Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-3047-2021Pulmonary 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.Item 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; 37983282INTRODUCTION: 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.skItem 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-1219-2021Objectives: 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.Item 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-4338-2020Item 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-8097-2021Objectives: 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.Item 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-1582-2021Item 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-4338-2020Objectives: 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.Item 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-4338-2020Objectives: 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.Item 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-8097-2021Item 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-6628-2021Objectives: 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.