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Öğe Adequate use of pulmonary embolism clinical prediction rule in COPD patients(European Respiratory Soc Journals Ltd, 2011) Gunen, H.; Gulbas, G.; In, E.; Yetkin, O.; Hacievliyagil, S. S.[Abstract Not Available]Öğe Airway inflammatory markers in chronic obstructive pulmonary disease patients and healthy smokers(Medknow Publications & Media Pvt Ltd, 2013) Hacievliyagil, S. S.; Mutlu, L. C.; Temel, I.Background: Cigarette smoke with its toxic ingredients leads to chronic inflammations in the airways. Objectives: In this study, the effect of cigarette smoke on the levels of inflammatory markers, interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-) in induced sputum was investigated. Materials and Methods: Twenty patients with chronic obstructive pulmonary disease (COPD) (group I), 20 healthy smokers (group II), and 20 healthy nonsmokers (group III) were included in the study. The levels of IL-6, IL-8, and TNF- in induced sputum were measured in these groups, and comparison analysis between the groups and correlation analysis for smoking load (pack-years) and spirometric parameters were performed. Results: Mean age of the patients in groups I, II, and III were 61.2 1.7, 58.2 1.6, and 59.1 5.4 years, respectively (P > 0.05). Smoking loads of group I and group II were 38.6 2.1 and 29.5 2.3 pack-years, respectively (P < 0.05). All cytokine levels were significantly higher in group I than groups II and III (P < 0.05). In addition to this, mean cytokines levels were significantly higher in group II than group III (P < 0.05). Smoking load of group II subjects was positively correlated with IL-6, IL-8, and TNF- in induced sputum (P < 0.05). Conclusions: We found that inflammatory marker levels in induced sputum were significantly higher in COPD patients and smokers than nonsmokers. Moreover, there was a moderate positive correlation between IL-6, IL-8, and TNF- levels and smoking load in the healthy smokers. We think that further studies are needed to determine whether higher levels of cytokine levels in sputum might be helpful in predicting the healthy smokers who will develop COPD in future.Öğe Assessment of B-type natriuretic peptide in patients with pneumonia(Wiley, 2008) Yetkin, O.; Hacievliyagil, S. S.; Gunen, H.The mammalian heart synthesises and secretes B-type natriuretic peptide (BNP), which has potent diuretic, natriuretic and vascular smooth muscle-relaxing effects as well as complex interactions with the hormonal and nervous systems. Recent studies described that BNP was acute phase reactant. In this study, we aimed to evaluate BNP levels in patients with pneumonia. Twenty-one patients with pneumonia and 21 healthy control subjects were enrolled in this study. Their serum levels of BNP were measured in addition to the standard evaluations. Leucocyte count [19.3 (13.2-25.7) 10(6)/Ml VS. 9.55 (3.7-13.9) 106/Ml, p < 0.0011, erythrocyte sedimentation rate [73 (57-81) mm/h vs. 35 (4-55) mm/h, p < 0.001], C-reactive protein (CRP) [127.72 (27-290) mg/l vs. 13.19 (3-41) mg/l, p < 0.0011 and BNP [53.1 (17-91) pg/ml vs. 16.24 (1-38) pg/ml, p < 0.0011 levels significantly decreased after treatment period. Initial BNP levels were significantly higher than control groups (53.10 +/- 15.07 pg/ml vs. 18.62 +/- 14.05 pg/ml, p < 0.001) and decreased after treatment to the levels comparable with control subjects. BNP levels correlated with CRP levels at admission (r = 0.716, p < 0.001). We have shown that BNP levels show a transient increase in patients with pneumonia and correlate well with CRP.Öğe Venous thromboemboli and exacerbations of COPD(European Respiratory Soc Journals Ltd, 2010) Gunen, H.; Gulbas, G.; In, E.; Yetkin, O.; Hacievliyagil, S. S.The aim of the present study was to determine the prevalence of and risk factors for venous thromboembolism (VTE) in exacerbations of chronic obstructive pulmonary disease (COPD). COPD patients hospitalised with an exacerbation were included consecutively. Symptoms, signs and clinical, haematological and epidemiological parameters on admission were noted. All patients underwent computed tomographic angiography and ultrasonographic examination for deep vein thrombosis and pulmonary embolism (PE). Wells and Geneva scores were calculated. Patients were followed-up for 1 yr in order to determine mortality. Deep vein thrombosis and PE were detected in 14 and 18 patients, respectively. The prevalence of VTE was three times higher in patients with an exacerbation of unknown origin than in patients with an exacerbation of known origin (p=0.016). Of patients with VTE, 20 (95%) had high D-dimer levels. The negative predictive value of D-dimer testing was 0.98. Although the moderate-and high-risk categories of both the Wells and Geneva methods covered all PE patients, the Wells method identified 49% less potential patients for PE investigation. Mortality at 1 yr was higher (61.9% versus 31.8%) in VTE patients (p=0.013). VTE is a common problem in COPD patients hospitalised with an exacerbation, leading to high long-term mortality. D-dimer levels and the Wells criteria can be used to determine whether or not these patients are assessed for a thromboembolic event.
