Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-4815-2019Item Anti-Tumor Necrosis Factor Alpha Treatment and Tuberculin Skin Test(2015) Bozkirli, Emine Duygu Ersozlu; Tufan, Muge Aydin; Ozisik, Lale; Sen, Nazan; Yucel, Ahmet EftalPurpose: 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.Item Schistosomiasis and pulmonary hypertension(2017) Sen, Nazan; 0000-0002-4171-7484; 29135402; AAI-8947-2021Schistosomiasis is one of the most prevelant parazitic diseases in the world. It is endemic in more than 70 countries, and more than 200 million people worldwide are infected with Schistosoma. Pulmonary hypertension (PHT) is one of the chronic complications of schistosomiasis. The exact pathogenesis of schistosomiasisassociated pulmonary hypertension (S-PHT) remains unclear, although several mechanisms such as parazitic arterial embolisation, pulmonary arteriopathy, and portopulmonary hypertension have been suggested. Pathological pulmonary vascular changes in S-PHT were found similar to those in idiopathic pulmonary arterial hypertension (IPAH). The fact that schistosomiasis is one of the most common causes of pulmonary arterial hypertension (PAH), particularly in the developing countries, underlines the importance of enhancing our knowledge on this disease. Developments in the treatment of PAH have resulted in improved prognosis and significant increase in life expectancy and quality of life in the last two decades, which has enhanced the importance of S-PHT. Schistosomiasis is treated with praziquantel. Nevertheless, there is limited evidence that this treatment is effective for PHT. Although antihelmintic medications do not lead to significant improvement, they have beneficial effects and may slow down disease progression. Using PAH-specific treatments in the patients with schistosomiasis-associated PAH (S-PAH) can improve prognosis. However, inadequate clinical studies and limited sources in the endemic regions restrict extensive usage of these expensive medications. Further studies are required to determine the efficacy of these treatment modalities.Item Pulmonary complications in adult patients with sickle cell disease(2018) Sen, NazanSickle cell disease (SCD) is an inherited hemoglobin disorder, associated with recurrent painful episodes, ongoing hemolytic anemia and progressive multi-organ failure. While survival beyond the fourth decade of life for a patient with SCD was previously considered unusual; nowadays, in countries with developed health care systems, patients with SCD could reach into adulthood. However, irreversible organ damages have become more prevalent along with the patients' reaching adulthood. The lungs as well are among the organs involved in SCD. Pulmonary complications are significant causes of morbidity and mortality and are substantially responsible for deaths. Although our understanding of these conditions has improved over the past 10-15 years, there remains no specific treatment of pulmonary complications of SCD. Limited data on health care issues, particularly in older adults with SCD, poses multiple challenges to patients, their families and health care providers. The incidence and severity of pulmonary complications require the physicians' further interest in this subject. The present review comprises the following pulmonary complications of SCD: i) acute chest syndrome, ii) venous thromboembolus, iii) asthma, iv) respiratory dysfunction, v) respiratory disorders during sleeping, vi) pulmonary hypertension.