Browsing by Author "Sen, Nazan"

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Anti-Tumor Necrosis Factor Alpha Treatment and Tuberculin Skin Test
(2015) Bozkirli, Emine Duygu Ersozlu; Tufan, Muge Aydin; Ozisik, Lale; Sen, Nazan; Yucel, Ahmet Eftal
Purpose: The use of anti-tumor necrosis factor alpha (anti-TNF) drugs has been a milestone in the treatment of rheumatic diseases. Despite their strong efficacy, there are some factors restricting the use of anti-TNF agents. We must be careful especially for the granulomatous diseases which can be seen endemic in our country such as tuberculosis and leishmaniasis. In our country according to the RAED 2005 Consensus Meeting Reports, patients candidate for anti-TNF treatment are evaluated for both active and inactive tuberculosis before treatment and prophylaxis with isoniazid (INH) has been performed where indicated. Material and Methods: Tuberculin skin tests (TST) of 43 patients followed up in the Rheumatology Clinic and receiving anti-TNF therapy were repeated under treatment. Patients' pretreatment first TST results, drugs they used, INH prophylaxis state, smoking status and the duration of anti-TNF treatment were evaluated. Results: 14 patients (32.6%) were women, while 29 (67.4%) were men. The mean of first TST values were 11.72 +/- 90.3 mm (0-30) and the mean of second TST values were 12.06 +/- 12.4 mm (0-45). 48.8% of the patients were smoking and 74.4% of the patients had received INH prophylaxis for 9 months. The mean total duration of anti-TNF drug use was found as 22.67 +/- 19.11 (5-68) months. No statistically significant difference (p=0.888) was observed between the first pretreatment and second under treatment TST results of the patients. Discussion: Tuberculosis remains to be a serious public health problem for both our country and the whole world. For this reason in our country, a detailed assessment is performed for all patients before anti-TNF treatment. In our study patients who are planned to start anti-TNF therapy were assessed with their first TST values and INH prophylaxis were given to 32 patients (74.4%) before treatment. No statistically significant difference was observed between pre and post-treatment TST values when control TST were performed with the earliest after five months of treatment. These findings may suggest that there is no evident increase in the risk of tuberculosis for patients receiving anti-TNF treatment with appropriate INH prophylaxis.
Anxiety and Depression Levels of Healthcare Workers During COVID-19 Pandemic
(2021) Turan, Muzaffer Onur; Demirci, Nilgun Yilmaz; Ak, Guntulu; Akcay, Sule; Akturk, Ulku Aka; Bilaceroglu, Semra; Coskun, Funda; Kokturk, Oguz; Mirici, Arzu; Cengiz, Ozdemi. R.; Sen, Nazan; Yilmaz, Ulku
The Approach to Community-Acquired Pneumonia: A Survey Study
(2018) Ozyurek, Berna Akinci; Erturk, Arzu; Aydemir, Yusuf; Sen, Nazan; Alizoroglu, Dursun; Ozhan, Mustafa Hikmet; https://orcid.org/0000-0002-4171-7484; AAI-8947-2021
INTRODUCTION AND AIM: Community-acquired pneumonia (CAP), which is often seen in daily practice, is a lower respiratory tract and pulmonary parenchyma infection which develops in society and daily life with community-acquired pathogens in individuals with no known immune failure. Delay in the treatment of pneumonia is known to increase morbidity and mortality. Various scoring systems are currently used in the identification of treatment groups in pneumonia. With the aim of evaluating the approach to CAP cases, the infection. MATERIALS AND METHODS: Working Group of the Turkish Respiratory Research Association (TUSAD) prepared a 22-item questionnaire. RESULTS: The survey was published on the TUSAD official website between July 2013 and June 2016. A total of 78 individuals responded to the questionnaire on the website. CONCLUSION: The responses to the questionnaire could indicate the way forward for new guidelines for physicians in respect of the approach to CAP.
