients with metastatic or inoperable NSCLC at the time of diagnosis and 60 demographically-matched controls. Morning fasting venous blood serum samples from both NSCLC and control group were stored at À80 C for equal periods and then TT, NT, and SS levels were measured spectrophotometrically. Serum TT, NT, and SS levels were compared between groups and their relationships with demographic features and survival of NSCLC patients were analyzed. In results, Serum TT, NT, and SS levels were significantly lower in NSCLC patients than those in control group, with a low SS level being an independent indicator of poor survival.
Objective: Obstructive sleep apnea syndrome (OSAS) is the most common condition among sleep-relat... more Objective: Obstructive sleep apnea syndrome (OSAS) is the most common condition among sleep-related respiratory disorders. The etiology is not clear. However, systemical and local inflammation in the respiratory tract of the patients has been acknowledged. Monocytes and macrophages play the critical role in the inflammation process. These cells participate in the release of the proinflammatory cytokines in inflammation sites. High-density lipoprotein (HDL) cholesterol is a molecule with an anti-inflammatory effect. Monocyte/HDL cholesterol ratio (MHR) is an inflammation marker being used recently. In our study, we aimed to compare inflammation marker levels between patients diagnosed with OSAS with subsequent polysomnography and the non OSAS group, determine the relationship between the severity of OSAS and MHR and, investigate the utility of the MHR for diagnosing OSAS. Materials and Methods: The data from the patients' files who had polysomnography due to OSAS symptoms in our unit between July 2017 and December 2017 have been retrospectively analyzed, and polysomnography results were recorded. Demographic data and the results of biochemistry and complete blood count (CBC) panels of patients with OSAS and who were not also were recorded. Results: Out of 147 patients who underwent polysomnography in the period identified, 104 were diagnosed with OSAS. Monocyte count and MHR values were significantly high (p<0,0001 in both) and HDL levels were significantly low (p=0,03) in OSAS group. There was also a moderately significant positive correlation between apnea-hypopnea index (AHI) and MHR (p<0,0001, r: 0,411). Conclusion: MHR may be a useful tool for diagnosing OSAS. Because of the positive correlation between MHR and AHI which represents the severity of the disease, MHR may be used for the classification of OSAS. Öz Amaç: Obstrüktif uyku apne sendromu (OSAS) uyku ile ilişkili solunum bozuklukları içerisinde en sık görülen hastalıktır. OSAS'ın etyolojisi kesin olarak bilinmemekle birlikte hastalarda sistemik ve havayolunda lokal inflamasyon varlığı gösterilmiştir. Monosit ve makrofajlar inflamasyonda rol alan önemli hücrelerdir. İnflamasyon bölgesinde proinflamatuar sitokinlerin salınmasında görev alırlar. Yüksek dansiteli lipoprotein (HDL) kolesterolü anti inflamatuar etkisi olan bir moleküldür. Monosit/HDL kolesterol oranı (MHO) yakın zamanda kullanılmaya başlanan bir inflamasyon belirtecidir. Çalışmamızda ünitemizde polisomnografi ile OSAS tanısı alanların ve almayanların Ad dress for Cor res pon den ce/Ya zış ma Ad re si:
Malign mezotelyoma (MM) büyük çoğunluğu plevra olmak üzere perikard, periton ve tunika vajinalist... more Malign mezotelyoma (MM) büyük çoğunluğu plevra olmak üzere perikard, periton ve tunika vajinalisten de gelişen nadir görülen ve kötü prognozlu bir tümördür. Malign plevral mezotelyoma (MPM), plevrayı döşeyen mezotel hücrelerinden köken alır. Hastalığın erken evrelerinde; cerrahi, radyoterapi ve kemoterapinin oluşturduğu trimodal tedavi standart tedavi yöntemdir. Trimodal tedavide uygulanan kemoterapi neoadjuvan veya adjuvan olarak uygulanabilir. Neo-adjuvan kemoterapide kullanılan ajanlar öncelikle sisplatin-pemetreksed veya sisplatin-gemsitabin kombinasyonudur. Sisplatin-vinorelbin kombinasyonunun da neoadjuvan kemoterapide kullanılabileceğini gösteren çalışmalar mevcuttur. Adjuvan kemoterapide sisplatin-pemetreksed kombinasyonu kullanılması önerilir. Cerrahi