Serife Savas Bozbas - Academia.edu (original) (raw)

Papers by Serife Savas Bozbas

Research paper thumbnail of Lack of association of matrix metalloproteinase-9 promoter gene polymorphism in obstructive sleep apnea syndrome

Journal of Cranio-maxillofacial Surgery, Sep 1, 2015

Obstructive sleep apnea syndrome (OSAS) is a public health problem. There is an effort to establi... more Obstructive sleep apnea syndrome (OSAS) is a public health problem. There is an effort to establish the genetic contributions to the development of OSAS. One is matrix metalloproteinases, extracellular matrix degrading enzymes related to systemic inflammation. However, the impact of matrix metalloproteinase-9 (MMP-9) genotypes on the development of OSAS is unknown. Our aim was to determine whether MMP-9 single nucleotide polymorphism (SNP) (MMP-9 -1562C > T) is related to susceptibility to OSAS. A total of 106 patients with a history of sleep apnea and 88 controls without a history of sleep apnea were enrolled in this study. Genotypes were determined by restriction fragment length polymorphism analyses after polymerase chain reaction. Genotypes and allele frequencies of the MMP-9 -1562C > T SNP was not statistically different between the patient and control groups (p > 0.05). There was a statistical association between apnea-hypopnea index (AHI) and body mass index (BMI), and also between AHI and neck circumference (p < 0.001). There was no association among the genotypes and AHI, neck circumference, or BMI (p > 0.05). We found no association between MMP-9 -1562C > T SNP and OSAS. Studies to investigate the role of other polymorphisms and expression of MMP-9 gene will provide more information.

Research paper thumbnail of Risk factors for post operative pulmonary complications and mortality in cardiac transplantation patients

Annals of Transplantation, Dec 9, 2009

Background: Pulmonary disorders are common in patients with advanced heart failure (HF). In this ... more Background: Pulmonary disorders are common in patients with advanced heart failure (HF). In this study we sought to evaluate the findings detected on pre and postoperative assessment of heart failure patients who underwent orthotopic heart transplantation (OHT). Material/methods: The records of 30 patients with advanced HF who underwent OHT at our center were evaluated. Clinical and demographic characteristics, laboratory and radiological findings were noted. Pulmonary function tests (PFTs) and cardiopulmonary exercise testing (CPET) results were obtained. Results: The mean age was 31.0+/-16.8 years and 7 were female. History of smoking was present in 15 (50%) patients. PFTs revealed normal findings in 50%, obstructive pattern in 26.7%, restrictive in 16.7% and mixed pattern in 6.6% of the patients. CPET was performed to 17 patients. Mean peak VO2 of the patients was 11.5+/-4.9 ml/kg/min and mean VO2 at anaerobic threshold was 10.9+/-3.5 ml/kg/min. The mean left ventricular ejection fraction on the postoperative first week was 46+/-11%. The mean extubation time was 80.4 hours. Postoperative pulmonary complications were developed in 11 (36.7%) patients. Postoperative pneumonia was observed in 5 (16.7%) cases. Thoracentesis was performed to 7 patients with large pleural effusion, which was transudative in 5 and exudative in 2 patients. Thoracentesis culture was positive in 2 cases. Mortality was observed in 7 patients. CPET and PFTs results were found to have no significant effect on postoperative pulmonary complications and mortality (P>0.05). Conclusions: These findings indicate that pulmonary disorders are frequent in patients with advanced heart failure waiting heart transplantation, and following heart transplantation pulmonary complications are common. Further prospective researches with larger patient numbers are needed to determine risk factors for postoperative pulmonary complications in patients undergoing heart transplantation.

Research paper thumbnail of Relation between carotid intima-media thickness, serum paraoxonase levels and severity of obstructive sleep apnea syndrome

OSAS is a disorder characterized by repetitive upper airway obstruction associated with an increa... more OSAS is a disorder characterized by repetitive upper airway obstruction associated with an increased breathing effort and frequent sleep fragmentations resulting from this obstructed airway.Repeated cycles of hypoxia/reoxygenation and oxidative stress pertaining to patients with untreated OSAS have a significant effect on the development of cardiovascular complications. Evaluation of carotid artery intima-media thickness which is the early sign of atherosclerosis and, that of change in paraoxonase serum level which is an indicator of oxidative damage and moreover investigation of the relationship between these two parameters and severity of the disease are the main objectives of our study. 30 cases with AHI

Research paper thumbnail of Evaluation of Right Ventricular Diastolic Function in Patients with Chronic Obstructive Pulmonary Disease Using Pulsed Doppler Tissue Imaging

Journal of Advances in Medical and Pharmaceutical Sciences, Jan 10, 2015

Objective: To evaluate the global and segmental diastolic function of the right ventricle using p... more Objective: To evaluate the global and segmental diastolic function of the right ventricle using pulsed tissue Doppler imaging (TDI) in patients with clinically stable chronic obstructive pulmonary disease (COPD) without pulmonary hypertension (PHT). Methods: Twenty stable patients with COPD (mean age 61.4±8.6, 16 males) with normal pulmonary artery pressure (PAP) (Group I) and 20 age-matched normal subjects (mean age Original Research Article Ugurlu et al.; JAMPS, 2(3): 107-116, 2015; Article no.JAMPS.2015.014 108 57.8±4.0, 11 males, Group II) were enrolled. All the participants underwent conventional echocardiography and TDI. TDI of the right ventricle was performed from four different segments. The early myocardial diastolic peak velocity (Em), late myocardial diastolic peak velocity (Am), systolic peak velocity (Sm), early diastolic velocity deceleration time (eDTm), duration of the S wave, isovolumetric relaxation time (IVRTm), and isovolumetric contraction time (IVCTm) were measured. Results: The conventional echocardiographic measurements of the two groups were similar, but specific TDI parameters differed between the groups. The Em of the anterior wall was lower, and the duration of the anterior S wave and IVRTm in the apical 4-chamber (A4C) view for all the right ventricular (RV) segments were longer. The eDTm measured from the apex was shorter in the COPD patients (parasternal Em, p=0.003; duration of anterior wall S wave, p=0.02; A4C apical IVRTm, p=0.02; A4C middle IVRTm, p=0.001; A4C basal IVRTm, p=0.01; A4C apical eDTm, p=0.05). Conclusion: TDI was more sensitive than conventional echocardiography in the evaluation of diastolic function in the patients with COPD. In COPD patients with an unlikely diagnosis of PHT, the diastolic functions of the right ventricle seemed to show some deterioration, but this difference failed to reach a significant level. Measurements of the basal segment of the RV free wall can be used to determine global RV diastolic function.

