Browsing by Author "Balcan, Baran"

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Altered pulmonary functions due to biomass smoke in a rural population of Turkish women: a descriptive study
(2018) Ozsancak Ugurlu, Aylin; Balcan, Baran; Akan, Selcuk; Ceyhan, Berrin; 30246655; A-4721-2018
Introduction: Wood or other organic sources of fuel are used as source of energy for heating or cooking particularly in developing countries. The aim of the current study was to evaluate the association between biomass exposure time and parameters of pulmonary function tests. Materials and Methods: Four hundred twenty-four consecutive women who lived and exposed to biomass smoke in a small province in Eastern Turkey were involved. This study was performed with women who had come to pulmonology out-patient clinic with symptom of dyspnea. Results: The independent variables assessed in the study patients were age, BMI, starting age of cooking, hours per day and weeks per month spent cooking, and cooking years; the dependent variables were PFT parameters. Ninety-two (21.6%) patients had an obstructive PFT pattern. Sixty-seven (73%) of these patients were classified as GOLD 2 and 25 (27%) patients were classified as GOLD 3. Seventy-five (17.6 %) of the patients had restrictive lung disease; 54 (72%) of these patients were found to have a mild and 21 (27%) had a moderate restrictive pattern. Increased number of years in cooking and to start cooking at younger ages were a risk factors for the development of obstructive and restrictive disease. There was a statistically significant and negative correlation between increased number of years and the value of FEV1 (r=-0.917; p=<0.001), FEV1/FVC (r=-0.739; p<0.001), and FVC (r=-0.906; p<0.001). The median time of cooking required was 23 years for the development of obstruction, and 25 years for restriction, respectively. Conclusion: Cumulative biomass exposure time is associated with impairment in PFT parameters; results in both obstructive and restrictive lung disease. Biomass exposure is a public health problem and pre-cautions should be taken in order to prevent impaired pulmonary functions.
Determination of Factors Affecting Mortality of Patients with Sepsis in a Tertiary Intensive Care Unit
(2015) Balcan, Baran; Olgun, Sehnaz; Torlak, Fatih; Sagmen, Seda Beyhan; Eryuksel, Emel; Karakurt, Sait; 29404090
OBJECTIVES: Sepsis is a disease with high mortality that is frequently observed in intensive care units. This study aimed to determine the risk factors affecting mortality of patients with sepsis who were followed up in the intensive care unit (ICU). We aimed to contribute to literature by evaluating the relationship between mortality and pro-brain natriuretic peptide (pro-BNP9), C-reactive protein (CRP), thrombocyte count, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, duration of hospitalization in the intensive care unit, and the presence of multidrug-resistant microorganism. MATERIAL AND METHODS: Patients hospitalized in ICU because of the diagnosis of sepsis and septic shock between December 2010 and June 2012 were included in this retrospective study. RESULTS: A total of 141 patients, including 74 male (52.5%) and 67 female (47.5%) patients, were involved in the study, and the median age was 66.8 +/- 17.9 years. Sixty-nine patients (48.9%) were discharged from the ICU; however, 72 patients (51.1%) were exitus. Multi-drug-resistant microorganism was detected in 34 patients (24.1%). The patients' median SOFA score was 9.16 +/- 3.16, median APACHE-II score was 24.9 +/- 7.83, and median duration of hospitalization in the ICU was 8.44 +/- 11.61 days. It was found that mortality rate significantly increased in patients with the APACHE-II score of 24.5 and over, SOFA score of 8.5 and over, pro BNP value of 7241 ng/L and over, and CRP value of 96.5 mg/dL and over. Mortality rate was detected to be higher in patients undergoing invasive mechanical ventilation than in patients undergoing non-invasive mechanical ventilation. When thrombocyte count and mortality were associated with each other, it was found that the median value was 86000 mg/dL in exitus patients, whereas it was 185000 mg/dL in patients discharged from the ICU. CONCLUSION: It was revealed that increased APACHE-II score, increased SOFA score, increased pro BNP score, increased CRP, the presence of multidrug-resistant microorganism, and decreased thrombocyte count elevated the rate of mortality. However, no relationship was observed between the duration of hospitalization in the ICU and mortality.
