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Öğe Acute interstitial pneumonia associated with vinorelbine usage(Kare Publ, 2023) Atila, Aysenur; Yalcinsoy, Murat; Aytemur, Zeynep Ayfer; Yetkin, FundaVinorelbine, an analogue of vinca alkaloids, has an antineoplastic effect. Adverse effects related to vinca alkaloids are rare. A 57-year-old patient who presented to the emergency room with dyspnea and back pain was hospitalized with the diagnosis of overload related to cardiac decompensation and complicated urinary tract infection due to its acute clinical and radiological findings. While under treatment, his respiratory failure progressed. Considering his history of vinorelbine usage 2 weeks prior, it was thought to be interstitial pneumonia. High-flow oxygen treatment and 250 mg/day pulse methylprednisolone for 3 days was started; after the fourth day, methylprednisolone was reduced and continued at 1 mg/kg/day. His oxygen need decreased on the seventh day of the treatment, and the findings on the chest X-ray regressed almost completely. However, the patient died due to acute gastrointestinal bleeding.Öğe Applicability of the ROX index in decision-making for hospitalization in COVID-19 patients(Bayrakol Medical Publisher, 2022) Kasapoglu, Umut Sabri; Selcuk, Engin Burak; Yalcinsoy, Murat; Uckac, Kadir; Sahin, Abdullah Fahri; Bentli, RecepAim: Data on the outpatient follow-up of COVID-19 cases is still scarce. Also, the significance of the ROX index in decision-making for hospitalization in the ambulatory COVID-19 cases remains unknown. The aim of this study is to determine the general characteristics of COVID-19 patients treated as outpatients and to investigate whether the ROX index is applicable in hospitalization decisions.Material and Methods: This retrospective cohort study was conducted in confirmed adult COVID-19 cases between 15 October 2020 and 01 March 2021. A total of 5240 confirmed COVID-19 patients were included in the present study. Factors affecting hospitalization were investigated.Results: The study population was divided into two groups as those who require hospitalization (n=672) and those who did not (n=4568). The number of male patients and the mean age of the patients were significantly higher in hospitalized patients group (p=0.046, p<0.001). ROX index that was calculated at the home visit on the third day of disease was found significantly lower in the group of hospitalized patients (p<0.001). There was a significant correlation between ROX index and inflammatory biomarkers in the present study (p<0.001). The ROX index was found the most accurate parameter for decision-making for hospitalization in ambulatory COVID-19 patients (AUC=0.794 CI=0.773-0.814, p<0.001).Discussion: The ROX index can be a useful and objective clinical tool for decision making for hospitalization in the ambulatory COVID-19 cases.Öğe Can patients with moderate to severe acute respiratory failure from COPD be treated safely with noninvasive mechanical ventilation on the ward?(Dove Medical Press Ltd, 2016) Yalcinsoy, Murat; Salturk, Cuneyt; Oztas, Selahattin; Gungor, Sinem; Ozmen, Ipek; Kabadayi, Feyyaz; Oztim, Aysem AskimPurpose: Noninvasive mechanical ventilation (NIMV) usage outside of intensive care unit is not recommended in patients with COPD for severe acute respiratory failure (ARF). We assessed the factors associated with failure of NIMV in patients with ARF and severe acidosis admitted to the emergency department and followed on respiratory ward. Patients and methods: This is a retrospective observational cohort study conducted in a tertiary teaching hospital specialized in chest diseases and thoracic surgery between June 1, 2013 and May 31, 2014. COPD patients who were admitted to our emergency department due to ARF were included. Patients were grouped according to the severity of acidosis into two groups: group 1 (pH= 7.20-7.25) and group 2 (pH= 7.26-7.30). Results: Group 1 included 59 patients (mean age: 70 +/- 10 years, 30.5% female) and group 2 included 171 patients (mean age: 67 +/- 11 years, 28.7% female). On multivariable analysis, partial arterial oxygen pressure to the inspired fractionated oxygen (PaO2/FiO(2)) ratio <200, delta pH value <0.30, and pH value <7.31 on control arterial blood gas after NIMV in the emergency room and peak C-reactive protein were found to be the risk factors for NIMV failure in COPD patients with ARF in the ward. Conclusion: NIMV is effective not only in mild respiratory failure but also with severe forms of COPD patients presenting with severe exacerbation. The determination of the failure criteria of NIMV and the expertise of the team is critical for treatment success.