Characteristics of hospitalised COVID-19 patients and parameters associated with severe pneumonia
(2021) Turan, Onur; Mirici, Arzu; Akcali, Serap Duru; Turan, Pakize Ayse; Batum, Ozgur; Sengul, Aysun; Unsal, Zuhal Ekici; Kabakoglu, Nalan Isik; Ogan, Nalan; Torun, Serife; Ak, Guntulu; Akcay, Sule; Komurcuoglu, Berna; Sen, Nazan; Mutlu, Pinar; Yilmaz, Ulku; 34480831
Background After the first case of coronavirus disease 2019 (COVID-19) was reported in China in December 2019, it caused a global pandemic, including Turkey. Objectives The aim of this study was to analyse the characteristics of hospitalised COVID-19 patients and assess the parameters related to severe pneumonia. Methods Included in the study were hospitalised COVID-19 patients with positive naso-oropharyngeal swabs. Patients' demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively. Results Of 1013 patients, 583 were males (57.6%) and 430 were females (42.4%), with a mean age of 53.7 +/- 17.9. More than half of the patients had at least one comorbidities, the most common of which were hypertension and diabetes mellitus. Cough (59.8%), fatigue (49.5%) and fever (41.2%) were the most common presenting symptoms. Of the hospitalised COVID-19 patients, 84.9% had pneumonia and 83.5% had typical radiological COVID-19 appearances (94.5%: ground-glass areas). The most common laboratory findings were high C-reactive protein (CRP) (73.6%) and lactate dehydrogenase (LDH) (46.2%) levels, as well as lymphopenia (30.1%). Severe pneumonia was present in 28.1% of COVID-19 patients. Multivariate logistic regression analysis indicated that advanced age, hypotension, anaemia and elevated CRP and LDH serum levels were independent risk factors for the severity of COVID-19 pneumonia (P = .011, .006, .017, .003 and .001, respectively). Conclusion This study, as one of the first multicentre studies about characteristics of COVID-19 in Turkey, may guide about disease-related parameters and severity of pneumonia. Age, blood pressure, complete blood count and routine biochemical tests (including CRP and LDH) would appear to be important parameters for the evaluation of the severity of COVID-19 pneumonia.
Characteristics of hospitalized COVID-19 patients and parameters associated with severe pneumonia
(2021) Turan, Muzaffer Onur; Mirici, Arzu; Akcali, Serap Duru; Turan, Pakize Ayse; Batum, Ozgur; Sengul, Aysun; Unsal, Zuhal Ekici; Kabakoglu, Nalan Isik; Ogan, Nalan; Torun, Serife; Ak, Guntulu; Akcay, Sule; Komurcuoglu, Berna; Sen, Nazan; Mutlu, Pinar; Yilmaz, Ulku
Characteristics Of Our Hypoxemic COVID-19 Pneumonia Patients Receiving Corticosteroids And Mortality-Associated Factors
(2022) Sengul, Aysun; Mutlu, Pinar; Ozdemir, Ozer; Satici, Celal; Turan, Muzaffer Onur; Arslan, Sertac; Ogang, Nalan; Unsal, Zuhal Ekici; Bozkus, Fulsen; Capraz, Aylin; Demirkol, Mustafa Asim; Mutlu, Levent Cern; Gulhanm, Pinar Yildiz; Alkilinc, Ersin; Fazlioglu, Nevin; Soyler, Yasemin; Kabalak, Pinar Akin; Kizilgoz, Derya; Turan, Pakize Ayse; Yildirim, Fatma; Aydemir, Yusuf; Sen, Nazan; Mirici, Arzu; 35839345
Background COVID-19 is a disease associated with diffuse lung injury that has no proven effective treatment yet. It is thought that glucocorticoids may reduce inflammation-mediated lung injury, disease progression, and mortality. We aimed to evaluate our patient's characteristics and treatment outcomes who received corticosteroids for COVID-19 pneumonia. Methods We conducted a multicenter retrospective study and reviewed 517 patients admitted due to COVID-19 pneumonia who were hypoxemic and administered steroids regarding demographic, laboratory, and radiological characteristics, treatment response, and mortality-associated factors. Results Of our 517 patients with COVID-19 pneumonia who were hypoxemic and received corticosteroids, the mortality rate was 24.4% (n = 126). The evaluation of mortality-associated factors revealed that age, comorbidities, a CURB-65 score of >= 2, higher SOFA scores, presence of MAS, high doses of steroids, type of steroids, COVID-19 treatment, stay in the intensive care unit, high levels of d-dimer, CRP, ferritin, and troponin, and renal dysfunction were associated with mortality. Conclusion Due to high starting and average steroid doses are more associated with mortality, high-dose steroid administration should be avoided. We believe that knowing the factors associated with mortality in these cases is essential for close follow-up. The use of CURB-65 and SOFA scores can predict prognosis in COVID-19 pneumonia.
