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Papers by Nurhan Atilla

Arquivos Brasileiros de Cardiologia, 2024

Interdisciplinary Medical Journal, Aug 30, 2023

We aimed to investigate the ability of the Prognostic Nutritional Index (PNI) score to predict th... more We aimed to investigate the ability of the Prognostic Nutritional Index (PNI) score to predict the prognosis and mortality of patients hospitalized for COVID-19 Pneumonia. Methods: One hundred seventy-three patients were included in the study. The patients were grouped as patients with or without pneumonia, those who were hospitalized in the ward or intensive care unit, who were discharged, or who died. The ability of the PNI score, which was calculated according to the results at the time of admission, to predict hospitalization and mortality in the intensive care unit was evaluated. The mean age of the patients was found to be 53.9 years. Pneumonia was detected in 72.3% of the patients. The need for intensive care developed in 26% of them. The PNI score was found to be significantly lower (p<0.05) in patients with pneumonia compared to patients without pneumonia. The PNI score of the patients hospitalized in the intensive care unit was found to be significantly (p<0.05) lower than the patients hospitalized in the ward. The PNI score of the patients who died was found to be significantly lower (p<0.05) than the patients who were discharged. The cut-off value of the PNI score was found to be 46. The PNI score which are among routine blood tests, was found to be effective in predicting intensive care unit admission and mortality. We believe that using the PNI score together with other biomarkers will be beneficial for clinicians in the prediction of the prognosis of patients.

Journal of surgery and medicine, Aug 1, 2020

OZET Trakeal bronkus brons agacinin dogumsal nadir gorulen bir anomalisidir. Bu anomali asempto... more OZET Trakeal bronkus brons agacinin dogumsal nadir gorulen bir anomalisidir. Bu anomali asemptomatik hastalardan, tekrarlayan akciger enfeksiyonuna kadar degisen spektrumda klinik bulguya sebep olabilir. Tanida bilgisayarli tomografi ile sanal bronkoskopi trakeobronsial agacin goruntulemesinde son yillarda kullanilan yeni bir yontemdir. Bizde trakeal bronkuslu olgumuzu nadir gorulmesi nedeniyle litaratur esliginde sunmayi amacladik. Anahtar Kelime: Trakeal brons; bronsiyal anomali; nadir olgu. ABSTRACT Tracheal bronchus is a rarely seen congenital anomaly of the bronchial tree. This anomaly may cause a variable spectrum of clinical findings, rang-ing from asymptomatic patients to recurrent pulmo-nary infections. Virtual bronchoscopy via computed tomography is a recently developed diagnostic method used for imaging the tracheobronchial tree. Because tracheal bronchus is rare, we would like to present a case with the accompanying literature. Key Words: Tracheal bronchus; bronchial anomaly; rare case.

Annals of the Rheumatic Diseases, Jun 1, 2015

Cureus, Jul 25, 2023

Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by r... more Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by right heart failure following recurrent pulmonary embolism (PE). It is important to know the predictors of the development of CTEPH after PE as it is a treatable cause of pulmonary arterial hypertension. Soluble ST2 is a biomarker closely associated with heart failure and the inflammatory process. The aim of this study was to investigate the relationship between sST2 level and the development of CTEPH in patients with PE. Methodology: Baseline characteristics, electrocardiographic findings, laboratory findings, transthoracic echocardiography (TTE) findings, location, and extent of involvement in CT pulmonary angiography were recorded in 100 patients with acute PE included in our prospective study. Treatment modalities and treatment durations were followed. Ventilation-perfusion scintigraphy was performed in patients with a systolic pulmonary artery pressure (sPAP) of 35 mmHg or more on TTE and residual thrombus on CT pulmonary angiography after at least three months of anticoagulant use. In the case of findings compatible with CTEPH in these examinations, patients were diagnosed with CTEPH by right heart catheterization. The sST2 levels obtained from all patients at admission were evaluated between the groups of patients with and without CTEPH. Results: CTEPH was observed in 11 of the 100 patients who participated in the trial, with a median followup of 284 ± 60 days. The mean age of the 11 patients with CTEPH was 67 ± 10 years; five were males and six were females. The mean age of 89 patients without CTEPH was 65 ± 18 years, 36 were males and 53 were females. The sST2 values of the group with CTEPH were found to be statistically significantly higher than those of patients without ) vs 58.6 (29.5-122.9) p=0.020]. This receiver operating characteristic (ROC) curve shows that the optimal cutoff point of sST2 levels in the prediction of CTEPH was > 157.4 with specificity of 83.7% and sensitivity of 81.8% (area under the curve = 0.783; 95% CI, 1.005-1.027; p < 0.001). In acute PE patients, sST2 levels may be a useful biomarker to predict the development of CTEPH.