Effect of Biomass Exposure on Lung Function
(2015) Balcan, Baran; Akan, Selcuk; Ceyhan, Berrin; A-4721-2018; ABI-4175-2020
Effects of biomass smoke on pulmonary functions: a case control study
(2016) Balcan, Baran; Akan, Selcuk; Ugurlu, Aylin Ozsancak; Handemir, Bahar Ozcelik; Ceyhan, Berrin Bagci; Ozkaya, Sevket; 27486318
Background: Biomass smoke is the leading cause of COPD in developing countries such as Turkey. In rural areas of Turkey, females are more exposed to biomass smoke because of traditional lifestyles. Aim: The aim of this study was to determine the adverse effects of biomass smoke on pulmonary functions and define the relationship between duration in years and an index (cumulative exposure index) with altered pulmonary function test results. Participants and methods: A total of 115 females who lived in the village of Kagizman (a borough of Kars located in the eastern part of Turkey) and were exposed to biomass smoke were included in the study. The control group was generated with 73 individuals living in the same area who were never exposed to biomass smoke. Results: Twenty-seven (23.8%) females in the study group and four (5.5%) in the control group had small airway disease (P=0.038). Twenty-two (19.1%) females in the study group and ten (13.7%) in the control group had obstruction (P=0.223). Twenty (17.3%) females in the study group who were exposed to biomass smoke had restriction compared with ten (13%) in the control group (P=0.189). The duration needed for the existence of small airway disease was 16 years, for obstructive airway disease was 17 years, and for restrictive airway disease was 17 years. The intensity of biomass smoke was defined in terms of cumulative exposure index; it was calculated by multiplying hours per day, weeks per month, and total years of smoke exposure and dividing the result by three. Conclusion: Exposure to biomass smoke is a serious public health problem, especially in rural areas of developing countries, because of its negative effects on pulmonary functions. As the duration and the intensity of exposure increase, the probability of having altered pulmonary function test results is higher.
Increased Mortality Among Renal Transplant Patients With Invasive Pulmonary Aspergillus Infection
(2018) Balcan, Baran; Ozcelik, Umit; Ugurlu, Aylin Ozsancakli; Aydin, Mehtap; Nalcaci, Serdar; Karakayali, Feza Yarbug; 0000-0003-1073-2494; 0000-0003-3598-3986; 0000-0003-4044-9366; 0000-0002-1874-947X; 30235978; A-4721-2018; AAG-8651-2021; AAA-2925-2020; HLX-0937-2023; AAB-3888-2021
Introduction: Renal transplantation is the most effective and preferred definite treatment option in patients with end-stage renal disease. Due to long-term immunesuppressive treatment, renal transplant recipients become vulnerable to opportunistic infections, especially to fungal infections. Method: This was a single-center, retrospective observational study of 438 patients who underwent renal transplantation between 2010 and 2016. Results: Thirty-eight renal transplant recipients who had lower respiratory tract infection with median age of 41.5 years were evaluated for invasive pulmonary aspergillus (IPA). Of these, 52.6% were female and 84.2% had living donors. Eleven of 38 lower respiratory patients were found to have IPA infection, 5 with proven infection. Compared to patients who did not have fungal pulmonary infection, patients with invasive aspergillus were older and had high fever, galactomannan levels, and leukocyte counts. Mortality was also higher in those patients. Having fever at the baseline and IPA infection was significantly associated with mortality in univariate analysis and remained related in multivariate model after adjustment for age, gender, and fever. Conclusion: Invasive pulmonary aspergillus infection is highly associated with increased mortality rates in renal transplant patients. Fungal pulmonary infections in immune-suppressed patients should be diagnosed and treated immediately in order to avoid the life-threatening complications and may greatly improve prognosis.
