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Öğe Acute amiodarone toxicity causing respiratory failure(Assoc Medica Brasileira, 2017) Kaya, Saltuk Bugra; Deger, Seyda; Hacievliyagil, Suleyman Savas; Aytemur, Zeynep AyferA 66-year-old male patient was referred to our clinic with severe pneumonia. Bronchoscopy was performed due to clinical worsening despite antibiotics and diuretic therapy, respiratory failure and radiographic progression. Because bacterial cultures of the bronchoalveolar lavage fluid were negative and after using amiodarone for almost one month, we eliminated amiodarone from his medication regimen due to suspicion of amiodarone toxicity. Accordingly, we also initiated systemic steroid therapy. Chest X-ray done after 72 hours showed a significant resolution of lung consolidations and the patient exhibited significant clinical improvement, with decline of his oxygen requirements.Öğe Alterations in the pulmonary function tests of inflammatory bowel diseases(Aves, 2011) Ates, Fehmi; Karincaoglu, Melih; Hacievliyagil, Suleyman Savas; Yalniz, Mehmet; Seckin, YukselBackground/aims: We aimed to determine the changes in the pulmonary function tests of the patients with inflammatory bowel diseases. Methods: Forty inflammatory bowel dieases patients; 30 ulcerative colitis and 10 Crohn's disease, and age- and sex-matched control group, consisting of 30 healthy persons, were included in the study. Disease activity in patients with ulcerative colitis was assessed by Truelove and Witts Criteria and in Crohn's disease patients by Chron's Disease Activity Index. Results: Pulmonary function tests were found abnormal at least in. one parameter in, 17 / 30 ulcerative colitis patients (56%) and in 5/10 Crohn's disease patients (50%) in the activation period and in 5/30 ulcerative colitis patients (17%) and in 2/10 Crohn's disease patients (20%) in the remission period of the diseases of the same patients. Forced vital capacity, first second, residual volume 1 total lung capacity, diffusing capacity of the lung for carbon monoxide and diffusing capacity of the lung for carbon monoxide per liter alveolar volume values were found significantly impaired in the activation period in comparison with the values of the same patients in the remission period (p<0.01). It was found that pulmonary function test values in patients with inflammatory bowel dieases were not affected by either the type of disease or treatment with 5-aminosalicylic acid. However, they were affected notably by the disease activity. Conclusion: Pulmonary function test abormalities were found frequently in patients with inflammatory bowel dieases without presence of any respiratory symptoms and lung radiograph findings. The severity and frequency of these pulmonary function test abnormalities which were detected even in the remission periods increase with the activation of the disease. Therefore, pulmonary function test may be used as a non-invasive diagnostic procedure in determining the activation of inflammatory bowel dieases and might aid to the early diagnosis of the latent respiratoryÖğe Attitude of Employees in the Institution of Malatya Provincial Tobacco Control Committee Towards Content and Being in Force of the 4207 of Law(Bilimsel Tip Publishing House, 2012) Tulucu, Fadime; Aytemur, Zeynep Ayfer; Hacievliyagil, Suleyman Savas; Gunes, GulsenObjective: The current success of the implementation of the tobacco act is closely related to the perspective, knowledge and level of awareness of enforcing agencies. The aim our study was to identify the levels of awareness and responsibility regarding the tobacco law of employees of public institution members of Malatya Provincial Tobacco Control Committee (PTCC). Materials and Methods: A questionnaire was carried out with 305 employees of public institution members of PTCC. In the questionnaire, the demographic data, smoking characteristics, attitudes to smoking after changing the law and their opinions about the functioning of the law were obtained and they were asked how they had learnt about the law and their thoughts on individual and corporate responsibility. Results: The mean age was 35.9 +/- 8.9 years. 