Ezgi Ozyilmaz - Academia.edu (original) (raw)
Papers by Ezgi Ozyilmaz
Sarkoidoz, pulmoner tromboemboli için bilinen bir risk faktörü olmamakla birlikte son yıllarda bi... more Sarkoidoz, pulmoner tromboemboli için bilinen bir risk faktörü olmamakla birlikte son yıllarda bilinen başka risk faktörü olmaksızın sarkoidozlu hastalarda pulmoner tromboemboli gelişimi ile ilgili yeni veriler bildirilmektedir. Bu sunumda, 47 yaşında sarkoidoz tanısıyla beş aydır metilprednizolon tedavisi altında takip edilmekte olan kadın hastada gelişen bir masif tromboembolizm olgusu bildirilmiştir. Bu olgu ile, sarkoidozun pulmoner tromboembolinin risk faktörlerinden biri olabileceği ve takip altındaki sarkoidozlu hastalarda klinik bozulmanın ayırıcı tanısında pulmoner tromboembolinin de akılda tutulması gerekliliği düşünülmüştür.
Objective: Many pulmonary disorders are reported in end-stage renal disease (ESRD) patients who u... more Objective: Many pulmonary disorders are reported in end-stage renal disease (ESRD) patients who underwent hemodialysis therapy.The aim of this study is to evaluate the effect of erythropoietin and interdialytic weight gain on pulmonary function tests (PFTs) in hemodialysis patients. Material and Methods: Forty-adult patients were included in this prospective study. After recording baseline demographical variables, erythropoietin use and interdialytic weight gain, PFTs were performed to all of the patients just before and in the first hour after hemodialysis therapy. Results: Twenty percentage of the patients represented any PFT abnormality. When the PFT results compared before and after hemodialysis therapy no significant change was observed. The pre and postdialysis PFT results among patients who receive erythropoietin treatment do not represent any difference from those who do not receive this therapy. FEV1/FVC and FEF25-75 were improved with hemodialysis therapy among patients wh...
Respiratory insufficiency is one of the most frequent causes of intensive care unit (ICU) admissi... more Respiratory insufficiency is one of the most frequent causes of intensive care unit (ICU) admissions among obstetric patients. The challenges faced in the treatment of this patient population are even greater due to the fact that there are two young lives to be saved simultaneously: mother and fetus. Any treatment which may be the best choice for the mother may adversely affect the fetus. The aim of this review is to summarize the reasons and the management of the most common pulmonary disorders requiring ICU admissions in pregnancy for the obstetrician. In the spectrum of this review the most common reasons of respiratory failure such as bronchial asthma, pulmonary embolism, amnion fluid embolism and pneumonia will be discussed. Optimal management for all of the disorders requires early identification and treatment of the respiratory failure, stabilizing the hemodynamics, improve oxygenation and close fetal and maternal monitoring.
Tuberkuloz ve Toraks, 2012
Postoperative respiratory failure is related with the highest mortality and morbidity among all p... more Postoperative respiratory failure is related with the highest mortality and morbidity among all perioperative complications. The most common underlying mechanism of postoperative respiratory failure is the development of atelectasis. Anaesthesia, medications which cause respiratory depression, high FiO2 use, postoperative pain and disruption of muscle forces due to surgery leads to decrease in functional residual capacity and results in atelectasis formation. Atelectasis causes severe hypoxemia due to ventilation, perfusion mismatch, shunt and increased peripheral vascular resistance. Intrathoracic positive pressure is an effective therapeutic option in both prevention and treatment of atelectasis. Non-invasive mechanical ventilation is related with a lower mortality and morbidity rate due to lack of any potential complication risks of endotracheal intubation. Non-invasive mechanical ventilation can be applied as prophylactic or curative. Both of these techniques are related with lower reintubation rates, nosocomial infections, duration of hospitalization and mortality in patients with postoperative respiratory failure. The differences of this therapy from standard application and potential complications should be well known in order to improve prognosis in these group of patients. The primary aim of this review is to underline the pathogenesis of postoperative respiratory failure. The secondary aim is to clarify the optimum method, effect and complications of non-invasive mechanical ventilation therapy under the light of the studies which was performed in specific patient groups.