Turkish Journal of Medical Sciences, 2016

Sarcoidosis Vasculitis and Diffuse Lung Diseases, 2022

Introduction: The aim of our study is to investigate the etiological distribution of ILD in Turke... more Introduction: The aim of our study is to investigate the etiological distribution of ILD in Turkey by stratifying the epidemiological characteristics of ILD cases, and the direct cost of initial diagnosis of the diagnosed patients. Material-Method: The study was conducted as a multicenter, prospective, cross-sectional, clinical observation study. Patients over the age of 18 and who accepted to participate to the study were included and evaluated as considered to be ILD. The findings of diagnosis, examination and treatment carried out by the centers in accordance with routine diagnostic procedures were recorded observationally. Results: In total,1070 patients were included in this study. 567 (53%) of the patients were male and 503 (47%) were female. The most frequently diagnosed disease was IPF (30.5%). Dyspnea (75.9%) was the highest incidence among the presenting symptoms. Physical examination found bibasilar inspiratory crackles in 56.2 % and radiological findings included reticular opacities and interlobular septal thickenings in 55.9 % of the cases. It was observed that clinical and radiological findings were used most frequently (74.9%) as a diagnostic tool. While the most common treatment approaches were the use of systemic steroids and antifibrotic drugs with a rate of 30.7% and 85.6%, respectively. The total median cost from the patient’s admission to diagnosis was 540 Turkish Lira. Conclusion: We believe that our findings compared with data from other countries will be useful in showing the current situation of ILD in our country to discuss this problem and making plans for a solution.

Journal of contemporary medicine, 2016

Annals of the Rheumatic Diseases, 2015

Background: Chronic inflammation, the basic feature of rheumatoid arthritis (RA), plays a major r... more Background: Chronic inflammation, the basic feature of rheumatoid arthritis (RA), plays a major role in accelerated atherosclerosis through its influence on insulin resistance (IR), lipid status, and other risk factors. Objectives: To investigate the prevalence of IR in RA pts with normal glycoregulation and to determine its association with inflammatory disease burden, or therapy exposure. Methods: The study population included 90 RA pts (mean age 52.4±9.9 yrs), 86.7% females, with median disease duration of 9 yrs (range 4-13). Clinical workup included determination of the body mass index, waist cucumference (WC), and blood pressure (TA). RA specific evaluation comprised assessment of disease activity (mDAS28-SE, mDAS28-CRP, mHAQ) as well as antirheumatic treatment. All pts were on disease modifying antirheumatic drugs, 59/90 (65.6%), steroids (median 5 mg/day, range 5-10), and biologic therapy 25/90 (27.8%). Pts on steroids >10 mg/day were excluded. Laboratory analyses included inflammation markers (SE, hsCRP) and lipids. Serum specific insulin was measured by a sensitive ELISA, which employs a monoclonal antibody to insulin. IR was calculated using the updated-computer Homeostasis Model Assessment (HOMA2-IR), based on fasting plasma glucose and serum specific insulin concentrations. The output of the HOMA2 model was calibrated to give IR of 1 as normal. Therefore, values were considered abnormal when HOMA2-IR was >1. Because of high coefficient of variation (53%) values of HOMA2-IR were logarithmically transformed. Results: Increased logHOMA2-IR was noted in 71/90 (74.4%) pts with median of 1.4 (range 1.0-2.3). Pts with high disease activity (DAS28-SE≥5.1) had statisticaly higher concentration of specific insulin 79 (58-120) pmol/l and higher logHOMA2-IR=1.7 (1.2-2.5) than those with DAS28-SE<5.1: insulin 57 (39-91), logHOMA2-IR=1.3 (0.9-1.9) (p<0.01 for both). Importantly, both groups were comparable regarding all other factors that might influence IR (age, BMI, blood pressure, WC, and triglicerides), duration of RA and anti-inflammatory treatment inlcuding glycocorticoids. Univariant regression revealed association of logHOMA2-IR with all IR risk factors, as well as with disease activity. After adjustment for age, BMI, TA, and triglycerides in multivariant regression analysis, association of logHOMA2-IR persisted for the number of tender joints (β 0.008 (95% CI, 0.001-0.016), p=0.029), values for visual analogue scale (β 0.003 (95% CI, 0.001-0.005) p=0.010), HAQ (β 0.086 (95% CI, 0.007-0.165) p=0.034, mDAS28-SE (β 0.034 (95% CI, 0.006-0.061) p=0.017, and mDAS28-CRP (β 0.034 (95% CI, 0.006-0.063) p=0.019. On the other hand we did not find significant association with the counts of swollen joints, SE rate and hsCRP-a. Of note, we obtained a negative association of logHOMA2-IR with duration of anti-inflammatory therapy, including steroids. Conclusions: We demonstrated a significant association of disease activity and impaired insulin sensitivity in RA patients, which remains valid after correction for factors with well established influence on insulin resistance. The lack of association with swollen joint counts and acute phase reactants may implicate that the influence of inflammatory disease burden is important but not the only risk factor for IR in RA.