73.1% males, 92.1% high school and 58.4% were university. smokers. The rate of smoking in the Tuberculosis Dispensary was higher than in other institutions (75%). The greatest decrease in the smoking rate after the law was seen in Police Department (51%). 77% of the cases were informed through the media about the law, while 6% of them learned through the authority of the institution, 81.3% of the cases supported the law. 30% know that cigarettes can be smoked at their institution and 22.3% continue the cigarette selling despite banning. A quarter of employees do not feel responsibility regarding the law. Conclusion: In public institution members of PTCC, the law is not sufficiently functional. The levels of awareness and responsibility regarding the tobacco law of employees of public institution members of NTCC were insufficient.Öğe A case report: Pulmonary involvement in rheumatoid arthritis(Inonu University Faculty of Medicine, Department of Chest Diseases, Malatya, Turkey, 2017) Kaya, Saltuk Bugra; Keles, Emir Omer; Otlu, Ceren; Hacievliyagil, Suleyman Savas; Aytemur, Zeynep Ayfer[Abstract Not Acailable]Öğe A Case Report: Pulmonary Involvement In Rheumatoid Arthritis(2017) Kaya, Saltuk Bugra; Keles, Emir Omer; Otlu, Ceren; Hacievliyagil, Suleyman Savas; Aytemur, Zeynep Ayfer57 years old male patient, due to the increase in 15 years follow-up of RA patients under cyclosporine therapy because of complaints by the rheumatology clinic patients considered as appropriate to launch abatement was directed to us by the patient isoniazid prophylaxis. A pleural effusion was diagnosed on chest X-ray. The patient was accompanied by thoracentesis on USG. The pleural effusions were exudative. Tracking of fever, cough, sputum complaint and low acute phase reactants excluded empyema. ADA levels were under 70, and TB pleurisy was excluded by the lack of growth in ARB and culture results. The lung involvement of RA was suspected without interstitial lung disease. Rheumatoid arthritis with interstitial lung disease is the commonest form of lung involvement; the incidence of pleural effusion and nodular lesions in the form is less common. Although pleural effusion has been reported before it was thought be caused by the new biological agents for treatment of rheumatoid arthritis.Öğe Clinical Use of Chest Expansion Corrected for Age and Sex in Patients with Ankylosing Spondylitis(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2011) Durmus, Bekir; Altay, Zuhal; Baysal, Ozlem; Ersoy, Yuksel; Hacievliyagil, Suleyman Savas; Baysal, Tamer; Aytemur, Zeynep AyferObjective: The aim of this study was to investigate if the chest expansion corrected by age and sex was appropriate for clinical practice or not and to evaluate the relation of chest expansion with pulmonary functions and disease severity in patients with ankylosing spondylitis (AS). Metarials and Methods: Eighty-two patients with AS and 42 healthy controls were included in the study. The patients were divided into two groups according to chest expansion corrected by age and sex: restricted and non-restricted groups. Additional to the clinical evaluation, the Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), and Bath AS Metrology Index (BASMI) were used to evaluate disease activity functional impairment, and mobility respectively. Results: Forced vital capacity and forced expiratory volume in the first second were significantly decreased in the restricted group when compared to the non-restricted and control groups. Pain, BASFI, and BASMI scores were significantly higher in the restricted group compared to the non-restricted one. Chest expansion was significantly correlated with clinical parameters and pulmonary function tests. Conclusion: Chest expansion measurement corrected for age and sex is appropriate for clinical practice and chest expansion is associated with pulmonary functions and disease severity. Turk J Phys Med Rehab 2011;57:128-33.