Browsing by Author "Bozbas, Serife Savas"

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Clinical Characteristics of Acinetobacter baumannii Infection in Solid-Organ Transplant Recipients
(2018) Serifoglu, Irem; Dedekarginoglu, Balam Er; Bozbas, Serife Savas; Akcay, Sule; Haberal, Mehmet; 0000-0002-7230-202X; 0000-0002-8360-6459; 0000-0002-7230-202X; 0000-0002-3462-7632; 29528021; AAS-6628-2021; AAI-8064-2021; AAB-5175-2021; AAJ-8097-2021
Objectives: Acinetobacter baumannii, depending on the immune status of the host, may result in one of the most serious hospital infections. Infections involving A. baumannii infection have been recently rising. However, little is known about the clinical features of A. baumannii infection in solid-organ transplant recipients. We aimed to share our clinical experiences with A. baumannii infection in our transplant recipients. Materials and Methods: Between 2011 and 2017, 41 solid-organ transplant patients developed A. baumannii infection at Baskent University Hospital. Medical records were reviewed, and patient demographics, microbiology results, and overall outcome data were noted. Results: Of 41 solid-organ transplant patients with A. baumannii infection, 29 were male and 12 were female patients with mean age of 47.15 +/- 13.24 years. Our infection rate with A. baumannii infection was 6.1%. The most common sites of infection were deep tracheal aspirate (48.8%)and bloodstream (36.6%). Onset of infection 1 year post-transplant was identified in 58.5% of recipients. Risk factors included presence of invasive procedures (56.1%) and administration of high-dose corticosteroids for rejection 1 year before infection (68.3%). Thirty-day mortality rate was 41.5% (17/41 patients)and was not associated with the infection site, microbiological cure, clinical cure, and drug resistance in our study group. Conclusions: Acinetobacter baumannii is an important cause of hospital-acquired infection and mortality worldwide. A major problem with A. baumannii infection is delayed initiation of appropriate antibiotic treatment and the rising numbers of extensively drugresistant organisms. Predicting the potential risk factors, especially in the already at-risk solid-organ transplant population, has an important role in patient outcomes.
Clinical Features of SARS-CoV-2 Infection in Patients Undergoing Solid-Organ Transplant: Baskent University Experience
(2023) Yuce, Gulbahar Darilmaz; Ulubay, Gaye; Tek, Korhan; Bozbas, Serife Savas; Erol, Cigdem; Buyukasik, Piril; Haberal, Kemal Murat; Arslan, Ayse Hande; Akcay, Muserref Sule; Haberal, Mehmet; 0000-0002-2535-2534; 34635037; AAJ-1219-2021
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 solid-organ 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.
The Clinical Outcomes of Covid-19 Disease in Patients with Solid Organ Transplantation
(2021) Yuce, Gulbahar Darilmaz; Ulubay, Gaye; Karakaya, Emre; Tek, Korhan; Akdur, Aydincan; Bozbas, Serife Savas; Gedik, Ender; Kupeli, Elif; Erol, Cigdem; Arslan, Hande; Akcay, Sule; Haberal, Mehmet; https://orcid.org/0000-0002-4879-7974; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-2535-2534; https://orcid.org/0000-0002-5708-7915; https://orcid.org/0000-0002-3462-7632; JBS-4193-2023; AAD-5466-2021; AAA-3068-2021; AAJ-1219-2021; ABG-7034-2021; AAJ-8097-2021
The Clinical Outcomes Of Covid-19 Disease In Patients With Solıid Organ Transplantation
(2021) Yuce, Gulbahar Darilmaz; Ulubay, Gaye; Karakaya, Emre; Tek, Korhan; Akdur, Aydincan; Bozbas, Serife Savas; Gedik, Ender; Kupeli, Elif; Erol, Cigdem; Arslan, Hande; Akcay, Sule; Haberal, Mehmet; 0000-0002-8726-3369; 0000-0002-2535-2534; 0000-0002-5708-7915; 0000-0002-3462-7632; AAA-3068-2021; AAJ-1219-2021; ABG-7034-2021; AAJ-8097-2021
Coronary flow reserve is impaired in patients with obstructive sleep apnea
(2017) Bozbas, Serife Savas; Eroglu, Serpil; Ozyurek, Berna Akinci; Eyuboglu, Fusun Omer; 0000-0002-7230-202X; 0000-0002-5525-8207; 0000-0003-3055-7953; 29118860; ABG-1582-2021; AAI-8064-2021; AAR-4338-2020