BMC Pulmonary Medicine, 2014
Background: Identifying the predictors of noninvasive ventilation (NIV) failure has attracted sig... more Background: Identifying the predictors of noninvasive ventilation (NIV) failure has attracted significant interest because of the strong link between failure and poor outcomes. However, very little attention has been paid to the timing of the failure. This narrative review focuses on the causes of NIV failure and risk factors and potential remedies for NIV failure, based on the timing factor. Results: The possible causes of immediate failure (within minutes to <1 h) are a weak cough reflex, excessive secretions, hypercapnic encephalopathy, intolerance, agitation, and patient-ventilator asynchrony. The major potential interventions include chest physiotherapeutic techniques, early fiberoptic bronchoscopy, changing ventilator settings, and judicious sedation. The risk factors for early failure (within 1 to 48 h) may differ for hypercapnic and hypoxemic respiratory failure. However, most cases of early failure are due to poor arterial blood gas (ABGs) and an inability to promptly correct them, increased severity of illness, and the persistence of a high respiratory rate. Despite a satisfactory initial response, late failure (48 h after NIV) can occur and may be related to sleep disturbance.
European Respiratory Journal, Sep 1, 2013
Number: 2321 Publication Number: P4219 Abstract Group: 6.1. Epidemiology
Japanese Journal of Infectious Diseases, Feb 1, 2005
To determine the bacterial etiology of lower respiratory tract infections (LRTIs) in Turkey, quan... more To determine the bacterial etiology of lower respiratory tract infections (LRTIs) in Turkey, quantitative cultures of sputum were carried out. The major pathogens for LTRIs were found to be Haemophilus influenzae, followed by Streptococcus pneumoniae and Moraxella catarrhalis. Only 6.1% of the H. inlfuenzae and all strains of M. catarrhalis were -lactamase producers. An E-test showed that 31.2% of the S. pneumoniae strains had an intermediate resistance to penicillin, and the remaining strains were susceptible; no fully resistant strains were detected.
Turkiye Klinikleri Cardiovascular Sciences, 2013
Minerva medica
Pulmonary function tests (PFT) have an important role in the assessment of pulmonary and nonpulmo... more Pulmonary function tests (PFT) have an important role in the assessment of pulmonary and nonpulmonary complications of hematopoetic stem cell transplantation (HSCT). In this study the relationship between PFTs and DLCOadj values and the complications of HSCT was investigated. The possible role of iron overload in the deterioration of the PFTs after HSCT was also searched. One hundred and fifty one patients who had undergone allogeneic HSCT between years 2003 through 2008, and had the records of PFTs prior to and at 1, 3, 6, 9 and 12 months after transplantation were included in the study. Prospectively collected data of these patients were analysed retrospectively. Although no significant difference was identified in other PFT parameters, a significant decrease in DLCOadj was determined after 1st and 3rd months of HSCT. A significant correlation was found between pretransplant DLCOadj value <%70 and sinusoidal obstruction syndrome (SOS) (P=0.001, r=0.323), but in multivariate ana...
Tuberkuloz ve toraks
Severe community-acquired pneumonia (CAP) is an important cause of intensive care unit (ICU) admi... more Severe community-acquired pneumonia (CAP) is an important cause of intensive care unit (ICU) admissions. Many different pneumonia scoring systems have been developed in order to assess the severity of pneumonia and to decide the ICU follow-up and treatment. But still debate is going on about their performances and also they have not been tested yet if they can predict ICU mortality in severe CAP patients requiring mechanical ventilation. The aim of this study is to evaluate the performances of pneumonia and ICU scores in predicting mortality in CAP patients requiring mechanical ventilation. A retrospective observational cohort study. The files of mechanically ventilated CAP patients were reviewed and demographic, clinic and laboratory characteristics were recorded. Scoring systems of pneumonia [revised American Thoracic Society (ATS) criteria, CURB-65, pneumonia severity index (PSI)] and ICU [Acute Physiology Assessment and Chronic Health Evaluation (APACHE) II, Sequential Organ Fai...