Comparison of the clinical course of COVID-19 infection in sickle cell disease patients with healthcare professionals
(2021) Boga, Can; Asma, Suheyl; Leblebisatan, Goksel; Sen, Nazan; Tombak, Anil; Demiroglu, Yusuf Ziya; Yeral, Mahmut; Akin, Sule; Yesilagac, Hasan; Habesoglu, Mehmet Ali; Aribogan, Anis; Kasar, Mutlu; Korur, Asli; Ozdogu, Hakan; 0000-0002-9866-2197; 34032899; AAZ-9711-2021; AAY-2668-2021
It is highly expected that COVID-19 infection will have devastating consequences in sickle cell disease (SCD) patients due to endothelial activation and decreased tissue and organ reserve as a result of microvascular ischemia and continuous inflammation. In this study, we aimed to compare the clinical course of COVID-19 in adult SCD patients under the organ injury mitigation and clinical care improvement program (BASCARE) with healthcare professionals without significant comorbid conditions. The study was planned as a retrospective, multicenter and cross-sectional study. Thirty-nine SCD patients, ages 18 to 64 years, and 121 healthcare professionals, ages 21 to 53, were included in the study. The data were collected from the Electronic Health Recording System of PRANA, where SCD patients under the BASCARE program had been registered. The data of other patients were collected from the Electronic Hospital Data Recording System and patient files. In the SCD group, the crude incidence of COVID-19 was 9%, while in healthcare professionals at the same period was 23%. Among the symptoms, besides fever, loss of smell and taste were more prominent in the SCD group than in healthcare professionals. There was a significant difference between the two groups in terms of development of pneumonia, hospitalization, and need for intubation (43 vs 5%, P < 0.00001; 26 vs 7%, P = 0.002; and 10 vs 1%, P = 0.002, respectively). Prophylactic low molecular weight heparin and salicylate were used more in the SCD group than in healthcare professionals group (41 vs 9% and 28 vs 1%; P < 0.0001 for both). The 3-month mortality rate was demonstrated as 5% in the SCD group, while 0 in the healthcare professionals group. One patient in the SCD group became continously dependent on respiratory support. The cause of death was acute chest syndrome in the first case, hepatic necrosis and multi-organ failure in the second case. In conclusion, these observations supported the expectation that the course of COVID-19 in SCD patients will get worse. The BASCARE program applied in SCD patients could not change the poor outcome.
Congenital Bronchial Artery - Pulmonary Artery Fistula in a Young Adult
(2015) Kara, Sibel; Sen, Nazan; Ozkan, Ugur; Akcay, M.Sule
Primary vascular malformations such as connection between bronchial artery and pulmonary artery or pulmonary vein are quite rare. A 18-year-old male patient with the first episode of massive hemoptysis was found to have bronchial artery-pulmonary artery fistula, a rare vascular anomaly, on selective bronchial angiography. Since medical history revealed no acquired cause, it is considered congenital. He underwent bronchial artery embolization and hemoptysis was completely resolved after endovascular treatment. The presence of such vascular anomalies should be suspected in patients with massive hemoptysis. Bronchial artery embolization is a safe and effective nonsurgical treatment option for such patients.