Research paper thumbnail of Postoperative pleural effusions after orthotopic heart transplantation: The ethiology, clinical manifestations and course

1.13 Clinical Problems - Other, 2016

Postoperative pleural effusions are common in patients who undergo cardiac surgery and orthotopic... more Postoperative pleural effusions are common in patients who undergo cardiac surgery and orthotopic heart transplant. Postoperative pleural effusions may also occur as postcardiac injury syndrome. Most of these effusions are nonspecific and develop as a harmless complication of the surgical procedure itself and generally have a benign course. Here, we investigated the cause and clinical and laboratory features of postoperative early and late pleural effusions in orthotopic heart transplant patients. We retrospectively reviewed the medical records of 50 patients who underwent orthotopic heart transplant between 2004 and 2015 at Baskent University. Patient demographics and clinical and laboratory data, including cause of heart failure, presence of pleural effusions at chest radiography in the first year after transplant, timing of onset, microbiologic and biochemical analyses of pleural effusions, and treatment strategies were noted. Mean age of patients was 39.22 ± 13.83 years (39 men, 11 women). Reason for heart failure was dilated cardiomyopathy in most patients (76%). Nineteen patients (38%) had postoperative pleural effusions, with 15 patients (78.9%) with pleural effusion during the first week after transplant. Of these, 4 patients had recurrent pleural effusion. A diagnostic thoracentesis was performed in 10 patients, with 4 showing transudative effusion and 6 showing exudative effusion secondary to infection (2 patients), postcardiac injury syndrome (1 patient), and hemothorax (3 patients). Aspergillus fumigatus was detected by quantitative culture from pleural effusion in 1 patient. Tube thoracoscopy drainage was performed in 10 patients (25%), and 2 patients received antibiotic therapy. Pleural effusions are frequent after cardiac transplant. Complications may occur in a small portion of patients, with most effusions being nonspecific and having a benign course with spontaneous resolution. Early diagnostic thoracentesis could improve postoperative outcomes in these patients.

Research paper thumbnail of Diagnostic Impact of Quantitative Dual-Energy Computed Tomography Perfusion Imaging for the Assessment of Subsegmental Pulmonary Embolism

Journal of Computer Assisted Tomography, 2020

OBJECTIVE The aim of this study was to investigate the quantitative differences of dual-energy co... more OBJECTIVE The aim of this study was to investigate the quantitative differences of dual-energy computed tomography perfusion imaging measurements in subsegmental pulmonary embolism (SSPE), between normal lung parenchyma (NLP) and hypoperfused segments (HPS) with and without thrombus on computed tomography angiography (CTA). METHODS Lung attenuation, iodine density, and normalized uptake values were measured from HPS and NLP on iodine maps of 43 patients with SSPE. Presence of pulmonary embolism (PE) on CTA was recorded. One-way repeated-measures analysis of variance and Kruskal-Wallis analyses with post hoc comparisons were conducted. RESULTS The numbers of HPS with and without SSPE on CTA were 45 (55.6%) and 36 (44.4%), respectively. Lung attenuation of NLP was significantly different from HPS (P < 0.001). Iodine density and normalized uptake values of HPS with PE were significantly lower than those of HPS without PE, which is significantly lower than NLP (P < 0.001). CONCLUSIONS Subsegmental pulmonary embolism causes HPS on dual-energy computed tomography perfusion imaging, which demonstrates different iodine density and normalized uptake values depending on the presence of thrombus.

Research paper thumbnail of Subklavian kateterizasyona bağlı gelişen pulmoner tromboembolizm: 2 olgu nedeniyle

Research paper thumbnail of Clinical Features of SARS-CoV-2 Infection in Patients Undergoing Solid-Organ Transplant: Başkent University Experience

Experimental and Clinical Transplantation, 2021

OBJECTIVES The clinical features and treatment approaches, outcomes, and mortality predictors of ... more OBJECTIVES The clinical features and treatment approaches, outcomes, and mortality predictors of COVID-19 in solid-organ transplant recipients have not been well defined. This study investigated the clinical features of COVID-19 infection in solid-organ transplant recipients at our center in Turkey. MATERIALS AND METHODS Our study included 23 solidorgan transplant recipients and 336 nontransplant individuals (143 previously healthy and 193 patients with at least 1 comorbidity) who were hospitalized due to COVID-19 disease in our hospital between March 2020 and January 2021. Demographic, clinical, and laboratory data of patients were compared. We used SPSS version 20.0 for statistical analysis. All groups were compared using chi-square and Mann-Whitney U tests. P < .05 was considered statistically significant. RESULTS Mean age of solid-organ transplant recipients was 49.8 ± 13.7 years (78.3% men, 21.7% women). Among the 23 recipients, 17 (73.9%) were kidney and 6 (26.1%) were liver transplant recipients. Among nontransplant individuals, 88.7% (n = 298) had mild/moderate disease and 11.3% (n = 38) had severe disease. Among transplant recipients, 78.3% (n = 18) had mild/moderate disease and 21.7% (n = 5) had severe disease (P = .224). Transplant recipients had greater requirements for nasal oxygen (P = .005) and noninvasive mechanical ventilation (P = .003) and had longer length of intensive care unit stay (P = .030) than nontransplant individuals. No difference was found between the 2 groups in terms of mortality (P = .439). However, a subgroup analysis showed increased mortality in transplant recipients versus previously healthy patients with COVID-19 (P < .05). Secondary infections were major causes of mortality in transplant recipients. CONCLUSIONS COVID-19 infection resulted in higher mortality in solid-organ transplant recipients versus that shown in healthy patients. More attention on secondary infections is needed in transplant recipients to reduce mortality.