Öğe Can red blood cell distribution width (RDW) level predict the severity of acute exacerbation of chronic obstructive pulmonary disease (AECOPD)?(Wiley-Hindawi, 2021) Alparslan Bekir, Sumeyye; Tuncay, Eylem; Gungor, Sinem; Yalcinsoy, Murat; Sogukpinar, Ozlem; Gundogus, Baran; Aksoy, EmineBackground Elevated red blood cell distribution width (RDW) levels were associated with mortality in patients with stable chronic obstructive lung pulmonary diseases (COPD). There are limited data about RDW levels in acute exacerbation of COPD (AECOPD). Aim/Objective The association of the RDW levels with the severity of AECOPD was evaluated according to admission location, (outpatient-clinic, ward and intensive care unit (ICU)). Methods Cross sectional retrospective study was designed in tertiary care hospital for chest diseases in 2015. Previously COPD diagnosed patients admitted to hospital outpatient-clinic, ward and ICU due to AECOPD were included in the study. Patients demographics, RDW, biomarkers (CRP, RDW, Neutrophil to lymphocyte ratio (NLR), platelet to mean platelet volume (PLT-MPV)) C-CRP, biochemistry values were recorded from hospital electronic system. RDW values were subdivided below 0.11% (low), above and equal 0.15% (high) and between 0.11%-0.15% (normal). Neutrophil to lymphocyte ratio (NLR) and platelet to mean platelet volume (PLT-MPV) were also calculated. Biomarker values were compared according to where AECOPD was treated. Results 2771 COPD patients (33% female) and 1429 outpatients-clinic, 1156 ward and 186 ICU were enrolled in the study. The median RDW values in outpatients-clinic, ward and ICU were 0.16 (0.09-0.26), 0.07 (0.01-0.14) and 0.01 (0.00-0.07) respectively (P < .001). In outpatient to ward and ICU, low RDW values were significantly increased (31%, 66%, 83%, respectively) and high RDW values significantly decreased (54%, 24%, 10%) (P < .001). According to attack severity, low RDW values were determined. Conclusion Patients with AECOPD, lower RDW values should be considered carefully. Lower RDW can be used for decision of COPD exacerbation severity and follow up treatment responseÖğe Clinical Characteristics and Outcomes of Liver Transplantation Recipients With COVID-19 Pneumonia(Elsevier Science Inc, 2021) Kose, Adem; Toplu, Sibel Altunisik; Yalcinsoy, Murat; Yakupogullari, Yusuf; Otlu, Baris; Otan, Emrah; Aydin, CemalettinBackground. We aimed to evaluate the clinical characteristics and outcomes of mild-severe COVID-19 pneumonia cases in liver transplant (LT) recipients. Methods. Ten LT recipients diagnosed as having COVID-19 pneumonia in a 6-month period in our transplantation center were included. Demographic and medical data of the recipients were retrospectively collected; clinical courses, treatment responses, and outcomes were evaluated. Results. Ten LT recipients were male, had a median age of 57 years (min-max, 36-69 years; interquartile range [IQR], 13 years), and had right lobe from living donor LT performed in a median of 11 months (min-max, 1-72 months; IQR, 12 months). Five patients had severe pneumonia, and the remaining patients had mild/moderate pneumonia. The most frequent symptoms were fever (90%) and cough (70%). Favipiravir, enoxaparin sodium, and corticosteroid were initiated at the time of the diagnosis; immunosuppressive drug doses were reduced or discontinued in 3 cases. Lymphopenia median: 510/mL (min-max, 90-1400 mL; IQR, 610 mL), increased levels of C-reactive protein median: 4.72 (min-max, 0.31-23.4; IQR, 8.5), and ferritin median: 641 (min-max, 40 to >= 1650; IQR, 1108) were frequent. Four patients required antibacterial treatments because of emerging bacterial pneumonia and/or sepsis. All patients were hospitalized for a median of 10 days. One patient with sepsis died on the 26th day after intensive care unit admission, and the remaining 9 survived. No further complication was recorded for 1-month follow-up. Conclusions. Commencing favipiravir, enoxaparin sodium, and corticosteroid treatments; close follow-up of the developing complications; the temporary reduction or cessation of immunosuppression; a multidisciplinary approach; early awareness of the bacterial infections; and the initiation appropriate antibiotic treatments can contribute to success.