International Journal of Clinical Practice
Severe exacerbations are the leading cause of fatal events in chronic obstructive pulmonary disea... more Severe exacerbations are the leading cause of fatal events in chronic obstructive pulmonary disease (COPD). The new Global Initiative for Chronic Obstructive Lung Disease strategy included the number of exacerbations in the grading of the disease. The primary aim of this study was to evaluate the potentially modifiable precipitating factors of frequent severe exacerbations requiring hospital admission in COPD. The secondary aim was to investigate the risk factors of readmission within 2 months following an exacerbation requiring hospitalisation. Data regarding the number of exacerbations in the previous year, current comorbidities, medications, and clinical and functional status of COPD patients were evaluated. We included 107 COPD patients (85% men). The mean number of severe exacerbations was 1.3 ± 1.7 (per patient/per year), and 37.4% of the patients had frequent severe exacerbations (≥ 2/year). Multivariate analysis indicated that haematocrit < 41%, angiotensin converting enz...
# Bu çalışma, Toraks Derneği IV. Ulusal Kongresi (24-27 Nisan 2002, Antalya)'nde sunulmuştur.
Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG / World Association of Sarcoidosis and Other Granulomatous Disorders, 2014
Several HLA-DR alleles have been described as a potential risk factor for sarcoidosis between dis... more Several HLA-DR alleles have been described as a potential risk factor for sarcoidosis between distinct ethnic groups however the relationship between HLA-DR alleles and extra-pulmonary sarcoidosis (EPS) is still scarce. The aim of this prospective study is to investigate the relationship between extra-pulmonary involvement and HLA-DR genetic analysis in Turkish patients with sarcoidosis. In this study, we HLA-typed sarcoidosis patients with and without extra-pulmonary involvement, and compared with healthy control subjects. The presence of EPS was evaluated with previously defined standard criteria (ACCESS) and only patients with definite and probable involvement were accepted as positive. Sequence Specific Oligonucletide Probes method was used for typing of HLA-DRB1 alleles from DNA samples in both groups. The frequency of HLA DRB1*15 allele was more frequent in patients with sarcoidosis than controls (% 20.4 vs % 9.6)(pcorr=0.017). According to multivariate analysis (MVA), the pre...
Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG / World Association of Sarcoidosis and Other Granulomatous Disorders, 2013
Hermansky-Pudlak Syndrome (HPS) is a rare autosomal recessive disorder presenting with oculocutan... more Hermansky-Pudlak Syndrome (HPS) is a rare autosomal recessive disorder presenting with oculocutaneous albinism, bleeding diathesis and lysosomal accumulation of ceroid lipofuscin which leads to interstitial fibrosis in lung. Pulmonary fibrosis which is usually associated with HPS-1 and HPS-4 subtypes usually manifests in the third/fourth decades of life representing with giant lamellar bodies of alveolar type-II-cells and their apparent degeneration causes restrictive lung disease. Pulmonary manifestation of this syndrome may lead to premature death. Pulmonary Alveolar Proteinosis(PAP) is another rare disease characterized by alveolar deposition of surfactant phospholipids and proteins secondary to defective clearance by alveolar macrophages. PAP may occur as autoimmune diseases and/or secondary to toxic inhalation, systemic infections or hematological disorders. None of the cases were reported secondary to HPS according to the best our knowledge. As well, pulmonary involvement of H...
The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2012
Extraintestinal manifestations of inflammatory bowel diseases are well recognized and mainly affe... more Extraintestinal manifestations of inflammatory bowel diseases are well recognized and mainly affect the joints, skin, liver, and eyes; however, clinically significant pulmonary involvement is very rare. Early identification of pulmonary involvement is important and will be life-saving. We report herein a case of an ulcerative colitis patient, presenting with acute respiratory distress syndrome and bilateral recurring pneumothorax, pneumomediastinum and subcutaneous emphysema, i.e., air leak syndrome. He was diagnosed with open lung biopsy as bronchiolitis obliterans organizing pneumonia most probably due to viral etiology and responded well to steroid therapy, with almost complete resolution of radiographic and clinical findings. In inflammatory bowel disease patients, bronchiolitis obliterans organizing pneumonia developing due to viral or fungal infectious etiology or due to the inflammatory bowel disease itself may progress to acute respiratory distress syndrome and may present w...
