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Öğe Adult Diagnosis of Swyer-James-Macleod Syndrome: Retrospective Analysis of Four Cases(Daedalus Enterprises Inc, 2014) Sen, Hadice Selimoglu; Taylan, Mahsuk; Abakay, Ozlem; Sezgi, Cengizhan; Cetincakmak, Mehmet GuliSwyer-James-Macleod syndrome (SJMS) is a rare constrictive bronchiolitis with air-flow obstruction and a decreased number and diameter of ipsilateral peripheral pulmonary vessels. This syndrome is characterized by unilateral hyperlucency on chest radiography. Computed tomography provides useful additional information. The diagnosis is usually made in childhood but sometimes occurs in adulthood. The disease often presents with dyspnea, decreased exercise tolerance, cough, hemoptysis, and recurrent pulmonary infections. SJMS may be confused with asthma or pulmonary embolism due to similar symptoms and may result in inappropriate therapy. This case series examined the clinical and imaging spectrum of four patients who were diagnosed with SJMS in adulthood.Öğe Adult diagnosis of Swyer-James-MacLeod syndrome: Retrospective analysis of four cases(European Respiratory Soc Journals Ltd, 2013) Sen, Hadice Selimoglu; Taylan, Mahsuk; Abakay, Ozlem; Sezgi, Cengizhan; Cetincakmak, Mehmet Guli[Abstract Not Available]Öğe Alterations in platelet count and mean platelet volume as predictors of patient outcome in the respiratory intensive care unit(Wiley, 2015) Sezgi, Cengizhan; Taylan, Mahsuk; Kaya, Halide; Sen, Hadice Selimoglu; Abakay, Ozlem; Demir, Melike; Abakay, AbdurrrahmanIntroductionThrombocytopenia is associated with increased mortality in intensive care unit (ICU) patients. Mean platelet volume (MPV) reflects platelet function and activation. Elevated MPV is associated with poor outcomes and increased mortality rate in diseases that are commonly encountered in the respiratory ICU. MethodsWe retrospectively enrolled 95 patients who died in the ICU (dead group), 80 patients who improved and were transferred from the ICU (survived group), and 80 healthy individuals as controls. Laboratory parameters including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin, and complete blood count (CBC) were recorded within 24h on admission and transfered from the ICU or died. White blood cell (WBC) count, hemoglobin (Hb), red cell distribution width, MPV, platelet distribution width (PDW), and platelet count (PC) were obtained from the CBC. ResultsAdmission PC and MPV levels were not different in the survived and dead groups. But in the survived group, admission WBC, MPV and PDW levels decreased, while PC increased when compared with admission levels. In the dead group, admission MPV and PDW levels increased, while PC decreased with respect to admission levels. The admission mean PC of the dead group was 182103, which was above the thrombocytopenia limit. The ratio of admission thrombocytopenia was 45.3% in the dead group, which was significantly higher than that of the survived group (13.8%) (P<0.001) ConclusionsIncreasing MPV and decreasing platelet count may alert intensivists to the worse course of disease in patients who had normal platelet counts at ICU admission. The development of thrombocytopenia may also be essential to assessing the outcome of ICU patientsÖğe Alterations of the neutrophil-lymphocyte ratio during the period of stable and acute exacerbation of chronic obstructive pulmonary disease patients(Wiley, 2017) Taylan, Mahsuk; Demir, Melike; Kaya, Halide; Sen, Hadice Selimoglu; Abakay, Ozlem; Carkanat, Ali Ihsan; Abakay, AbdurrrahmanObjectivesWe aimed to investigate the importance of neutrophil-lymphocyte ratio (NLR) in patients with chronic obstructive pulmonary disease (COPD) for identifying the severity of inflammation and recognition of acute exacerbation. MethodsWe retrospectively enrolled 100 patients with a diagnosis of COPD exacerbation who were admitted to our clinic. Complete blood count (CBC), measurement of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were determined within 2 h of hospital admission. Three months after an acute exacerbation, these measurements were obtained from the same patients during the stable period of COPD. The control group included 80 healthy subjects. NLR was calculated from