Cem Mutlu - Academia.edu (original) (raw)

Papers by Cem Mutlu

Revista da Associação Médica Brasileira, 2021

OBJECTIVE: To investigate the correlation of D-dimer levels and computed tomography properties of... more OBJECTIVE: To investigate the correlation of D-dimer levels and computed tomography properties of pulmonary embolism. METHODS: A total of 58 treated patients with diagnosis of properties of pulmonary embolism were retrospectively studied. All patients underwent a D-dimer blood test. In computed tomography images, septal angle, interventricular septal thickness, and the diameters of all cardiac chambers and pulmonary arteries were measured. The thrombus volume (load) and density at all pulmonary arteries (main, right, left pulmonary arteries, and segmental arteries) were calculated. RESULTS: A significant correlation was found between D-dimer and total thrombus volume (p=0.009, r=0.342). Total thrombus volume and total thrombus density were calculated with mean value of 23.40±60.63 ml and 66.16±38.48 hounsfield unit (HU), respectively. Right ventricle/left ventricle ratio showed positive correlation with the D-dimer level (p=0.02). CONCLUSION: Increased D-dimer levels with RV/LV ratio and their correlation with total thrombus volume suggest that it may be a prognostic factor.

Background: This study was designed to evaluate the hypothesis that nebulized budesonide (NB) mig... more Background: This study was designed to evaluate the hypothesis that nebulized budesonide (NB) might be an alternative to systemic corticosteroids (SC) in the treatment of patients with exacerbations of COPD (ECOPD). Methods: Patients, hospitalized with ECOPD (n=159), were randomized into three groups. Group I received only standard bronchodilator treatment (SBDT), Group II received SC (40 mg prednisolon) plus SBDT, and Group III received NB (1500 mcg qid) plus SBDT. Improvement during 10-day hospitalization, and exacerbation and re-hospitalization rates after discharge were compared. Results: While mean age was 64,1±8,9 years (F/M=0,1), mean FEV1 at admission was found 37,2±12,2 % predicted. Arterial blood gases and spirograms recovered faster in Group II and III. While improvements in PaO2 and FVC in Group II, and improvements in PaO2, FVC and FEV1 in Group III became significant at 24-hour control, first significant improvement in Group I appeared in SaO2 at 72-hour control. Mean ...

The Clinical Respiratory Journal, 2019

INTRODUCTION:Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovasc... more INTRODUCTION:Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovascular morbidity and mortality. Carotid intima-media thickness (CIMT) is a non-invasive method assessing atherosclerosis. OBJECTIVE:It was aimed to determine relationship and survival between COPD and CIMT. METHODS:CIMT was measured using Doppler ultrasound(USG) in 668 stable COPD patients at 24 centers. Patients were followed-up for two years. RESULTS: There were 610 patients who completed the study. There were 200 patients CIMT with<0.78 mm (group 1), and 410 with CIMT≥0.78 mm (group 2). There was a significant difference at the parameters of age, gender, smoking load, biomass exposure, GOLD groups and degree of airway obstruction (FEV1) between group 1 and 2. Our results revealed positive correlations between mean CIMT and age, smoking load (pack-years), biomass exposure(years), exacerbation rate(last year), duration of hypertension(years) and cholesterol level; negative correlations between CIMT and FEV 1 (p<0.05). According to logistic regression model,compared with Group A, risk of CIMT increase was 2.2 folds in Group B, 9.7 folds in Group C, and 4.4 folds in Group D(p<0.05). Risk of CIMT increase was also related with cholesterol level (p<0.05). Compared with infrequent exacerbation, it was 2.8 folds in Accepted Article This article is protected by copyright. All rights reserved. the patients with frequent exacerbation(p<0.05). The mean survival time was slightly higher in Group 1,but not significant(23.9 versus 21.8 months) (p>0.05). CONCLUSION:This study is the first regarding CIMT with combined GOLD assessment groups. It has revealed important findings supporting the increase in atherosclerosis risk in COPD patients. We recommend Doppler USG of the carotid artery in COPD patients at severe stages.