Tüberküloz ve toraks, 2010
Dead space ventilation (Vd/Vt) is a valuable parameter which indicates the ventilated but not per... more Dead space ventilation (Vd/Vt) is a valuable parameter which indicates the ventilated but not perfused lung areas. The normal range is between 30-50% in mechanically ventilated patients. Increased levels could be observed in many pulmonary diseases such as pulmonary embolism, acute respiratory distress syndrome and chronic obstructive pulmonary disease. Vd/Vt is also used for the prediction of extubation success and a value of < 55-60% indicates successful extubation according to several studies. The aim of this study is to evaluate the value of baseline capnographic measurements on extubation success. A total of 35 patients were included in this prospective study; and 25 (71%) of them who were extubated successfully were named as group 1 and the remaining 10 (29%) patients with extubation failure were named as group 2. When the two groups were compared, Vd/Vt value, measured at the first 24 hours of hospitalization, was found to be higher in group 2 (0.66 vs. 0.54, p< 0.05). ...
Tüberküloz ve toraks, 2010
Severe community-acquired pneumonia (CAP) is an important cause of intensive care unit (ICU) admi... more Severe community-acquired pneumonia (CAP) is an important cause of intensive care unit (ICU) admissions. Many different pneumonia scoring systems have been developed in order to assess the severity of pneumonia and to decide the ICU follow-up and treatment. But still debate is going on about their performances and also they have not been tested yet if they can predict ICU mortality in severe CAP patients requiring mechanical ventilation. The aim of this study is to evaluate the performances of pneumonia and ICU scores in predicting mortality in CAP patients requiring mechanical ventilation. A retrospective observational cohort study. The files of mechanically ventilated CAP patients were reviewed and demographic, clinic and laboratory characteristics were recorded. Scoring systems of pneumonia [revised American Thoracic Society (ATS) criteria, CURB-65, pneumonia severity index (PSI)] and ICU [Acute Physiology Assessment and Chronic Health Evaluation (APACHE) II, Sequential Organ Fai...
Mikrobiyoloji bülteni, 2005
In the present study, 34 new pulmonary tuberculosis cases prediagnosed upon clinical and radiolog... more In the present study, 34 new pulmonary tuberculosis cases prediagnosed upon clinical and radiological findings, have been evaluated by means of microbiological aspects such as microscopy [Ehrlich-Ziehl Neelsen (EZN) and Auramin-Rhodamine (A-R) stains], culture [inoculation into Lowenstein-Jensen (LJ) media] and three different molecular methods [Cobas Amplicor Mycobacterium tuberculosis polymerase chain reaction (PCR), Gen-Probe amplified M. tuberculosis direct test and TaqMan Real Time ABI 5700 PCR]. M.tuberculosis positivity of the sputum samples were 55.8% (n: 19) with EZN staining, 52.9% (n: 18) with A-R staining and 58.8% (n: 20) with culture methods. Among molecular techniques, Cobas Amplicor and TaqMan PCR yielded positive results in 21 patients (61.7%), however, the positivity rate of Gen-Probe AMTD was 47.0% (n: 16). Of 34 samples, 10 (29.4%) were found to be positive with all of the methods used, while six (17.6%) of them were negative with all methods. It can be concluded...
Japanese journal of infectious diseases, 2005
To determine the bacterial etiology of lower respiratory tract infections (LRTIs) in Turkey, quan... more To determine the bacterial etiology of lower respiratory tract infections (LRTIs) in Turkey, quantitative cultures of sputum were carried out. The major pathogens for LTRIs were found to be Haemophilus influenzae, followed by Streptococcus pneumoniae and Moraxella catarrhalis. Only 6.1% of the H. inlfuenzae and all strains of M. catarrhalis were beta-lactamase producers. An E-test showed that 31.2% of the S. pneumoniae strains had an intermediate resistance to penicillin, and the remaining strains were susceptible; no fully resistant strains were detected.
Hepato-gastroenterology
Lung involvement due to inflammatory bowel disease (IBD) is frequent, however the pathogenic mech... more Lung involvement due to inflammatory bowel disease (IBD) is frequent, however the pathogenic mechanism is still debatable. Although the evidence of inflammation in colonic and lung tissue has been documented, the possible effect of oxidative stress in lung tissue has not been evaluated to date. We sought to assess the effects of oxidant/antioxidants on lung tissue in a model of experimental colitis. Colitis was induced with intra-colonic administration of 4% acetic acid. Control group received isotonic saline. Serum and lung tissue markers of oxidative stress were explored. Serum total oxidant status was significantly higher in the colitis group than the controls while total antioxidant status was similar. The determinants of oxidants including lipid peroxidation assay and myeloperoxidase activity were significantly higher in the lung tissue of the colitis group whereas the indicators of antioxidant capacity determined as superoxide dismutase, catalase, glutathione and glutathione p...