Annals of the Rheumatic Diseases, 2015

International Journal of Medical Sciences, 2012

Journal of health sciences and medicine, Oct 22, 2020

Cite this article as/Bu makaleye atıf için: Arpağ H, Atilla N, Fındıklı E. Comparison of affectiv... more Cite this article as/Bu makaleye atıf için: Arpağ H, Atilla N, Fındıklı E. Comparison of affective temperament profiles in male patients with chronic obstructive pulmonary disease according to groups.

Journal of Medicine and Palliative Care

Although many mechanisms leading to lung fibrosis in systemic sclerosis-associated interstitial l... more Although many mechanisms leading to lung fibrosis in systemic sclerosis-associated interstitial lung disease (SSc-ILD) have been suggested, this issue has not been fully understood yet. Recently, there has been increased evidence that the mediators and pathological mechanisms responsible for idiopathic pulmonary fibrosis (IPF) are similar to those in SSc-ILD. Accordingly, studies have been conducted to support that antifibrotic agents used in the treatment of IPF may also be useful in SSc-ILD. There are currently two antifibrotic agents on the market, namely nintedanib and pirfenidon. Although studies on the use of pirfenidone in SSc-ILD are not satisfactory, nintedanib studies have yielded positive results. The SENSCIS (Safety and Efficacy of Nintedanib in Systemic Sclerosis) study is the first and most comprehensive Phase III study on this subject. In 2019, the results of SENSCIS trial showed that, nintedanib significantly reduced the annual decline in lung function in SSc-ILD. Af...

Anatolian Current Medical Journal, 2021

The aim of this study is to investigate the effects of procalcytonin (PCT), C-reactive protein (C... more The aim of this study is to investigate the effects of procalcytonin (PCT), C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) on the mortality and duration of hospital stay in patients diagnosed with pneumonia. Material and Method: The study consists of 111 cases of pneumonia followed in our chest diseases service and intensive care unit between 2017 to 2018. Collected data included demographic information, NLR, PCT, CURB-65 scores. The data were evaluated by parametric tests (paired sample T test, independent sample T test). Chi-square test was used in order to compare categorical variables. P value ≤0.05 was considered statistically significant. Results: A statistically significant positive correlation was detected between PCT and NLR (p<0.001; r=0.343), PCT and CRP (p<0.001; r=0.502), NLR and CRP (p<0.001; r=0.427). There was a statistically significant correlation between mortality and CRP (p<0.001; 0.427), mortality and PCT (p<0.001; r=0.343) and mortality and NLR (p=0.013; r=0.235). There was a statistically significant correlation between duration of hospital stay and PCT (p=0.036; r=0.199) duration of hospital stay and NLR (p=0.030; r=0.206) but not with duration of hospital stay and CRP (p=0.298; r=0.102). Conclusion: Besides PCT and CRP, NLR can also be used for prognosis estimation in pneumonia patients.