Research paper thumbnail of Role of Serum Procalcitonin Levels in Solid-Organ Transplant Patients

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, Nov 1, 2016

Systemic infection is among the common complications after solid-organ transplant and is associat... more Systemic infection is among the common complications after solid-organ transplant and is associated with increased mortality and morbidity. Because it has prognostic significance, timely diagnosis and treatment are crucial. Procalcitonin is a propeptide of calcitonin and has been increasingly used as a biomarker of bacterial infection. Here, we investigated procalcitonin's role in identifying infectious complications in solid-organ transplant recipients. We retrospectively evaluated the records of 86 adult patients who underwent solid-organ transplant (between 2011 and 2015) with procalcitonin levels determined at our center. Clinical and demographic variables and laboratory data were noted. Relation between C-reactive protein and procalcitonin serum levels were compared in patients who were diagnosed as having pneumonia on clinical, microbiologic, and radiologic findings. Mean age of our patients was 45.5 ± 13.4 years (range, 18-70 y), with 61 male patients (70.9%). We included...

Research paper thumbnail of Tıkayıcı Uyku Apnesinin Dizziness Üzerine Etkisi

Research paper thumbnail of Astımda hastalık kontrolü ile demografik özellikler, yaşam kalitesi ve emosyonel durumun ilişkisi

... Şerife Savaş Bozbaş, Berna Akıncı Özyürek, Gaye Ulubay Başkent Üniversitesi Tıp Fakültesi, Gö... more ... Şerife Savaş Bozbaş, Berna Akıncı Özyürek, Gaye Ulubay Başkent Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Ankara ... Astım Kontrol Testi AKT hastaların astım nedeniyle günlük aktivitelerinde etkilenme düzeyi, gündüz ve gece astım semptomlarının sıklığı ...

Research paper thumbnail of İnhaler Tedavilerin Kronik Obstrüktif Akciğer Hastalıgı Veya Astım Tanısı İle Reçetelendirilme Zorunluluğu: Veri Tabanında Tanı Hataları

Research paper thumbnail of Renal alıcılarda periferik kas gücü ile solunum fonsiyonları arasındaki ilişki

Research paper thumbnail of Prevalence, Cause, and Treatment of Respiratory Insufficiency After Orthotopic Heart Transplant

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, 2015

OBJECTIVES Heart transplant is the best treatment for end-stage heart failure. Respiratory insuff... more OBJECTIVES Heart transplant is the best treatment for end-stage heart failure. Respiratory insufficiency after heart transplant is a potentially serious complication. Pulmonary complications, pulmonary hypertension, allograft failure or rejection, and structural heart defects in the donor heart are among the causes of hypoxemia after transplant. In this study, we evaluated the prevalence of hypoxemia and respiratory insufficiency in patients with orthotopic heart transplant during the early postoperative period. MATERIALS AND METHODS We retrospectively evaluated the medical records of 45 patients who had received orthotopic heart transplant at our center. Clinical and demographic variables and laboratory data were noted. Oxygen saturation values from patients in the first week and the first month after transplant were analyzed. We also documented the cause of respiratory insufficiency and the type of treatment. RESULTS Mean age was 35.3 ± 15.3 years (range, 12-61 y), with males comp...

Research paper thumbnail of Pulmonary Artery Distensibility is Worsened in Obstructive Sleep Apnea Syndrome

Acta Cardiologica Sinica, 2019

Background Obstructive sleep apnea syndrome (OSAS) leads to right ventricular (RV) dysfunction an... more Background Obstructive sleep apnea syndrome (OSAS) leads to right ventricular (RV) dysfunction and pulmonary hypertension (PH) in the later stages. Early determination of these conditions is very important. Objectives We aimed to evaluate the correlations of pulmonary artery distensibility, right pulmonary artery fractional shortening (RPA-FS), and pulmonary artery stiffness (PAS) with PH among newly diagnosed OSAS patients. Methods We prospectively evaluated 34 newly diagnosed OSAS patients and 28 controls. The study subgroups were determined according to the apnea-hypopnea index (AHI). All patients underwent a transthoracic echocardiographic examination. Conventional RV parameters, PAS, and RPA-FS parameters were measured. Results RPA-FS was significantly lower in the OSAS group (p < 0.001) and positively correlated with tricuspid annular systolic excursion (TAPSE) (p = 0.047) and pulmonary acceleration time (PAT) (p = 0.006), and inversely correlated with systolic pulmonary ar...

Research paper thumbnail of Türk popülasyonunda obstrüktif uyku apne sendromunda rol oynayan antropometrik ölçümlerin belirlenmesi

Tuberk Toraks, 2019

Sonuç: Boyun çevresi erkeklerde standart değerin altında iken, kadınlarda üstünde bulundu. Bel/ka... more Sonuç: Boyun çevresi erkeklerde standart değerin altında iken, kadınlarda üstünde bulundu. Bel/kalça oranı hem erkeklerde hem de kadınlarda ideal ölçülerin üzerinde idi. Bu bağlamda ülke değerlerinin tespiti OSAS olasılığı olan hastaların belirlenmesini ve polisomnografi için uyku merkezlerine yönlendirilmesini sağlayacaktır.