Öğe Clinical features and prognostic factors affecting survival of ambulatory followed COVID-19 patients aged over 65 years(Bayrakol Medical Publisher, 2022) Yalcinsoy, Murat; Selcuk, Engin Burak; Uckac, Kadir; Sahin, Abdullah Fahri; Tas, Ayse; Kasapoglu, Umut; Bentli, RecepAim: The majority of the patients with COVID-19 are followed ambulatory. Determination of prognostic factors of mortality in risky groups is essential to improve patient management. The aim of this study is to describe the clinical presentation in patients over 65 years of age with COVID-19 who are followed up at home by a physician and provide insights into the initial prognostic factors in this distinctive population. Material and Methods: This is a retrospective and observational study. Clinical records of the patients aged over 65 years who were visited by the filiation team, including a physician at home, due to the diagnosis of COVID-19 disease within 2 months were reviewed. Factors affecting mortality were examined. Results: Our study included 51 deceased (mean age: 75,1 +/- 9,0 years, 40,2% males), and 102 patients with COVID-19 who survived (mean age: 73,0 +/- 6,9 years, 68,6% male). Platelet count ( < 150.000, OR 7,26, p=0,001), CRP level ( < 4, OR 4,55, p=0,02), albumin level ( OR 3,24, p=0,02), and Troponin I level (OR 0,03, p=0,02) were the strongest predictors for death. When propensity score matching was applied, gender (male, OR 7,14, p=0,02) and platelet count (< 150.000, OR 5,34, p=0,02) were the strongest predictor Discussion: Elderly COVID-19 patients have a high mortality rate. An easily measurable and accessible platelet count may be a predictor of a bad outcome. Close follow-up and timely treatment may significantly reduce mortality in high- risk elderly patients under.Öğe A comparison of propofol-midazolam and midazolam alone for sedation in endobronchial ultrasound-guided transbronchial needle aspiration: a retrospective cohort study(Wiley, 2017) Oztas, Selahattin; Akturk, Ulku Aka; Alpay, Levent A.; Meydan, Burhan; Ogun, Hamza; Taylan, Mahsuk; Yalcinsoy, MuratObjectivesEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new, minimally invasive, bronchoscopic technique used in the evaluation of inthrathoracic lymph nodes.Use of sedation drugs before the procedure differs among centres. There is no standardization about sedation before EBUS-TBNA.We used a policy decision to shift from use of propofol with midazolam vs midazolam alone in a large tertiary hospital to evaluate the diagnostic yield and safety of EBUS-TBNA procedure. MethodsFiles of all the patients who were performed EBUS-TBNA between the dates of September 2010 and May 2014 were surveyed. All the EBUS-TBNA cases were performed under sedation of propofol and midazolam with an accompanying anesthesiologist in the beginning, however, sedation is applied with midazolam without an accompanying anesthesiologist after April 2013 due to changes in sedation policy. The diagnostic yield and complication rates were compared by chi-squared analysis between two groups. ResultsThe files of 340 EBUS-TBNA performed patients were evaluated. Of the patients 274 eligible patients were analysed. 152 patients who fulfilled the inclusion criteria were analysed in propofol-midazolam (P) sedated group and 122 patients were analysed in midazolam (M) group. There is no statistically significant difference between two different sedated groups in terms of age and gender. Diagnostic value was detected as 77.6% in P group and 85.7% in M group and the difference was not statistically significant. No difference between complication rates of both groups was observed. ConclusionBoth sedation-types for performing EBUS-TBNA showed similar diagnostic value and complication rates in our study. Propofol with midazolam application requires with an accompanying anaesthesiologist, therefore, it increases cost. EBUS-TBNA procedures had been performed in safe with no decrease in diagnostic yield under moderate sedation.Öğe A comparison of propofol-midazolam and midazolam alone for sedation in endobronchialultrasound-guided transbronchial needle aspiration: a retrospective cohort study(Wıley, 111 rıver st, hoboken 07030-5774, nj usa, 2017) Yalcinsoy, Murat; Calisir, Haluk C.ObjectivesEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new, minimally invasive, bronchoscopic technique used in the evaluation of inthrathoracic lymph nodes.Use of sedation drugs before the procedure differs among centres. There is no standardization about sedation before EBUS-TBNA.We used a policy decision to shift from use of propofol with midazolam vs midazolam alone in a large tertiary hospital to evaluate the diagnostic yield and safety of EBUS-TBNA procedure. MethodsFiles of all the patients who were performed EBUS-TBNA between the dates of September 2010 and May 2014 were surveyed. All the EBUS-TBNA cases were performed under sedation of propofol and midazolam with an accompanying anesthesiologist in the beginning, however, sedation is applied with midazolam without an accompanying anesthesiologist after April 2013 due to changes in sedation policy. The diagnostic yield and complication rates were compared by chi-squared analysis between two groups. ResultsThe files of 340 EBUS-TBNA performed patients were evaluated. Of the patients 274 eligible patients were analysed. 