tedaviye aday olmayan ya da herhangi bir nedenle opere edilemeyen iyi performanslı MPM'li hastaların tedavisinde primer kemoterapi uygun bir seçenektir. Primer kemoterapide bugün için kabul edilmiş standart yaklaşım sisplatin ile pemetreksed veya raltitreksed kombinasyonudur. Sisplatin kullanılamayan hastalarda karboplatin verilebilir. Bu tedaviye alternatif olarak sisplatin-gemsitabin kombinasyonu alternatif olarak düşünülebilir. Bunun dışında birinci sıra tedavide immunomodulator ajanlar, hedef biyoterapiler ve aşıların klinik çalışma protokolleri dışında kullanılması uygun değildir. MPM'de primer kemoterapiden sonra idame tedavisinin yararı henüz gösterilememiştir. İkinci sıra kemoterapide ise birinci sıra platin-pemetreksed kombinasyonu kullanan hastalarda, progresyonsuz survi (PFS) 12 aydan fazla ise pemetreksed tek ilaç veya platin ile kombine olarak tercih edilebilir. Bu grupta PFS<12 ay ise vinorelbin ya da gemsitabin tercih edilebilir. Birinci sıra pemetreksed dışı ilaç kullanan hastalarda, ikinci sıra kemoterapide pemetreksed tercih edilebilir. İkinci sıra ve üçüncü sıra kemoterapide hedefe yönelik tedavilerin, biyolojik ajanların ve immünoterapinin henüz yararı gösterilememiştir. Kemoterapiye uygun olmayan hastalar için destek tedavi önerilir. MPM'de uygulanan tedavilere rağmen hastalık halen kürabl değildir ve yüksek mortaliteye sahiptir. Bütün bu sonuçlar karşısında yeni tedavi rejimleri için çalışmalar devam etmektedir. Günümüzde halen rehberlere girecek sonuçlara ulaşılmamasına rağmen hedefe yönelik tedaviler, biyolojik ajanlar ve immunoterapi tedavileri için çok sayıda çalışma devam etmektedir. Bu çalışmalarla ilgili iyi sonuçlar bildirilmesine rağmen halen rehberlere girmemiştir. Bu makalede yeni tedavilerden bahsedilecektir.
INTRODUCTION Medical thoracoscopy is a minimally invasive procedure that enables a pulmonologist ... more INTRODUCTION Medical thoracoscopy is a minimally invasive procedure that enables a pulmonologist to directly visualize the pleural space and take samples from pathological sites (1, 2). Compared to video-assisted thoracoscopic surgery (VATS), which is performed under general anesthesia with double-lumen tracheal intubation, medical thoracoscopy is immensely advantageous since it can be performed with local anesthesia and conscious sedation (3). Several studies show medical thoracoscopy has increased diagnostic rates in cases where thoracentesis and blind pleural biopsy were not diagnostic (4). In our study, we evaluated the diagnostic value and safety of medical thoracoscopy in patients with exudative pleural effusion where clinical, radiologic, and cytological finding were inconclusive. METHODS Thirty-seven patients who had undergone medical thoracoscopy due to exudative pleural effusion in our clinic from March 2011 to August 2014 were studied retrospectively. These patients had a failed diagnosis by classical methods, including thoracentesis and closed pleural biopsy, before medical thoracoscopy. Medical thoracoscopy was performed by a rigid thoracoscope (Karl Storz, Germany). In all, 500 cc of fluid was drained from the pleural cavity and the same of volume air was administered instead to create an iatrogenic pneumothorax prior to the procedure. The patients were positioned
Amiloid, çeşitli klinik bozukluklarda birçok doku ve organda hücreler arasında biriken normal olm... more Amiloid, çeşitli klinik bozukluklarda birçok doku ve organda hücreler arasında biriken normal olmayan protein yapısında bir maddedir. Dokuda amiloid birikimi, parenkimal hücrelerin atrofisine, dokunun mekanik fonksiyonlarının bozulmasına ve vazokonstrüktör mekanizmasının hasar görmesine bağlı olarak hemorajiye neden olabilir [1]. Amiloidozis;