Research paper thumbnail of Value of cardiopulmonary exercise testing in the diagnosis of coronary artery disease

Tuberk Toraks, 2019

Value of cardiopulmonary exercise testing in the diagnosis of coronary artery disease Introductio... more Value of cardiopulmonary exercise testing in the diagnosis of coronary artery disease Introduction: Respiratory and cardiac functions in association with skeletal and neurophysiologic systems can be evaluated with cardiopulmonary exercise testing (CPET). Compared to treadmill exercise test, CPET provides more comprehensive data about the hemodynamic response to exercise. Materials and Methods: We aimed to evaluate the relationship with CPET findings and coronary lesions identified on angiography in patients with angina pectoris who underwent teradmill exercise, CPET and coronary angiography (CAG). By this way we sought to examine the CPET parameters that might be predictive for coronary artery disease (CAD) before diagnostic exercise test results and ischemia symptoms develop. Thirty patients in whom CAG was planned because of symptoms and exercise test results were enrolled in the study. Oxygen consumption (VO 2), carbondioxide production (VCO 2), minute ventilation (VE), maximum work rate (WR), DVO 2 /DWR and O 2 pulse (VO 2 /HR) values were calculated. Significant CAD was defined as ≥ 50% narrowing in at least one of the coronary arteries.

Research paper thumbnail of Bronşiektazili Hastalarda Mortalite ve Morbiditeyi Etkileyen Faktörler

Kocatepe Tıp Dergisi, 2019

Bronşektazide tekrarlayan bronş enfeksiyonları; akciğer fonksiyonlarında azalma, mortalite ve mor... more Bronşektazide tekrarlayan bronş enfeksiyonları; akciğer fonksiyonlarında azalma, mortalite ve morbiditede artışa yol açar. Çalışmamızda bronşektazide mortalite oranlarını ve mortaliteye yol açan risk faktörlerini değerlendirmeyi amaçladık. GEREÇ VE YÖNTEM: Çalışmaya yüksek rezolüsyonlu bilgisayarlı tomografisi (YRBT) olan 104 hasta dahil edildi. Demografik özellikleri, semptomları, fizik muayene bulguları, YRBT bulguları, solunum fonksiyon testleri, balgam analizleri ve kültür sonuçları, antibiyotik dirençleri, infeksiyon parametreleri, yoğun bakım ihtiyaçları ve mortalite oranları retrospektif olarak değerlendirildi. BULGULAR: Ortalama yaş 59.5±15.1 idi. Hastaların % 65.4'ünün balgam şikayeti vardı, % 27.9'unda balgam kültüründe mikroorganizma saptandı. % 11.5 olguda antibiyotik direnci saptandı. Enfeksiyon sıklığı, antibiyotik direnci; yaş, sigara ve solunum yetmezliği mortalite ile ilişkili bulundu (p<0.05). Antibiyotik direnci olan ve olmayan hastalar arasında FEV1%'de farklılık saptandı (p<0.05). FEV1 ile antibiyotik direnci (r=-0.257, p=0.02), solunum yetmezliği (r=-0.288, p=0.01) ve infeksiyon sıklığı (r=-0.329, p=0.003) arasında negatif ilişki saptandı. Sık enfeksiyon geçirenlerde FEV1 < % 60 olarak ölçüldü (p=0.003). Pulmoner hipertansiyon daha yaygın olarak tübüler ve bilateral bronşektazisi olan hastalarda bulundu (% 21.2). SONUÇ: Bronşektazide ileri yaş, sigara içimi, enfeksiyon sıklığı, solunum yetmezliği ve antibiyotik direnci mortalite riskinin artması ile ilişkilidir. Çalışmamızda antibiyotik direnci saptanan hastalarda FEV1 < % 60 olarak bulunmasının mortaliteyi artırdığını saptadık.

Research paper thumbnail of Lack of association of matrix metalloproteinase-3 gene polymorphism with susceptibility to rheumatoid arthritis: a meta-analysis

BMC musculoskeletal disorders, Jan 18, 2014

Epidemiological studies have investigated the association between matrix metalloproteinase-3(MMP-... more Epidemiological studies have investigated the association between matrix metalloproteinase-3(MMP-3) gene-1171 5A/6A polymorphism and rheumatoid arthritis (RA), but the results were inconsistent. To evaluate the specific relationship, we performed a meta-analysis to clarify the controversies. The relevant literatures dated to December 07th 2013 were retrieved from PubMed, EMBASE and the China National knowledge Infrastructure (CNKI) databases. The number of the alleles and genotypes for MMP-3 were obtained. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the association between MMP-3 5A/6A promoter polymorphism and RA. All of the statistical analyses were conducted by STATA11.0 software. A total of 6 case-control studies covering 1451 cases and 1239 controls were included in the final meta-analysis. There was no significant association between MMP-3 5A/6A promoter polymorphism and RA in all genetic models (for 6A versus 5A: OR=1.19, 95% CI=0.91-1.56, P=0.20...

Research paper thumbnail of Gastropleural Fistula As A Delayed Complication Of Blunt Abdominal Trauma: Spontaneous Closure Of The Lesion

The Internet Journal of Gastroenterology, 2003

... Citation: . Karacan, . Savaş, . Akçay, E. Türk & A. Harman : Gastropleural Fistula As A D... more ... Citation: . Karacan, . Savaş, . Akçay, E. Türk & A. Harman : Gastropleural Fistula As A Delayed Complication Of Blunt Abdominal Trauma: Spontaneous Closure Of The Lesion . ... The fistula closed spontaneously after oral feeding was stopped. Introduction. ...

