Browsing by Author "Hekimoglu, Koray"

Now showing 1 - 14 of 14

Coronavirus Disease (COVID-19) in Kidney and Liver Transplant Patients: A Single-Center Experience
(2020) Akdur, Aydincan; Karakaya, Emre; Soy, Ebru H. Ayvazoglu; Alshalabi, Omar; Kirnap, Mahir; Arslan, Hande; Ulubay, Gaye; Hekimoglu, Koray; Moray, Gokhan; Haberal, Mehmet; 0000-0002-0993-9917; 0000-0002-0805-0841; 0000-0002-3462-7632; 0000-0003-2478-9985; 0000-0003-2498-7287; 0000-0002-8726-3369; 0000-0002-4879-7974; 32519617; AAC-5566-2019; AAD-9097-2021; AAJ-8097-2021; AAB-5064-2021; AAE-1041-2021; AAA-3068-2021; AAD-5466-2021
Objectives: The novel 2019 coronavirus (COVID-19) was first described in December 2019 in Wuhan, China and subsequently announced as a pandemic on March 12, 2020. In several studies, solid-organ transplant recipients were reported to have higher risk for COVID-19. Here, we aimed to determine the frequency of COVID-19 in our kidney and liver transplant patients. Materials and Methods: Our study included 583 transplant patients who were admitted to our outpatient transplant clinics and emergency departments between March 1 and May 1, 2020. Seventy-four of them were liver transplant recipients (46 male, 28 female, of which 14 were pediatric and 60 were adult patients) and 509 of them were kidney transplant recipients (347 male, 162 female, of which 16 were pediatric and 493 were adult patients). We retrospectively evaluated demographic characteristics, currently used immunosuppressant treatment, present complaints, treatment and diagnosis of comorbid diseases, and results of COVID-19 tests. Results: Of 583 transplant recipients, 538 were seen in our outpatient transplant clinics and 45 were seen in our emergency departments. Of these, 18 patients who had had cough and fever were evaluated by respiratory clinic doctors, and nasopharyngeal swab samples were taken. One kidney transplant recipient had a positive COVID-19 test; he was followed with home isolation. He received treatment with hydroxychloroquine (400 mg/day). The other 17 patients had negative tests. There were no mortalities due to COVID-19. Conclusions: Transplant patients also got affected during the COVID-19 pandemic. According to the data of our centers, this effect is not much more different from the normal population. We recommend that transplant recipients should be warned in terms of personal hygiene and should be closely monitored by organ transplant centers. If there is an indication for hospitalization, they should be followed in an isolated unit, with no aggressive changes made to immunosuppressive doses unless necessary
Cross-Sectional Analysis Of Tobacco Addiction In Hospitalized COVID-19 Patients
(2022) Darilmaz Yuce, Gulbahar; Torun, Serife; Hekimoglu, Koray; Tuna, Derin; Sozbilici, Betul Rana; Cetin, Hikmet Oguz; Narlioglu, Mehmet Emin; Balli, Murat; Ozyesil, Ahmet Suheyl; Yavuz Colak, Meric; Ulubay, Gaye; Akcay, Muserref Sule; https://orcid.org/0000-0002-0805-0841; 36164949; AAD-9097-2021
Introduction: The COVID-19 pandemic has become an important health issue with consequences for special populations since 2019. Tobacco use is an important public health issue and tobacco users are a risk group for lung infections.Materials and Methods: The aim of this study is to obtain information about disease prevalence and severity, laboratory parameters, and changes in radio-logical findings between smokers and non-smokers who were hospitalized, followed up, and treated for COVID-19, and to find answers to critical questi-ons regarding the response to antiviral and supportive therapy. Two hundred eighty-six patients who were hospitalized and treated between March 2020-February 2021 in the COVID-19 Isolation Ward of Baskent University Hospital were included in the study. The patients were grouped as current smokers, non-smokers, and ex-smokers. The groups were compared in terms of symptoms, laboratory findings, radiological findings, and treatment respon-se.Results: The median age of the patients included in the study was 59 (IQR= 32). Of the patients, 40.6% were female and 59.4% were male. In our study, we discovered that there were fewer female smokers (p< 0.001). When the current smokers (n= 56), non-smokers (n= 159), and ex-smokers (n= 71) were compared based on their findings, it was found that dyspnea was more common in current smokers (p= 0.009). Lung involvement was found to be more common (p= 0.002) and multifocal in the current smokers group (p= 0.038). The levels of oxygen saturation at the times of admission and discharge were lower in current smokers (p= 0.002 and p= 0.038). The need for nasal oxygen and noninvasive mechanical ventilation was also found to be higher in current smokers (p= 0.008 and p= 0.039). Systemic steroid requirement was higher in current smokers (p= 0.013). There was no statistically significant differen-ce in terms of mortality between current smokers, ex-smokers, and non-smokers (p= 0.662).Conclusion: The analysis of the findings of the patients hospitalized in the COVID-19 isolation ward indicated that COVID-19 leads to a more serious course in patients with a history of smoking.