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is common in adult populations. Accumulating data indicate that it is independently associated with a variety of cardiovascular diseases and has prognostic importance in affected cases. In this study, we aimed to evaluate coronary flow reserve (CFR) in patients with OSA and controls. METHODS: Sixty-one patients undergoing an overnight polysomnography were enrolled in this study. Patients with an apneauhypopnea index (AHI) 5 were accepted as OSA group (n = 45) and those with an AHI <5 were taken as controls (n = 16). Using Doppler echocardiography at baseline and following dipyridamole infusion, coronary peak flow velocities were obtained. CFR was calculated as the ratio of peak diastolic flow to baseline diastolic flow. A CFR value <2 was accepted as impaired coronary microvascular function. RESULTS: The mean age was 50.8 10.8 years, of which 16 (26.2%) were female. Both groups had similar features with regard to demographic and clinical variables. The mean value of CFR was significantly lower in patients with OSA compared to those controls (2.24 0.46 vs. 2.74 0.62, respectively, P = 0.001). An abnormal CFR value was observed in 12 (26.7%) patients with OSA and in 1 (6.3%) participant in control group. CONCLUSIONS: The findings of this study indicate that CFR, an indicator of coronary microvascular function, is significantly impaired in patients with OSA. Coronary microvascular function, an early sign of atherosclerosis, can be evaluated noninvasively in these patients might be used as a predictor of cardiovascular risk.
Culture-Positive Pulmonary Aspergillosis Infection: Clinical and Laboratory Features of Solid-Organ Transplant Recipient
(2017) Dedekarginoglu, Balam Er; Bozbas, Serife Savas; Ulubay, Gaye; Eyuboglu, Fusun Oner; Haberal, Mehmet; https://orcid.org/0000-0002-7230-202X; https://orcid.org/0000-0003-2478-9985; https://orcid.org/0000-0002-5525-8207; https://orcid.org/0000-0002-3462-7632; 28260471; AAI-8064-2021; AAB-5064-2021; AAR-4338-2020; AAJ-8097-2021
Objectives: Aspergillosis is a common fungal infection among solid-organ transplant recipients. Even after awareness of this infection occurs, there are still gaps in nonculture diagnostic tests, which can delay treatment initiation. Here, we aimed to define the common traits of pulmonary aspergillosis infection among solid-organ transplant recipients, thus shedding light on prevention and early diagnosis. Materials and Methods: We conducted a database search of patients at Baskent University who had a positive aspergillosis culture between January 2010 and March 2016. Among 20 patients identified, 15 (mean age of 50.93 +/- 11.17 y, 2 female and 13 male patients) with solid-organ transplant were included in the study. Results: Of the 15 study patients, 7 were heart transplant, 6 were kidney transplant, and 2 were liver transplant recipients. Three patients had positive aspergillosis cultures from extrapulmonary specimens (1 brain biopsy and 2 wound swap cultures). Other patients with positive cultures were from broncho alveolar lavage (6 patients), sputum (4 patients), both bronchoalveolar lavage and sputum (1 patient), and deep tracheal aspiration specimen (1 patient). Aspergillus fumigatus was the most common species. Mean hospitalization duration was 31.53 days (range, 2-135 d). Although all patients had positive culture results, 7 patients (46.7%) had negative galacto mannan test results at the time of culture specimen collection. Positive galactomannan test results were statistically higher in 6 heart transplant patients (P = .045). All patients had fever at presentation, and 13 patients had been referred to the pulmonary disease department before positive culture results were obtained. Conclusions: Risk factors for pulmonary aspergillosis and its clinical presentation in solid-organ transplant recipients are still unclear. Although the expected time for aspergillosis infection in solid-organ transplant recipients is 6 months after transplant, clinicians must remember the nonspecific presentation of infections in these patients and be aware of the reliability of diagnostic tools.