Research paper thumbnail of Lack of association of matrix metalloproteinase-9 promoter gene polymorphism in obstructive sleep apnea syndrome

Journal of Cranio-maxillofacial Surgery, Sep 1, 2015

Obstructive sleep apnea syndrome (OSAS) is a public health problem. There is an effort to establi... more Obstructive sleep apnea syndrome (OSAS) is a public health problem. There is an effort to establish the genetic contributions to the development of OSAS. One is matrix metalloproteinases, extracellular matrix degrading enzymes related to systemic inflammation. However, the impact of matrix metalloproteinase-9 (MMP-9) genotypes on the development of OSAS is unknown. Our aim was to determine whether MMP-9 single nucleotide polymorphism (SNP) (MMP-9 -1562C &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; T) is related to susceptibility to OSAS. A total of 106 patients with a history of sleep apnea and 88 controls without a history of sleep apnea were enrolled in this study. Genotypes were determined by restriction fragment length polymorphism analyses after polymerase chain reaction. Genotypes and allele frequencies of the MMP-9 -1562C &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; T SNP was not statistically different between the patient and control groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). There was a statistical association between apnea-hypopnea index (AHI) and body mass index (BMI), and also between AHI and neck circumference (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). There was no association among the genotypes and AHI, neck circumference, or BMI (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). We found no association between MMP-9 -1562C &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; T SNP and OSAS. Studies to investigate the role of other polymorphisms and expression of MMP-9 gene will provide more information.

Research paper thumbnail of Risk factors for post operative pulmonary complications and mortality in cardiac transplantation patients

Annals of Transplantation, Dec 9, 2009

Background: Pulmonary disorders are common in patients with advanced heart failure (HF). In this ... more Background: Pulmonary disorders are common in patients with advanced heart failure (HF). In this study we sought to evaluate the findings detected on pre and postoperative assessment of heart failure patients who underwent orthotopic heart transplantation (OHT). Material/methods: The records of 30 patients with advanced HF who underwent OHT at our center were evaluated. Clinical and demographic characteristics, laboratory and radiological findings were noted. Pulmonary function tests (PFTs) and cardiopulmonary exercise testing (CPET) results were obtained. Results: The mean age was 31.0+/-16.8 years and 7 were female. History of smoking was present in 15 (50%) patients. PFTs revealed normal findings in 50%, obstructive pattern in 26.7%, restrictive in 16.7% and mixed pattern in 6.6% of the patients. CPET was performed to 17 patients. Mean peak VO2 of the patients was 11.5+/-4.9 ml/kg/min and mean VO2 at anaerobic threshold was 10.9+/-3.5 ml/kg/min. The mean left ventricular ejection fraction on the postoperative first week was 46+/-11%. The mean extubation time was 80.4 hours. Postoperative pulmonary complications were developed in 11 (36.7%) patients. Postoperative pneumonia was observed in 5 (16.7%) cases. Thoracentesis was performed to 7 patients with large pleural effusion, which was transudative in 5 and exudative in 2 patients. Thoracentesis culture was positive in 2 cases. Mortality was observed in 7 patients. CPET and PFTs results were found to have no significant effect on postoperative pulmonary complications and mortality (P>0.05). Conclusions: These findings indicate that pulmonary disorders are frequent in patients with advanced heart failure waiting heart transplantation, and following heart transplantation pulmonary complications are common. Further prospective researches with larger patient numbers are needed to determine risk factors for postoperative pulmonary complications in patients undergoing heart transplantation.

Research paper thumbnail of Relation between carotid intima-media thickness, serum paraoxonase levels and severity of obstructive sleep apnea syndrome

OSAS is a disorder characterized by repetitive upper airway obstruction associated with an increa... more OSAS is a disorder characterized by repetitive upper airway obstruction associated with an increased breathing effort and frequent sleep fragmentations resulting from this obstructed airway.Repeated cycles of hypoxia/reoxygenation and oxidative stress pertaining to patients with untreated OSAS have a significant effect on the development of cardiovascular complications. Evaluation of carotid artery intima-media thickness which is the early sign of atherosclerosis and, that of change in paraoxonase serum level which is an indicator of oxidative damage and moreover investigation of the relationship between these two parameters and severity of the disease are the main objectives of our study. 30 cases with AHI

Research paper thumbnail of Evaluation of Right Ventricular Diastolic Function in Patients with Chronic Obstructive Pulmonary Disease Using Pulsed Doppler Tissue Imaging

Journal of Advances in Medical and Pharmaceutical Sciences, Jan 10, 2015

Objective: To evaluate the global and segmental diastolic function of the right ventricle using p... more Objective: To evaluate the global and segmental diastolic function of the right ventricle using pulsed tissue Doppler imaging (TDI) in patients with clinically stable chronic obstructive pulmonary disease (COPD) without pulmonary hypertension (PHT). Methods: Twenty stable patients with COPD (mean age 61.4±8.6, 16 males) with normal pulmonary artery pressure (PAP) (Group I) and 20 age-matched normal subjects (mean age Original Research Article Ugurlu et al.; JAMPS, 2(3): 107-116, 2015; Article no.JAMPS.2015.014 108 57.8±4.0, 11 males, Group II) were enrolled. All the participants underwent conventional echocardiography and TDI. TDI of the right ventricle was performed from four different segments. The early myocardial diastolic peak velocity (Em), late myocardial diastolic peak velocity (Am), systolic peak velocity (Sm), early diastolic velocity deceleration time (eDTm), duration of the S wave, isovolumetric relaxation time (IVRTm), and isovolumetric contraction time (IVCTm) were measured. Results: The conventional echocardiographic measurements of the two groups were similar, but specific TDI parameters differed between the groups. The Em of the anterior wall was lower, and the duration of the anterior S wave and IVRTm in the apical 4-chamber (A4C) view for all the right ventricular (RV) segments were longer. The eDTm measured from the apex was shorter in the COPD patients (parasternal Em, p=0.003; duration of anterior wall S wave, p=0.02; A4C apical IVRTm, p=0.02; A4C middle IVRTm, p=0.001; A4C basal IVRTm, p=0.01; A4C apical eDTm, p=0.05). Conclusion: TDI was more sensitive than conventional echocardiography in the evaluation of diastolic function in the patients with COPD. In COPD patients with an unlikely diagnosis of PHT, the diastolic functions of the right ventricle seemed to show some deterioration, but this difference failed to reach a significant level. Measurements of the basal segment of the RV free wall can be used to determine global RV diastolic function.