Endobronchial Renal Cell Carcinoma Treated with Interventional Bronchoscopy : Case Report Endobronchial Metastases of Renal Cell Carcinoma Treated with Interventional Bronchoscopy
(2014) Ozaydin, Derya; Segmen, Fatih; Aktas, Zafer; Yilmaz, Aydin; Sen, Nazan; Demirag, Funda; 0000-0003-4790-8369; 0000-0002-4171-7484; 0000-0001-5358-5522; 24814084; K-4938-2019; AAI-8947-2021; C-4815-2019
Evaluation of Subclinical Atherosclerosis with Carotid Intima-Media and Epicardial Fat Thickness in Patients with Sarcoidosis
(2020) Yilmaz, Hatice Eylul Bozkurt; Yilmaz, Mustafa; Erol, Tansel; Sen, Nazan; Unsal, Zuhal Ekici; Kara, Sibel; Habesoglu, Mehmet Ali; Akcay, Sule; 0000-0002-3628-4661; 0000-0002-2557-9579; 0000-0002-8360-6459; 0000-0003-3225-2686; 0000-0002-4171-7484; 32584234; AAN-5153-2021; S-6973-2016; AAI-8069-2021; AAB-5175-2021; AAD-5602-2021; AAI-8947-2021
OBJECTIVES: Since many similar mechanisms may play a role in the pathophysiology of sarcoidosis and atherosclerosis, the risk of subclinical atherosclerosis may be increased in patients with sarcoidosis. The aim of this study was to evaluate known markers of subclinical atherosclerosis, namely epicardial fat thickness (EFT) and carotid intima-media thickness (CIMT) in patients with sarcoidosis. MATERIALS AND METHODS: This cross-sectional study included a total of 183 subjects, including 94 patients with sarcoidosis (patient group) and a control group of 89 healthy individuals. Measurements of EFT and CIMT were taken from all subjects and recorded. The groups were compared, and differences were analyzed statistically. RESULTS: EFT was higher in patients than in control subjects (6.42 +/- 1.12 mm vs 7.13 +/- 1.41 mm, p<0.001). CIMT was higher in patients than in control subjects (0.51 +/- 0.02 mm vs 0.52 +/- 0.02 mm, p=0.003). CONCLUSION: EFT and CIMT were found to be higher in patients with sarcoidosis than in healthy people. These results indicate that the risk of subclinical atherosclerosis might be increased in these patients.
Factors Affecting Mortality In Geriatric Patients Diagnosed With Community-Acquired Pneumonia Treated In Intensive Care Units
(2021) Bozkurt Yilmaz, Hatice Eylul; Unsal, Zuhal Ekici; Habesoglu, Mehmet Ali; Kara, Sibel; Sen, Nazan
Introduction: The aim of this study was to determine the factors affecting mortality in elderly patients with community-acquired pneumonia who were receiving intensive care unit. Materials and Methods: The study was retrospective, cross-sectional, and descriptive. The medical records of patients over 65 years of age who were admitted to the intensive care unit with a diagnosis of community-acquired pneumonia between January 1, 2013 and February 29, 2020 were reviewed. The factors associated with mortality in the patients who had died were examined. Results: A total of 208 patients with a mean age of 75.11 +/- 5.59 years, 78 of whom were women (37.5%), were included in the study. During the follow-up 35 (16.82%) of 208 patients had died from pneumonia or complications due to pneumonia. According to multiple linear regression analysis, the following parameters were found to be predictors of mortality: Charlson comorbidity index value (odds ratio: 1.44, 95% confidence interval: 1.132-1.1841, p=0.003), chronic obstructive pulmonary disease (odds ratio: 0.292, 95% confidence interval: 0.094-1.149, p=0.038), congestive heart failure (odds ratio: 0.199, 95% confidence interval: 0.051-0.782, p=0.021), saturation value in arterial blood gas (odds ratio: 0.569, 95% confidence interval: 0.804-0.939, p<0.001), intubation duration (odds ratio: 3.476, 95% confidence interval: 1.880-6.425, p<0.001), hypertension (odds ratio: 3.449, 95% confidence interval: 0.941-12.649, p=0.042), and the presence of diabetes mellitus (odds ratio: 3.116, 95% confidence interval: 2.673-59.021, p=0.046). Conclusion: Community-acquired pneumonia requiring intensive care unit is a clinical condition with high mortality in the elderly patient population. The presence of comorbid diseases and prolonged intubation time may be associated with higher mortality.