Diagnostic Impact of Quantitative Dual-Energy Computed Tomography Perfusion Imaging for the Assessment of Subsegmental Pulmonary Embolism
(2021) Celtikci, Pinar; Hekimoglu, Koray; Kahraman, Gokhan; Bozbas, Serife; Gultekin, Bahadir; Akay, Hakki Tankut; 0000-0002-1655-6957; 0000-0002-0805-0841; 33186173; AAD-9097-2021; ABA-7388-2021
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.
Diagnostic importance of maximum intensity projection technique in the identification of small pulmonary nodules with computed tomography
(2020) Guleryuz Kizil, Pinar; Hekimoglu, Koray; Coskun, Mehmet; Akcay, Sule; 0000-0001-5630-022X; 0000-0002-0805-0841; 0000-0002-8360-6459; 32718138; AAM-4120-2021; AAD-9097-2021; AAB-5175-2021
Introduction: In this retrospective study, the aim is to determine the sensitivity of maximum intensity projection (MIP) technique to 3 mm-thick axial sections in patients with small pulmonary nodules identified via examination using computed tomography (CT), and to identify whether this technique provides significant reduction in duration of nodule evaluation. Materials and Methods: A total of 69 patients (339 nodules) who underwent thoracic tomography due to various complaints and in whom pulmonary nodules were identified as a result of the examination were included in the study. Their axial sections that are 3 mm-thick and MIP sections obtained in the axial plane were evaluated by two different radiologists at different times by keeping time. the dimensions and evaluation times of the nodules were recorded separately for each method. Results: Evaluation compatibility between the radiologists was found to be 86.8% and it was considered to be perfectly compatible. Sensitivity of the 1st radiologist in the detection of nodules with MIP was 81.4%, whereas the sensitivity of the 2nd radiologist was 83.4%. In the evaluation for the reporting periods, when the duration of evaluation of MIP images were compared with the gold standard, a statistically significant reduction was found in the reporting times of both radiologists (p< 0.01). Conclusion: It was found that utilization of MIP images as an alternative method to detect pulmonary modules reduces the duration of evaluation significantly and provides the ability to detect nodules with high sensitivity. According to these data, MIP imaging may be preferred as an adjunct method in the evaluation of lung nodules as it provides fast and reliable information besides classical axial sections.
Diagnostic importance of maximum intensity projection technique in the identification of small pulmonary nodules with computed tomography
(2020) Guleryuz Kizil, Pinar; Hekimoglu, Koray; Coskun, Mehmet; Akcay, Sule; 0000-0002-0805-0841; 0000-0001-5630-022X; 0000-0002-8360-6459; 32755123; AAD-9097-2021; AAM-4120-2021; AAB-5175-2021
Dual-Energy Computed Tomography Pulmonary Angiography With Ultra-Low Dose Contrast Administration: Comparison Of Image Quality With Standard Computed Tomography Pulmonary Angiography
(2022) Celtikci, Pinar; Hekimoglu, Koray; Kahraman, Gokhan; Haberal, Kemal Murat; Kilic, Dalokay
Background: This study aims to compare quantitative and qualitative image quality between standard computed tomography pulmonary angiography and dual-energy computed tomography pulmonary angiography protocols. Methods: Between September 2017 and August 2018, a total of 91 consecutive patients (34 males, 57 females; mean age: 65.9 +/- 15 years; range, 37 to 91 years) who were referred for computed tomography pulmonary angiography were randomly imaged with either a standard or dual-energy protocol. Standard protocol (n=49) was acquired with a 64-slice multidetector computed tomography scanner using 60 mL contrast media (18 g iodine). A third-generation dual-energy computed tomography scanner was utilized to acquire dual-energy computed tomography pulmonary angiography and simultaneous lung perfusion imaging (n=42), which required 40 mL contrast media (12 g iodine). Two radiologists reviewed images separately to determine interobserver variability. Attenuation and noise in three central and two segmental pulmonary arteries were measured; signal-to-noise ratio and contrast-to-noise ratio were calculated. A five-point scale was utilized to evaluate image quality and image noise qualitatively. Results: The standard protocol required a significantly higher amount of iodine. Comparison of two groups employing quantitative measurements (attenuation value in five pulmonary arteries, mean attenuation value, mean background noise, signal-to-noise ratio, and contrast-to-noise ratio) and employing qualitative measurements (five-point scale scores of image quality and image noise) revealed no significant difference between dual-energy and standard groups (p>0.05). Qualitative and quantitative evaluations demonstrated low interobserver variability. Conclusion: Dual-energy computed tomography pulmonary angiography protocol delivers image quality equal to standard protocol, while requiring less amount of iodinated contrast medium and providing simultaneous lung perfusion imaging to contribute the diagnosis of pulmonary embolism.