OBJECTIVE: Asthma is known as a chronic infl ammatory lung disease which has also systemic featur... more OBJECTIVE: Asthma is known as a chronic infl ammatory lung disease which has also systemic features. Insulin-like growth factor I (IGF-I) plays a role for asthma pathogenesis. Controversially, IGF-binding protein 3 (IGFBP3) blocks asthma development. That is why IGF-I and IGFBP3 are targeted for future therapeutic treatments of asthma. We aimed to investigate serum level of IGF-I and IGFBP3 in patients with asthma. This study was performed in 27 asthma and 23 healthy individuals. Serum levels of IGF-I and IGFBP3 were measured by human ELISA assay kits. Serum levels of IGF-I and IGFBP3 were signifi canlty higher in the asthma group than the control group. Signifi cant negative correlation was found between IGF-I and asthma control test (ACT) puan, O 2 saturation, Forced Expiratory Volume in 1 second/ Forced Vital Capacity (FEV1/FVC), Forced Expiratory Flow 25 second/75 second (FEF2575) (%). Signifi cant positive correlation was found between IGFBP3 and IGF-I, systolic blood pressure. Signifi cant negative correlation was found between IGF-I and FEV1 (ml). RESULTS: Our results indicate that the serum levels of IGF-I and IGFBP3 are signifi canlty elevated in the asthma group. We assume that current treatment strategies are not really good enough for asthma. We suppose further strategies which are seeking to balance IGF-I and IGFBP3 should be developed for more effective and curative treatment of asthma (Tab. 2, Fig. 2, Ref. 22).
Inflammatory myofibroblastic tumors (IMTs) are rare childhood neoplasms, with benign clinical cou... more Inflammatory myofibroblastic tumors (IMTs) are rare childhood neoplasms, with benign clinical course. Although etiology of IMTs are not clear, recent studies have reported that IMT is a true neoplasm rather than a reactive or inflammatory lesion. IMTs are rarely seen in adults and tracheal involvement is also rare both in adults and also in children. We describe a 16-year old female patient who was misdiagnosed and treated as asthma in another center for a few months and presented with acute respiratory distress due to upper airway obstruction. Computerized tomography (CT) of the chest and rigid bronchoscopy revealed a mass lesion that was nearly totally obliterating tracheal lumen. Bronchoscopic resection was performed under general anesthesia and the final pathological diagnosis was tracheal IMT.
Several forms of cardiovascular involvement have been described in acute coronavirus disease-2019... more Several forms of cardiovascular involvement have been described in acute coronavirus disease-2019 (COVID-19) infection and also it has been shown that acute infection is responsible for cardiac symptoms. However, the data on cardiac involvement and associated symptoms in chronic phase remains unclear. Recent evidence have shown that the reason for persistent dyspnea can be persistent cardiac dysfunction in post COVID-19 infection. The aim of our study was to investigate the relationship between persistent dyspnea and cardiac involvement in post COVID-19 patients without pulmonary sequelae. Material and Methods: In our study, we recruited 30 post COVID-19 patients with dyspnea between January 2021 and July 2021. In all patients, the absence of pulmonary sequelae was detected with PFT and chest-CT. 2D-TTE, 2D-STE and MPS were performed for each case. Results: Left ventricular dysfunction was detected in 63.3% of patients and also 93.3% of patients had extensive abnormal GLS at 3 month follow-up. Of the patients, 33.3% had myocardial perfusion defect (MPD) and all MPDs were observed to be reversible defects. MPD was obviously seen in anterior wall (60%) and mid (20%) to apical (70%) segments. As compared with patients without MPD, patients with MPD had higher CK-MB (p: 0.016) and troponin I (p: 0.011), lesser PW thickness (p:0.020) and lower peak systolic strain rate at A2C view (p:0.031). Patients with NYHA III had more impaired GLS than patients with NYHA II (p:0.035). Conclusion: Our study suggests ischemic or nonischemic cardiac dysfunction may be associated with persistent dyspnea in post-COVID-19 patients without lung sequelae.
Sağlık hizmetlerinde hasta memnuniyeti ilk kez 1956 yılında Amerika Birleşik Devletleri&amp;#... more Sağlık hizmetlerinde hasta memnuniyeti ilk kez 1956 yılında Amerika Birleşik Devletleri&amp;#x27;nde hem-şirelik alanında değerlendirilmiştir. Son on yıldır ise özellikle ABD ve İngiltere gibi gelişmiş ülkeler-de hasta memnuniyeti sağlık bakım kalitesinin bir sonuç ölçütü olarak önemli bir ...