Granulomatous polyangitis (Wegener granulomatosis): Clinical findings and results of long-term follow-up
(2016) Sen, Nazan; Aydin Tufan, Muge; Yildiz, Reyhan; Ersozlu Bozkirli, Emine Duygu; Yucel, Eftal; 0000-0002-4171-7484; 28393729; AAI-8947-2021
Introduction: To evaluate long-term outcome of patients with granulomatous polyangitis (GPA) followed up in a tertiary university hospital. Patients and Methods: We reviewed medical records of 22 patients with GPA diagnosis confirmed by tissue biopsies between 2004 and 2014. Results: The mean time from the onset of symptoms to diagnosis was 7.8 +/- 12.3 months [interquartile range (IR)= 4.0]. The most commonly involved organs were the upper respiratory tract (URT) (72.7%), lower respiratory tract (81.8%) and kidneys (72.7%). URT involvement indicated good prognosis (p= 0.046). Survival in the patients with and without URT involvement was 124.6 +/- 6.9 months and 59.7 +/- 22.9 months, respectively. End-stage renal failure (ESRF) requiring dilaysis and cardiac involvement were associated with mortality (p= 0.022 and p= 0.026, respectively). Of the 12 dialysis-dependent patients at diagnosis, 11 survived > 3 months and seven regained renal function permanently. Dialysis dependency was significantly lower in patients who received plasmapheresis (p= 0.047). Overall mortality rate was 18% (4/22). Mean survival was 55.9 +/- 42.8 months (IR= 84.0). Conclusion: Diagnosis of GPA may be delayed by the nonspecific nature of its symptoms. URT involvement was associated with good prognosis, whereas cardiac involvement and ESRF requiring dialysis were associated with poor outcome. Plasmapheresis may increase the rate of renal recovery in the patients with ESRF requiring dialysis.
Investigation of the Factors Affecting the Mortality of Patients Over 80 Years of Age Diagnosed with Acute Pulmonary Thromboembolism
(2023) Sen, Nazan; Yilmaz, Mustafa; 0000-0002-2557-9579; S-6973-2016
Introduction: To investigate the factors affecting the 30-day mortality of patients over 80 years of age diagnosed with acute pulmonary thromboembolism.Materials and method: This descriptive, retrospective, and single-center study reviewed the medical records of patients over 80 years of age who were admitted to the hospital with a diagnosis of acute pulmonary thromboembolism between January 1, 2008, and April 30, 2023. The factors associated with mortality in patients who had died were examined. The recorded values of factors considered to be the determinants of 30-day mortality were also determined.Results: This study included 113 patients, with a mean age of 83.7 +/- 2.7 years, and comprised of 68 (60.2%) females. During the one-month follow-up period, 30 patients (26.5%) died of acute pulmonary thromboembolism or related complications. No statistically significant difference in age and gender was observed between the exitus and non-exitus groups (p > 0.05). Moreover, no significant difference was observed between the two groups in terms of hypertension and diabetes (p > 0.05), whereas other comorbidities were statistically significantly higher in the exitus group (p < 0.05). In the linear regression analysis, heart failure (p < 0.001), D-dimer level (p = 0.019), partial arterial oxygen pressure (p < 0.001), systolic pulmonary artery pressure (p < 0.001), and recent history of major surgery (p = 0.021) were found to be factors that affected the mortality.Conclusion: The presence of comorbidities, poor hemodynamic findings, poor oxygenation, high pulmonary artery pressure, and high D-dimer levels may be mortality indicators in acute pulmonary thromboembolism patients over 80 years of age.
