Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-6973-2016Introduction: 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.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 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-8233-2020Objective: 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.Item 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-8233-2020Item 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-8947-2021INTRODUCTION 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.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 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; 35839345Background 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.Item The Relationship Between COVID-19 Severity and Bacillus Calmette-Guerin (BCG)/ Mycobacterium Tuberculosis Exposure History in Healthcare Workers: A Multi-Center Study(2021) Torun, Serife; Ozkaya, Sevket; Sen, Nazan; Kanat, Fikret; Karaman, Irem; Yosunkaya, Sebnem; Sengoren Dikis, Ozlem; Asan, Ali; Aydogan Eroglu, Selma; Semih Atal, Sefa; Ayten, Omer; Aksel, Nimet; Ermis, Hilal; Ozcelik, Neslihan; Demirelli, Meryem; Kara, Iskender; Sumer, Sua; Marakoglu, Kamile; Uzer, Fatih; Uyar, Yasin; Cicek, Tuba; Unsal, Zuhal E.; Vatansev, Husamettin; Botan Yildirim, Berna; Kuruoglu, Tuba; Atilla, Aynur; Ersoy, Yasemin; Kandemir, Bahar; Durduran, Yasemin; Goksin Cihan, Fatma; Demirbas, Nur; Yildirim, Fatma; Tatar, Dursun; Akcay, M. Sule; 0000-0002-6530-6153; 0000-0002-8697-4919; 34014806; ABF-1652-2021The COVID-19 pandemic has brought countries' health services into sharp focus. It was drawn to our group's attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine.Item 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-2668-2021It 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.
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