ÖZET Konvansiyonel transbronşiyal akciğer biyopsisinin tanısal başarısı çeşitli parankimal akciğe... more ÖZET Konvansiyonel transbronşiyal akciğer biyopsisinin tanısal başarısı çeşitli parankimal akciğer hastalıkları arasında değişkenlik gösterir. Sarkoidoz ve lenfanjitis karsinomatozada bu oran yüksek iken usual interstisyel pnömoni ve nonspesifik interstisyel pnömoni gibi kompleks histopatolojik özelliklere sahip olan hastalıklarda materyalin küçük olması ve ezilme artefaktları nedeniyle oldukça düşüktür. Son yıllarda, kriyoprobların kullanımı tanıda gittikçe önem kazanmaktadır. Yeterli doku örneklemesine olanak sağlaması yanında pnömotoraks ve kanama gibi kontrol edilebilir yan etkilere sahip olması sebebiyle transbronşiyal akciğer kriyobiyopsinin, yakın gelecekte cerrahi akciğer biyopsisine alternatif olabilecek umut verici yeni bir teknik olacağı düşünülmektedir.
Aim:We performed the current study to evaluate the effects of caspase-8 (CASP8), Mitogen-activate... more Aim:We performed the current study to evaluate the effects of caspase-8 (CASP8), Mitogen-activated protein kinase 1 (MAPK1) gene expression levels, and their products on preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods:40 individuals with SARS-CoV-2 infection were included in the current study. The patients were divided into four main groups mild (n=7), moderate (n=10), severe(n=14), and critical(n=9) levels of the disease. Individuals under the age of 18 and pregnant women were excluded. Patients were classi ed according to the WHO classi cation system (WHO/2019-nCoV/clinical/2021.1). Results: Totally 40 individuals (male: 15 (37.5%); female: 25 (62.5%) with SARS-CoV2 infection were included in the current study. When all groups were taken into consideration, statistically signi cant differences were detected among all groups for both CASP82-ΔΔCt(p=0.006) and MAPK1 2-ΔΔCtvalues (p=0.015). Also, statistically signi cant differences were detected between mild and moderate (p=0.013), moderate and critical (p=0.018), and severe and critical (p=0.023) groups for lymphocytes. Conclusions:The CASP8/MAPK1 expression levels and/or its products are essential in preventing injury caused by SARS-CoV-2 infection. They play crucial roles in maintaining cellular homeostasis and viability. Perhaps CASP8/MAPK1 levels can provide information about the severity of the disease.
Journal of bronchology & interventional pulmonology, Oct 1, 2015
Hydatid cyst is a parasitic infestation caused by Echinococcus granulosus. Lungs are the second m... more Hydatid cyst is a parasitic infestation caused by Echinococcus granulosus. Lungs are the second most common site of involvement after liver. The diagnosis of complicated pulmonary hydatid cysts may not be easy because hydatid cyst disease mimics tuberculosis, lung cancer, empyema, or abscess. Fiberoptic bronchoscopy can be a valuable tool in the diagnosis of the infestation by visualization of hydatid cyst membrane. Here, we report the case of a 33-year-old woman who presented with hemoptysis and chest discomfort and was diagnosed with a hydatid cyst by fiberoptic bronchoscopy.
Objective: The objective of this study was to evaluate the effect of comorbid bronchiectasis on q... more Objective: The objective of this study was to evaluate the effect of comorbid bronchiectasis on quality-of-life in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: 103 patients were diagnosed with COPD were included in our study. Spirometric measurements were made. The following measurement tools were used to collect data: 6-Minute Walk Test (6MWT), Modified Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT), St. George Respiratory Questionnaire (SGRQ), and Short Form 36 (SF-36) quality-of-life questionnaire. Furthermore, all the patients' high Resolution Computed Tomography (HRCT) images for the last three years were included in the study. Results: 93.2% of the patients were male, with a mean age of 64.79 ± 9.35 years. It was found that SGRQ and SF-36 quality of life scores decreased to approximately half of the full score in all patients. The volume/forced vital capacity (FEV1/FVC) values in the first second of forced expiration were significantly lower in the group with bronchiectasis. A significant correlation was found to exist between the patients' mMRC dyspnea scale and CAT scores, 6MWT distances, and all subscales of SGRQ and SF-36. In addition, a significant correlation was also found to exist between FEV1 values and all subscales of SGRQ, and between subscales of SF-36. Conclusions: In our study, when we compared the quality-of-life scores of the patients with COPD and bronchiectasis with those with COPD alone, we found that the quality-of-life of both groups was impaired, but there was no significant difference between them.
