Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Author: search.filters.author.Serifoglu, Iremsearch.filters.applied.f.publicationcategory: search.filters.publicationcategory.Makale - Uluslararası Hakemli Dergi

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    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-6628-2021
    Objectives: 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.
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    Utility of Mean Platelet Volume to Diagnose Pneumonia in Patients With Solid-Organ Transplant
    (2018) Ulubay, Gaye; Soy, Ebru Ayvazoglu; Serifoglu, Irem; Sozen, Fisun; Moray, Gokhan; Haberal, Mehmet; 0000-0003-2478-9985; 0000-0002-0993-9917; 0000-0002-1951-2693; 0000-0003-2498-7287; 0000-0002-3462-7632; 29528024; AAB-5064-2021; AAC-5566-2019; AAS-6628-2021; AAC-1823-2021; AAE-1041-2021; AAJ-8097-2021
    Objectives: Despite improved success with solid-organ transplant procedures, recipients remain at risk for infections, including pneumonia, due to their immunosuppressive regimens. In solid-organ transplant patients, clinical findings of pneumonia can be nonspecific, and diagnosis of pneumonia may be difficult as several conditions (drug lung, hypervolemia, infections, hemorrhage) can led to pulmonary infiltrates, mimicking pneumonia in these patients. The role of mean platelet volume, a predictor of inflammatory disease, with elevated values inversely correlated with inflammatory problems, in the diagnosis of pneumonia has not yet been investigated in solid-organ transplant patients. Here, we retrospectively investigated mean platelet volume in diagnosis of pneumonia in transplant patients. Materials and Methods: Medical records of solid-organ transplant patients from 2011 to 2016 were reviewed for demographic, clinical, radiographic, laboratory, and microbiology data. Transplant type, immunosuppressive drugs, and clinical outcomes were noted. Pneumonia diagnosis was based on clinical respiratory symptoms and signs, imaging findings, positive microbiological tests, pathologic findings, laboratory findings, or effective clinical treatment trials. Results: Our study included 70 patients (47 male/23 female; mean age of 46 +/- 14 years), comprising 26 liver and 44 renal transplant recipients. Pneumonia was diagnosed radiologically in 30 patients (42.9%), with procalcitonin positive in 11 patients (36.7%), C-reactive protein elevated in 29 patients (96.7%), and leukocytes increased in 6 patients (20%). When laboratory measurements were compared with mean platelet volume, mean platelet volume values were significantly lower in patients with pneumonia who had elevated procalcitonin levels (P=.038). Conclusions: We found that mean platelet volume for diagnosis of pneumonia in solid-organ transplant patients was not a promising tool. Considering the difficulties in caring for transplant patients with pulmonary infiltrates, clinical decisions should be based on clinical, laboratory, microbiological, and radiologic findings.
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    Radiologically Occult Invasive Pulmonary Aspergillosis in a Patient With Liver Transplant
    (2018) Esendagli, Dorina; Serifoglu, Irem; Bozbas, Serife Savas; Tepeoglu, Merih; Akcay, Sule; Haberal, Mehmet; 0000-0002-6619-2952; 0000-0002-7230-202X; 0000-0002-9894-8005; 0000-0002-8360-6459; 0000-0002-3462-7632; 29528022; ABF-9398-2020; AAS-6628-2021; AAI-8064-2021; AAK-5222-2021; AAB-5175-2021; AAJ-8097-2021
    Invasive pulmonary aspergillosis is an infection seen in patients receiving intensive immunosuppressive regimens, such as transplant recipients. Some risk factors that increase the incidence of infection have been determined, and patients defined as having high risk are recommended to take antifungal prophylaxis and be monitored closely. Here, we present a liver transplant patient with mild respiratory symptoms and a normal chest radiography on day 26 posttransplant. However, he had acute renal failure and underwent hemodialysis, which are both defined to increase significantly the risk of aspergillosis. Although the radiographic scan was initially normal, thorax tomography and later bronchoscopy showed findings compatible with pulmonary aspergillosis, and the patient was started on antifungal treatment. The nonspecific mild symptoms and an initial normal radiology can make diagnosis of invasive fungal infections difficult; thus caution and close follow-up of high-risk patients should be performed.
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    Clinical Characteristics of Acinetobacter baumannii Infection in Solid-Organ Transplant Recipients
    (2018) Serifoglu, Irem; Dedekarginoglu, Balam Er; Bozbas, Serife Savas; Akcay, Sule; Haberal, Mehmet; 0000-0002-7230-202X; 0000-0002-8360-6459; 0000-0002-7230-202X; 0000-0002-3462-7632; 29528021; AAS-6628-2021; AAI-8064-2021; AAB-5175-2021; AAJ-8097-2021
    Objectives: Acinetobacter baumannii, depending on the immune status of the host, may result in one of the most serious hospital infections. Infections involving A. baumannii infection have been recently rising. However, little is known about the clinical features of A. baumannii infection in solid-organ transplant recipients. We aimed to share our clinical experiences with A. baumannii infection in our transplant recipients. Materials and Methods: Between 2011 and 2017, 41 solid-organ transplant patients developed A. baumannii infection at Baskent University Hospital. Medical records were reviewed, and patient demographics, microbiology results, and overall outcome data were noted. Results: Of 41 solid-organ transplant patients with A. baumannii infection, 29 were male and 12 were female patients with mean age of 47.15 +/- 13.24 years. Our infection rate with A. baumannii infection was 6.1%. The most common sites of infection were deep tracheal aspirate (48.8%)and bloodstream (36.6%). Onset of infection 1 year post-transplant was identified in 58.5% of recipients. Risk factors included presence of invasive procedures (56.1%) and administration of high-dose corticosteroids for rejection 1 year before infection (68.3%). Thirty-day mortality rate was 41.5% (17/41 patients)and was not associated with the infection site, microbiological cure, clinical cure, and drug resistance in our study group. Conclusions: Acinetobacter baumannii is an important cause of hospital-acquired infection and mortality worldwide. A major problem with A. baumannii infection is delayed initiation of appropriate antibiotic treatment and the rising numbers of extensively drugresistant organisms. Predicting the potential risk factors, especially in the already at-risk solid-organ transplant population, has an important role in patient outcomes.
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    Causes of Hemoptysis in Renal Transplant Patients
    (2018) Serifoglu, Irem; Dedekarginoglu, Balam Er; Soy, Ebru Hatice Ayvazoglu; Ulubay, Gaye; Haberal, Mehmet; 0000-0002-0993-9917; 0000-0003-2478-9985; 0000-0002-3462-7632; 29527996; AAS-6628-2021; AAC-5566-2019; AAJ-8097-2021
    Objectives: Hemoptysis is a symptom that can be caused by airway disease, pulmonary parenchymal disease, or pulmonary vascular disease, or it can be idiopathic. Infection is the most common cause of hemoptysis, accounting for 60% to 70% of cases. Hemoptysis is also an initial symptom of diffuse alveolar hemorrhage syndrome, although it may be absent at presentation in one-third of patients. Diffuse alveolar hemorrhage is characterized by disruption of the alveolar-capillary basement membranes because of either injury or inflammation of the arterioles, venules, or capillaries, resulting in bleeding in alveolar spaces. To date, no study in the literature has investigated the cause of hemoptysis in renal transplant patients. In this retrospective study, we aimed to investigate the causes of hemoptysis in renal recipients. Materials and Methods: The data included in this study were obtained from 352 renal transplant patients who were consulted by the pulmonology department regarding hemoptysis between 2011 and 2017 at Baskent University. Patient medical records were reviewed for demographic, clinical, radiographic, bronchoscopic features, and microbiology data. Immunosuppressive drugs and clinical outcome data were also noted. Results: This study included 352 renal transplant patients (139 male patients with mean age of 34.9 +/- 7 years and 113 female patients with mean age of 31.1 +/- 5 years). Hemoptysis was detected in 17 patients (4.8%),with 3 (0.85%) having massive hemoptysis as a result of diffuse alveolar hemorrhage syndrome. Fourteen of our patient group (4%) had pneumonia, and Aspergillus species was detected in 5 patients (1.4%). The only reason for diffuse alveolar hemorrhage was immunosuppressive agents, including sirolimus and mycophenolate mofetil. Conclusions: Hemoptysis is an important respiratory symptom in renal transplant patients. Although community- or hospital-acquired pneumonia may result in hemoptysis, drug-induced diffuse alveolar hemorrhage and Aspergillus infection should be considered for causes in renal transplant patients.