Turgut Ozal Tıp Merkezi Dergisi, 2002

Pulmonary thromboembolus is a disease with high mortality and morbidity. In addition to well know... more Pulmonary thromboembolus is a disease with high mortality and morbidity. In addition to well known and frequent risk factors, there are some rare congenital predisposing factors. In five of 43 patients (11.6%) diagnosed as pulmonary embolus between 1998 and 2001 in our clinic we detected a genetic risk factor for venous thromboemboli. Except one patient, there were no formerly known genetic risk factor. Due to our results, it can be proposed that the genetical predisposition should be searched in patients who developed venous thromboemboli without any known risk factor. We discussed 3 patients with antiphospholipid syndrome, one patient with protein C deficiency and one patient with protein S deficiency and activated protein C resistance (APC-R), in total 5 cases, with regard to current literature. Keywords: Antiphospholipid Syndrome, Protein C Deficency, Protein S Deficency, Activated C Resistance, Pulmonary Thromboemboli

European Respiratory Journal, Sep 1, 2013

European Respiratory Journal, 2015

ASPECT study, a prospective multicenter study conducted in Turkey with the participation of 26 ce... more ASPECT study, a prospective multicenter study conducted in Turkey with the participation of 26 centers, including all patients with lung cancer, who agreed to participate in the study, were re-evaluated in terms of demographic characteristics of patients (pts), disease characteristics, and the treatment options in lung cancer. Among 1245 cases (88.7% man) included, %83.4 had advanced stage (stage 3-4) lung cancer. Histopathologic types were squamous cell in 39.3%, adenocancer in 29.6%, SCLC in 19.0%, NSCLC in 10.2% and others. Of the pts, 45.5% had a comorbid disease, 49.3% had weight loss (at least 5% of body weight), and 31.6% had a history of cancer in family. PET-CT was used in 83.3% of the pts for diagnosis of staging. Metastasis was detected in 54.2% of pts (43.9% bone, 23.1% brain, %20.2% liver, 17.3% surrenal metastasis). Treatment options were chemotherapy in 45.9%, chemo-radiotherapy in 28.2%, and surgery in 18.4% of the pts. Chemotherapy was mostly platin based doubles including etoposide (14.9%), paclitaxel (14.0%), gemcitabine (12.3%), docetaxol (4.3%), pemetrexed (2.2%), vinorelbin (4.9%), and others. The use of targeted therapies was detected in 1.1% of the pts. Palliative radiotherapy was given in 21.1% of the pts (8.5% brain, 7.2% bone, 6.7% thorax, and others). Interventional bronchoscopy or bronchial stenting was performed in 2.0% and pleurodesis in 1.8%. Of the pts, 10.5% reported the use of herbal medicine products. Most pts with lung cancer presented in advanced stages and only 18.4% had a chance for surgery. Conventional chemotherapy and radiotherapy was the most common therapeutic options but the use of targeted therapies and interventional procedures seems to be quite low.

Sarcoidosis is a multisystemic, granulomatous disease with an unknown etiology. Although granulom... more Sarcoidosis is a multisystemic, granulomatous disease with an unknown etiology. Although granulomas suggest an eti-ology related to infectious, and organic agents, their etiolo-gies are still unknown. A 16 year-old girl referred with complaints of cough, malaise, and painful lesions on legs lasting for 4 months. On physical examination, no patholo-gical sign was observed, except an erythema nodosum-like purple lesion, the largest one being 5 cm in diameter was detected on the tibial region. Erythrocyte sedimentation rate was 60/1 hour and CRP 15.66 mg/L. Angiotension conver-ting enzyme level was elevated. High resolution thoracal CT results were reported as multiple mediastinal lymphadeno-paties and micronodular parenchymal infiltrations at right middle and lower lobes. In biopsy, taken during bronchos-copy, granulamatous lesions were observed. Patient was suggestively diagnosed as sarcoidosis with these findings and followed up without treatment because of relatively lesser severit...

Journal of Infection and Public Health, 2016

The aim of the present study was to increase awareness regarding the rational use of medicines. T... more The aim of the present study was to increase awareness regarding the rational use of medicines. The data were obtained via the Material Resources Management System Module of the Ministry of Health. For the appropriateness of treatments, the Global Initiative for Asthma, the Global Initiative for Chronic Obstructive Lung Disease, and the guidelines for the rational use of medicines were used. We also investigated whether any de-escalation method or physical exercise was performed. Statistical analyses were performed using descriptive statistics to determine the mean, standard deviation, and frequency. The results showed that healthcare providers ignored potential drug reactions or adverse interactions, and

Angiology, Jan 15, 2015

Obstructive sleep apnea (OSA) is associated with increased cardiovascular (CV) morbidity and mort... more Obstructive sleep apnea (OSA) is associated with increased cardiovascular (CV) morbidity and mortality. Endocan is a surrogate endothelial dysfunction marker that may be associated with CV risk factors. In this study, we tested whether serum endocan is a biomarker for OSA. Serum endocan levels were measured at baseline in 40 patients with OSA and 40 healthy controls and after 3 months of continuous positive airway pressure (CPAP) treatment in the patients with OSA. All participants were evaluated by full polysomnography. Flow-mediated dilatation (FMD) and carotid intima media thickness (cIMT) were measured in all participants. Endocan levels were significantly higher in patients with OSA than in healthy controls. After adjusting confounders, endocan was a good predictor of OSA. Endocan levels correlated with OSA severity (measured by the apnea-hypopnea index [AHI]). After 3 months of CPAP treatment, endocan levels significantly decreased. Endocan levels were significantly and indepe...