Sarkoidoz, pulmoner tromboemboli için bilinen bir risk faktörü olmamakla birlikte son yıllarda bi... more Sarkoidoz, pulmoner tromboemboli için bilinen bir risk faktörü olmamakla birlikte son yıllarda bilinen başka risk faktörü olmaksızın sarkoidozlu hastalarda pulmoner tromboemboli gelişimi ile ilgili yeni veriler bildirilmektedir. Bu sunumda, 47 yaşında sarkoidoz tanısıyla beş aydır metilprednizolon tedavisi altında takip edilmekte olan kadın hastada gelişen bir masif tromboembolizm olgusu bildirilmiştir. Bu olgu ile, sarkoidozun pulmoner tromboembolinin risk faktörlerinden biri olabileceği ve takip altındaki sarkoidozlu hastalarda klinik bozulmanın ayırıcı tanısında pulmoner tromboembolinin de akılda tutulması gerekliliği düşünülmüştür.
Objective: Many pulmonary disorders are reported in end-stage renal disease (ESRD) patients who u... more Objective: Many pulmonary disorders are reported in end-stage renal disease (ESRD) patients who underwent hemodialysis therapy.The aim of this study is to evaluate the effect of erythropoietin and interdialytic weight gain on pulmonary function tests (PFTs) in hemodialysis patients. Material and Methods: Forty-adult patients were included in this prospective study. After recording baseline demographical variables, erythropoietin use and interdialytic weight gain, PFTs were performed to all of the patients just before and in the first hour after hemodialysis therapy. Results: Twenty percentage of the patients represented any PFT abnormality. When the PFT results compared before and after hemodialysis therapy no significant change was observed. The pre and postdialysis PFT results among patients who receive erythropoietin treatment do not represent any difference from those who do not receive this therapy. FEV1/FVC and FEF25-75 were improved with hemodialysis therapy among patients wh...
Respiratory insufficiency is one of the most frequent causes of intensive care unit (ICU) admissi... more Respiratory insufficiency is one of the most frequent causes of intensive care unit (ICU) admissions among obstetric patients. The challenges faced in the treatment of this patient population are even greater due to the fact that there are two young lives to be saved simultaneously: mother and fetus. Any treatment which may be the best choice for the mother may adversely affect the fetus. The aim of this review is to summarize the reasons and the management of the most common pulmonary disorders requiring ICU admissions in pregnancy for the obstetrician. In the spectrum of this review the most common reasons of respiratory failure such as bronchial asthma, pulmonary embolism, amnion fluid embolism and pneumonia will be discussed. Optimal management for all of the disorders requires early identification and treatment of the respiratory failure, stabilizing the hemodynamics, improve oxygenation and close fetal and maternal monitoring.
Tuberkuloz ve Toraks, 2012
Postoperative respiratory failure is related with the highest mortality and morbidity among all p... more Postoperative respiratory failure is related with the highest mortality and morbidity among all perioperative complications. The most common underlying mechanism of postoperative respiratory failure is the development of atelectasis. Anaesthesia, medications which cause respiratory depression, high FiO2 use, postoperative pain and disruption of muscle forces due to surgery leads to decrease in functional residual capacity and results in atelectasis formation. Atelectasis causes severe hypoxemia due to ventilation, perfusion mismatch, shunt and increased peripheral vascular resistance. Intrathoracic positive pressure is an effective therapeutic option in both prevention and treatment of atelectasis. Non-invasive mechanical ventilation is related with a lower mortality and morbidity rate due to lack of any potential complication risks of endotracheal intubation. Non-invasive mechanical ventilation can be applied as prophylactic or curative. Both of these techniques are related with lower reintubation rates, nosocomial infections, duration of hospitalization and mortality in patients with postoperative respiratory failure. The differences of this therapy from standard application and potential complications should be well known in order to improve prognosis in these group of patients. The primary aim of this review is to underline the pathogenesis of postoperative respiratory failure. The secondary aim is to clarify the optimum method, effect and complications of non-invasive mechanical ventilation therapy under the light of the studies which was performed in specific patient groups.