Öğe Effects of Recombinant Activated Protein C Derived From Drotrecogin-Alpha on Bleomycin-Induced Pulmonary Fibrosis in Rats Compared with Methyl-Prednisolone(Bilimsel Tip Publishing House, 2013) Yildiz, Kadir; Iraz, Mustafa; Samdanci, Emine; Ozerol, Elif; Kuku, Irfan; Aytemur, Zeynep Ayfer; Hacievliyagil, Suleyman SavasOBJECTIVE: In this study, we aimed to test the preventive effects of intraperitoneally administered drotrecogin alpha which is derived from activated protein C (APC), on bleomycin-induced pulmonary fibrosis in rats, and to compare the effects of APC with the effects of methyl-prednisolone, a traditional therapy. MATERIAL AND METHODS: Thirty male Wistar albino rats were randomly allocated into four groups: 1. Saline alone (n= 6); 2. Bleomycin+ placebo (n= 7); 3. Bleomycin+ methyl-prednisolone (n= 7); 4. Bleomycin+ APC (n= 10). The rats (except for the control group) were given intratracheal bleomycin (2.5 mg/kg). The bleomycin+ APC group was given APC (100 mu g/kg/day) and methyl-prednisolone treated rats were injected with 5mg/kg/day methyl-prednisolone intraperitoneally two days before the bleomycin injection; the drug was administered at the same dose for 16 days. All of the rats were killed 14 days after the intratracheal injection of bleomycin. Fibrotic changes in the lungs were demonstrated by analysing the cellular composition of bronchoalveolar lavage fluid, histological evaluation and lung hydroxyproline content. RESULTS: Fibrosis was experimentally induced in the lungs of rats using bleomycin. Fibrosis scores in the bleomycin+ methyl-prednisolone and the bleomycin+ APC groups were significantly lower than in the bleomycin+ placebo group (p< 0.05). The scores of the bleomycin+ APC group and the bleomycin+ methyl-prednisolone group were similar. The lung tissue hydroxyproline contents in the bleomycin+ placebo and bleomycin+ methyl-prednisolone groups were significantly higher than the control group (p< 0.05), but the hydroxyproline content in the bleomycin+ APC group was significantly lower than in the other groups (p< 0.05). CONCLUSION: Drotrecogin alpha that is derived from recombinant APC has a protective effect on the pulmonary fibrosis induced by bleomycin. The protective effect seen with methylprednisolone is similar.Öğe Excess Deaths in Malatya in the COVID-19 Pandemic(Aves, 2021) Aytemur, Zeynep Ayfer; Yalcinsoy, Murat; Arslan, Ahmet Kadir; Hacievliyagil, Suleyman SavasOBJECTIVE: In our study, the effects of the COVID-19 pandemic in Malatya province, other than confirmed case deaths, were investigated. MATERIAL AND METHODS: The records of those who died between 2016 and 2020 were reviewed on the official website of the Malatya Metropolitan Municipality, and the numbers of deaths in those 5 years were recorded on a weekly basis. The arithmetic mean of the deaths between 2016 and 2019 was calculated, and it was investigated whether the number of deaths in 2020 was more than expected. RESULTS: In 2020, 1743 (61%) excess deaths were detected. While the mean number of deaths reported 4 years before 2020 was 2860, it was determined that the number of deaths in 2020 was 4603, and there were 1743 (61%) excess deaths. CONCLUSION: The deaths occurred in Malatya during the COVID-19 pandemic were more than expected. It has been supposed that some deaths were of polymerase chain reaction negative and hence unrecorded COVID-19 patients' deaths, and some deaths were caused by other indirect effects of the pandemic.Öğe Noninfectious causes of diffuse pulmonary infiltrations in chronic renal failure: metastatic pulmonary calsification(Via Medica, 2019) Kaya, Saltuk Bugra; Deger, Seyda; Hacievliyagil, Suleyman Savas; Aytemur, Zeynep AyferMetastatic pulmonary calsification (MPC) is a metabolic lung disease characterized by the deposition of calcium in pulmonary parenchyma. It may occur due to many bening or malign pathologies. Especially it is most commonly seen in patients with end stage chronic renal failure received renal replacement treatment. The case we report here involved a history of renal transplantation about 22 months ago. His thorax computed tomography had demonstrated bilateral disseminated infiltrations with ground-glass densities predominantly in the upper lobes and it was seen partially preserved subpleural areas and basal zones. The histopathological results in transbronchial lung biopsy indicated metastatic pulmonary calsification. We wanted to discuss patient with the accompaniment of literature.