152 patients who fulfilled the inclusion criteria were analysed in propofol-midazolam (P) sedated group and 122 patients were analysed in midazolam (M) group. There is no statistically significant difference between two different sedated groups in terms of age and gender. Diagnostic value was detected as 77.6% in P group and 85.7% in M group and the difference was not statistically significant. No difference between complication rates of both groups was observed. ConclusionBoth sedation-types for performing EBUS-TBNA showed similar diagnostic value and complication rates in our study. Propofol with midazolam application requires with an accompanying anaesthesiologist, therefore, it increases cost. EBUS-TBNA procedures had been performed in safe with no decrease in diagnostic yield under moderate sedation.Öğe Contribution of aspiration to the diagnosis of lung cancer in endobronchial ultrasound-guided fine-needle biopsy(Assoc Medica Brasileira, 2021) Guven, Arzu Nakis; Yalcinsoy, Murat; Akatli, Ayse Nur; Arslan, Ahmet KadirOBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration has been successfully applied in both diagnosis and staging of mediastinal and hilar lymphadenopathies and masses, especially in malignant cases. However, the optimal procedure of Endobronchial ultrasound-guided transbronchial needle aspiration to further increase diagnostic yield and minimize processing complexity remains controversial. This study aims to compare aspiration biopsy (Endobronchial ultrasound-guided transbronchial needle aspiration) and non-aspiration biopsy (Endobronchial ultrasound-guided transbronchial needle capillary sampling) in terms of sample adequacy, diagnosis, and quality in malignant cases. METHODS: Between March 2018 and June 2020, Endobronchial ultrasound- guided was performed sequentially on patients with mediastinal and/or hilar lymph nodes that were considered malignant. Each lymphadenopathy was sampled with and without aspiration. A single-blinded pathologist evaluated the samples. RESULTS: A total of 84 lymph nodes evaluations of 51 patients were included. Most samples were taken from the right lower paratracheal lymph nodes ( n=27, 32.2%) and subcarinal LN (n=21, 25%). The mean size of the lymph nodes was 21.21 +/- 8.257 (8-40) mm. The agreement between the two procedures in terms of sample adequacy and diagnostic yield was 69.1% (95%CI 58-78.7, p=0.076). In addition, according to the goodness-of-fit statistics, the kappa values were 0.255 (p=0.015) and 0.302 (p=0.004) for sample adequacy and diagnostic yield, respectively. There was no difference between the two procedures in relation to complications. CONCLUSION: Although the agreement between the two procedures is weak, Endobronchial ultrasound-guided transbronchial needle capillary sampling can be performed with less personnel, without reducing diagnostic yield and tissue adequacy. These findings can assist clinicians in determining the optimal procedure for Endobronchial ultrasound-guided.Öğe Cytomegalovirus associated severe pneumonia in three liver transplant recipients(J Infection Developing Countries, 2020) Kose, Adem; Yalcinsoy, Murat; Samdanci, Emine Turkmen; Barut, Bora; Otlu, Baris; Yilmaz, Sezai; Bayindir, YasarIntroduction: Cytomegalovirus (CMV), is the most common opportunistic infection, remains a cause of life-threatening disease and allograft rejection in liver transplant (LT) recipients. The purpose of this case series is to state that CMV may lead to severe pneumonia along with other bacteria. Methodology: CMV pneumonia was diagnosed with the thoracic computed tomography (CT) scan findings, bronchoscopic biopsy, real time quantitative Polymerase Chain Reaction (qPCR) and clinical symptoms. For extraction of CMV DNA from the clinical sample, EZ1 Virus Mini Kit v2.0 (Qiagen, Germany) was used, and aplification was performed with CMV QS-RGQ Kit (Qiagen, Germany) on Rotor Gene Q 5 Plex HMR (Qiagen, Germany) device. Results: All recipients had severe pneumonia, leukopenia, thrombocytopenia and at least two-fold increase in transaminases on seventh, twenty-eighth and twenty-second days after surgery, respectively. Thoracic CT scan revealed as diffuse interstitial infiltration in the lung parenchyma. Bronchoscopy, Gram-staining and culture from bronchoalveolar lavage (BAL) fluid were performed in all of them. During bronchoscopy, a bronchial biopsy was administered to two recipients. One recipient could not be performed procedure because of deep thrombocytopenia. PCR results were positive from serum and BAL fluid. Bronchial biopsy was compatible with CMV pneumonia. However, Pseudomonas aeruginosae was found in two cases and Klebsiella pneumoniae in one case BAL fluid cultures. Conclusions: CMV pneumonia can be seen simultaneously with bacterial agents due to the indirect effects of the CMV. It should be kept in mind that CMV pneumonia may cause severe clinical courses and can be mortal.