Research paper thumbnail of Postoperative pleural effusions after orthotopic heart transplantation: The ethiology, clinical manifestations and course

1.13 Clinical Problems - Other, 2016

Postoperative pleural effusions are common in patients who undergo cardiac surgery and orthotopic... more Postoperative pleural effusions are common in patients who undergo cardiac surgery and orthotopic heart transplant. Postoperative pleural effusions may also occur as postcardiac injury syndrome. Most of these effusions are nonspecific and develop as a harmless complication of the surgical procedure itself and generally have a benign course. Here, we investigated the cause and clinical and laboratory features of postoperative early and late pleural effusions in orthotopic heart transplant patients. We retrospectively reviewed the medical records of 50 patients who underwent orthotopic heart transplant between 2004 and 2015 at Baskent University. Patient demographics and clinical and laboratory data, including cause of heart failure, presence of pleural effusions at chest radiography in the first year after transplant, timing of onset, microbiologic and biochemical analyses of pleural effusions, and treatment strategies were noted. Mean age of patients was 39.22 ± 13.83 years (39 men, 11 women). Reason for heart failure was dilated cardiomyopathy in most patients (76%). Nineteen patients (38%) had postoperative pleural effusions, with 15 patients (78.9%) with pleural effusion during the first week after transplant. Of these, 4 patients had recurrent pleural effusion. A diagnostic thoracentesis was performed in 10 patients, with 4 showing transudative effusion and 6 showing exudative effusion secondary to infection (2 patients), postcardiac injury syndrome (1 patient), and hemothorax (3 patients). Aspergillus fumigatus was detected by quantitative culture from pleural effusion in 1 patient. Tube thoracoscopy drainage was performed in 10 patients (25%), and 2 patients received antibiotic therapy. Pleural effusions are frequent after cardiac transplant. Complications may occur in a small portion of patients, with most effusions being nonspecific and having a benign course with spontaneous resolution. Early diagnostic thoracentesis could improve postoperative outcomes in these patients.

Research paper thumbnail of Diagnostic Impact of Quantitative Dual-Energy Computed Tomography Perfusion Imaging for the Assessment of Subsegmental Pulmonary Embolism

Journal of Computer Assisted Tomography, 2020

OBJECTIVE The aim of this study was to investigate the quantitative differences of dual-energy co... more OBJECTIVE The aim of this study was to investigate the quantitative differences of dual-energy computed tomography perfusion imaging measurements in subsegmental pulmonary embolism (SSPE), between normal lung parenchyma (NLP) and hypoperfused segments (HPS) with and without thrombus on computed tomography angiography (CTA). METHODS Lung attenuation, iodine density, and normalized uptake values were measured from HPS and NLP on iodine maps of 43 patients with SSPE. Presence of pulmonary embolism (PE) on CTA was recorded. One-way repeated-measures analysis of variance and Kruskal-Wallis analyses with post hoc comparisons were conducted. RESULTS The numbers of HPS with and without SSPE on CTA were 45 (55.6%) and 36 (44.4%), respectively. Lung attenuation of NLP was significantly different from HPS (P < 0.001). Iodine density and normalized uptake values of HPS with PE were significantly lower than those of HPS without PE, which is significantly lower than NLP (P < 0.001). CONCLUSIONS Subsegmental pulmonary embolism causes HPS on dual-energy computed tomography perfusion imaging, which demonstrates different iodine density and normalized uptake values depending on the presence of thrombus.

Research paper thumbnail of Subklavian kateterizasyona bağlı gelişen pulmoner tromboembolizm: 2 olgu nedeniyle

Research paper thumbnail of Clinical Features of SARS-CoV-2 Infection in Patients Undergoing Solid-Organ Transplant: Başkent University Experience

Experimental and Clinical Transplantation, 2021

OBJECTIVES The clinical features and treatment approaches, outcomes, and mortality predictors of ... more OBJECTIVES The clinical features and treatment approaches, outcomes, and mortality predictors of COVID-19 in solid-organ transplant recipients have not been well defined. This study investigated the clinical features of COVID-19 infection in solid-organ transplant recipients at our center in Turkey. MATERIALS AND METHODS Our study included 23 solidorgan transplant recipients and 336 nontransplant individuals (143 previously healthy and 193 patients with at least 1 comorbidity) who were hospitalized due to COVID-19 disease in our hospital between March 2020 and January 2021. Demographic, clinical, and laboratory data of patients were compared. We used SPSS version 20.0 for statistical analysis. All groups were compared using chi-square and Mann-Whitney U tests. P < .05 was considered statistically significant. RESULTS Mean age of solid-organ transplant recipients was 49.8 ± 13.7 years (78.3% men, 21.7% women). Among the 23 recipients, 17 (73.9%) were kidney and 6 (26.1%) were liver transplant recipients. Among nontransplant individuals, 88.7% (n = 298) had mild/moderate disease and 11.3% (n = 38) had severe disease. Among transplant recipients, 78.3% (n = 18) had mild/moderate disease and 21.7% (n = 5) had severe disease (P = .224). Transplant recipients had greater requirements for nasal oxygen (P = .005) and noninvasive mechanical ventilation (P = .003) and had longer length of intensive care unit stay (P = .030) than nontransplant individuals. No difference was found between the 2 groups in terms of mortality (P = .439). However, a subgroup analysis showed increased mortality in transplant recipients versus previously healthy patients with COVID-19 (P < .05). Secondary infections were major causes of mortality in transplant recipients. CONCLUSIONS COVID-19 infection resulted in higher mortality in solid-organ transplant recipients versus that shown in healthy patients. More attention on secondary infections is needed in transplant recipients to reduce mortality.