Öğe Prevalence of COPD: First epidemiological study of a large region in Turkey(Elsevier, 2008) Gunen, Hakan; Hacievliyagil, Suleyman Savas; Yetkin, Ozkan; Gulbas, Gazi; Mutlu, Levent Cem; Pehlivan, ErkanBackground: Although chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality and morbidity worldwide, epidemiological data oil COPD is very limited. This study was designed to obtain some baseline data on COPD in the Malatya region of Turkey. Methods: Sixty clusters from urban and rural regions were randomly selected. Ten and seven consecutive households were included in the study from each urban and rural cluster, respectively. A validated questionnaire on the epidemiology of COPD was completed for each participant over 18 by a Pulmonary physician. Each subject underwent standard spirometric measurement and early bronchodilation testing. Results: A total of 1160 participants completed the study (93%). Some 6.9% of the participants were found to have COPD (F/M = 1/4). While the prevalence of COPD was 18.1 % in current smokers over 40 years of age, the prevalence was 4.5% among younger smokers. Some 25.5% of the women and 57.2% of the men were current smokers. Biomass exposure, as a sole reason for COPD, was significantly common among female patients living in rural areas (54.5%). In the development of COPD, the relative risk ratio of cigarette smoke was found to be 3.4 and 3.3 times higher than biomass exposure and occupational exposure, respectively. Conclusions: Smoking rate and COPD prevalence were found to be unexpectedly high in the region, and biomass exposure is still an important cause of COPD, particularly among females living in rural areas. We think that national policies against smoking and biomass exposure should be implemented immediately. (C) 2009 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.Öğe Prognostic role of simplified Pulmonary Embolism Severity Index and the European Society of Cardiology Prognostic Model in short- and long-term risk stratification in pulmonary embolism(Professional Medical Publications, 2014) Kilic, Talat; Gunen, Hakan; Gulbas, Gazi; Hacievliyagil, Suleyman Savas; Ozer, AliObjectives: Hemodynamic status, cardiac enzymes, and imaging-based risk stratification are frequently used to evaluate a pulmonary embolism (PE). This study investigated the prognostic role of a simplified Pulmonary Embolism Severity Index (sPESI) score and the European Society of Cardiology (ESC) model. Methods: The study included 50 patients from the emergency and pulmonology department of,one medical center between October 2005 and June 2006. The ability of the sPESI and ESC model to predict short-term (in-hospital) and long-term (6-month and 6-year) overall mortality was assessed, in addition to the accurancy of the sPESI and ESC model in predicting short-term adverse events, such as cardiopulmonary resuscitation, or major bleeding. Results: Of the 50 patients, the in-hospital and 6-year mortality rates were 14% and 46%, respectively. Fifteen (30%) of these experienced adverse events during hospitalization. Importantly, patients classified as low-risk according to the sPESI had no short-term adverse events as opposed to 4.8 % in the ESC low-risk group. They also had no in-hospital, 6-month, or 6-year mortality compared to 4.8%, %14.3, and %23.8, respectively, in the ESC low-risk group. Conclusions: The sPESI predicted short-term and long-term survival. The exclusion of short-term adverse events does not appear to require imaging and laboratory testing.Öğe The relationship between severity of liver cirrhosis and pulmonary function tests(Springer, 2008) Yigit, Irem Pembegul; Hacievliyagil, Suleyman Savas; Seckin, Yuksel; Oner, Ramazan Ilyas; Karincaoglu, MelihPulmonary complications, mainly hepatopulmonary syndrome (HPS), are frequently observed in liver cirrhosis. In this study, the aim was to investigate the frequency of hypoxemia and impairment of pulmonary function tests (PFT) in patients with liver cirrhosis and to examine the relationships of these impairments with liver failure. A total of 39 patients with cirrhosis, 24 males and 15 females, were included in our study. The mean age of the patients was 47.5 +/- 17.2 years. Arterial blood gases, PFT, and carbon monoxide diffusion tests (DLCO) were performed in all patients. Out of 39 cirrhotic