BMC Pulmonary Medicine, 2014
Background: Identifying the predictors of noninvasive ventilation (NIV) failure has attracted sig... more Background: Identifying the predictors of noninvasive ventilation (NIV) failure has attracted significant interest because of the strong link between failure and poor outcomes. However, very little attention has been paid to the timing of the failure. This narrative review focuses on the causes of NIV failure and risk factors and potential remedies for NIV failure, based on the timing factor. Results: The possible causes of immediate failure (within minutes to <1 h) are a weak cough reflex, excessive secretions, hypercapnic encephalopathy, intolerance, agitation, and patient-ventilator asynchrony. The major potential interventions include chest physiotherapeutic techniques, early fiberoptic bronchoscopy, changing ventilator settings, and judicious sedation. The risk factors for early failure (within 1 to 48 h) may differ for hypercapnic and hypoxemic respiratory failure. However, most cases of early failure are due to poor arterial blood gas (ABGs) and an inability to promptly correct them, increased severity of illness, and the persistence of a high respiratory rate. Despite a satisfactory initial response, late failure (48 h after NIV) can occur and may be related to sleep disturbance.
European Respiratory Journal, Sep 1, 2013
Number: 2321 Publication Number: P4219 Abstract Group: 6.1. Epidemiology
Japanese Journal of Infectious Diseases, Feb 1, 2005
To determine the bacterial etiology of lower respiratory tract infections (LRTIs) in Turkey, quan... more To determine the bacterial etiology of lower respiratory tract infections (LRTIs) in Turkey, quantitative cultures of sputum were carried out. The major pathogens for LTRIs were found to be Haemophilus influenzae, followed by Streptococcus pneumoniae and Moraxella catarrhalis. Only 6.1% of the H. inlfuenzae and all strains of M. catarrhalis were -lactamase producers. An E-test showed that 31.2% of the S. pneumoniae strains had an intermediate resistance to penicillin, and the remaining strains were susceptible; no fully resistant strains were detected.
Turkiye Klinikleri Cardiovascular Sciences, 2013
Minerva medica
Pulmonary function tests (PFT) have an important role in the assessment of pulmonary and nonpulmo... more Pulmonary function tests (PFT) have an important role in the assessment of pulmonary and nonpulmonary complications of hematopoetic stem cell transplantation (HSCT). In this study the relationship between PFTs and DLCOadj values and the complications of HSCT was investigated. The possible role of iron overload in the deterioration of the PFTs after HSCT was also searched. One hundred and fifty one patients who had undergone allogeneic HSCT between years 2003 through 2008, and had the records of PFTs prior to and at 1, 3, 6, 9 and 12 months after transplantation were included in the study. Prospectively collected data of these patients were analysed retrospectively. Although no significant difference was identified in other PFT parameters, a significant decrease in DLCOadj was determined after 1st and 3rd months of HSCT. A significant correlation was found between pretransplant DLCOadj value <%70 and sinusoidal obstruction syndrome (SOS) (P=0.001, r=0.323), but in multivariate ana...
Tuberkuloz ve toraks
Severe community-acquired pneumonia (CAP) is an important cause of intensive care unit (ICU) admi... more Severe community-acquired pneumonia (CAP) is an important cause of intensive care unit (ICU) admissions. Many different pneumonia scoring systems have been developed in order to assess the severity of pneumonia and to decide the ICU follow-up and treatment. But still debate is going on about their performances and also they have not been tested yet if they can predict ICU mortality in severe CAP patients requiring mechanical ventilation. The aim of this study is to evaluate the performances of pneumonia and ICU scores in predicting mortality in CAP patients requiring mechanical ventilation. A retrospective observational cohort study. The files of mechanically ventilated CAP patients were reviewed and demographic, clinic and laboratory characteristics were recorded. Scoring systems of pneumonia [revised American Thoracic Society (ATS) criteria, CURB-65, pneumonia severity index (PSI)] and ICU [Acute Physiology Assessment and Chronic Health Evaluation (APACHE) II, Sequential Organ Fai...
International Journal of Clinical Practice
Severe exacerbations are the leading cause of fatal events in chronic obstructive pulmonary disea... more Severe exacerbations are the leading cause of fatal events in chronic obstructive pulmonary disease (COPD). The new Global Initiative for Chronic Obstructive Lung Disease strategy included the number of exacerbations in the grading of the disease. The primary aim of this study was to evaluate the potentially modifiable precipitating factors of frequent severe exacerbations requiring hospital admission in COPD. The secondary aim was to investigate the risk factors of readmission within 2 months following an exacerbation requiring hospitalisation. Data regarding the number of exacerbations in the previous year, current comorbidities, medications, and clinical and functional status of COPD patients were evaluated. We included 107 COPD patients (85% men). The mean number of severe exacerbations was 1.3 ± 1.7 (per patient/per year), and 37.4% of the patients had frequent severe exacerbations (≥ 2/year). Multivariate analysis indicated that haematocrit < 41%, angiotensin converting enz...