Is Exposure to Biomass Smoke Really Associated with COPD? Reply
(2017) Balcan, Baran; Akan, Selcuk; Ugurlu, Aylin Ozsancak; Handemir, Bahar Ozcelik; Ceyhan, Berrin Bagci; Ozkaya, Sevket; https://orcid.org/0000-0003-3598-3986; A-4721-2018; AAA-2925-2020
New bronchodilators in treatment of chronic obstructive pulmonary disease
(2016) Balcan, Baran
Chronic obstructive pulmonary disease (COPD), a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Clinical diagnosis of COPD should be considered in any individual, who has dyspnea, chronic cough, sputum production, and positive history of risk factors. Pharmacologic therapy can reduce COPD symptoms, reduce the frequency and severity of exacerbations, and improve health status and exercise tolerance. After cessation of smoking and life style modification, bronchodilator therapy is the first step in COPD treatment. Beside commonly used bronchodilator therapy newly developed bronchodilators started to be preferred. These drugs consist of long-acting beta2 agonist (Indacatarol, Vilanterol, Olodaterol, Abediterol), long acting muscarinic antagonism (Umeclidinium), long-acting beta2 agonist with inhaled steroid (combination of fluticasone furoate and vilanterol), long-acting beta2 agonist with a long-acting muscarinic antagonist (Fixed-dose combination of indacaterol with glycopyrronium by means of breezhaler device).
Relationship between mannose-binding lectin and febrile neutropenia in acute leukemia patients
(2020) Akan, Selcuk; Bakanay, Sule Mine; Bilen, Yusuf; Balcan, Baran; Erdem, Fuat
Aim: Mannose-binding lectin (MBL) is an important component of the natural immune system. Its low levels have been linked to increased frequency of opportunistic infections. This study aimed to determine the association of serum MBL levels and duration of febrile neutropenia (FN) after cytotoxic chemotherapy in patients with acute leukemia. Material and Methods: Seventy patients aged 15-75 years with acute leukemia (40 AML (Acute myeloid leukemia), 30 ALL (Acute lymphoblastic leukemia)), and 30 age-matched healthy subjects were included in this study. Blood MBL levels were measured using ELISA Kit before chemotherapy (MBL1) and at FN (MBL2). Results: The MBL1 levels of the patient group (Median 466 ng/ml; interquartile range (iqr): 4507) were higher than that of the control group (Median 485 ng/ml; iqr: 1872), but this difference was statistically insignificant (p=0.92). During FN, MBL levels of 49 (70%) patients increased and 21 (30%) patients remained at the same level. The MBL2 levels (Median 772 ng/ml; iqr: 5870) of the patients were significantly higher than the MBL1 levels (p< 0.001). Patients with very low (<100 ng/ml) MBL2 levels had significantly longer FN duration than patients with normal (>1000 ng/ml) MBL2 levels (p=0.016). Discussion: Our results suggest that duration of FN is longer when MBL level is low especially less than 100 ng/ml. These patients seem to have the highest risk for infection-related morbidity and mortality and deserve interest for trials of MBL replacement.