Research paper thumbnail of Role of Serum Procalcitonin Levels in Solid-Organ Transplant Patients

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, Nov 1, 2016

Systemic infection is among the common complications after solid-organ transplant and is associat... more Systemic infection is among the common complications after solid-organ transplant and is associated with increased mortality and morbidity. Because it has prognostic significance, timely diagnosis and treatment are crucial. Procalcitonin is a propeptide of calcitonin and has been increasingly used as a biomarker of bacterial infection. Here, we investigated procalcitonin's role in identifying infectious complications in solid-organ transplant recipients. We retrospectively evaluated the records of 86 adult patients who underwent solid-organ transplant (between 2011 and 2015) with procalcitonin levels determined at our center. Clinical and demographic variables and laboratory data were noted. Relation between C-reactive protein and procalcitonin serum levels were compared in patients who were diagnosed as having pneumonia on clinical, microbiologic, and radiologic findings. Mean age of our patients was 45.5 ± 13.4 years (range, 18-70 y), with 61 male patients (70.9%). We included...

Research paper thumbnail of Tıkayıcı Uyku Apnesinin Dizziness Üzerine Etkisi

Research paper thumbnail of Astımda hastalık kontrolü ile demografik özellikler, yaşam kalitesi ve emosyonel durumun ilişkisi

... Şerife Savaş Bozbaş, Berna Akıncı Özyürek, Gaye Ulubay Başkent Üniversitesi Tıp Fakültesi, Gö... more ... Şerife Savaş Bozbaş, Berna Akıncı Özyürek, Gaye Ulubay Başkent Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Ankara ... Astım Kontrol Testi AKT hastaların astım nedeniyle günlük aktivitelerinde etkilenme düzeyi, gündüz ve gece astım semptomlarının sıklığı ...

Research paper thumbnail of İnhaler Tedavilerin Kronik Obstrüktif Akciğer Hastalıgı Veya Astım Tanısı İle Reçetelendirilme Zorunluluğu: Veri Tabanında Tanı Hataları

Research paper thumbnail of Renal alıcılarda periferik kas gücü ile solunum fonsiyonları arasındaki ilişki

Research paper thumbnail of Prevalence, Cause, and Treatment of Respiratory Insufficiency After Orthotopic Heart Transplant

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, 2015

OBJECTIVES Heart transplant is the best treatment for end-stage heart failure. Respiratory insuff... more OBJECTIVES Heart transplant is the best treatment for end-stage heart failure. Respiratory insufficiency after heart transplant is a potentially serious complication. Pulmonary complications, pulmonary hypertension, allograft failure or rejection, and structural heart defects in the donor heart are among the causes of hypoxemia after transplant. In this study, we evaluated the prevalence of hypoxemia and respiratory insufficiency in patients with orthotopic heart transplant during the early postoperative period. MATERIALS AND METHODS We retrospectively evaluated the medical records of 45 patients who had received orthotopic heart transplant at our center. Clinical and demographic variables and laboratory data were noted. Oxygen saturation values from patients in the first week and the first month after transplant were analyzed. We also documented the cause of respiratory insufficiency and the type of treatment. RESULTS Mean age was 35.3 ± 15.3 years (range, 12-61 y), with males comp...

Research paper thumbnail of Pulmonary Artery Distensibility is Worsened in Obstructive Sleep Apnea Syndrome

Acta Cardiologica Sinica, 2019

Background Obstructive sleep apnea syndrome (OSAS) leads to right ventricular (RV) dysfunction an... more Background Obstructive sleep apnea syndrome (OSAS) leads to right ventricular (RV) dysfunction and pulmonary hypertension (PH) in the later stages. Early determination of these conditions is very important. Objectives We aimed to evaluate the correlations of pulmonary artery distensibility, right pulmonary artery fractional shortening (RPA-FS), and pulmonary artery stiffness (PAS) with PH among newly diagnosed OSAS patients. Methods We prospectively evaluated 34 newly diagnosed OSAS patients and 28 controls. The study subgroups were determined according to the apnea-hypopnea index (AHI). All patients underwent a transthoracic echocardiographic examination. Conventional RV parameters, PAS, and RPA-FS parameters were measured. Results RPA-FS was significantly lower in the OSAS group (p < 0.001) and positively correlated with tricuspid annular systolic excursion (TAPSE) (p = 0.047) and pulmonary acceleration time (PAT) (p = 0.006), and inversely correlated with systolic pulmonary ar...

Research paper thumbnail of Türk popülasyonunda obstrüktif uyku apne sendromunda rol oynayan antropometrik ölçümlerin belirlenmesi

Tuberk Toraks, 2019

Sonuç: Boyun çevresi erkeklerde standart değerin altında iken, kadınlarda üstünde bulundu. Bel/ka... more Sonuç: Boyun çevresi erkeklerde standart değerin altında iken, kadınlarda üstünde bulundu. Bel/kalça oranı hem erkeklerde hem de kadınlarda ideal ölçülerin üzerinde idi. Bu bağlamda ülke değerlerinin tespiti OSAS olasılığı olan hastaların belirlenmesini ve polisomnografi için uyku merkezlerine yönlendirilmesini sağlayacaktır.