Öğe Delays in Diagnosis and Treatment in Patients Underwent Endobronchial Ultrasound-Transbronchial Needle Aspiration (EBUS-TBNA)(Wiley-Hindawi, 2022) Gulcek, Emine; Yalcinsoy, Murat; Gulcek, Ilham; Guven, Arzu Nakis; Ermis, Hilal; Aytemur, Zeynep AyferObjectives. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been recognized as the first method of choice in the diagnosis of mediastinal and hilar lesions. Although the procedure is commonly used, there is no study assessing its contribution to the duration required for diagnosis and treatment. In this study, we aimed to determine the extent of diagnosis and treatment delays when using the EBUS-TBNA procedure and to address the possible factors contributing to these delays. Materials and Methods. The demographic data, pathological diagnosis, need for additional procedures, symptoms, presenting complaints, and the time until the beginning of treatment were recorded retrospectively in all patients who had undergone EBUS-TBNA. Results. A total of 134 patients (mean age 60.7 & PLUSMN; 12 years, M/F: 78/56) were included. Delay of the patients was found in 60.4% (n = 81), delayed referral in 35.8% (n = 48), diagnosis delays in 84.3% (n = 113), treatment delays in 38.8% (n = 52), and total delay in 73.1% (n = 98) of the patients. A statistically significant association was found between referral delay and total delay with age groups (p=0.006) and between patient delay and the presence of symptoms (p=0.027). EBUS-TBNA was found to have the lowest effect among all delay parameters (beta: 0.104, p < 0.001) in the regression analysis. When diagnosis times' subgroups were compared, EBUS-TBNA was found to have the least effect (correlation coefficient: 0.134, p=0.004). Conclusion. We found that approximately 3/4 of the patients had a delay and this is not acceptable in real terms. Considering that the patient burden is increasing day by day, it is necessary to make a radical change in health care or a change in strategy in order to prevent delays. EBUS-TBNA, which is in the diagnosis delay subgroup, is less invasive and accelerates the process.Öğe Delays in diagnosis in patients with pulmonary and extrapulmonary sarcoidosis(2019) Acarturk Tuncay, Eylem; Yalcinsoy, Murat; Gungor, Sinem; Selcuk, Engin Burak; Tokgoz Akyil, Fatma; Yavuz, Dilek; Sucu, Pakize; Alpaslan Bekir, Sumeyye; Ocakli, Birsen; Aksoy, EmineAim: Sarcoidosis is a multisystemic disease with typical or atypical pulmonary and extra-pulmonary symptoms or frequently without symptoms. Presence of typical clinical findings and symptoms contribute to rapid diagnosis, whereas asymptomatic progression leads to delays in the diagnosis. The aim of this study was to investigate the delay in diagnosis in between patients with pulmonary and/or extra-pulmonary involvement and related symptoms and those without symptoms. Material and Methods: Patients in the sarcoidosis clinics between 2010-2015, were retrospectively evaluated. The cases were grouped according to the presence or absence of symptoms (pulmonary and/or extra-pulmonary). The groups were compared with regard to the delay in diagnosis. Results: Among the 300 patients, 209 (69%) were female. The mean age was 43±11.68. The disease was stage I in 67.3%, stage II in 23.7%, stage III in 5.7% and stage 0 in 3.3% of the patients. No significant difference was observed between symptomatic and asymptomatic patients with regard to total duration until diagnosis (p=0.78). A statistically significant difference was observed between patients groups with regard to physician-related delayed diagnosis(p=0.026). The mean delay in physician-related diagnosis was observed to be longer in asymptomatic cases (21.44 days) compared to patients with pulmonary symptoms (13.66 days)(p=0.036). In asymptomatic cases, the mean duration of physician-related delayed diagnosis (21.44 days) was observed to be longer in comparison with patients with extra-pulmonary symptoms (12.79 days)(p=0.016). In patient-related delayed diagnosis, no difference was observed between groups with regard to the duration until diagnosis(p=0.78). Conclusion: Comparison of delayed diagnosis between patients with or without pulmonary and/or extra-pulmonary symptoms revealed a longer duration of delay in asymptomatic cases compared to symptomatic cases. The timing of diagnosis is very important in sarcoidosis in order to reduce morbidity and mortality; a suspicious approach to asymptomatic patients will increase the possibility of diagnosis and prevent delayed diagnosis.Keywords: Sarcoidosis; diagnosis; delay; extrapulmonary symptoms.