Results of Polysomnographies and Treatment Strategies in Elderly Patients with Symptoms of Obstructive Sleep Apnea Syndrome
(2017) Ugurlu, Aylin Ozsancak; Balcan, Baran; 0000-0003-3598-3986; 29404173; A-4721-2018; AAA-2925-2020
OBJECTIVES: In this study, we evaluated data regarding the management of geriatric patients with symptoms of obstructive sleep apnea syndrome (age, >65 years) who were admitted to our sleep clinic. MATERIAL AND METHODS: Symptoms and sleep data of the patients were retrospectively evaluated, and the patients were reevaluated after treatment. RESULTS: A total of 85 patients with a median age of 69 years were included. Snoring and fatigue were the most common symptoms. Cardiovascular diseases were the most frequently listed comorbidity. The median Epworth sleepiness scale was 10, and based on Berlin sleep questionnaire findings, 63.5% of the participants were in the high-risk group. Eighty-seven percent were diagnosed with obstructive sleep apnea (2/3 of them were positional), and moderate-to-severe obstructive sleep apnea was observed more in women than in men. Only one patient was diagnosed with central sleep apnea. There were positive and linear correlations between increased age and the apnea-hypopnea index, arousal index, Epworth sleepiness scale, and being in a high-risk group according to the Berlin sleep scale; however, there was no correlation between increased age and the number of hypopnea and apnea events. There were also positive and linear correlations between the apnea-hypopnea index and the Epworth sleepiness scale, being in a high-risk group according to the Berlin sleep questionnaire, an increased number of known medical conditions, and increased body mass index. We were able to contact 72 of the 85 patients via phone calls. Patients who adjusted to treatment had positive feedbacks. CONCLUSION: Sleep disorders are observed more in the elderly, and an increasing age is an independent factor for sleep disorders. Besides the usual signs and symptoms of sleep disorders, it should be considered in elderly who have cognitive dysfunction and dementia.
Sirolimus-Induced Diffuse Alveolar Hemorrhage: A Case Report
(2016) Balcan, Baran; Simsek, Ergun; Ugurlu, Aylin O.; Demiralay, Ebru; Sahin, Sevgi; 0000-0003-3598-3986; 26849007; A-4721-2018; AAA-2925-2020
Sirolimus is a mammalian target of the rapamycin, a protein kinase, which is responsible for inhibition of T cell and B cell proliferation. Sirolimus has side effects on lugs, and may cause cryptogenic organizing pneumonia, diffuse alveolar hemorrhage, lymphocytic pneumonitis, hypersensitivity pneumonitis, desquamative interstitial pneumonia, and pulmonary alveolar proteinosis. Diagnosis is based on the combination of clinical, radiological, histological, and pathological investigation. We report a case of diffuse alveolar hemorrhage in a 33-year-old, female renal transplant recipient. After discontinuation of sirolimus, radiological images and clinical condition of the patient got better. We also planned steroid therapy for 6 months by tapering the dosage slowly. After steroid therapy, full recovery of pulmonary functions achieved, and the patient is observed in our outpatient clinic with lack of any pulmonary symptoms.
Tru-cut biopsy in cryptogenic organizing pneumonia
(2015) Balcan, Baran; Olgun, Sehnaz; Sagmen, Seda Beyhan; Bagci Ceyhan, Berrin
Cryptogenic organizing pneumonia (COP) was first described by Davison and colleagues in 1983. Previously, it was called bronchiolitis obliterans organizing pneumonia (BOOB). The following are known causes of COP: toxic gas inhalation, chemotherapy, radiation therapy, aspiration, blood transfusion, upper respiratory tract infections, or it can be idiopathic. The clinical features of the patients resemble those of pneumonia or upper respiratory tract infection. In COP, imaging scans of the lungs reveal diffuse migrating patchy infiltrations which are in contact with the pleura. Corticosteroids are the first choice for treatment, but in some patients other immunosuppressive drugs are needed. Low doses may result in relapses. Transbronchial biopsy has a low yield in the diagnosis, instead tru-cut biopsy is the first choice for a definitive diagnosis. In this paper, we define our experience with two patients from whom we obtained a tru-cut lung biopsy in order to reach for a diagnosis.
Wegener Granulomatosis Complicated by Brain Abscess Caused by Nocardia spp.
(2016) Sahin, Sevgi; Balcan, Baran; Kiziltas, Safak; Aydin, Mehtap; Y-1366-2018; A-4721-2018
Wegener granulomatosis is a multisystemic disease associated with high mortality rate and characterized by necrotizing granulomatous vasculitis predominantly in the respiratory tract and kidneys. Presence of kidney failure at the time of diagnosis describes a poor prognostic marker. We presented a Wegener granulomatosis case complicated with brain abscess caused by Nocardia.