Early Pulmonary Complications of Liver Transplant
(2014) Dogrul, Mustafa Ilgaz; Akcay, Sule; Bozbas, Serife Savas; Dedekarginoglu, Balam Er; Eyuboglu, Fusun Oner; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-7230-202X; https://orcid.org/0000-0002-5525-8207; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24635815; AAI-8064-2021; AAR-4338-2020; AAE-1041-2021; AAJ-8097-2021
Objectives: Pulmonary complications are a leading problem after a liver transplant. This study sought to predict postoperative early complications by a chest radiograph performed after a transplant among adult orthotopic liver transplant recipients. Materials and Methods: One hundred thirty-five patients (43 women, 92 men; mean age, 40 y; range, 16-66 y) were included and their medical data reviewed retrospectively. A postoperative chest radiograph of each patient was evaluated to check for pulmonary complications. Results: Smoking history was noted in 61 patients (45.2%). Postoperative first chest radiograph evaluation showed normal findings in 56 patients (41.5%). Right pleural effusion was found in 25 patients (18.5%), and atelectasis was found in 25 (18.5%). Bilateral pleural effusion was the second most-frequent finding on postoperative radiograph (14.8%). Effusion accompanied by atelectasis was found in 3 patients (2.2%). Other postoperative chest radiograph findings were consolidation (n=2, 1.5%), left pleural effusion (n=2, 1.5%), and bronchiectasis (n=2, 1.5%). Conclusions: We investigated the reflection of the first chest radiograph after liver transplant on postoperative early complications. Postoperative first chest radiograph can be an inexpensive and accessible diagnostic tool for predicting postoperative problems.
Effect of CPAP Therapy on Mean Platelet Volume and Hematocrit in Obstructive Sleep Apnea Syndrome (OSAS)
(2014) Cetin, Gulcan; Kupeli, Elif; Bozbas, Serife Savas; Eyuboglu, Fusun Oner; https://orcid.org/0000-0002-5826-1997; https://orcid.org/0000-0002-7230-202X; https://orcid.org/0000-0002-5525-8207; AAB-5345-2021; AAI-8064-2021; AAR-4338-2020
Lung Malignancy in Solid Organ Transplant Recipients: ACase Series
(2018) Esendagli, Donna; Kupeli, Elif; Bozbas, Serife Savas; Tepeoglu, Merih; Ozdemir, B. Handan; Akcay, Sule; Haberal, Mehmet; 0000-0002-5826-1997; 0000-0002-7230-202X; 0000-0002-9894-8005; 0000-0002-7528-3557; 0000-0002-8360-6459; 0000-0002-3462-7632; AAB-5345-2021; AAI-8064-2021; AAK-5222-2021; X-8540-2019; AAB-5175-2021; AAJ-8097-2021
Peripheral Muscle Strength Indicates Respiratory Function Testing in Renal Recipients
(2017) Ulubay, Gaye; Uyanik, Saliha; Dedekarginoglu, Balam Er; Serifoglu, Irem; Kupeli, Elif; Bozbas, Serife Savas; Sezer, Siren; Haberal, Mehmet; 0000-0002-5826-1997; 0000-0002-7230-202X; 0000-0002-3462-7632; 0000-0003-2478-9985; 28260479; AAB-5345-2021; AAI-8064-2021; AAJ-8097-2021; AAB-5064-2021; AAS-6628-2021
Objectives: Muscle wasting occurs in renal recipients due to decreased physical performance, and de creased respiratory muscle strength may occur due to changes in structure and function. Data are scarce regarding the roles of sarcopenia and nutritional status on respiratory muscle function in these patients. Here, we evaluated interactions among peripheral muscle strength, sarcopenia, nutritional parameters, and respiratory muscle function in renal transplant recipients. Materials and Methods: Ninety-nine patients were prospectively enrolled between September and April 2016 at Baskent University. Forced vital capacity values (via pulmonary function tests), respiratory muscle strength (via maximal static inspiratory and expiratory pressures), and peripheral muscle strength (via hand grip strength test) were recorded. Nutritional para meters, fat weight, arm circumference, waist circumference, and C-reactive protein levels were also recorded. Results: Of 99 patients, 68 were renal transplant recipients (43 men, mean age: 39.09 +/- 10.70 y) and 31 were healthy participants (14 men, mean age: 34.94 +/- 10.95 y). Forced vital capacity (P < .001, r = 0.65), maximal inspiratory (P = .002, r = 0.39) and expiratory (P < .001, r = 0.4) pressure, and hand grip strength showed significant relations in transplant recipients. Positive correlations were found between serum albumin levels and both hand grip strength (P = .16, r = 0.347) and forced vital capacity (P = .03, r = 0.436). Forced vital capacity was statistically different between renal recipients and healthy participants (P = .013), whereas maximal inspiratory and expiratory pressures were not (P > .05). No statistically significant relation was observed between biochemical para meters and maximal inspiratory and expiratory pressures (P > .05). Conclusions: Respiratory function and peripheral muscle strength were significantly related in renal transplant recipients, with significantly lower peripheral muscle strength suggesting the presence of inadequate respiratory function. Peripheral and respiratory muscle training and nutritional replacement strategies could help to improve postoperative respiratory function.