Liver Perivascular Epithelioid Cell Tumor with an Unusual Location: Diagnostic Characteristics with Multidetector Computed Tomography and Magnetic Resonance Imaging
(2017) Hekimoglu, Koray; Haberal, Murat; 0000-0002-0805-0841; 0000-0002-8211-4065; 28975043; AAD-9097-2021; R-9398-2019
Primary perivascular epithelioid cell tumor (PEComa) of the liver is a very rare tumor that originates from mesenchyma. Gastrointestinal tract with perivascular distribution is the most common anatomic sites of these tumors. Only few cases of hepatic PEComa have been described so far. Malignant PEComas exhibit aggressive behavior with poor prognosis, making early diagnosis crucial. Hereby, we report a 79-year-old female with unusually located mass in the liver. A partial curative hepatectomy has been done, and PEComa was diagnosed histopathologically. No evidence of recurrence was observed during the 6-month follow-up.
LONG-TERM DIAGNOSTIC ANALYSIS OF INVASIVE PULMONARY ASPERGILLOSIS AFTER SOLID ORGAN TRANSPLANTATION: SPECTRUM OF INITIAL AND FOLLOW-UP CT FINDINGS
(2020) Hekimoglu, Koray; Esendagli, Dorina; Haberal, Murat; Kirnap, Mahir; Sezgin, Atilla; Haberal, Mehmet A.
New challenges for management of COVID-19 patients: Analysis of MDCT based "Automated pneumonia analysis program"
(2021) Sezer, Rahime; Esendagli, Dorina; Erol, Cigdem; Hekimoglu, Koray; 34307790
Purpose: The aim of this study is to define the role of an "Automated Multi Detector Computed Tomography (MDCT) Pneumonia Analysis Program" as an early outcome predictor for COVID-19 pneumonia in hospitalized patients. Materials and Methods: A total of 96 patients who had RT-PCR proven COVID-19 pneumonia diagnosed by non contrast enhanced chest MDCT and hospitalized were enrolled in this retrospective study. An automated CT pneumonia analysis program was used for each patient to see the extent of disease. Patients were divided into two clinical subgroups upon their clinical status as good and bad clinical course. Total opacity scores (TOS), intensive care unit (ICU) entry, and mortality rates were measured for each clinical subgroups and also laboratory values were used to compare each subgroup. Results: Left lower lobe was the mostly effected side with a percentage of 78.12 % and followed up by right lower lobe with 73.95 %. TOS, ICU entry, and mortality rates were higher in bad clinical course subgroup. TOS values were also higher in patients older than 60 years and in patients with comorbidities including, Hypertension (HT), Diabetes Mellitus (DM), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and malignancy. Conclusion: Automated MDCT analysis programs for pneumonia are fast and an objective way to define the disease extent in COVID-19 pneumonia and it is highly correlated with the disease severity and clinical outcome thus providing physicians with valuable knowledge from the time of diagnosis.
Nowadays COVID underestimates the other suspects
(2020) Esendagli, Dorina; Tek, Korhan; Yuce, Gulbahar Darilmaz; Hekimoglu, Koray; Ulubay, Gaye; 0000-0003-2478-9985; 0000-0002-0805-0841; 0000-0002-6619-2952; 0000-0001-8231-1475; 33295734; AAJ-4345-2021; AAB-5064-2021; AAD-9097-2021; ABF-9398-2020
The whole world has been facing the pandemic of SARS-CoV-2 infection and every day we still find out new knowledge regarding the disease. COVID-19 which is the name given to the clinical syndrome related to this infection has been shown to own a wide diversity of clinical presentations which challenges the healthcare workers and makes difficult the diagnosis and management of patients. Pulmonary embolism is also an entity that accompanies this type of infection and sometimes it is difficult to differentiate between the two. Here we present a patient who was admitted inward with typical lesions on chest tomography for COVID-19, but that turned out to be a submassive pulmonary embolism case without any infection. This case is remarkable because it shows that patients suspected for COVID-19 should be carefully examined and that pulmonary embolism can per se mimick the parenchymal lesions caused by viral infections.
