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    A Case of Tracheobronchopathia Osteochondroplastica Mimicing Endobronchial Mass
    (Aves, 2010) Ermis, Hilal; Sen, Nazan; Erbay, Gurcon; Canpolat, Emine Tuba
    Tracheobrcmchopathia ostecwhondroplastica (TO) is a rare benign disorder with unknown aetiology. The condition is diaracteri/ed by submuck)sal nodulcs progressing slk)wly. TO usually has been repotted in literature as sporadic CaSCS. Although endobronchial lesikms considered as malignancy especially in the presence of smoking history, rarely it may be a benign condition. In this kind of situations bonchoscopic inspection comes into prominence. Seventy-one year -old man who is asymptomatic and heavy smoker, was admitted to our clinic because of the suspicious endobronchial lesion determined on the thorax computed tomography which was performed incidentally. The diagnosis of TO is confirmed histopathologically accompanied by radiologic and bronchoscopic findings.
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    Pulmonary Embolism in Young and Elderly Patients: Clinical Characteristics, Laboratory and Instrumental Findings and Differences Between Age Groups
    (Bilimsel Tip Publishing House, 2010) Sen, Nazan; Ermis, Hilal; Altinkaya, Naime; Ermis, Necip; Karatasli, Meltem; Ulubay, Gaye
    Objective: The mortality and incidence of pulmonary thromboembolism (PE) increases with advancing age. Despite the diagnostic developments in recent years, the disease is still difficult to diagnose especially in elderly people. The aim of this study was to compare the clinical presentation of PE in young and elderly patients, examine the parameters determining the risk and prognosis and finally contribute to a decrease in mortality. Material and Method: This study comprised 141 patients diagnosed as PE. The patients were divided into two groups, < 65 years (young group) and 65 years (elderly group). The clinical, laboratory and instrumental findings of the patients were evaluated retrospectively. Results: The most common risk factors in both groups were immobility and recent surgery. Chest pain and hemoptysis were less frequent in the elderly group, while tachycardia was more common in this group of patients (p<0.001, p=0.013 and p=0.047, respectively). Patients with massive PE had a higher value of D-Dimer and electrocardiography (ECG) score compared to patients with non-massive PE (p=0.01, p<0.001, respectively). D-Dimer and cardiac troponin levels and ECG score were higher in patients who died in the hospital when compared to the individuals who survived (p=0.02, p=0.018, p=0.008, respectively). Conclusion: Since PE may present with atypical clinical findings in the elderly, a high level of clinical suspicion is required for the diagnosis. Use of the parameters which can determine the severity, risk and prognosis of the disease at an early stage may enable the initiation of appropriate treatment in the early phases of the disease, thereby decreasing the mortality.
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    QT dispersion in patients with pulmonary embolism
    (Springer Wien, 2010) Ermis, Necip; Ermis, Hilal; Sen, Nazan; Kepez, Alper; Cuglan, Bilal
    Background: Various ECG patterns have been associated with acute pulmonary embolism. However, there is no data regarding the association between QT interval measurements and pulmonary embolism. We aimed to investigate the association between QT dispersion and the severity of pulmonary embolism (PE). Methods: One hundred twenty-nine pulmonary embolism patients (mean age 58 +/- 16.5 years) with ECGs obtained within the first 24 hours of hospital admission were included in the study. Patients were classified into low, intermediate and high-risk groups. We retrospectively measured ECG scores; maximum and minimum corrected QT intervals (QTc(max) and QTc(min)) and corrected QT interval dispersion (QTcd) in each risk group of patients. Results: There was an increasing ECG score through from low to high-risk PE [3 (Interquartile Range, IQR: 2), 5 (IQR: 6) and 10 (IQR: 7) p < 0.0001]. QT interval analysis showed that QTcd was higher in high-risk group than in low and intermediate-risk groups (59.5 +/- 23.4, 69.2 +/- 21, 95.9 +/- 33.2, p < 0.001 and p = 0.01, respectively). Patients who died after diagnosis had significantly higher QTcd values at baseline compared with the QTcd values of surviving patients (89.1 +/- 45.5 to 65 +/- 22.9, p = 0.001). The sensitivity of QTcd > 71.5 ms for prediction of mortality was 71% with a specificity of 73% (p = 0.001). We observed a strong correlation between QTcd and ECG score values (r = 0.69, p< 0.001). There was also a correlation between QTcd values and pulmonary artery pressure (PAP) (r = 0.027, p = 0.001) Conclusion: QTcd is significantly increased in high-risk PE patients compared to intermediate and low-risk patients. In addition, QTcd is significantly correlated with ECG score and PAP.r = 0.27, p = 0.05).
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    The Relationship between COVID-19 Severity and Bacillus Calmette-Guerin (BCG)/ Mycobacterium tuberculosis exposure history in healthcare workers: a multi-center study
    (Taylor & Francis Ltd, 2021) Torun, Serife; Ozkaya, Sevket; Sen, Nazan; Kanat, Fikret; Karaman, Irem; Yosunkaya, Sebnem; Sengoren Dikis, Ozlem
    The COVID-19 pandemic has brought countries' health services into sharp focus. It was drawn to our group's attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine.