Wos İndeksli Yayınlar Koleksiyonu
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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.Item Characteristics of hospitalised COVID-19 patients and parameters associated with severe pneumonia(2021) Turan, Onur; Mirici, Arzu; Akcali, Serap Duru; Turan, Pakize Ayse; Batum, Ozgur; Sengul, Aysun; Unsal, Zuhal Ekici; Kabakoglu, Nalan Isik; Ogan, Nalan; Torun, Serife; Ak, Guntulu; Akcay, Sule; Komurcuoglu, Berna; Sen, Nazan; Mutlu, Pinar; Yilmaz, Ulku; 34480831Background After the first case of coronavirus disease 2019 (COVID-19) was reported in China in December 2019, it caused a global pandemic, including Turkey. Objectives The aim of this study was to analyse the characteristics of hospitalised COVID-19 patients and assess the parameters related to severe pneumonia. Methods Included in the study were hospitalised COVID-19 patients with positive naso-oropharyngeal swabs. Patients' demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively. Results Of 1013 patients, 583 were males (57.6%) and 430 were females (42.4%), with a mean age of 53.7 +/- 17.9. More than half of the patients had at least one comorbidities, the most common of which were hypertension and diabetes mellitus. Cough (59.8%), fatigue (49.5%) and fever (41.2%) were the most common presenting symptoms. Of the hospitalised COVID-19 patients, 84.9% had pneumonia and 83.5% had typical radiological COVID-19 appearances (94.5%: ground-glass areas). The most common laboratory findings were high C-reactive protein (CRP) (73.6%) and lactate dehydrogenase (LDH) (46.2%) levels, as well as lymphopenia (30.1%). Severe pneumonia was present in 28.1% of COVID-19 patients. Multivariate logistic regression analysis indicated that advanced age, hypotension, anaemia and elevated CRP and LDH serum levels were independent risk factors for the severity of COVID-19 pneumonia (P = .011, .006, .017, .003 and .001, respectively). Conclusion This study, as one of the first multicentre studies about characteristics of COVID-19 in Turkey, may guide about disease-related parameters and severity of pneumonia. Age, blood pressure, complete blood count and routine biochemical tests (including CRP and LDH) would appear to be important parameters for the evaluation of the severity of COVID-19 pneumonia.Item Anxiety and Depression Levels of Healthcare Workers During COVID-19 Pandemic(2021) Turan, Muzaffer Onur; Demirci, Nilgun Yilmaz; Ak, Guntulu; Akcay, Sule; Akturk, Ulku Aka; Bilaceroglu, Semra; Coskun, Funda; Kokturk, Oguz; Mirici, Arzu; Cengiz, Ozdemi. R.; Sen, Nazan; Yilmaz, UlkuItem Characteristics of hospitalized COVID-19 patients and parameters associated with severe pneumonia(2021) Turan, Muzaffer Onur; Mirici, Arzu; Akcali, Serap Duru; Turan, Pakize Ayse; Batum, Ozgur; Sengul, Aysun; Unsal, Zuhal Ekici; Kabakoglu, Nalan Isik; Ogan, Nalan; Torun, Serife; Ak, Guntulu; Akcay, Sule; Komurcuoglu, Berna; Sen, Nazan; Mutlu, Pinar; Yilmaz, UlkuItem Evaluation of Subclinical Atherosclerosis with Carotid Intima-Media and Epicardial Fat Thickness in Patients with Sarcoidosis(2020) Yilmaz, Hatice Eylul Bozkurt; Yilmaz, Mustafa; Erol, Tansel; Sen, Nazan; Unsal, Zuhal Ekici; Kara, Sibel; Habesoglu, Mehmet Ali; Akcay, Sule; 0000-0002-3628-4661; 0000-0002-2557-9579; 0000-0002-8360-6459; 0000-0003-3225-2686; 0000-0002-4171-7484; 32584234; AAN-5153-2021; S-6973-2016; AAI-8069-2021; AAB-5175-2021; AAD-5602-2021; AAI-8947-2021OBJECTIVES: Since many similar mechanisms may play a role in the pathophysiology of sarcoidosis and atherosclerosis, the risk of subclinical atherosclerosis may be increased in patients with sarcoidosis. The aim of this study was to evaluate known markers of subclinical atherosclerosis, namely epicardial fat thickness (EFT) and carotid intima-media thickness (CIMT) in patients with sarcoidosis. MATERIALS AND METHODS: This cross-sectional study included a total of 183 subjects, including 94 patients with sarcoidosis (patient group) and a control group of 89 healthy individuals. Measurements of EFT and CIMT were taken from all subjects and recorded. The groups were compared, and differences were analyzed statistically. RESULTS: EFT was higher in patients than in control subjects (6.42 +/- 1.12 mm vs 7.13 +/- 1.41 mm, p<0.001). CIMT was higher in patients than in control subjects (0.51 +/- 0.02 mm vs 0.52 +/- 0.02 mm, p=0.003). CONCLUSION: EFT and CIMT were found to be higher in patients with sarcoidosis than in healthy people. These results indicate that the risk of subclinical atherosclerosis might be increased in these patients.Item Potential treatment of COVID-19(2020) Ayten, Omer; Ozdemir, Cengiz; Akturk, Ulku Aka; Sen, Nazan; 0000-0002-4171-7484; AAI-8947-2021Following the first reported cases of pneumonia of unknown etiology at the end of 2019 in Wuhan city, Hubei province, China, the causative agent was demonstrated to be a new coronavirus that has not been defined in humans before. The World Health Organization (WHO) named this virus as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease caused by the virus as coronavirus disease-19 (COVID-19). The disease spread rapidly to other countries through human-to-human transmission, and WHO declared a pandemic on March 11, 2020. As of April 2020, the number of individuals infected with SARS-CoV-2 and COVID-19 related deaths continue to increase rapidly worldwide. The main reason for the increase in the rate of infection is person-to-person transmission, while the main reason for the increase in mortality rate is the lack of a proven medical treatment specific to COVID-19 and the severe course of the disease in the elderly with low immunity. While a vast majority of individuals infected with SARS-CoV-2 are asymptomatic or recover after displaying mild symptoms, hospitalization is required in 14% of cases and severe disease requiring intensive care admission is seen in 5% of the infected individuals. WHO and national guidelines do not make clear recommendations regarding treatments for symptomatic patients. Currently, there is no vaccine or specific antiviral treatment for COVID-19, however supportive care, isolation and protective measures and experimental drugs/treatments are being used for the management of COVID-19. Medical treatments being used for COVID-19, aim to prevent the entry of the virus into the cell, to inhibit or reduce its replication, and to suppress the increased inflammatory response. In addition, "convalescent" plasma, which includes antibodies of patients who were completely recovered from the infection, is among the treatment options.Item Investigation of the Relationship between Asthma and Visceral Obesity by Epicardial Fat Thickness Measurement(2019) Yilmaz, Hatice Eylul Bozkurt; Yilmaz, Mustafa; Sen, Nazan; Unsal, Zuhal Ekici; Eyuboglu, Fusun Oner; Akcay, Sule; 0000-0003-3225-2686; 0000-0002-8360-6459; AAB-5175-2021; 30664419; AAR-4338-2020; AAD-5602-2021OBJECTIVES: Obesity is a risk factor defined in recent years for asthma. It is associated not only with asthma but also with many cardiovascular diseases. Visceral obesity is a more significant risk factor than general obesity in cardiovascular diseases. Although the association of visceral obesity with cardiovascular diseases is well known, the relationship in patients with asthma is not fully understood. The aim of the present study was to investigate whether there is a relationship between asthma and visceral fat by using epicardial fat thickness (EFT) measurement. MATERIALS AND METHODS: A total of 401 subjects (229 patients with persistent asthma and 172 controls) were enrolled in the study. In our study, EFT was measured, recorded by echocardiography, and was evaluated whether there was a statistical significant difference between the two groups. RESULTS: The mean EFT was 5.84 +/- 0.79 mm in the patient group and 5.71 +/- 0.93 mm in the control group. There was no statistically significant difference between the groups (p=0.145). Similarly, when we compared control and asthma severity subgroups, we did not find statistically significant differences (control group mean 5.71 +/- 0.93 mm, mild group mean 5.86 +/- 0.81 mm, moderate group mean 5.8 +/- 0.84 mm, and severe group mean 5.83 +/- 0.67 mm, p=0.505). CONCLUSION: In the present study, we observed that the EFT did not increase in patients with asthma compared with the normal population. Based on our results, we suggest that visceral obesity may not be a significant risk factor for asthma.Item A Novel Simplified Combination of Monoclonal Antibodies for Flow Cytometric Analysis of Bronchoalveolar Lavage Samples(2019) Pepedil-Tanrikulu, Funda; Sen, Nazan; Buyukkurt, Nurhilal; Sariturk, Cagla; Kozanoglu, Ilknur; 31532092Background: The profile of leukocytes in bronchoalveolar lavage (BAL) fluid provides important information for diagnosing various lung diseases. A differential cell count of BAL is conventionally performed by evaluating centrifuged samples under a light microscope and enumerating the stained cells. Another rarely used method to identify BAL leukocytes is flow cytometry (FCM). However, there are no guidelines for standardizing this method and related literature is limited. This study aimed to evaluate the accuracy of FCM for identifying BAL leukocytes. Methods: The BAL samples accepted to the hematology laboratory between 2014 - 2018 were retrospectively evaluated via light microscopy (LM) by a hematologist; while flow cytometric analyses with a monoclonal antibody panel composed of CD45/CD14/CD16 were noted by another doctor. The percentages of macrophages, lymphocytes, neutrophils and eosinophils determined by both methods were recorded for analysis. Correlations between the results from LM and FCM were investigated. In addition, compatibility between LM and FCM for denoting pathological values for each cell type was checked. Results: Among 140 reviewed BAL samples, 76 were included for further analysis. Comparisons revealed strong correlations between FCM and LM for identifying macrophages, lymphocytes, neutrophils, and eosinophils. In addition, regarding the normal cutoff values for each leukocyte type, FCM and LM were similar in the identification of pathological changes of all cell types except eosinophils. Conclusions: Flow cytometry was found to be feasible for use instead of LM and might become a more widely used technique to analyze BAL fluid in the future.