CBC. ResultsNLR and other inflammatory markers, such as WBC, CRP and ESR were found to be significantly elevated in exacerbated COPD compared to stable COPD and control participants. There was a significant correlation of NLR with CRP (r=0.415, P<0.001), WBC (r=0.304, P=0.002) and ESR (r=0.275, P=0.035). For an NLR cutoff of 3.29, sensitivity for detecting exacerbation of COPD was 80.8% and specificity was 77.7% (AUC 0.894, P=0.001). Some patients presenting with acute exacerbation of COPD and CRP, WBC or ESR levels lower than the optimal cut-off value had high NLR values. ConclusionsElevated NLR can be used as a marker similar to CRP, WBC and ESR, in the determination of increased inflammation in acutely exacerbated COPD. NLR could be beneficial for the early detection of potential acute exacerbations in patients with COPD who have normal levels of traditional markers.Öğe Breast Tuberculosis in Southeast Turkey: Report of 27 Cases(Karger, 2010) Tanrikulu, Abdullah C.; Abakay, Abdurrahman; Abakay, Ozlem; Kapan, MuratBackground: Breast tuberculosis (TB) is a very rare form of TB. Case series on breast TB are scarce. Patients and Methods: The patients with breast TB treated between 2004 and 2008 at our hospital were retrospectively investigated. Results: All patients were female (mean age 31.5 +/- 8.4 years). All but 1 patient were new cases. Patients presented with swelling of the breast (48.1%), mass and fluctuation (each, 40.7%), and breast pain (18.5%). The mean treatment duration was significantly shorter in 14 patients who received directly observed therapy (DOT) compared with those (n = 12) who did not (6.7 +/- 1.7 months vs. 8.5 +/- 1.6 months, respectively; p = 0.01). Seven patients underwent segmental mastektomy as complementary surgery. The highest rate of breast TB was seen in 2007 (37.1% compared with 14.8% between 2004 and 2006). Conclusions: Breast TB should be considered in patients with breast neoplasia, swelling, and discharge, and can be successfully treated by DOT with shorter treatment duration.Öğe Clinical and demographic characteristics of tracheobronchial variations(Medknow Publications & Media Pvt Ltd, 2011) Abakay, Abdurrahman; Tanrikulu, Abdullah C.; Sen, Hadice Selimoglu; Abakay, Ozlem; Aydin, Ayse; Carkanat, Ali I.; Senyigit, AbdurrahmanBackground: There are various anatomic variations in tracheobronchial system (tracheal bronchus, ectopic bronchus, and accessory bronchus). We aimed to investigate the bronchoscopic findings of the patients with tracheobronchial variations (TBVs) during bronchoscopy and to describe their clinical characteristics. Materials and Methods: A total of 3322 records of bronchoscopic examinations in university hospital and 1560 in chest disease hospital total 4882 were retrospectively analyzed and 198 (134 male, 64 female) patients were diagnosed as TBV. Results: Mean age of patients was 48.5 +/- 17.8 (range, 15-78) years. Most of the tracheobronchial variations (n = 68, 33.1%) were localized at the right upper lobe bronchus. The most common type of TBVs at this region was right upper lobe with two segments. Symptoms were found in 21 (10.2%) patients with TBVs (7 accessory cardiac bronchus, 5 tracheal bronchus, 5 accessory segmental bronchus in left main bronchus and 4 accessory segmental bronchus in right main bronchus). Their symptoms cough, hemoptysis and recurrent pneumonia with unknown etiologies were thought as related to TBVs. No other potential causes leading these symptoms were found in these patients. Conclusion: According to our best of knowledge our study population is one of the largest series of bronchoscopy for investigate of TBVs. Although TBVs were usually reported as asymptomatic, nearly 10% of our patients with TBVs had symptoms such as recurrent pneumonia, cough and hemoptysis. TBVs should be taken into consideration in symptomatic patients before fiber-optic bronchoscopic examination.