Moxifloxacin related thrombocytopenia: A case report Drug-induced thrombocytopenia can be caused ... more Moxifloxacin related thrombocytopenia: A case report Drug-induced thrombocytopenia can be caused by various medications, most frequently, antibiotics. There have been reports of thrombocytopenia cases due to the usage of quinolone antibiotics, although moxifloxacin-related thrombocytopenia has been reported very rarely. The case is here presented of a 60-year old male with chronic obstructive pulmonary disease who presented with complaints of progressively worsening dyspnea. After hospitalization, progressive thrombocytopenia was detected which had started on the 3 rd day of moxifloxacin treatment. Other causes of thrombocytopenia were excluded and the thrombocyte count returned to normal after discontinuation of moxifloxacin.
Aim The current study aimed to evaluate the effects of caspase-8 (CASP8) and mitogen-activated pr... more Aim The current study aimed to evaluate the effects of caspase-8 (CASP8) and mitogen-activated protein kinase 1 (MAPK1) gene expression levels and their products on preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods A total of 40 patients (men, 15 [37.5%]; women, 25 [62.5%]) with COVID-19 infection were included in the current study. The patients were divided into four main groups based on disease severity: mild (n = 7), moderate (n = 10), severe (n = 14), and critical (n = 9). Individuals aged < 18 years and pregnant women were excluded. Patients were classified according to the World Health Organization (WHO) classification system (WHO/2019-nCoV/clinical/2021.1). Results Considering all groups, statistically significant differences were detected among all groups for both CASP8 2−ΔΔCt (p = 0.006) and MAPK1 2 −ΔΔCt values (p = 0.015). Moreover, statistically significant differences were detected between mild and moderate (p = 0.013), moderate and critical (p = 0.018), and severe and critical (p = 0.023) groups for lymphocytes. Conclusion The CASP8/MAPK1 expression levels and/or its products are essential in preventing injury caused by COVID-19 infection. They play crucial roles in maintaining cellular homeostasis and viability. Furthermore, CASP8/MAPK1 levels can provide information about disease severity.
AIM We aimed to investigate the effect of short-term pirfenidone treatment on prolonged COVID-19 ... more AIM We aimed to investigate the effect of short-term pirfenidone treatment on prolonged COVID-19 pneumonia. METHOD Hospital files of patients hospitalized with a diagnosis of critical COVID-19 pneumonia between November 2020 and March 2021 were retrospectively reviewed. Chest computed tomography images taken both before treatment and 2 months after treatment, demographic characteristics and laboratory parameters of patients receiving pirfenidone+methylprednisolone (n=13) and only methylprednisolones (n=9) were recorded. Pulmonary function tests were performed after the second month of the treatment. CT involvement rates were determined by machine learning. RESULTS A total of 22 patients, 13 of whom (59.1%) were using methylprednisolone + pirfenidone and 9 of whom (40.9%) were using only methylprednisolone were included. When the blood gas parameters and pulmonary function tests of the patients were compared at the end of the second month, it was found that the FEV1, FEV1%, FVC, and FVC% values were statistically significantly higher in the methylprednisolone + pirfenidone group compared to the methylprednisolone group (p=0.025, p=0.012, p=0.026, and p=0.017, respectively). When the rates of change in CT scans at diagnosis and second month of treatment were examined, it was found that the involvement rates in the methylprednisolone + pirfenidone group were statistically significantly decreased (p<0.001). CONCLUSION Antifibrotic agents can reduce fibrosis that may develop in the future. These can also help dose reduction and/or non-use strategy for methylprednisolone therapy, which has many side effects. Further large series and randomized controlled studies are needed on this subject.