Öğe Delays in diagnosis in patients with pulmonary and extrapulmonary sarcoidosis(2019) Tuncay Acarturk, Eylem; Yalcinsoy, Murat; Gungor, Sinem; Selcuk, Engin Burak; Tokgoz Akyil, Fatma; Yavuz, Dilek; Sucu, Pakize; Alpaslan Bekir, Sumeyye; Ocaklı, Birsen; Aksoy, EmineAbstract: Aim: Sarcoidosis is a multisystemic disease with typical or atypical pulmonary and extra-pulmonary symptoms or frequently withoutsymptoms. Presence of typical clinical findings and symptoms contribute to rapid diagnosis, whereas asymptomatic progressionleads to delays in the diagnosis. The aim of this study was to investigate the delay in diagnosis in between patients with pulmonaryand/or extra-pulmonary involvement and related symptoms and those without symptoms.Material and Methods: Patients in the sarcoidosis clinics between 2010-2015, were retrospectively evaluated. The cases weregrouped according to the presence or absence of symptoms (pulmonary and/or extra-pulmonary). The groups were compared withregard to the delay in diagnosis.Results: Among the 300 patients, 209 (69%) were female. The mean age was 43±11.68. The disease was stage I in 67.3%, stage IIin 23.7%, stage III in 5.7% and stage 0 in 3.3% of the patients. No significant difference was observed between symptomatic andasymptomatic patients with regard to total duration until diagnosis (p=0.78). A statistically significant difference was observedbetween patients groups with regard to physician-related delayed diagnosis(p=0.026). The mean delay in physician-relateddiagnosis was observed to be longer in asymptomatic cases (21.44 days) compared to patients with pulmonary symptoms (13.66days)(p=0.036). In asymptomatic cases, the mean duration of physician-related delayed diagnosis (21.44 days) was observed to belonger in comparison with patients with extra-pulmonary symptoms (12.79 days)(p=0.016). In patient-related delayed diagnosis, nodifference was observed between groups with regard to the duration until diagnosis(p=0.78).Conclusion: Comparison of delayed diagnosis between patients with or without pulmonary and/or extra-pulmonary symptomsrevealed a longer duration of delay in asymptomatic cases compared to symptomatic cases. The timing of diagnosis is veryimportant in sarcoidosis in order to reduce morbidity and mortality; a suspicious approach to asymptomatic patients will increasethe possibility of diagnosis and prevent delayed diagnosis.Öğe Diagnostic Value of Adenosine Deaminase Level for the Differential Diagnosis of Tuberculosis and Malignancy in Exudative Lymphocytic Pleurisy(Aves, 2016) Altinsoy, Bulent; Yalcinsoy, Murat; Unver, Edhem; Gungor, Sinem; Mihmanli, Aydanur; Akkaya, EsenObjective: To evaluate the diagnostic performance of adenosine deaminase (ADA) levels in patients with exudative lymphocytic pleurisy for the differential diagnosis of tuberculous pleurisy (TBP) and malignant pleural effusion (MPE). Methods: Data on patients with exudative lymphocytic pleurisy were retrospectively analyzed. The study population comprised 54 patients. Thirty-seven were diagnosed with TBP and 17 were diagnosed with MPE. Results: Significant differences were determined in terms of age and ADA, total protein, albumin, and LDH levels between the TBP and MPE groups. The optimal cut-off value of ADA levels was 35.1 U/L for diagnosing TBP. Sensitivity and specificity were 92% and 100%, respectively. Logistic regression analysis was performed to assess independent variables associated with TBP. Independent predictive factors in the model were ADA (OR: 1.21, 95% CI: 1.06-1.39, p=0.006)], and (OR: 0.92, 95% CI: 0.84-1.00, p=0.052)]. The AUC value by the regression equation was 0.979 (p<0.001). When patients were categorized according to age (<50 ve >= 50), two different cut-off values (> 13.51 and > 35.1) for each age range were found in all, but one, TBP patients. Conclusion: ADA levels are useful for the diagnosis of TBP in cases where pleural biopsy cannot be performed or that are inconclusive in making a diagnosis of TBP. In this group, reducing the conventional cut-off value and/or performing an age-based approach seems to improve the diagnostic performance of ADA levels.