Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-8097-2021Hydrothorax 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.Item 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-8097-2021Objectives: 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.Item Change of respiratory functions, the STOP-Bang questionnaire, and Epworth sleepiness scale after bariatric surgery(2020) Kara, Sibel; Habesoglu, Mehmet Ali; Yabanoglu, Hakan; 33055387INTRODUCTION AND OBJECTIVE: Obesity is a highly morbid and fatal syndrome that reduces respiratory function. Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder in morbid obesity. Herein, we aimed to determine how respiratory function tests changed over time after bariatric surgery and to assess non-PSG (polysomnography) tests, namely STOP-Bang questionnaire and Epworth sleepiness tests, for predicting OSAS risk. METHOD: This retrospectively conducted study enrolled 35 patients who underwent bariatric surgery. Patients were divided into three groups formed on the basis of time passed after surgery (1, 2, or 3 years). Preoperative and postoperative respiratory function test parameters assessed by spirometry, body mass index (BMI), STOP-Bang questionnaire, and Epworth sleepiness test scores were recorded. RESULTS: Twenty-four (68.6%) patients were female, 11 (31.4%) male. The mean age was 36.5 +/- 10.5 years. Postoperative weight loss of the study groups was 26% p=0.001, 23.6% p=0.002 and 25.9% p=0.005. Reductions in BMI were 32 kg/m(2) p=0.001, 34.5 kg/m(2) p=0.002, 35.8 kg/m(2) p=0.005 respectively. Postoperative FVC (440 ml, 390 ml, 430 ml p = 0.005) and FEV1 (220 ml p = 0.005, 250 ml p = 0.004, 214 ml p = 0.005) increased in all three groups. STOP-Bang questionnaire and Epworth sleepiness scale scores significantly decreased after weight loss compared to preoperative period in all the study groups. CONCLUSION: We showed that FVC and FEV1 increased in the short and long term after weight loss by bariatric surgery; we also found that STOP-Bang questionnaire and Epworth sleepiness scale scores decreased postoperatively. These tests may be helpful to assess OSAS risk before and after surgery.