Investigation of the Relationship Between Asthma and Subclinical Atherosclerosis by Carotid/Femoral Intima Media and Epicardial Fat Thickness Measurement
(2017) Yilmaz, Mustafa; Yilmaz, Eylul Bozkurt; Sen, Nazan; Altin, Cihan; Muderrisoglu, Haldun; 0000-0002-2557-9579; 0000-0002-9635-6313; S-6973-2016; AAG-8233-2020
Investigation of The Relationship Between Asthma and Subclinical Atherosclerosis by Carotid/Femoral Intima Media and Epicardial Fat Thickness Measurement
(2018) Yilmaz, Mustafa; Yilmaz, Hatice Eylul Bozkurt; Sen, Nazan; Altin, Cihan; Tekin, Abdullah; Muderrisoglu, Haldun; https://orcid.org/0000-0002-2557-9579; https://orcid.org/0000-0002-4171-7484; https://orcid.org/0000-0002-5658-870X; https://orcid.org/0000-0002-9635-6313; 28453377; S-6973-2016; AAI-8947-2021; ABD-7304-2021; AAG-8233-2020
Objective: Since asthma and atherosclerosis may share similar pathophysiological mechanism, this study is planned to investigate whether epicardial fat thickness (EFT), carotid and femoral intima media thicknesses, which are markers of subclinical atherosclerosis, are increased in patients with asthma. Methods: The study was designed as a cross-sectional study. A total of 154 participants (83 patients with asthma and 71 healthy volunteers) were enrolled into the study. Epicardial fat, carotid, and femoral intima media thicknesses were measured and recorded in both groups. The statistical difference between the two groups was examined. Results: Both carotid and femoral intima media thicknesses were significantly higher in patients with asthma compared to control group (5.52 +/- 0.4 mm vs. 5.36 +/- 0.4 mm; p = 0.038 and 5.64 +/- 0.4 mm vs. 5.46 +/- 0.5 mm; p = 0.036, respectively). However, there was not a significant difference in EFT between the groups [5.9 mm (5.3-6.6; IQR = 1.3) vs. 5.6 mm (4.7-6.5; IQR = 1.8); p = 0.1]. On comparison of control group and asthma subgroups (mild, moderate, and severe), there was a statistically significant difference among these four groups in terms of carotid and femoral intima media thicknesses (p = 0.002 and p < 0.001, respectively). Subgroup analyses showed that this difference was mainly due to patients with severe asthma. Conclusions: Carotid and femoral intima media thicknesses in asthmatic patients were found to be increased compared to the normal population. As a result, the risk of subclinical atherosclerosis in asthmatic patients may be high.
Investigation of the Relationship between Asthma and Visceral Obesity by Epicardial Fat Thickness Measurement
(2019) Yilmaz, Hatice Eylul Bozkurt; Yilmaz, Mustafa; Sen, Nazan; Unsal, Zuhal Ekici; Eyuboglu, Fusun Oner; Akcay, Sule; 0000-0003-3225-2686; 0000-0002-8360-6459; AAB-5175-2021; 30664419; AAR-4338-2020; AAD-5602-2021
OBJECTIVES: Obesity is a risk factor defined in recent years for asthma. It is associated not only with asthma but also with many cardiovascular diseases. Visceral obesity is a more significant risk factor than general obesity in cardiovascular diseases. Although the association of visceral obesity with cardiovascular diseases is well known, the relationship in patients with asthma is not fully understood. The aim of the present study was to investigate whether there is a relationship between asthma and visceral fat by using epicardial fat thickness (EFT) measurement. MATERIALS AND METHODS: A total of 401 subjects (229 patients with persistent asthma and 172 controls) were enrolled in the study. In our study, EFT was measured, recorded by echocardiography, and was evaluated whether there was a statistical significant difference between the two groups. RESULTS: The mean EFT was 5.84 +/- 0.79 mm in the patient group and 5.71 +/- 0.93 mm in the control group. There was no statistically significant difference between the groups (p=0.145). Similarly, when we compared control and asthma severity subgroups, we did not find statistically significant differences (control group mean 5.71 +/- 0.93 mm, mild group mean 5.86 +/- 0.81 mm, moderate group mean 5.8 +/- 0.84 mm, and severe group mean 5.83 +/- 0.67 mm, p=0.505). CONCLUSION: In the present study, we observed that the EFT did not increase in patients with asthma compared with the normal population. Based on our results, we suggest that visceral obesity may not be a significant risk factor for asthma.