Öğe DO disease stages affect oxidative stress in stable COPD?(Cell Press, 2024) Yalcinsoy, Murat; Beykumul, Aysegul; Gulbas, Gazi; Arslan, Ahmet Kadir; Neselioglu, SalimBackground: Detection of oxidative stress level may lead us to understand the pathogenesis of COPD better and to search for new treatments. Oxidative stress levels have also been shown to be elevated in stable COPD patients. We aimed to investigate whether the stage of COPD affects the severity of inflammation-induced oxidative stress in patients with stable COPD. Methods: Between June 2019 and March 2020, all consecutive patients admitted to COPD-specific outpatient clinics were included. Patients were classified A, B, and E according to the GOLD guideline. Results: The median age of 98 patients (Male: 92 (93.9 %)) was 65 (min-max: 49-86). A statistically significant difference was found between the groups in FEV1, FVC, and FEV1/FVC (p < 0.001). age, and thiols (r = -0.168, p = 0.049; r = -0.184, p = 0.035) and DS (r = -0.209, p = 0.019) were found to be negatively correlated at a low level. When adjusted for age, oxidative stress parameters were similar between stages. Conclusion: No difference between stages and oxidative stress parameters according to GOLD classification in stable COPD patients. Our results may be a guide for not using anti-inflammatory therapy except for attacks.Öğe Evaluation of the cardiovascular effects of varenicline in rats(Dove Medical Press Ltd, 2015) Selcuk, Engin Burak; Sungu, Meltem; Parlakpinar, Hakan; Ermis, Necip; Taslidere, Elif; Vardi, Nigar; Yalcinsoy, MuratBackground: Cardiovascular disease is an important cause of morbidity and mortality among tobacco users. Varenicline is widely used worldwide to help smoking cessation, but some published studies have reported associated cardiovascular events. Objective: To determine the cardiovascular toxicity induced by varenicline in rats. Materials and methods: We randomly separated 34 rats into two groups: 1) the control group (given only distilled water orally, n=10) and the varenicline group (given 9 mu g/kg/day varenicline on days 1-3, 9 mu g/kg twice daily on days 4-7, and 18 mu g/kg twice daily on days 8-90 [total 83 days], n=24). Each group was then subdivided equally into acute and chronic subgroups, and all rats in these groups were euthanized with anesthesia overdose on days 45 and 90, respectively. Body and heart weights, hemodynamic (mean oxygen saturation, mean blood pressure, and heart rate, electrocardiographic (PR, QRS, and QT intervals) biochemical (oxidants and antioxidants), and histopathological analyses (including immunostaining) were performed. Results: Acute varenicline exposure resulted in loss of body weight, while chronic varenicline exposure caused heart weight loss and decreased mean blood pressure, induced lipid peroxidation, and reduced antioxidant activity. Both acute and chronic varenicline exposure caused impairment of mean oxygen saturation. QT interval was prolonged in the chronic varenicline group, while PR interval prolongation was statistically significant in both the control and acute varenicline groups. Caspase-9 activity was also significantly increased by chronic exposure. Moreover, histopathological observations revealed severe morphological heart damage in both groups. Conclusion: Adverse effects of chronic varenicline exposure on cardiovascular tissue were confirmed by our electrocardiographic, biochemical, and histopathological analyses. This issue needs to be investigated with new experimental and clinical studies to evaluate the exact mechanism(s) of the detrimental effects of varenicline. Physicians should bear in mind the toxic effects of varenicline on the cardiovascular system when prescribing it for smoking cessation.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 Familial Sarcoidosis: An Analysis of Twenty-Eight Cases(Aves, 2016) Duman, Dildar; Sevim, Tulin; Sertcelik, Lale; Akkan, Olga; Gungor, Sinem; Yalcinsoy, Murat; Erdem, IpekObjective: Sarcoidosis is a multisystemic disease, exact cause of disease is unknown but it is assumed that genetic predisposition and ethnic factors play a role in etiology. Studies related with familial sarcoidosis is limited and only case reports about familial sarcoidosis is available from our country. We aimed to evaluate the prevelance of familial sarcoidosis and clinical findings of cases with familial sarcoidosis. Methods: We retrospectively documented file records of 678 patients diagnosed with sarcoidosis and followed up in outpatient clinic of sarcoidosis from January 1996 to February 2016. 