İL-12, İFN-γ ve sİL-2 Düzeyleri IL-12, IFN-γ and sIL-2 Levels in Bronchoalveolar Lavage of Patien... more İL-12, İFN-γ ve sİL-2 Düzeyleri IL-12, IFN-γ and sIL-2 Levels in Bronchoalveolar Lavage of Patients with Pulmonary Tuberculosis ÖZ Amaç: Çalışmamızda lokal immün cevabı yansıttığı düşünülen sitokin seviyelerini (İL-12, İFN-γ ve sİL-2) bronkoalveolar lavaj sıvısında ölçerek balgamda yayma negatif saptanan hastalar ile balgam yayması pozitif olan hastaları karşılaştırmayı amaçladık. Gereç ve Yöntemler: Çalışma retrospektif olarak dizayn edildi. Çalışmaya Ekim 1998-Şubat 1999 arasında Yedikule Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi'nde tetkik ve tedavi edilen 24 tüberküloz hastası alındı. Kontrol grubu olarak diğer nedenlerle bronkoskopi yapılmış olan akciğer malignitesi veya tüberkülozu olmayan 15 hasta alındı. Bulgular: Hasta ve kontrol grupları İL-12, İFN-γ ve sİL-2 düzeyleri açısından karşılaştırıldığında İL-12 ve İFN-γ düzeylerinin anlamlı şekilde farklı olduğu tespit edildi (sırasıyla p: 0,02 ve p<0,001). Sonuç: Tüberküloz hastalarının bronkoalveolar lavaj sıvılarında İFN-γ düzeyinde belirgin artış tespit edilmesi önemli bir bulgudur. Bu İFN-γ artışına İL-12 düzeyi artışının da eşlik etmesi bu iki sitokinin lokal inflamasyon belirteci olarak da kullanılabileceğini düşündürmüştür. Bu sitokinlerin tanısal anlamda da kullanılabilirliğini araştıran daha kapsamlı çalışmalara ihtiyaç vardır.
Serum Total Thiol (TT), Native Thiol (NT), and Disulfide (SS) levels were found significantly low... more Serum Total Thiol (TT), Native Thiol (NT), and Disulfide (SS) levels were found significantly lower in benign proliferative pathologies and cancer disease compared to healthy subjects. We conducted this prospective study to investigate the possible predictive and prognostic significance of these markers in non-small cell lung cancer (NSCLC), which is one of the most associated cancers with oxidative stress. This was a non-randomized, prospective, and case-control study of 120 subjects, including 60 patients with metastatic or inoperable NSCLC at the time of diagnosis and 60 demographically-matched controls. Morning fasting venous blood serum samples from both NSCLC and control group were stored at À80 C for equal periods and then TT, NT, and SS levels were measured spectrophotometrically. Serum TT, NT, and SS levels were compared between groups and their relationships with demographic features and survival of NSCLC patients were analyzed. In results, Serum TT, NT, and SS levels were significantly lower in NSCLC patients than those in control group, with a low SS level being an independent indicator of poor survival.
Objective: Obstructive sleep apnea syndrome (OSAS) is the most common condition among sleep-relat... more Objective: Obstructive sleep apnea syndrome (OSAS) is the most common condition among sleep-related respiratory disorders. The etiology is not clear. However, systemical and local inflammation in the respiratory tract of the patients has been acknowledged. Monocytes and macrophages play the critical role in the inflammation process. These cells participate in the release of the proinflammatory cytokines in inflammation sites. High-density lipoprotein (HDL) cholesterol is a molecule with an anti-inflammatory effect. Monocyte/HDL cholesterol ratio (MHR) is an inflammation marker being used recently. In our study, we aimed to compare inflammation marker levels between patients diagnosed with OSAS with subsequent polysomnography and the non OSAS group, determine the relationship between the severity of OSAS and MHR and, investigate the utility of the MHR for diagnosing OSAS. Materials and Methods: The data from the patients' files who had polysomnography due to OSAS symptoms in our unit between July 2017 and December 2017 have been retrospectively analyzed, and polysomnography results were recorded. Demographic data and the results of biochemistry and complete blood count (CBC) panels of patients with OSAS