# Bu çalışma, Toraks Derneği IV. Ulusal Kongresi (24-27 Nisan 2002, Antalya)'nde sunulmuştur.
Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG / World Association of Sarcoidosis and Other Granulomatous Disorders, 2014
Several HLA-DR alleles have been described as a potential risk factor for sarcoidosis between dis... more Several HLA-DR alleles have been described as a potential risk factor for sarcoidosis between distinct ethnic groups however the relationship between HLA-DR alleles and extra-pulmonary sarcoidosis (EPS) is still scarce. The aim of this prospective study is to investigate the relationship between extra-pulmonary involvement and HLA-DR genetic analysis in Turkish patients with sarcoidosis. In this study, we HLA-typed sarcoidosis patients with and without extra-pulmonary involvement, and compared with healthy control subjects. The presence of EPS was evaluated with previously defined standard criteria (ACCESS) and only patients with definite and probable involvement were accepted as positive. Sequence Specific Oligonucletide Probes method was used for typing of HLA-DRB1 alleles from DNA samples in both groups. The frequency of HLA DRB1*15 allele was more frequent in patients with sarcoidosis than controls (% 20.4 vs % 9.6)(pcorr=0.017). According to multivariate analysis (MVA), the pre...
Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG / World Association of Sarcoidosis and Other Granulomatous Disorders, 2013
Hermansky-Pudlak Syndrome (HPS) is a rare autosomal recessive disorder presenting with oculocutan... more Hermansky-Pudlak Syndrome (HPS) is a rare autosomal recessive disorder presenting with oculocutaneous albinism, bleeding diathesis and lysosomal accumulation of ceroid lipofuscin which leads to interstitial fibrosis in lung. Pulmonary fibrosis which is usually associated with HPS-1 and HPS-4 subtypes usually manifests in the third/fourth decades of life representing with giant lamellar bodies of alveolar type-II-cells and their apparent degeneration causes restrictive lung disease. Pulmonary manifestation of this syndrome may lead to premature death. Pulmonary Alveolar Proteinosis(PAP) is another rare disease characterized by alveolar deposition of surfactant phospholipids and proteins secondary to defective clearance by alveolar macrophages. PAP may occur as autoimmune diseases and/or secondary to toxic inhalation, systemic infections or hematological disorders. None of the cases were reported secondary to HPS according to the best our knowledge. As well, pulmonary involvement of H...
The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2012
Extraintestinal manifestations of inflammatory bowel diseases are well recognized and mainly affe... more Extraintestinal manifestations of inflammatory bowel diseases are well recognized and mainly affect the joints, skin, liver, and eyes; however, clinically significant pulmonary involvement is very rare. Early identification of pulmonary involvement is important and will be life-saving. We report herein a case of an ulcerative colitis patient, presenting with acute respiratory distress syndrome and bilateral recurring pneumothorax, pneumomediastinum and subcutaneous emphysema, i.e., air leak syndrome. He was diagnosed with open lung biopsy as bronchiolitis obliterans organizing pneumonia most probably due to viral etiology and responded well to steroid therapy, with almost complete resolution of radiographic and clinical findings. In inflammatory bowel disease patients, bronchiolitis obliterans organizing pneumonia developing due to viral or fungal infectious etiology or due to the inflammatory bowel disease itself may progress to acute respiratory distress syndrome and may present w...
Tüberküloz ve toraks, 2010
Dead space ventilation (Vd/Vt) is a valuable parameter which indicates the ventilated but not per... more Dead space ventilation (Vd/Vt) is a valuable parameter which indicates the ventilated but not perfused lung areas. The normal range is between 30-50% in mechanically ventilated patients. Increased levels could be observed in many pulmonary diseases such as pulmonary embolism, acute respiratory distress syndrome and chronic obstructive pulmonary disease. Vd/Vt is also used for the prediction of extubation success and a value of < 55-60% indicates successful extubation according to several studies. The aim of this study is to evaluate the value of baseline capnographic measurements on extubation success. A total of 35 patients were included in this prospective study; and 25 (71%) of them who were extubated successfully were named as group 1 and the remaining 10 (29%) patients with extubation failure were named as group 2. When the two groups were compared, Vd/Vt value, measured at the first 24 hours of hospitalization, was found to be higher in group 2 (0.66 vs. 0.54, p< 0.05). ...