Öğe Clinical and laboratory characteristics of 48 patients with miliary tuberculosis(Academic Journals, 2011) Abakay, Ozlem; Abakay, Abdurrahman; Tanriverdi, Mehmet Halis; Sen, Hadice S.; Sezgi, Cengizhan; Kaya, Halide; Tanrikulu, Abdullah CetinMiliary tuberculosis (TB) is a progressive form of TB, indicating disseminated hematogenous spread. Data were collected by scanning the Dicle University Hospital records between January 1990 and December 2010. Forty eight adult patients which were diagnosed miliary TB and followed by hospitalization were enrolled in this study. The mean age was 41.2 +/- 14.1 years. Twenty-four patients (50%) had history of contact with TB patients; six patients (12.5%) had a history of previous TB disease. The most common presenting symptoms were loss of appetite (77.1%), cough (70.8%) and weight loss (64.5%), respectively. Typical miliary pattern were diagnosed radiologically on chest radiographs of all patients. There was cavity at Thoracic tomography in six of 31 patients (12.5%). The most common laboratory finding was elevated erythrocyte sedimentation rate (83.3%). The patients were diagnosed by microbiological (10%), histological (29%) and clinical-radiological (61%) methods. 10 patients (20.8%) had a history of an additional disease accompanying TB. Five patients (10.4%) died during hospitalization. As a result, miliary TB is a form of TB that is more frequent and severe in risk groups with co morbid disease. After clinical suspicion, the use of microbiological and histopathological methods up to radiological methods thought to be useful for fast and accurate diagnosis.Öğe Clinical characteristics and treatment outcomes in 132 patients with malignant mesothelioma(Medknow Publications & Media Pvt Ltd, 2011) Abakay, Abdurrahman; Tanrikulu, Abdullah C.; Kaplan, Muhammet Ali; Kucukoner, Mehmet; Abakay, Ozlem; Sen, Hadice; Isikdogan, AbdurrahmanPurpose: Our objective is to scrutinize clinical, laboratory, radiological characteristics, treatment regimens, and treatment outcomes of malignant mesothelioma (MM) cases in our hospital. Materials and Methods: We investigated, retrospectively, the clinical characteristics and treatment outcomes of all 132 MM patients at Dicle University Hospital between January 2006 and April 2010. Results: A total of 82 (62.1%) patients were male, and 50 (37.9%) female. Median age was 56.0 years. Mean survival time was 9.66.9 months. Mean survival time of patients who had received best supportive care was 7.5 months, chemotherapy 10.4 months, and multimodality treatment regimen 12.6 months. Patients in the multimodality treatment group survived longer than did those in the other two groups (P=0.042). A total of 76 patients received chemotherapy, of whom 17 (22.3%) were administered Cisplatin/Carboplatin and Gemcitabine, 58 (76.4%) Cisplatin/Carboplatin and Pemetrexed, and one (1.3%) Cisplatin Docetaxel. Complete and partial response to treatment in patients receiving Cisplatin/Carboplatin and Gemcitabine was found 47.1% and Cisplatin/Carboplatin and Pemetrexed was found 50.0% (P>0.05). Conclusions: MM related to asbestos exposure is seen frequently in Turkey. Patients present with the typical clinical features of dyspnea, weight loss, and chest pain. Survival analysis shows that patients receiving multimodality treatment may be better.Öğe Clinical Characteristics of Patients with Mesothelioma: A University Hospital of 2011 Data(Derman Medical Publ, 2013) Tanrikulu, Abdullah Cetin; Abakay, Abdurrahman; Abakay, Ozlem; Sezgi, Cengizhan; Sen, Hadice Selimoglu; Onder, Omer Faruk; Senyigit, AbdurrahmanAim: Malignant mesothelioma (MM) in the etiology of environmental and occupational asbestos exposure is usually to be responsible. The fibrous zeolite erionite was accused. MM due to environmental asbestos exposure is a common disease in our region. Material and Method: University Hospital in 2011 followed up a total of 28 patients with MM was evaluated retrospectively. Clinical radiological and histopathological features were investigated. Results: Fifteen patients were female and thirteen male. The mean age was 59.9 +/- 12.4 (36-81) years. In nine patients Ergani four patients Cermik district appealed. Fifteen patients (53.6%) were positive for asbestos exposure and mean asbestos exposure time was 24.7 years. Fourteen patients (50%) were diagnosed biopsy. In twelve patients left sides were involved. Seventeen patients had epithelial type. Pleural fluid cytology was positive in only four patients. The most frequent clinical symptom dyspnea. Patients with alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) values were higher. Discussion: People living in dense region are the theme of environmental asbestos MM appropriate should be considered in patients with symptoms and signs. For the prevention of disease in our region for the abandonment of the use of asbestos in environmental studies will be useful to do.