and who were not also were recorded. Results: Out of 147 patients who underwent polysomnography in the period identified, 104 were diagnosed with OSAS. Monocyte count and MHR values were significantly high (p<0,0001 in both) and HDL levels were significantly low (p=0,03) in OSAS group. There was also a moderately significant positive correlation between apnea-hypopnea index (AHI) and MHR (p<0,0001, r: 0,411). Conclusion: MHR may be a useful tool for diagnosing OSAS. Because of the positive correlation between MHR and AHI which represents the severity of the disease, MHR may be used for the classification of OSAS. Öz Amaç: Obstrüktif uyku apne sendromu (OSAS) uyku ile ilişkili solunum bozuklukları içerisinde en sık görülen hastalıktır. OSAS'ın etyolojisi kesin olarak bilinmemekle birlikte hastalarda sistemik ve havayolunda lokal inflamasyon varlığı gösterilmiştir. Monosit ve makrofajlar inflamasyonda rol alan önemli hücrelerdir. İnflamasyon bölgesinde proinflamatuar sitokinlerin salınmasında görev alırlar. Yüksek dansiteli lipoprotein (HDL) kolesterolü anti inflamatuar etkisi olan bir moleküldür. Monosit/HDL kolesterol oranı (MHO) yakın zamanda kullanılmaya başlanan bir inflamasyon belirtecidir. Çalışmamızda ünitemizde polisomnografi ile OSAS tanısı alanların ve almayanların Ad dress for Cor res pon den ce/Ya zış ma Ad re si:
Malign mezotelyoma (MM) büyük çoğunluğu plevra olmak üzere perikard, periton ve tunika vajinalist... more Malign mezotelyoma (MM) büyük çoğunluğu plevra olmak üzere perikard, periton ve tunika vajinalisten de gelişen nadir görülen ve kötü prognozlu bir tümördür. Malign plevral mezotelyoma (MPM), plevrayı döşeyen mezotel hücrelerinden köken alır. Hastalığın erken evrelerinde; cerrahi, radyoterapi ve kemoterapinin oluşturduğu trimodal tedavi standart tedavi yöntemdir. Trimodal tedavide uygulanan kemoterapi neoadjuvan veya adjuvan olarak uygulanabilir. Neo-adjuvan kemoterapide kullanılan ajanlar öncelikle sisplatin-pemetreksed veya sisplatin-gemsitabin kombinasyonudur. Sisplatin-vinorelbin kombinasyonunun da neoadjuvan kemoterapide kullanılabileceğini gösteren çalışmalar mevcuttur. Adjuvan kemoterapide sisplatin-pemetreksed kombinasyonu kullanılması önerilir. Cerrahi tedaviye aday olmayan ya da herhangi bir nedenle opere edilemeyen iyi performanslı MPM'li hastaların tedavisinde primer kemoterapi uygun bir seçenektir. Primer kemoterapide bugün için kabul edilmiş standart yaklaşım sisplatin ile pemetreksed veya raltitreksed kombinasyonudur. Sisplatin kullanılamayan hastalarda karboplatin verilebilir. Bu tedaviye alternatif olarak sisplatin-gemsitabin kombinasyonu alternatif olarak düşünülebilir. Bunun dışında birinci sıra tedavide immunomodulator ajanlar, hedef biyoterapiler ve aşıların klinik çalışma protokolleri dışında kullanılması uygun değildir. MPM'de primer kemoterapiden sonra idame tedavisinin yararı henüz gösterilememiştir. İkinci sıra kemoterapide ise birinci sıra platin-pemetreksed kombinasyonu kullanan hastalarda, progresyonsuz survi (PFS) 12 aydan fazla ise pemetreksed tek ilaç veya platin ile kombine olarak tercih edilebilir. Bu grupta PFS<12 ay ise vinorelbin ya da gemsitabin tercih edilebilir. Birinci sıra pemetreksed dışı ilaç kullanan hastalarda, ikinci sıra kemoterapide pemetreksed tercih edilebilir. İkinci sıra ve üçüncü sıra kemoterapide hedefe yönelik tedavilerin, biyolojik ajanların ve immünoterapinin henüz yararı gösterilememiştir. Kemoterapiye uygun olmayan hastalar için destek tedavi önerilir. MPM'de uygulanan tedavilere rağmen hastalık halen kürabl değildir ve yüksek mortaliteye sahiptir. Bütün bu sonuçlar karşısında yeni tedavi rejimleri için çalışmalar devam etmektedir. Günümüzde halen rehberlere girecek sonuçlara ulaşılmamasına rağmen hedefe yönelik tedaviler, biyolojik ajanlar ve immunoterapi tedavileri için çok sayıda çalışma devam etmektedir. Bu çalışmalarla ilgili iyi sonuçlar bildirilmesine rağmen halen rehberlere girmemiştir. Bu makalede yeni tedavilerden bahsedilecektir.