Research paper thumbnail of Value of cardiopulmonary exercise testing in the diagnosis of coronary artery disease

Tuberk Toraks, 2019

Value of cardiopulmonary exercise testing in the diagnosis of coronary artery disease Introductio... more Value of cardiopulmonary exercise testing in the diagnosis of coronary artery disease Introduction: Respiratory and cardiac functions in association with skeletal and neurophysiologic systems can be evaluated with cardiopulmonary exercise testing (CPET). Compared to treadmill exercise test, CPET provides more comprehensive data about the hemodynamic response to exercise. Materials and Methods: We aimed to evaluate the relationship with CPET findings and coronary lesions identified on angiography in patients with angina pectoris who underwent teradmill exercise, CPET and coronary angiography (CAG). By this way we sought to examine the CPET parameters that might be predictive for coronary artery disease (CAD) before diagnostic exercise test results and ischemia symptoms develop. Thirty patients in whom CAG was planned because of symptoms and exercise test results were enrolled in the study. Oxygen consumption (VO 2), carbondioxide production (VCO 2), minute ventilation (VE), maximum work rate (WR), DVO 2 /DWR and O 2 pulse (VO 2 /HR) values were calculated. Significant CAD was defined as ≥ 50% narrowing in at least one of the coronary arteries.

Research paper thumbnail of Bronşiektazili Hastalarda Mortalite ve Morbiditeyi Etkileyen Faktörler

Kocatepe Tıp Dergisi, 2019

Bronşektazide tekrarlayan bronş enfeksiyonları; akciğer fonksiyonlarında azalma, mortalite ve mor... more Bronşektazide tekrarlayan bronş enfeksiyonları; akciğer fonksiyonlarında azalma, mortalite ve morbiditede artışa yol açar. Çalışmamızda bronşektazide mortalite oranlarını ve mortaliteye yol açan risk faktörlerini değerlendirmeyi amaçladık. GEREÇ VE YÖNTEM: Çalışmaya yüksek rezolüsyonlu bilgisayarlı tomografisi (YRBT) olan 104 hasta dahil edildi. Demografik özellikleri, semptomları, fizik muayene bulguları, YRBT bulguları, solunum fonksiyon testleri, balgam analizleri ve kültür sonuçları, antibiyotik dirençleri, infeksiyon parametreleri, yoğun bakım ihtiyaçları ve mortalite oranları retrospektif olarak değerlendirildi. BULGULAR: Ortalama yaş 59.5±15.1 idi. Hastaların % 65.4'ünün balgam şikayeti vardı, % 27.9'unda balgam kültüründe mikroorganizma saptandı. % 11.5 olguda antibiyotik direnci saptandı. Enfeksiyon sıklığı, antibiyotik direnci; yaş, sigara ve solunum yetmezliği mortalite ile ilişkili bulundu (p<0.05). Antibiyotik direnci olan ve olmayan hastalar arasında FEV1%'de farklılık saptandı (p<0.05). FEV1 ile antibiyotik direnci (r=-0.257, p=0.02), solunum yetmezliği (r=-0.288, p=0.01) ve infeksiyon sıklığı (r=-0.329, p=0.003) arasında negatif ilişki saptandı. Sık enfeksiyon geçirenlerde FEV1 < % 60 olarak ölçüldü (p=0.003). Pulmoner hipertansiyon daha yaygın olarak tübüler ve bilateral bronşektazisi olan hastalarda bulundu (% 21.2). SONUÇ: Bronşektazide ileri yaş, sigara içimi, enfeksiyon sıklığı, solunum yetmezliği ve antibiyotik direnci mortalite riskinin artması ile ilişkilidir. Çalışmamızda antibiyotik direnci saptanan hastalarda FEV1 < % 60 olarak bulunmasının mortaliteyi artırdığını saptadık.

Research paper thumbnail of Lack of association of matrix metalloproteinase-3 gene polymorphism with susceptibility to rheumatoid arthritis: a meta-analysis

BMC musculoskeletal disorders, Jan 18, 2014

Epidemiological studies have investigated the association between matrix metalloproteinase-3(MMP-... more Epidemiological studies have investigated the association between matrix metalloproteinase-3(MMP-3) gene-1171 5A/6A polymorphism and rheumatoid arthritis (RA), but the results were inconsistent. To evaluate the specific relationship, we performed a meta-analysis to clarify the controversies. The relevant literatures dated to December 07th 2013 were retrieved from PubMed, EMBASE and the China National knowledge Infrastructure (CNKI) databases. The number of the alleles and genotypes for MMP-3 were obtained. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the association between MMP-3 5A/6A promoter polymorphism and RA. All of the statistical analyses were conducted by STATA11.0 software. A total of 6 case-control studies covering 1451 cases and 1239 controls were included in the final meta-analysis. There was no significant association between MMP-3 5A/6A promoter polymorphism and RA in all genetic models (for 6A versus 5A: OR=1.19, 95% CI=0.91-1.56, P=0.20...

Research paper thumbnail of Gastropleural Fistula As A Delayed Complication Of Blunt Abdominal Trauma: Spontaneous Closure Of The Lesion

The Internet Journal of Gastroenterology, 2003

... Citation: . Karacan, . Savaş, . Akçay, E. Türk & A. Harman : Gastropleural Fistula As A D... more ... Citation: . Karacan, . Savaş, . Akçay, E. Türk & A. Harman : Gastropleural Fistula As A Delayed Complication Of Blunt Abdominal Trauma: Spontaneous Closure Of The Lesion . ... The fistula closed spontaneously after oral feeding was stopped. Introduction. ...