Turkish Thoracic Journal, 2022

OBJECTIVE Altered cardiac repolarization is an important mechanism in the development of malignan... more OBJECTIVE Altered cardiac repolarization is an important mechanism in the development of malignant cardiac arrhythmia and in the occurrence of sudden cardiac death. It is known that the risk of cardiac arrhythmia and sudden death is increased in patients with chronic obstructive pulmonary disease. Evaluating the measurements of repolarization in the electrocardiogram may provide useful information to determine potential risks for lethal arrhythmias in the patients with chronic obstructive pulmonary disease. In the present study, we investigated the possible relationships between repolarization parameters in the electrocardio and demographic, clinical, and biochemical findings in patients with chronic obstructive pulmonary disease. MATERIAL AND METHODS In the present study, 35 patients with Global Initiative for Chronic Obstructive Lung Disease A-B constituted group 1 and 35 patients with Global Initiative for Chronic Obstructive Lung Disease C-D constituted group 2. Cardiac repolarization and dispersion (QTc interval and QT dispersion) were measured on 12-lead electrocardiogram. QTc interval, QT dispersion, TP-e, and Tp-e/ QTc were evaluated in order to determine the patients at risk of sudden cardiac death. QTc interval >440 ms in men and >460 ms in women was considered as prolonged QTc interval. RESULTS QTc and QTd values were found to be statistically significantly prolonged in the group of GOLD C-D compared to the group of GOLD A-B (P < .001). QTc value showed negative correlation with the ratio of forced expiratory volume in 1 second to forced vital capacity and partial pressure of oxygen (P = .030, r = -0.260; P = .006, r = -0.332, respectively). No significant difference was in Tp-e and Tp-e/QTc between the groups (P = .73, P = .12, respectively). CONCLUSION QTc and QTd are non-invasive markers reflecting arrhythmogenicity, and our findings were found to be related to prolonged QTc and QTd in patients with chronic obstructive pulmonary disease. Prolongation in the dispersion of repolarization and altered cardiac repolarization in the population with chronic obstructive pulmonary disease may be related to hypoxemia and airway obstruction. Alterations in the cardiac repolarization may put these patients at high risk for malignant ventricular arrhythmia and sudden cardiac death.

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Göğüs Hastalıkları, Kahramanmaraş Kahramanmar... more Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Göğüs Hastalıkları, Kahramanmaraş Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Göğüs Hastalıkları, Kahramanmaraş Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları, Kahramanmaraş Fulsen Bozkuş1, Nurhan Atilla2, Selma Ateş3 Necrotising Pneumonia In Etiology of Massive Hemoptysis: A case report Masif Hemoptizi Etyolojisinde Nekrotizan Pnömoni: Olgu sunumu CASE REPORT OLGU SUNUMU

Tuberkuloz ve Toraks, 2018

Insights into chest computed tomography findings in Behcet's disease Introduction: To evaluate th... more Insights into chest computed tomography findings in Behcet's disease Introduction: To evaluate the spectrum and frequency of abnormal chest multidedector computed tomography (MDCT) findings in Behcet's disease(BD). Materials and Methods: Chest MDCT scans of 44 patients referred to radiology department for chest symptoms those had prior or newly established diagnosis of BD between 2009-2016 were retrospectively reviewed. Abnormal findings within pulmonary artery (PA), lungs, other large vessels, heart, mediastinum, pleura and pericardium were noted. results: Sixteen patients had one ore more computed tomography (CT) findings related to BD. PA involvement was most common (27.2%) presentation revealing thrombosis in 8 and aneurysms in 4 of 12 patients. Mean PA diameter was 29 ± 3.7 mm. Patients with PA involvement had significantly higher PA diameters than those without (p< 0.001). Hypertrophied bronchial artery seen as serpiginous vessels around hilum was a common finding (66.6%). Lung parenchyma findings was rarely isolated and usually associated with PA involvement with subpleural alveolar opacities, focal atelectasis and ill-defined nodular opacities. Cardiac filling defects were accompanying lesions in most of patients with PA aneurysms (75%). conclusion: BD is associated with a wide spectrum of simultaneous involvement of discrete anatomical sites. PA enlargement and hypertrophied bronchial artery is a clue for patients with PA involvement. Heart chambers should be checked for filling defects particularly in patients with PA aneurysms.