INTRODUCTION Medical thoracoscopy is a minimally invasive procedure that enables a pulmonologist ... more INTRODUCTION Medical thoracoscopy is a minimally invasive procedure that enables a pulmonologist to directly visualize the pleural space and take samples from pathological sites (1, 2). Compared to video-assisted thoracoscopic surgery (VATS), which is performed under general anesthesia with double-lumen tracheal intubation, medical thoracoscopy is immensely advantageous since it can be performed with local anesthesia and conscious sedation (3). Several studies show medical thoracoscopy has increased diagnostic rates in cases where thoracentesis and blind pleural biopsy were not diagnostic (4). In our study, we evaluated the diagnostic value and safety of medical thoracoscopy in patients with exudative pleural effusion where clinical, radiologic, and cytological finding were inconclusive. METHODS Thirty-seven patients who had undergone medical thoracoscopy due to exudative pleural effusion in our clinic from March 2011 to August 2014 were studied retrospectively. These patients had a failed diagnosis by classical methods, including thoracentesis and closed pleural biopsy, before medical thoracoscopy. Medical thoracoscopy was performed by a rigid thoracoscope (Karl Storz, Germany). In all, 500 cc of fluid was drained from the pleural cavity and the same of volume air was administered instead to create an iatrogenic pneumothorax prior to the procedure. The patients were positioned
Amiloid, çeşitli klinik bozukluklarda birçok doku ve organda hücreler arasında biriken normal olm... more Amiloid, çeşitli klinik bozukluklarda birçok doku ve organda hücreler arasında biriken normal olmayan protein yapısında bir maddedir. Dokuda amiloid birikimi, parenkimal hücrelerin atrofisine, dokunun mekanik fonksiyonlarının bozulmasına ve vazokonstrüktör mekanizmasının hasar görmesine bağlı olarak hemorajiye neden olabilir [1]. Amiloidozis;
OBJECTIVE: Asthma is known as a chronic infl ammatory lung disease which has also systemic featur... more OBJECTIVE: Asthma is known as a chronic infl ammatory lung disease which has also systemic features. Insulin-like growth factor I (IGF-I) plays a role for asthma pathogenesis. Controversially, IGF-binding protein 3 (IGFBP3) blocks asthma development. That is why IGF-I and IGFBP3 are targeted for future therapeutic treatments of asthma. We aimed to investigate serum level of IGF-I and IGFBP3 in patients with asthma. This study was performed in 27 asthma and 23 healthy individuals. Serum levels of IGF-I and IGFBP3 were measured by human ELISA assay kits. Serum levels of IGF-I and IGFBP3 were signifi canlty higher in the asthma group than the control group. Signifi cant negative correlation was found between IGF-I and asthma control test (ACT) puan, O 2 saturation, Forced Expiratory Volume in 1 second/ Forced Vital Capacity (FEV1/FVC), Forced Expiratory Flow 25 second/75 second (FEF2575) (%). Signifi cant positive correlation was found between IGFBP3 and IGF-I, systolic blood pressure. Signifi cant negative correlation was found between IGF-I and FEV1 (ml). RESULTS: Our results indicate that the serum levels of IGF-I and IGFBP3 are signifi canlty elevated in the asthma group. We assume that current treatment strategies are not really good enough for asthma. We suppose further strategies which are seeking to balance IGF-I and IGFBP3 should be developed for more effective and curative treatment of asthma (Tab. 2, Fig. 2, Ref. 22).
Inflammatory myofibroblastic tumors (IMTs) are rare childhood neoplasms, with benign clinical cou... more Inflammatory myofibroblastic tumors (IMTs) are rare childhood neoplasms, with benign clinical course. Although etiology of IMTs are not clear, recent studies have reported that IMT is a true neoplasm rather than a reactive or inflammatory lesion. IMTs are rarely seen in adults and tracheal involvement is also rare both in adults and also in children. We describe a 16-year old female patient who was misdiagnosed and treated as asthma in another center for a few months and presented with acute respiratory distress due to upper airway obstruction. Computerized tomography (CT) of the chest and rigid bronchoscopy revealed a mass lesion that was nearly totally obliterating tracheal lumen. Bronchoscopic resection was performed under general anesthesia and the final pathological diagnosis was tracheal IMT.
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