28 familial sarcoidosis cases in 14 families were enrolled into the study. Their demographic findings, family relationship, symptoms, laboratory and pulmonary function test results, radiological apperances, diagnostic methods, treatments were recorded. Results: Twenty-eight sarcoidosis patients out of 678 reported as familial cases, giving a prevelance of familial sarcoidosis as 4%. There were 8 sarcoidosis sib, 4 sarcoidosis mother-child, 1 sarcoidosis father-child and 1 sarcoidosis cousin relationship. Female/male ratio was 1.8, mean age of the study population was 43, most freguent symptoms were cough and dyspnea, stage 2 was mostly seen according to chest X-ray, most common CT appearance was mediastinal lymphadenopathy and mediastinoscopy was the most freguent diagnostic method. Conclusion: This study is important to lead interrogation of family in patients with suspected sarcoidosis and future studies investigating familial aggregation in sarcoidosis.Öğe Idiopathic Chronic Eosinophilic Pneumonia: Retrospective Analysis of 17 Cases from a Single Center in Turkey(Aves, 2016) Arinc, Sibel; Kasapoglu, Umut Sabri; Gungor, Sinem; Agca, Meltem; Yalcinsoy, Murat; Irmak, Ilim; Guney, PinarObjective: Idiopathic chronic eosinophilic pneumonia (ICEP) is a rare eosinophilic lung disorder with an unknown etiology and is characterized by subacute or chronic respiratory and general symptoms, alveolar and/or peripheral eosinophilia, and the accumulation of eosinophils in the lungs. We aimed to present diagnostic test results and follow-up outcomes of 17 patients who were diagnosed with ICEP in our hospital in light of literature. Methods: Between 2008 and 2013, we examined 17 cases of ICEP. We evaluated clinical and laboratory findings together with the long-term follow-up data. Results: The patients had a mean age of 40.8 years at presentation, and the female/male ratio was 0.8. The most common symptoms were cough (94%), shortness of breath (76%), and high fever (35%). Bronchoalveolar lavage eosinophil percentages of the patients ranged from 3% to 80%. Nine (53%) patients experienced recurrence. Six patients were maintained on low dose steroid due to repeating relapses. Among these patients, 7 (77.7%) had a total IgE level of above 500/IU/mL. Conclusion: Relapses are common in ICEP after the withdrawal of corticosteroid treatment or during dose reduction. We point out the importance of the close monitoring of patients for identifying relapse. A higher total IgE level during diagnosis may serve as a predictor of recurrence.Öğe Lung carcinoma patients aged eighty years over and prognostic factors affecting survival(Turkish Assoc Tuberculosis & Thorax, 2017) Kasapoglu, Umut Sabri; Gungor, Sinem; Arinc, Sibel; Yalcinsoy, Murat; Misirlioglu, Aysun; Akbay, Ozlem MakbuleIntroduction: Almost 50% of all cancers and 70% of cancer deaths occur in cases aged 65 years and more. Thus diagnosis, treatment and follow up in old cases gain importance. Since there a limited number of study that show age-mortality relation in lung cancer cases aged 80 years and over, issues may arise in diagnosis and treatment process of these cases. In this study, we aimed to evaluate general characteristics of lung cancer cases aged 80 years or over and factors that affect survey. Materials and Methods: Between 2010 and 2013, the retrospective cohort study was done in Sureyyapasa Chest Diseases and Chest Surgery Training and Research Hospital and 100 cases of lung carcinoma were examined. Results: In the study, 70% of the cases were male and 30% were female. Median age was 83 +/- 2.91 (80-92) years. 71% of the cases were found to be suffering from a comorbid disease; 29% did not have any comorbid disease. Dyspnea (56%), cough (50%) and chest pain (41%) were the most frequent symptoms. Histopathologically, 41% of the patients diagnosed with adenocarcinoma and 40% were diagnosed with squamous cell carcinoma. Median survival time was 2.73 months (% 95 CI 0.96-4.49) and 1-year survival rate was 17%. Length of time of the cases with smoking history was found shorter than of cases without smoking history (p=0.013). Life expectancy of the cases with advanced disease and performance score of 3-4 was detected to be short (p=0.006, p< 0.001). Compared to the cases who operated on and had chemoradiotherapy, length of life who had symptomatic treatment was shorter (p< 0.001). Conclusion: Despite the comorbidity in lung cancer cases aged 80 years and over, life expectancy of the cases who had surgical and/or chemoradiotherapy treatment is longer. While deciding on treatment methods on these cases, patient's performance must be taken into consideration.