Arquivos Brasileiros de Cardiologia, 2024

Interdisciplinary Medical Journal, Aug 30, 2023

We aimed to investigate the ability of the Prognostic Nutritional Index (PNI) score to predict th... more We aimed to investigate the ability of the Prognostic Nutritional Index (PNI) score to predict the prognosis and mortality of patients hospitalized for COVID-19 Pneumonia. Methods: One hundred seventy-three patients were included in the study. The patients were grouped as patients with or without pneumonia, those who were hospitalized in the ward or intensive care unit, who were discharged, or who died. The ability of the PNI score, which was calculated according to the results at the time of admission, to predict hospitalization and mortality in the intensive care unit was evaluated. The mean age of the patients was found to be 53.9 years. Pneumonia was detected in 72.3% of the patients. The need for intensive care developed in 26% of them. The PNI score was found to be significantly lower (p<0.05) in patients with pneumonia compared to patients without pneumonia. The PNI score of the patients hospitalized in the intensive care unit was found to be significantly (p<0.05) lower than the patients hospitalized in the ward. The PNI score of the patients who died was found to be significantly lower (p<0.05) than the patients who were discharged. The cut-off value of the PNI score was found to be 46. The PNI score which are among routine blood tests, was found to be effective in predicting intensive care unit admission and mortality. We believe that using the PNI score together with other biomarkers will be beneficial for clinicians in the prediction of the prognosis of patients.

Journal of surgery and medicine, Aug 1, 2020

OZET Trakeal bronkus brons agacinin dogumsal nadir gorulen bir anomalisidir. Bu anomali asempto... more OZET Trakeal bronkus brons agacinin dogumsal nadir gorulen bir anomalisidir. Bu anomali asemptomatik hastalardan, tekrarlayan akciger enfeksiyonuna kadar degisen spektrumda klinik bulguya sebep olabilir. Tanida bilgisayarli tomografi ile sanal bronkoskopi trakeobronsial agacin goruntulemesinde son yillarda kullanilan yeni bir yontemdir. Bizde trakeal bronkuslu olgumuzu nadir gorulmesi nedeniyle litaratur esliginde sunmayi amacladik. Anahtar Kelime: Trakeal brons; bronsiyal anomali; nadir olgu. ABSTRACT Tracheal bronchus is a rarely seen congenital anomaly of the bronchial tree. This anomaly may cause a variable spectrum of clinical findings, rang-ing from asymptomatic patients to recurrent pulmo-nary infections. Virtual bronchoscopy via computed tomography is a recently developed diagnostic method used for imaging the tracheobronchial tree. Because tracheal bronchus is rare, we would like to present a case with the accompanying literature. Key Words: Tracheal bronchus; bronchial anomaly; rare case.

Annals of the Rheumatic Diseases, Jun 1, 2015

Cureus, Jul 25, 2023

Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by r... more Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by right heart failure following recurrent pulmonary embolism (PE). It is important to know the predictors of the development of CTEPH after PE as it is a treatable cause of pulmonary arterial hypertension. Soluble ST2 is a biomarker closely associated with heart failure and the inflammatory process. The aim of this study was to investigate the relationship between sST2 level and the development of CTEPH in patients with PE. Methodology: Baseline characteristics, electrocardiographic findings, laboratory findings, transthoracic echocardiography (TTE) findings, location, and extent of involvement in CT pulmonary angiography were recorded in 100 patients with acute PE included in our prospective study. Treatment modalities and treatment durations were followed. Ventilation-perfusion scintigraphy was performed in patients with a systolic pulmonary artery pressure (sPAP) of 35 mmHg or more on TTE and residual thrombus on CT pulmonary angiography after at least three months of anticoagulant use. In the case of findings compatible with CTEPH in these examinations, patients were diagnosed with CTEPH by right heart catheterization. The sST2 levels obtained from all patients at admission were evaluated between the groups of patients with and without CTEPH. Results: CTEPH was observed in 11 of the 100 patients who participated in the trial, with a median followup of 284 ± 60 days. The mean age of the 11 patients with CTEPH was 67 ± 10 years; five were males and six were females. The mean age of 89 patients without CTEPH was 65 ± 18 years, 36 were males and 53 were females. The sST2 values of the group with CTEPH were found to be statistically significantly higher than those of patients without ) vs 58.6 (29.5-122.9) p=0.020]. This receiver operating characteristic (ROC) curve shows that the optimal cutoff point of sST2 levels in the prediction of CTEPH was > 157.4 with specificity of 83.7% and sensitivity of 81.8% (area under the curve = 0.783; 95% CI, 1.005-1.027; p < 0.001). In acute PE patients, sST2 levels may be a useful biomarker to predict the development of CTEPH.