SUMMARY THE CAUSES OF EXACERBATIONS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE For th... more SUMMARY THE CAUSES OF EXACERBATIONS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE For the effective treatment of exacerbations of chronic obstructive pulmonary disease (COPD), its causes should be known. Two hundred and fifty patients who were admitted to Inonu University, Faculty of Medicine, Department of Pul- monary Medicine with COPD exacerbation between May 2001-May 2004 were included in the study. The mean age of the patients was 65.7 ± 9.4 years. The causes of 442 exacerbations in these patients were evaluated. The most frequent causes of exacerbation were found as non-compliance with the treatment 48.6% (215/442), tracheobronchial infections 33.3% (147/442), hearth failure 17.4% (77/442) and pneumonia 13.1% (58/442). The cause of acute exacerbations co- uld not be identified in 13.1% of patients. In conclusion, we think that the rate of exacerbation and hospitalizations will be decreased by providing regular stable COPD treatment, effective patient education, and pr...

Solunum, 2012

Kronik obstrüktif akciğer hastalığı (KOAH) oluşumunda genetik faktörlerin rolünün önemli olduğu f... more Kronik obstrüktif akciğer hastalığı (KOAH) oluşumunda genetik faktörlerin rolünün önemli olduğu fikri genel olarak kabul edilmektedir. Bununla birlikte, yarım asırdan uzun süredir yapılan birçok çalışmadan α-1 antitripsin eksikliğinin tek başına KOAH'a yol açabileceği bilgisi dışında kesin bir sonuç elde edilememiştir. Elimizdeki veriler ışığında, birçok gen bozuklukları arasındaki etkileşimlerin üstüne eklenen sigara dumanı gibi çevresel faktörlerin KOAH oluşumdan sorumlu olduğu söylenebilir. Şüphesiz gelecekte de KOAH oluşumunda genetik risk faktörleri, üzerinde en fazla çalışılan konulardan biri olmaya devam edecektir.

uvt.ulakbim.gov.tr

... Altmışüç Pulmoner Emboli Olgusunun Retrospektif Değerlendirilmesi Süleyman Savaş HACIEVLİYAGİ... more ... Altmışüç Pulmoner Emboli Olgusunun Retrospektif Değerlendirilmesi Süleyman Savaş HACIEVLİYAGİL, Levent Cem MUTLU, Özkan KIZKIN, Hakan GÜNEN, Gazi GÜLBAŞ ... Kırk beş (%71.4) hastada risk faktörü mevcuttu, bunların 5 (%7.9)'inde genetik risk faktörü tespit edildi. ...

Journal of the American College of Cardiology, 2013

Journal of Inonu …, 2010

Poland sendromu pektoralis major kasının tek taraflı yokluğu ile karakterize konjenital bir sendr... more Poland sendromu pektoralis major kasının tek taraflı yokluğu ile karakterize konjenital bir sendromdur. Bu sendroma meme, el ve diğer organ anomalileri de eşlik edebilir. Genellikle sağ tarafı tutar ve erkeklerde daha sıktır.

solunumhastaliklari.org

... Süleyman Savaş HACIEVLİYAGİL*, Mustafa DURAN**, Levent Cem MUTLU*, Hakan GÜNEN*, Aydın ŞENOĞL... more ... Süleyman Savaş HACIEVLİYAGİL*, Mustafa DURAN**, Levent Cem MUTLU*, Hakan GÜNEN*, Aydın ŞENOĞLU**, Ercüment EVLİYAOĞLU***, Şahin TEMİZ**, Zeynep ... 52.2'sinde ARB pozitifliği sap-tandığı bildirilmiştir (3). Ancak her VSD'in şartları aynı değildir, Bingöl VSD'de ...