Portopulmonary hypertension in liver transplant candidates
(2016) Bozbas, Serife Savas; Bozbas, Huseyin; 26877607
Pulmonary vascular disorders including portopulmonary hypertension (PoPHT) are among the common complications of liver disease and are prognostically significant. Survival is very low without medical treatment and liver transplantation. With advances in medical therapy for elevated pulmonary artery pressure (PAP) and liver transplant surgery, survival of patients with PoPHT and advanced liver disease is significantly improved. Because of the prognostic significance of PoPHT and the limited donor pool, a comprehensive preoperative cardio-pulmonary assessment is of great importance in cirrhotic patients prior to transplant surgery. Therefore, a detailed transthoracic Doppler echocardiographic examination must be an essential component of this evaluation. Patients with mild PoPHT can safely undergo liver transplant surgery. In cases of moderate to severe PoPHT, right heart catheterization (RHC) should be performed. In patients with moderate to severe PoPHT on RHC (mean PAP 35-45 mmHg), vasodilator therapy should be attempted. Liver transplantation should be encouraged in cases that demonstrate a positive response. Bridging therapy with specific pulmonary arterial hypertension treatment agents should be considered until the transplant surgery and should be continued during the peri-and post-operative periods as needed.
Postoperative Pleural Effusions After Orthotopic Heart Transplant: Cause, Clinical Manifestations, and Course
(2016) Ulubay, Gaye; Kupeli, Elif; Dedekarginoglu, Balam Er; Bozbas, Serife Savas; Alekberov, Mahal; Sever, Ozlem Salman; Sezgin, Atilla; 0000-0003-2478-9985; 0000-0002-5826-1997; 0000-0002-7230-202X; 27805531; AAB-5064-2021; AAB-5345-2021; AAI-8064-2021
Objectives: 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. Materials and Methods: 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. Results: 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 hemo thorax (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. Conclusions: 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 post operative outcomes in these patients.
Prevalence, Cause, and Treatment of Respiratory Insufficiency After Orthotopic Heart Transplant
(2015) Bozbas, Serife Savas; Ulubay, Gaye; Eyuboglu, Fusun Oner; Sezgin, Atilla; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-7230-202X; 0000-0003-2478-9985; 0000-0002-5525-8207; 26640935; AAJ-8097-2021; AAI-8064-2021; AAB-5064-2021; AAR-4338-2020
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 comprising 32 of 45 patients (71.1%). Two patients had mild chronic obstructive pulmonary disease and 1 had asthma. Twenty-five patients (55.6%) had a history of smoking. Respiratory insufficiency was noted in 9 patients (20%) during the first postoperative week. Regarding cause, 5 of these patients (11.1%) had pleural effusion, 2 (4.4%) had atelectasis, 1 (2.2%) had pneumonia, and 1 (2.2%) had acute renal failure. Therapies administered to patients with respiratory insufficiency were as follows: 5 patients had oxygen therapy with nasal canula/ mask, 3 patients had continuous positive airway pressure, and 1 patient had mechanical ventilation. One month after transplant, 2 patients (4.4%) had respiratory insufficiency 1 (2.2%) due to pleural effusion and 1 (2.2%) due to atelectasis. Conclusions: Respiratory insufficiency is a common complication in the first week after orthotopic heart transplant. Identification of the underlying cause is an important indicator for therapy. With appro priate care, respiratory insufficiency can be treated successfully.
Pulmonary Complications and Mortality After Liver Transplant
(Başkent Üniversitesi, 2008-12) Bozbas, Serife Savas; Haberal, Mehmet; Karakayali, Hamdi; Sevmis, Sinasi; Arslan, Nevra Gullu; Ergur, Figen Ozturk; Eyuboglu, Fusun Oner
Objectives: Pulmonary complications after liver transplant significantly affect mortality and morbidity; however, their relation has not been clearly established. We sought to determine pulmonary complications during the early and late term after liver transplant and identify risk factors for mortality. Materials and Methods: At our institution, 130 liver transplant patients (mean age, 40.1 ± 14.6 years; 71.1% male) were retrospectively evaluated, and 114 adult orthotopic liver transplant patients were included. Cause of liver disease, pulmonary function test results, arterial blood gas analyses, surgery duration, length of stay in the intensive care unit and the hospital, pulmonary complications, and mortality causes were noted. Results: Pulmonary complications were detected in 48 patients (42.1%), pneumonia in 24 patients (21.1%), and pleural effusion in 21 patients (18.4%). Development of pulmonary complications was found to be significantly related to survival (P = .001). Fifty-two patients (45.6%) were smokers, a significant predictor of pulmonary complications (P = .03). There was no relation between pulmonary function test results and orthodeoxia and pulmonary complications and mortality. Early and late survival rates were significantly lower in patients in whom a microorganism was isolated on deep tracheal aspirate culture, while early survival was significantly reduced in the presence of a pleural effusion (P < .005). Conclusions: Pulmonary complications after liver transplant are common. Care must be taken to determine preoperative risk factors, and patients should be observed closely for development of respiratory complications after liver transplant.