Turkish Journal of Medical Sciences, 2016

Sarcoidosis Vasculitis and Diffuse Lung Diseases, 2022

Introduction: The aim of our study is to investigate the etiological distribution of ILD in Turke... more Introduction: The aim of our study is to investigate the etiological distribution of ILD in Turkey by stratifying the epidemiological characteristics of ILD cases, and the direct cost of initial diagnosis of the diagnosed patients. Material-Method: The study was conducted as a multicenter, prospective, cross-sectional, clinical observation study. Patients over the age of 18 and who accepted to participate to the study were included and evaluated as considered to be ILD. The findings of diagnosis, examination and treatment carried out by the centers in accordance with routine diagnostic procedures were recorded observationally. Results: In total,1070 patients were included in this study. 567 (53%) of the patients were male and 503 (47%) were female. The most frequently diagnosed disease was IPF (30.5%). Dyspnea (75.9%) was the highest incidence among the presenting symptoms. Physical examination found bibasilar inspiratory crackles in 56.2 % and radiological findings included reticular opacities and interlobular septal thickenings in 55.9 % of the cases. It was observed that clinical and radiological findings were used most frequently (74.9%) as a diagnostic tool. While the most common treatment approaches were the use of systemic steroids and antifibrotic drugs with a rate of 30.7% and 85.6%, respectively. The total median cost from the patient’s admission to diagnosis was 540 Turkish Lira. Conclusion: We believe that our findings compared with data from other countries will be useful in showing the current situation of ILD in our country to discuss this problem and making plans for a solution.

Journal of contemporary medicine, 2016

Annals of the Rheumatic Diseases, 2015

Background: Chronic inflammation, the basic feature of rheumatoid arthritis (RA), plays a major r... more Background: Chronic inflammation, the basic feature of rheumatoid arthritis (RA), plays a major role in accelerated atherosclerosis through its influence on insulin resistance (IR), lipid status, and other risk factors. Objectives: To investigate the prevalence of IR in RA pts with normal glycoregulation and to determine its association with inflammatory disease burden, or therapy exposure. Methods: The study population included 90 RA pts (mean age 52.4±9.9 yrs), 86.7% females, with median disease duration of 9 yrs (range 4-13). Clinical workup included determination of the body mass index, waist cucumference (WC), and blood pressure (TA). RA specific evaluation comprised assessment of disease activity (mDAS28-SE, mDAS28-CRP, mHAQ) as well as antirheumatic treatment. All pts were on disease modifying antirheumatic drugs, 59/90 (65.6%), steroids (median 5 mg/day, range 5-10), and biologic therapy 25/90 (27.8%). Pts on steroids >10 mg/day were excluded. Laboratory analyses included inflammation markers (SE, hsCRP) and lipids. Serum specific insulin was measured by a sensitive ELISA, which employs a monoclonal antibody to insulin. IR was calculated using the updated-computer Homeostasis Model Assessment (HOMA2-IR), based on fasting plasma glucose and serum specific insulin concentrations. The output of the HOMA2 model was calibrated to give IR of 1 as normal. Therefore, values were considered abnormal when HOMA2-IR was >1. Because of high coefficient of variation (53%) values of HOMA2-IR were logarithmically transformed. Results: Increased logHOMA2-IR was noted in 71/90 (74.4%) pts with median of 1.4 (range 1.0-2.3). Pts with high disease activity (DAS28-SE≥5.1) had statisticaly higher concentration of specific insulin 79 (58-120) pmol/l and higher logHOMA2-IR=1.7 (1.2-2.5) than those with DAS28-SE<5.1: insulin 57 (39-91), logHOMA2-IR=1.3 (0.9-1.9) (p<0.01 for both). Importantly, both groups were comparable regarding all other factors that might influence IR (age, BMI, blood pressure, WC, and triglicerides), duration of RA and anti-inflammatory treatment inlcuding glycocorticoids. Univariant regression revealed association of logHOMA2-IR with all IR risk factors, as well as with disease activity. After adjustment for age, BMI, TA, and triglycerides in multivariant regression analysis, association of logHOMA2-IR persisted for the number of tender joints (β 0.008 (95% CI, 0.001-0.016), p=0.029), values for visual analogue scale (β 0.003 (95% CI, 0.001-0.005) p=0.010), HAQ (β 0.086 (95% CI, 0.007-0.165) p=0.034, mDAS28-SE (β 0.034 (95% CI, 0.006-0.061) p=0.017, and mDAS28-CRP (β 0.034 (95% CI, 0.006-0.063) p=0.019. On the other hand we did not find significant association with the counts of swollen joints, SE rate and hsCRP-a. Of note, we obtained a negative association of logHOMA2-IR with duration of anti-inflammatory therapy, including steroids. Conclusions: We demonstrated a significant association of disease activity and impaired insulin sensitivity in RA patients, which remains valid after correction for factors with well established influence on insulin resistance. The lack of association with swollen joint counts and acute phase reactants may implicate that the influence of inflammatory disease burden is important but not the only risk factor for IR in RA.

