Browsing by Author "Kocak, Nagihan Durmus"

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Evaluation of Exudative Pleural Effusions: A Multicenter, Prospective, Observational Study
(2022) Ak, Guntulu; Metintas, Selma; Taskin, Ayse Naz; Sener, Melahat Uzel; Soyler, Yasemin; Yilmaz, Meltem; Turna, Akif; Kabalak, Pinar Akin; Bilaceroglu, Semra; Koksal, Deniz; Demirci, Nilgun Yilmaz; Sogukpinar, Ozlem; Boga, Sibel; Ercelik, Merve; Karadeniz, Gulistan; Polat, Gulru; Guldaval, Filiz; Akturk, Ulku Aka; Yilmaz, Senay; Ogan, Nalan; Yilmaz, Saliha; Esendagli, Dorina; Caglayan, Benan; Zeybek, Arife; Kocak, Nagihan Durmus; Mutlu, Pinar; Baytemir, Cansel Atinkaya; Mutlu, Pinar; Baytemir, Cansel Atinkaya; Sarbay, Ismail; Yilmaz, Ulku; Metintas, Muzaffer; 36173482
Purpose The aim of this study is to determine the diagnostic performances of pleural procedures in undiagnosed exudative pleural effusions and to evaluate factors suggestive of benign or malignant pleural effusions in tertiary care centers. Methods This was a multicenter prospective observational study conducted between January 1 and December 31, 2018. A total of 777 patients with undiagnosed exudative pleural effusion after the initial work-up were evaluated. The results of diagnostic procedures and the patients' diagnoses were prospectively recorded. Sensitivity, specificity, and accuracy estimates with 95% confidence intervals were used to examine the performance of pleural procedures to detect malignancy. Results The mean age +/- SD of the 777 patients was 62.0 +/- 16.0 years, and 68.3% of them were male. The most common cause was malignancy (38.3%). Lung cancer was the leading cause of malignant pleural effusions (20.2%). The diagnostic sensitivity and accuracy of cytology were 59.5% and 84.3%, respectively. The diagnostic sensitivity of image-guided pleural biopsy was 86.4%. The addition of image-guided pleural biopsy to cytology increased diagnostic sensitivity to more than 90%. Thoracoscopic biopsy provided the highest diagnostic sensitivity (94.3%). The highest diagnostic sensitivity of cytology was determined in metastatic pleural effusion from breast cancer (86.7%). Conclusion The diagnostic performance increases considerably when cytology is combined with image-guided pleural biopsy in malignant pleural effusions. However, to avoid unnecessary interventions and complications, the development of criteria to distinguish patients with benign pleural effusions is as important as the identification of patients with malignant pleural effusions.
Frequency of Direct Oral Anticoagulants Usage in Acute Pulmonary Thromboembolism Treatment in Turkey (TUPEDO)
(2022) Tanriverdi, Elif; Tutar, Nuri; Senturk, Aysegul; Bahadir, Ayse; Aksel, Nimet; Yetkin, Nur Aleyna; Karadeniz, Gulistan; Cetin, Nazli; Tabaru, Ali; Yildirim, Binnaz Zeynep; Sen, Hatice Selimoglu; Ozcelik, Neslihan; Ozsari, Emine; Uzer, Fatih; Cicek, Tugba; Esendagli, Dorina; Hocanli, Iclal; Kocak, Nagihan Durmus; Tapan, Utku; Kurt, Bahar; Arinc, Sibel; Kavas, Murat; Sahin, Fusun; Ergun, Dilek; Ucar, Elif Yilmazel; Kilic, Talat; Gulmez, Inci; Emre, Julide Celdir; Dogan, Deniz; Ozdemir, Fatma; Duger, Mustafa; Alzafer, Suha; Yarar, Esra; Unat, Damla Serce; Salik, Bilge; 35330566
Background: Direct oral anticoagulants (DOACs) have been used in acute pulmonary thromboembolism as an alternative to warfarin due to drug interactions, narrow therapeutic range, and necessary close International Normalized Ratio (INR) monitoring. Phase 3 study results have reported that these drugs are at least as effective as warfarin and beneficial in terms of bleeding; however, studies that present up-to-date life data are necessary. Aims: To evaluate the frequency of using DOACs, which are prescribed with a limited number of indications in our country, and real-life data results. Study Design: Cross-sectional study Methods: This cross-sectional survey collected the clinical data (history, current treatment, treatment duration, etc.) of patients with pulmonary thromboembolism and who applied to the physician for follow-up between October 15, 2019, and March 15, 2020. The researchers kept the patient records sequentially. Results: Data from 836 patients with acute pulmonary thromboembolism from 25 centers were collected, and DOAC was used in 320 (38.5%) of them. The most preferred DOAC was rivaroxaban (n = 294, 91.9%). DOAC was mostly preferred because it could not provide an effective INR level with warfarin (n=133, 41.6%). Bleeding was observed in 13 (4%) patients. Conclusion: The use of direct oral anticoagulants is becoming almost as widespread as conventional therapy. Real-life data results are important for their contribution to clinical practice.
Spontaneos Pneumomediastinum After Persistent Cough in Asthmatic Patient: Case Report
(2014) Kocak, Nagihan Durmus; Eyuboglu, Fusun Oner; 0000-0003-4028-2797; 0000-0002-5525-8207; AFM-4219-2022; AAR-4338-2020
Spontaneous pneumomediastinum (SPM) is a clinical condition that is characterized by the presence of free air in the mediastinal space that is unrelated to trauma or medical procedure. Although SPM is a rare and generally benign condition, during the period of the status, life threatening complications can result such as tension pneumothorax, tension pneumomediastinum, pneumopericardium or acute upper airway obstruction. The patient who had persistent cough for a week and known asthma disease referred to the hospital with complaints of chest pain, dyspnea, and neck pain. Subcutaneous crepitation on the neck was the only pathological finding on physical examination. SPM and subcutaneous emphysema was detected on computed tomography of the chest. The patient was hospitalized with diagnosis of asthma, SPM and subcutaneous emphysema and discharged after 72 hours of hospital admission with successfully treated conservatively. We report this case because of this clinic condition is rare and serious complications may occur. In patients who have chest or neck pain, SPM must be in differential diagnosis when there are precipitating factors such as asthma attack or severe cough.