Pulmonary Embolism as the First Sign of Hepatocellular Carcinoma in A Patient Who Was Cured After Five Years
(2023) Esendagli, Dorina; Rahatli, Samed; Hekimoglu, Koray; Bozbas, Serife Savas; AAJ-3047-2021
Pulmonary embolism (PE) is a preventable cause of death associated with high morbidity and mortality rates. Cancer is a significant risk factor for PE. In this case report, we present a patient with PE who was diagnosed with hepatocellular carcinoma (HCC) one month later. The patient had an unresectable tumor in the liver that had invaded both the inferior vena cava and the right atrium. He underwent transarterial chemoembolization (TACE) and sorafenib treatment. After two years, he underwent stereotactic radiosurgery, and he was switched to regorafenib. After five years, he was cured. This case is unique in terms of long survival compared to the literature.
Pulmonary Hypertension Improves After Orthotopic Liver Transplant in Patients With Chronic Liver Disease
(2015) Bozbas, Serife Savas; Eroglu, Serpil; Eyuboglu, Fusun Oner; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0003-2498-7287; 0000-0002-7230-202X; 0000-0002-5525-8207; 0000-0003-3055-7953; 26640929; ABG-1582-2021; AAJ-8097-2021; AAE-1041-2021; AAI-8064-2021; AAR-4338-2020
Objectives: Pulmonary hypertension is a common finding in chronic liver disease patients that has prognostic significance. In this study, we aimed to evaluate the prevalence and severity of pulmonary hypertension in patients undergoing orthotopic liver transplant. We also evaluated pulmonary artery pressure changes after transplant surgery. Materials and Methods: The records of adult patients with chronic liver disease who underwent orthotopic liver transplant at our center between 2004 and 2015 were retrospectively evaluated. Clinical and demographic variables and laboratory data were noted. Transthoracic Doppler echo cardiographic examination reports were obtained. Using continuous-wave Doppler examination, systolic pulmonary artery pressure values were calculated. Pulmonary hypertension was defined as systolic pulmonary artery pressure >= 30 mm Hg. Among 208 adult patients who underwent orthotopic liver transplant, 203 who had Doppler echocardiographic examination were enrolled. Results: The mean age of patients was 42.1 +/- 14.1 years (range, 16-67 y), and 143 (70.4%) were men. During preoperative assessment, pulmonary hypertension was identified in 47 patients (23.2%), of whom 10 displayed systolic pulmonary artery pressure > 50 mm Hg. Compared with preoperative values of systolic pulmonary artery pressure (46.8 +/- 8.4 mm Hg), a significant reduction in mean values (to 39.3 +/- 13.3 mm Hg) was observed post operatively (P=.007). Conclusions: The findings of this study indicate that pulmonary hypertension is a common finding in adult chronic liver disease patients undergoing orthotopic liver transplant. A significant improve ment occurs in systolic pulmonary artery pressure values following transplant surgery. Regarding the prevalence and prognostic significance of pulmonary hypertension, all patients with chronic liver disease should be evaluated with transthoracic Doppler echocardiography before transplant.
Radiologically Occult Invasive Pulmonary Aspergillosis in a Patient With Liver Transplant
(2018) Esendagli, Dorina; Serifoglu, Irem; Bozbas, Serife Savas; Tepeoglu, Merih; Akcay, Sule; Haberal, Mehmet; 0000-0002-6619-2952; 0000-0002-7230-202X; 0000-0002-9894-8005; 0000-0002-8360-6459; 0000-0002-3462-7632; 29528022; ABF-9398-2020; AAS-6628-2021; AAI-8064-2021; AAK-5222-2021; AAB-5175-2021; AAJ-8097-2021
Invasive pulmonary aspergillosis is an infection seen in patients receiving intensive immunosuppressive regimens, such as transplant recipients. Some risk factors that increase the incidence of infection have been determined, and patients defined as having high risk are recommended to take antifungal prophylaxis and be monitored closely. Here, we present a liver transplant patient with mild respiratory symptoms and a normal chest radiography on day 26 posttransplant. However, he had acute renal failure and underwent hemodialysis, which are both defined to increase significantly the risk of aspergillosis. Although the radiographic scan was initially normal, thorax tomography and later bronchoscopy showed findings compatible with pulmonary aspergillosis, and the patient was started on antifungal treatment. The nonspecific mild symptoms and an initial normal radiology can make diagnosis of invasive fungal infections difficult; thus caution and close follow-up of high-risk patients should be performed.