Liver Transplant and Reexpansion Pulmonary Edema: A Case Report
(2018) Kara, Sibel; Sen, Nazan; Akcay, Sule; Moray, Gokhan; Kus, Murat; Haberal, Mehmet; 0000-0002-4171-7484; 0000-0002-8360-6459; 0000-0003-2498-7287; 0000-0001-6529-7579; 0000-0002-3462-7632; 29528016; AAI-8069-2021; AAI-8947-2021; AAB-5175-2021; AAE-1041-2021; AAJ-7870-2021; AAJ-8097-2021
Hydrothorax occurs frequently in patients with end-stage liver disease and usually requires drainage of pulmonary effusion during the hepatectomy phase of liver transplant. Reexpansion pulmonary edema is a rare but potentially fatal complication seen after rapid reexpansion of the collapsed lung following thoracentesis of pleural fluid or tube drainage of pneumothorax. This condition, which manifests with various degrees of clinical severity, is rarely reported following liver transplantation. Herein, we present a 62-year-old male patient who developed reexpansion pulmonary edema after drainage of massive pleural effusion, which caused a total collapse in the right hemithorax during liver transplant. Six hours after pleural fluid drainage, the patient developed a nonproductive cough, mild tachypnea, shortness of breath, and low oxygen saturation (88%). His chest radiograph showed diffuse heterogeneous opacities in the right hemithorax. Computed tomography of the thorax revealed consolidations containing air bronchograms and ground glass opacities in the parenchyma of the right lung; these findings did not extend to the periphery and were observed less frequently in the inferoposterior left lung. These symptoms and radiologic findings were diagnosed as reexpansion pulmonary edema. Complete clinical and radiologic improvements were achieved within 72 hours of mechanical ventilatory support.
A Novel Simplified Combination of Monoclonal Antibodies for Flow Cytometric Analysis of Bronchoalveolar Lavage Samples
(2019) Pepedil-Tanrikulu, Funda; Sen, Nazan; Buyukkurt, Nurhilal; Sariturk, Cagla; Kozanoglu, Ilknur; 31532092
Background: The profile of leukocytes in bronchoalveolar lavage (BAL) fluid provides important information for diagnosing various lung diseases. A differential cell count of BAL is conventionally performed by evaluating centrifuged samples under a light microscope and enumerating the stained cells. Another rarely used method to identify BAL leukocytes is flow cytometry (FCM). However, there are no guidelines for standardizing this method and related literature is limited. This study aimed to evaluate the accuracy of FCM for identifying BAL leukocytes. Methods: The BAL samples accepted to the hematology laboratory between 2014 - 2018 were retrospectively evaluated via light microscopy (LM) by a hematologist; while flow cytometric analyses with a monoclonal antibody panel composed of CD45/CD14/CD16 were noted by another doctor. The percentages of macrophages, lymphocytes, neutrophils and eosinophils determined by both methods were recorded for analysis. Correlations between the results from LM and FCM were investigated. In addition, compatibility between LM and FCM for denoting pathological values for each cell type was checked. Results: Among 140 reviewed BAL samples, 76 were included for further analysis. Comparisons revealed strong correlations between FCM and LM for identifying macrophages, lymphocytes, neutrophils, and eosinophils. In addition, regarding the normal cutoff values for each leukocyte type, FCM and LM were similar in the identification of pathological changes of all cell types except eosinophils. Conclusions: Flow cytometry was found to be feasible for use instead of LM and might become a more widely used technique to analyze BAL fluid in the future.