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.
Relationship between chest computed tomography findings and clinical conditions of coronavirus disease (COVID-19): A multicentre experience
(2021) Yilmaz Demirci, Nilgun; Ugras Dikmen, Asiye; Tasci, Canturk; Dogan, Deniz; Arslan, Yakup; Ocal, Nesrin; Tasar, Mustafa; Bozlar, Ugur; Artuk, Cumhur; Yilmaz, Gulden; Karacaer, Zehra; Avci, Ismail Yasar; Tuncer Ertem, Gunay; Erdinc, Fatma Sebnem; Kinikli, Sami; Altun Demircan, Serife; Ergun, Elif; Nercis Kosar, Pinar; Karakoc, Ayse Esra; Gokcek, Atila; Aloglu, Melike; Gulgosteren, Sevtap; Atikcan, Sukran; Akcay, Sule; Erol, Cigdem; Hekimoglu, Koray; Cerit, Mahi Nur; Erbas, Gonca; Ozger, Hasan Selcuk; Bozdayi, Gulendam; Senol, Esin; Yurdakul, Ahmet Selim; Yilmaz, Aydin; 0000-0002-2535-2534; 0000-0002-0805-0841; 34105857; AAJ-1219-2021; AAD-9097-2021
Aims This study aimed to investigate the clinical and chest computed tomography (CT) features associated with clinical parameters for coronavirus disease (COVID-19) in the capital of Turkey, Ankara. Materials and methods Epidemiological, clinical features, laboratory findings and radiological characteristics of 1563 hospitalised patients with COVID-19 in Ankara were collected, reviewed and analysed in this study. The risk factors associated with disease severity were investigated. Results Non-severe (1214; 77.7%) and severe cases (349; 22.3%) were enrolled in the study. Compared with the non-severe group, the severe group were significantly older and had more comorbidities (ie, hypertension, diabetes mellitus, cardiovascular disease and chronic kidney disease). Smoking was more common in the severe group. Severe patients had higher respiratory rates and higher incidences of cough and dyspnoea compared with non-severe patients. Compared with the non-severe patients, the severe patients had increased C-reactive protein (CRP), procalcitonin, neutrophil to lymphocyte ratio (NLR) and CRP/albumin ratio and decreased albumin. The occurrence rates of consolidation, subpleural sparing, crazy-paving pattern, cavity, halo sign, reversed halo sign, air bronchogram, pleural thickening, micronodule, subpleural curvilinear line and multilobar and bilateral involvement in the CT finding of the severe patients were significantly higher than those of the non-severe patients. Conclusions Many factors are related to the severity of COVID-19, which can help clinicians judge the severity of the patient and evaluate the prognosis. This cohort study revealed that male sex, age (>= 55 years), patients with any comorbidities, especially those with cardiovascular disease, dyspnoea, increased CRP, D-dimer and NLR, and decreased lymphocyte count and CT findings of consolidation and multilobar involvement were predictors of severe COVID-19.
Relationship between chest CT findings and clinical conditions of COVID-19: A multicentre experience
(2021) Akcay, Sule; Erol, Cigdem; Hekimoglu, Koray
The role of shear wave elastography in the diagnosis of chronic autoimmune thyroiditis
(2015) Hekimoglu, Koray; Donmez, Fuldem Yildirim; Arslan, Serdar; Ozdemir, Adnan; Demir, Canan; Yazici, Canan; 26343080
Aims: The aim of this study is to assess the applicability of shear wave elastography (SWE) in the diagnosis of chronic autoimmun thyroiditis (CAT) patients. Material and methods: The study group consisted of 50 patients with first-diagnosed CAT and 40 control subjects (CS). In all patients with CAT and CS, sonoelastographic measurements were made in both thyroid lobes. Optimal cut-off values were chosen to maximize the sum of sensitivity and specificity. Positive predictive value (PPV), negative predictive value (NPV), and accuracy values were also calculated. Results: Quantitative elastographic analysis evaluated by SWE in CAT patients (2.56 +/- 0.30 m/s) was significantly higher compared with CS (1.63 +/- 0.12 m/s) (p<0.001). The optimal cut-off value was 2.42 m/s. SWE had 77% sensitivity, 71% specificity, 92% PPV, 81% NPV, and 87% accuracy for the presence of CAT. Conclusions: Our data indicate that SWE correctly defines the elasticty of thyroid parenchyma, and this technique may assist in the diagnosis and treatment monitoring of CAT.