Relation Between Carotid Intima-Media Thickness, Serum Paraoxonase Levels and Severity of Obstructive Sleep Apnea Syndrome
(2023) Akkurt, Esma Sevil; Bozbas, Serife Savas; Eroglu, Serpil; Ozcalik, Emre; Ozer, Eda Ozturan; Ozyurek, Berna Akinci; Eyuboglu, Fusun Oner; 37983282
INTRODUCTION: Obstructive sleep apnea (OSA) has a significant effect on the development of cardiovascular complications. The aim of this study was to evaluate the relationship between carotid intimamedia thickness (IMT), paraoxonase 1 (PON 1) enzyme levels and severity of OSA. MATERIAL AND METHODS: A total of 120 cases were included in the study with 30 cases in each group, as follows: Group 1 (AHI < 5/h), Group 2 (AHI 5-15/h), Group 3 (AHI 16-30/h) and Group 4 (AHI > 30/h). Blood samples of the patients were taken to measure serum PON1 activity. Carotid IMT of all patients included in the study was measured by means of echocardiography using vascular probe and results were recorded. RESULTS: With regard to carotid IMT, a statistically significant increase was detected as severity of OSA increased (p < 0.001). A positive relationship was detected between IMT level and total oxygen desaturation time, oxygen desaturation index and SpO2 time < 90 % (p < 0.01). When the groups were compared, a statistically significant decline was observed in serum PON 1 level as severity of OSA increased (p < 0.05). CONCLUSIONS: The findings of our study indicate that PON1 and carotid IMT might be used as indicators of vascular damage in patients with OSA. Depending on the severity of OSA, measurement of PON1 enzyme activity in conjunction with carotid IMT may help us in predicting the cardiovascular risk in patients with OSA (Tab. 4, Fig. 2, Ref. 27). Tex t in PDF www.elis.sk
Relation Between Carotid Intima-Media Thickness, Serum Paraoxonase Levels and Severity of Obstructive Sleep Apnea Syndrome
(2015) Akkurt, Esma Sevil; Bozbas, Serife Savas; Eroglu, Serpil; Ozcalik, Emre; Eyuboglu, Fusun Oner; 0000-0002-7230-202X; 0000-0002-5525-8207; AAI-8064-2021; AAR-4338-2020; ABG-1582-2021
Role of Serum Procalcitonin Levels in Solid-Organ Transplant Patients
(2016) Bozbas, Serife Savas; Dedekarginoglu, Balam Er; Ulubay, Gaye; Haberal, Mehmet; 0000-0002-7230-202X; 0000-0003-2478-9985; 0000-0002-3462-7632; 27805529; AAI-8064-2021; AAB-5064-2021; AAJ-8097-2021
Objectives: 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. Materials and Methods: 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. Results: Mean age of our patients was 45.5 +/- 13.4 years (range, 18-70 y), with 61 male patients (70.9%). We included 26 liver, 44 kidney, 14 heart, and 2 heart and renal transplant recipients. Procalcitonin was positive in 43 patients (50%). Of the 39 patients who were diagnosed with pneumonia, procalcitonin was positive in 18 patients (46.2%). There was a significant correlation between serum levels of procalcitonin and C-reactive protein (r = 0.45; P < .001) and neutrophil count (r = 0.24; P = .025). There was no correlation between mortality and procalcitonin level, CRP level, or leukocyte count (P > .05). Conclusions: Our findings indicate that procalcitonin is a promising biomarker to detect infectious complications in transplant recipients. Physical examination and radiologic findings of bacterial pneumonia may be nonspecific, and in a considerable number of immunocompromised patients the site of infection could not be identified. Serum levels of procalcitonin should not be used as sole criteria for clinical decision making; however, it can guide us in therapy of such conditions in addition to currently used serum markers of infection.