Pneumonia in Renal Transplant Recipients: A Single-Center Study
(2018) Kara, Sibel; Sen, Nazan; Kursun, Ebru; Yabanoglu, Hakan; Yildirim, Sedat; Akcay, Sule; Haberal, Mehmet; 0000-0002-4171-7484; 0000-0002-1161-3369; 0000-0002-5735-4315; 0000-0002-8360-6459; 0000-0002-3462-7632; 29528008; AAI-8947-2021; AAG-5020-2020; AAJ-7865-2021; AAF-4610-2019; AAI-8069-2021; AAB-5175-2021; AAJ-8097-2021
Objectives: Pulmonary infections are a significant cause of morbidity and mortality in solid-organ transplant recipients despite enhanced facilities for perioperative care. The aim of this study was to evaluate the demographic characteristics, clinical course, and outcomes of renal transplant recipients with pneumonia. Materials and Methods: The medical records of all renal transplant recipients from January 2010 to December 2014 were retrospectively reviewed, and patients diagnosed with pneumonia according to Centers for Disease Control and Prevention criteria were evaluated. Pneumonia was classified as community acquired or nosocomial. Patient demographics, microbiologic findings, need for intensive care/mechanical ventilation over the course of treatment, and information about clinical follow-up and mortality were all recorded. Results: Eighteen (13.4%) of 134 renal transplant recipients had 25 pneumonia episodes within the study period. More than half (56%) of the pneumonia episodes developed within the first 6 months of transplant, whereas 44% developed after 6 months (all > 1 year). Eight cases (32%) were considered nosocomial pneumonia, and 17 (68%) were considered community-acquired pneumonia. Bacteria were the most common cause of pneumonia (28%), and fungi ranked second (8%). No viral or mycobacterial agents were detected. No patients required prolonged mechanical ventilation. No statistically significant difference was found in the need for intensive care or regarding mortality between patients with nosocomial and community-acquired pneumonia. Two patients (11%) died, and all remaining patients recovered. Conclusions: The present study confirmed that pneumonia after renal transplant is not a rare complication but a significant cause of morbidity. Long-term and close follow-up for pneumonia is necessary after renal transplant.
Potential treatment of COVID-19
(2020) Ayten, Omer; Ozdemir, Cengiz; Akturk, Ulku Aka; Sen, Nazan; 0000-0002-4171-7484; AAI-8947-2021
Following the first reported cases of pneumonia of unknown etiology at the end of 2019 in Wuhan city, Hubei province, China, the causative agent was demonstrated to be a new coronavirus that has not been defined in humans before. The World Health Organization (WHO) named this virus as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease caused by the virus as coronavirus disease-19 (COVID-19). The disease spread rapidly to other countries through human-to-human transmission, and WHO declared a pandemic on March 11, 2020. As of April 2020, the number of individuals infected with SARS-CoV-2 and COVID-19 related deaths continue to increase rapidly worldwide. The main reason for the increase in the rate of infection is person-to-person transmission, while the main reason for the increase in mortality rate is the lack of a proven medical treatment specific to COVID-19 and the severe course of the disease in the elderly with low immunity. While a vast majority of individuals infected with SARS-CoV-2 are asymptomatic or recover after displaying mild symptoms, hospitalization is required in 14% of cases and severe disease requiring intensive care admission is seen in 5% of the infected individuals. WHO and national guidelines do not make clear recommendations regarding treatments for symptomatic patients. Currently, there is no vaccine or specific antiviral treatment for COVID-19, however supportive care, isolation and protective measures and experimental drugs/treatments are being used for the management of COVID-19. Medical treatments being used for COVID-19, aim to prevent the entry of the virus into the cell, to inhibit or reduce its replication, and to suppress the increased inflammatory response. In addition, "convalescent" plasma, which includes antibodies of patients who were completely recovered from the infection, is among the treatment options.