European Respiratory Journal, 2007

The present study was designed to evaluate the hypothesis that nebulised budesonide (NB) might be... more The present study was designed to evaluate the hypothesis that nebulised budesonide (NB) might be an alternative to systemic corticosteroids (SC) in the treatment of patients with exacerbations of chronic obstructive pulmonary disease (ECOPD). Patients hospitalised with ECOPD (n5159) were randomised into three groups. Group 1 received only standard bronchodilator treatment (SBDT), group 2 received SC (40 mg prednisolone) plus SBDT, and group 3 received NB (1,500 mg q.i.d.) plus SBDT. Improvement during 10-day hospitalisation was compared with exacerbation and rehospitalisation rates after discharge. While mean¡SD age was 64.1¡8.9 yrs (female/male50.1), mean forced expiratory volume in one second (FEV1) at admission was found to be 37.2¡12.2% predicted. Arterial blood gases and spirograms recovered faster in groups 2 and 3. While improvements in arterial oxygen tension (Pa,O 2) and forced vital capacity (FVC) in group 2, and improvements in Pa,O 2 , FVC and FEV1 in group 3, became significant at 24-h control, the first significant improvement in group 1 appeared in arterial oxygen saturation at 72-h control. The mean improvement of Pa,O 2 after 10 days was 1.20 and 1.06 kPa (9 and 8 mmHg) higher in group 2 and 3, respectively, than in group 1. Blood glucose exhibited an upward trend only in group 2. The study demonstrates that nebulised budesonide may be an effective and safe alternative to systemic corticosteroids in the treatment of exacerbations of chronic obstructive pulmonary disease.

European review for medical and pharmacological sciences, 2017

OBJECTIVE Obstructive sleep apnea syndrome (OSAS) has been associated with elevated biochemical m... more OBJECTIVE Obstructive sleep apnea syndrome (OSAS) has been associated with elevated biochemical markers of inflammation. Although the exact mechanism is unknown, both sleep deprivation and hypoxemia are believed to be important causative factors. YKL-40, also known as chitinase-like protein, has been shown to be related to various inflammatory conditions including atherosclerosis, diabetes, cancer, and asthma. The present study aimed to evaluate the relationship between YKL-40 levels and the Apnea Hypopnea Index (AHI) in patients with obstructive sleep apnea syndrome. PATIENTS AND METHODS The study was conducted at the Sleep Unit of the Namik Kemal University Research Center. From January 2013 to December 2013, 120 patients diagnosed with OSAS by polysomnography and 40 subjects without OSAS were recruited. Patients in both groups were matched by age, sex, and body mass index (BMI). They were further divided into groups of mild, moderate and severe OSAS based on their AHI value. Seru...

Experimental and Therapeutic Medicine, 2018

Desquamative interstitial pneumonia is a type of smoking-associated major idiopathic interstitial... more Desquamative interstitial pneumonia is a type of smoking-associated major idiopathic interstitial pneumonia, which is characterized by accumulation of alveolar macrophages in alveolar lumens and septa and develops secondary to mainly active or passive exposure to cigarette smoke. Desquamative interstitial pneumonia mostly occurs in male smokers in association with non-specific symptoms responsive to steroid therapy and has a better prognosis than usual interstitial pneumonia. To date, no large-scale clinical studies have been performed on desquamative interstitial pneumonia patients. Factors responsible for the scarcity of data on the clinical course of this condition include the retrospective nature of the available information as well as its rare occurrence. Despite this, a general consensus exists as to the nature of its symptoms, association with smoking, age and gender distribution, findings of respiratory function tests, steroid responsivity and mortality. The objective of the present review article was to report on desquamative interstitial pneumonia and to describe its etiology, risk factors and clinical features, as well as the laboratory, bronchoalveolar lavage, radiological and histopathological findings, and the treatment and prognosis of affected patients.

European Respiratory Journal, 2005

Factors determining in-hospital mortality and long-term survival of patients hospitalised with ac... more Factors determining in-hospital mortality and long-term survival of patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are not precisely understood. The aim of the present study was to assess the parameters related to in-hospital mortality and long-term survival after hospitalisation of patients with AECOPD. Clinical and epidemiological parameters on admission in 205 consecutive patients hospitalised with AECOPD were prospectively assessed. Patients were followed-up for 3 yrs. Factors determining short-and long-term mortality were analysed. In total, 17 patients (8.3%) died in hospital. In-hospital mortality was significantly associated with lower arterial oxygen tension (Pa,O 2), higher carbon dioxide arterial tension, lower arterial oxygen saturation and longer hospital stay. The overall 6-month mortality rate was 24%, with 1-, 2and 3-yr mortality rates of 33%, 39% and 49%, respectively. Cox regression analysis revealed that long-term mortality was associated with longer disease duration (relative risk (RR)51.158), lower albumin (RR50.411), lower Pa,O 2 (RR50.871) and lower body mass index (RR50.830). When the model was run for the time elapsed since first hospitalisation, it also appeared as statistically significant (RR51.195). These findings show that patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease have poor short-and long-term survival. Prediction of survival status may be enhanced by considering arterial oxygen tension, albumin, body mass index, disease duration and time elapsed since the first hospitalisation.