Tüberküloz ve toraks, 2010
Severe community-acquired pneumonia (CAP) is an important cause of intensive care unit (ICU) admi... more Severe community-acquired pneumonia (CAP) is an important cause of intensive care unit (ICU) admissions. Many different pneumonia scoring systems have been developed in order to assess the severity of pneumonia and to decide the ICU follow-up and treatment. But still debate is going on about their performances and also they have not been tested yet if they can predict ICU mortality in severe CAP patients requiring mechanical ventilation. The aim of this study is to evaluate the performances of pneumonia and ICU scores in predicting mortality in CAP patients requiring mechanical ventilation. A retrospective observational cohort study. The files of mechanically ventilated CAP patients were reviewed and demographic, clinic and laboratory characteristics were recorded. Scoring systems of pneumonia [revised American Thoracic Society (ATS) criteria, CURB-65, pneumonia severity index (PSI)] and ICU [Acute Physiology Assessment and Chronic Health Evaluation (APACHE) II, Sequential Organ Fai...
Mikrobiyoloji bülteni, 2005
In the present study, 34 new pulmonary tuberculosis cases prediagnosed upon clinical and radiolog... more In the present study, 34 new pulmonary tuberculosis cases prediagnosed upon clinical and radiological findings, have been evaluated by means of microbiological aspects such as microscopy [Ehrlich-Ziehl Neelsen (EZN) and Auramin-Rhodamine (A-R) stains], culture [inoculation into Lowenstein-Jensen (LJ) media] and three different molecular methods [Cobas Amplicor Mycobacterium tuberculosis polymerase chain reaction (PCR), Gen-Probe amplified M. tuberculosis direct test and TaqMan Real Time ABI 5700 PCR]. M.tuberculosis positivity of the sputum samples were 55.8% (n: 19) with EZN staining, 52.9% (n: 18) with A-R staining and 58.8% (n: 20) with culture methods. Among molecular techniques, Cobas Amplicor and TaqMan PCR yielded positive results in 21 patients (61.7%), however, the positivity rate of Gen-Probe AMTD was 47.0% (n: 16). Of 34 samples, 10 (29.4%) were found to be positive with all of the methods used, while six (17.6%) of them were negative with all methods. It can be concluded...
Japanese journal of infectious diseases, 2005
To determine the bacterial etiology of lower respiratory tract infections (LRTIs) in Turkey, quan... more To determine the bacterial etiology of lower respiratory tract infections (LRTIs) in Turkey, quantitative cultures of sputum were carried out. The major pathogens for LTRIs were found to be Haemophilus influenzae, followed by Streptococcus pneumoniae and Moraxella catarrhalis. Only 6.1% of the H. inlfuenzae and all strains of M. catarrhalis were beta-lactamase producers. An E-test showed that 31.2% of the S. pneumoniae strains had an intermediate resistance to penicillin, and the remaining strains were susceptible; no fully resistant strains were detected.
Hepato-gastroenterology
Lung involvement due to inflammatory bowel disease (IBD) is frequent, however the pathogenic mech... more Lung involvement due to inflammatory bowel disease (IBD) is frequent, however the pathogenic mechanism is still debatable. Although the evidence of inflammation in colonic and lung tissue has been documented, the possible effect of oxidative stress in lung tissue has not been evaluated to date. We sought to assess the effects of oxidant/antioxidants on lung tissue in a model of experimental colitis. Colitis was induced with intra-colonic administration of 4% acetic acid. Control group received isotonic saline. Serum and lung tissue markers of oxidative stress were explored. Serum total oxidant status was significantly higher in the colitis group than the controls while total antioxidant status was similar. The determinants of oxidants including lipid peroxidation assay and myeloperoxidase activity were significantly higher in the lung tissue of the colitis group whereas the indicators of antioxidant capacity determined as superoxide dismutase, catalase, glutathione and glutathione p...