Annals of the Rheumatic Diseases, 2015

International Journal of Medical Sciences, 2012

Journal of health sciences and medicine, Oct 22, 2020

Cite this article as/Bu makaleye atıf için: Arpağ H, Atilla N, Fındıklı E. Comparison of affectiv... more Cite this article as/Bu makaleye atıf için: Arpağ H, Atilla N, Fındıklı E. Comparison of affective temperament profiles in male patients with chronic obstructive pulmonary disease according to groups.

Journal of Medicine and Palliative Care

Although many mechanisms leading to lung fibrosis in systemic sclerosis-associated interstitial l... more Although many mechanisms leading to lung fibrosis in systemic sclerosis-associated interstitial lung disease (SSc-ILD) have been suggested, this issue has not been fully understood yet. Recently, there has been increased evidence that the mediators and pathological mechanisms responsible for idiopathic pulmonary fibrosis (IPF) are similar to those in SSc-ILD. Accordingly, studies have been conducted to support that antifibrotic agents used in the treatment of IPF may also be useful in SSc-ILD. There are currently two antifibrotic agents on the market, namely nintedanib and pirfenidon. Although studies on the use of pirfenidone in SSc-ILD are not satisfactory, nintedanib studies have yielded positive results. The SENSCIS (Safety and Efficacy of Nintedanib in Systemic Sclerosis) study is the first and most comprehensive Phase III study on this subject. In 2019, the results of SENSCIS trial showed that, nintedanib significantly reduced the annual decline in lung function in SSc-ILD. Af...

Anatolian Current Medical Journal, 2021

The aim of this study is to investigate the effects of procalcytonin (PCT), C-reactive protein (C... more The aim of this study is to investigate the effects of procalcytonin (PCT), C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) on the mortality and duration of hospital stay in patients diagnosed with pneumonia. Material and Method: The study consists of 111 cases of pneumonia followed in our chest diseases service and intensive care unit between 2017 to 2018. Collected data included demographic information, NLR, PCT, CURB-65 scores. The data were evaluated by parametric tests (paired sample T test, independent sample T test). Chi-square test was used in order to compare categorical variables. P value ≤0.05 was considered statistically significant. Results: A statistically significant positive correlation was detected between PCT and NLR (p<0.001; r=0.343), PCT and CRP (p<0.001; r=0.502), NLR and CRP (p<0.001; r=0.427). There was a statistically significant correlation between mortality and CRP (p<0.001; 0.427), mortality and PCT (p<0.001; r=0.343) and mortality and NLR (p=0.013; r=0.235). There was a statistically significant correlation between duration of hospital stay and PCT (p=0.036; r=0.199) duration of hospital stay and NLR (p=0.030; r=0.206) but not with duration of hospital stay and CRP (p=0.298; r=0.102). Conclusion: Besides PCT and CRP, NLR can also be used for prognosis estimation in pneumonia patients.