patients, 21 (53.8%) had ascites, whereas 18 (46.2%) did not. Seven patients were in the Child-Pugh A group, 21 in the Child-Pugh B group, and 11 patients were in the Child-Pugh C group. Hypoxia was found in 33.3% of the patients. Although the PaO2 and SaO(2) values of patients with ascites were lower compared to those without ascites (P < 0.05), no statistically significant difference was determined in the comparison of hypoxia between the groups (P > 0.05). Among the PFT parameters, FEV1/FVC and FEF25-75% values were found to be lower in patients with ascites than those without (P < 0.05). No differences were established between these two groups of patients in terms of DLCO (P > 0.05). While no differences were found in comparison of the DLCO values in between the groups (P > 0.05), there was a statistically significant difference in the ratio of DLCO to the alveolar ventilation (DLCO/VA) in between the groups (P < 0.05). On the other hand, a negative correlation was found between the DLCO/VA and Child points when the relationship between the Child-Pugh score and PFT parameters were investigated (r = -0.371, P < 0.05). Consequently, a relationship was established between the severity of liver failure and diffusion tests showing pulmonary complications invasively. We believe diffusions tests should be performed in addition to the PFT in order to determine pulmonary involvements particularly in patients who are candidates for liver transplantation.Öğe Relationship between vitamin D and lung function, physical performance and balance on patients with stage I-III chronic obstructive pulmonary disease(Assoc Medica Brasileira, 2015) Yumrutepe, Tuncay; Aytemur, Zeynep Ayfer; Baysal, Ozlem; Taskapan, Hulya; Taskapan, Cagatay M.; Hacievliyagil, Suleyman SavasObjectives: vitamin D is important for muscle function and it affects different aspects of muscle metabolism. This study aim to determine whether serum 25(OH) D levels are related to lung functions, physical performance and balance in patients with chronic obstructive pulmonary disease (COPD). Methods: in 90 patients with COPD and 57 healthy controls lung function tests, physical performance tests (time up and go, gait velocity test, sit-to-stand test, isometric strength, isokinetic strength), static (functional reach test) and dynamic (time up and go) balance tests and the association of 25(OH)D levels with lung functions, physical performance and balance were evaluated. Results: the COPD patients had significantly more deficit in physical function and balance parameters, and in dynamic balance test (p<0.005). Isokinetic knee muscle strength (flexor and extensor) in COPD patients was significantly lower than in the controls (p<0.05); FEV1 (p=0.008), FVC (p=0.02), FEV1/FVC (p=0.04), TLC (p=0.01) were lower in COPD patients with vitamin D deficiency [25(OH) D less than 15ng/mL] than in COPD patients without vitamin D deficiency. Hand grip test (p=0.000) and isokinetic knee muscle strength (flexor and extensor) (p<0.05) were also lower in COPD patients with vitamin D deficiency. Vitamin D deficiency was more pronounced in patients with stage III COPD (p<0.05). Conclusion: patients with COPD had worst physical functioning, poor balance and less muscle strength. Severe disturbed lung and peripheral muscle functions are more pronounced in COPD patients with vitamin D deficiency.Öğe Septic pulmonary embolism secondary to dental focus(Quintessence Publishing Co Inc, 2008) Serefhanoglu, Kivanc; Bayindir, Yasar; Ersoy, Yasemin; Isik, Kubilay; Hacievliyagil, Suleyman Savas; Serefhanoglu, SongulA 24-year-old female was admitted to an infectious diseases unit with complaints of dyspnea and fever. She had suffered from multiple episodes of fever for 1 year. The diagnostic workup revealed multiple pulmonary nodules on the chest CT scan, suggesting septic pulmonary embolism, and a periapical abscess around the maxillary right central incisor. Because no other infectious source was found and resolution of the fever and the pulmonary lesions occurred only after extraction of the affected tooth and antibiotic therapy, the condition was diagnosed as a periapical abscess complicated by septic pulmonary embolism. (Quintessence Int 2008:39:753-756)