Turkish Thoracic Journal, 2022

OBJECTIVE Altered cardiac repolarization is an important mechanism in the development of malignan... more OBJECTIVE Altered cardiac repolarization is an important mechanism in the development of malignant cardiac arrhythmia and in the occurrence of sudden cardiac death. It is known that the risk of cardiac arrhythmia and sudden death is increased in patients with chronic obstructive pulmonary disease. Evaluating the measurements of repolarization in the electrocardiogram may provide useful information to determine potential risks for lethal arrhythmias in the patients with chronic obstructive pulmonary disease. In the present study, we investigated the possible relationships between repolarization parameters in the electrocardio and demographic, clinical, and biochemical findings in patients with chronic obstructive pulmonary disease. MATERIAL AND METHODS In the present study, 35 patients with Global Initiative for Chronic Obstructive Lung Disease A-B constituted group 1 and 35 patients with Global Initiative for Chronic Obstructive Lung Disease C-D constituted group 2. Cardiac repolarization and dispersion (QTc interval and QT dispersion) were measured on 12-lead electrocardiogram. QTc interval, QT dispersion, TP-e, and Tp-e/ QTc were evaluated in order to determine the patients at risk of sudden cardiac death. QTc interval >440 ms in men and >460 ms in women was considered as prolonged QTc interval. RESULTS QTc and QTd values were found to be statistically significantly prolonged in the group of GOLD C-D compared to the group of GOLD A-B (P < .001). QTc value showed negative correlation with the ratio of forced expiratory volume in 1 second to forced vital capacity and partial pressure of oxygen (P = .030, r = -0.260; P = .006, r = -0.332, respectively). No significant difference was in Tp-e and Tp-e/QTc between the groups (P = .73, P = .12, respectively). CONCLUSION QTc and QTd are non-invasive markers reflecting arrhythmogenicity, and our findings were found to be related to prolonged QTc and QTd in patients with chronic obstructive pulmonary disease. Prolongation in the dispersion of repolarization and altered cardiac repolarization in the population with chronic obstructive pulmonary disease may be related to hypoxemia and airway obstruction. Alterations in the cardiac repolarization may put these patients at high risk for malignant ventricular arrhythmia and sudden cardiac death.

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Göğüs Hastalıkları, Kahramanmaraş Kahramanmar... more Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Göğüs Hastalıkları, Kahramanmaraş Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Göğüs Hastalıkları, Kahramanmaraş Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları, Kahramanmaraş Fulsen Bozkuş1, Nurhan Atilla2, Selma Ateş3 Necrotising Pneumonia In Etiology of Massive Hemoptysis: A case report Masif Hemoptizi Etyolojisinde Nekrotizan Pnömoni: Olgu sunumu CASE REPORT OLGU SUNUMU

Tuberkuloz ve Toraks, 2018

Insights into chest computed tomography findings in Behcet's disease Introduction: To evaluate th... more Insights into chest computed tomography findings in Behcet's disease Introduction: To evaluate the spectrum and frequency of abnormal chest multidedector computed tomography (MDCT) findings in Behcet's disease(BD). Materials and Methods: Chest MDCT scans of 44 patients referred to radiology department for chest symptoms those had prior or newly established diagnosis of BD between 2009-2016 were retrospectively reviewed. Abnormal findings within pulmonary artery (PA), lungs, other large vessels, heart, mediastinum, pleura and pericardium were noted. results: Sixteen patients had one ore more computed tomography (CT) findings related to BD. PA involvement was most common (27.2%) presentation revealing thrombosis in 8 and aneurysms in 4 of 12 patients. Mean PA diameter was 29 ± 3.7 mm. Patients with PA involvement had significantly higher PA diameters than those without (p< 0.001). Hypertrophied bronchial artery seen as serpiginous vessels around hilum was a common finding (66.6%). Lung parenchyma findings was rarely isolated and usually associated with PA involvement with subpleural alveolar opacities, focal atelectasis and ill-defined nodular opacities. Cardiac filling defects were accompanying lesions in most of patients with PA aneurysms (75%). conclusion: BD is associated with a wide spectrum of simultaneous involvement of discrete anatomical sites. PA enlargement and hypertrophied bronchial artery is a clue for patients with PA involvement. Heart chambers should be checked for filling defects particularly in patients with PA aneurysms.