Öğe Clinical characteristics, treatment and survival outcomes in malignant pleural mesothelioma: An institutional experience in Turkey(Imprimatur Publications, 2014) Kucukoner, Mehmet; Kaplan, Mehmet Ali; Inal, Ali; Urakci, Zuhat; Abakay, Ozlem; Tanrikulu, Abdullah Cetin; Abakay, AbdurrahmanPurpose: To compare treatment modalities and investigate potential prognostic factors for survival in patients with malignant pleural mesothelioma (MPM). Methods: The present study has investigated the data of 150 patients with MPM who were examined and treated in our center from 2005 to 2012. Results: The study included 87 male (58%) and 63 female (42%) patients. Surgical resection (pleurectomy/decortications (P/D), and extrapleural pneumonectomy (EPP)) was performed in 32 (36.7%) patients; 87 patients (58%) received chemotherapy alone and 16 (10.7%) had surgery, chemotherapy and radiotherapy (trimodal treatment). The median progression free and overall survival (PFS and OS) for all patients were 10.6 and 14.8 months, respectively. No statistically significant difference was observed between the patients who received pemetrexed/cisplatin (N=54) and gemcitabine/cisplatin (N=28) in terms of PFS and OS (p=0.145, p=0.244, respectively). Also, no statistically significant difference was registered between operated and non operated patients (PFS and OS, p=0.416, p=0.095, respectively). There was no difference in both PFS and OS rates between patients who had P/D or EPP (p=0.87, p=0.652, respectively). Log rank analysis: Eastern Cooperative Oncology Group performance status (ECOG PS)(p=0.018), histology (p < 0.001), stage (p < 0.001) and leukocytosis (p=0.005) were found to be significant prognostic factors of OS. At multivariate analysis, ECOG PS (p=0.016) and stage (p < 0.001) were independent prognostic factors for OS. Conclusion: Median OS was approximately 1 year. ECOG PS, histological type, stage and presence of leukocytosis were prognostic factors that affected both PFS and OS. EPP or P/D surgical options did not provide difference in terms of survival. Survival rates in patients who received a combination of platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were similar.Öğe Clinical characteristics, treatment, and survival outcomes in malignant pleural mesothelioma: A institution experience in Turkey(Lippincott Williams & Wilkins, 2013) Kucukoner, Mehmet; Kaplan, Muhammed Ali; Inal, Ali; Urakci, Zuhat; Abakay, Ozlem; Tanrikulu, Abdullah; Abakay, Abdurrahman[Abstract Not Available]Öğe A Department of Chest Diseases: 2011 Data of Tuberculosis(Derman Medical Publ, 2013) Tanrikulu, Abdullah Cetin; Cakirca, Seher; Abakay, Abdurrahman; Sezgi, Cengizhan; Sen, Hadice Selimoglu; Onder, Omer Faruk; Abakay, OzlemAim: Tuberculosis (TB) is transmitted through inhalation, is a disease that can involve all the tissues and organs. The most common location was the lung involvement. In this study we aimed to discuss the clinical and demographic data of TB patients who were followed in the University of Chest Diseases Clinic in 2011. Material and Method: TB is still an important public health problem: order to analyze our data about the disease patients file retrospectively studied who followed clinical university hospital in 2011. During the study period 56 TB patients file were examined. Results: A total of 24 patients female were and 32 were male. The mean age of female patients was 28.8 and male was 32.5 years. A total of 28 patients were smear-positive pulmonary tuberculosis (11 female, 17 male). In smear-positive cases 25 sputum smear-positive and 3 cases gastric juice smear-positive. Three patients were diagnosed with smear-negative, while a positive in culture. In total, four patients had relapsed pulmonary TB. Six patients were diagnosed with TB pleurisy and four of the six patients diagnosed with pleural biopsy and two diagnosed pleural fluid adenosine deaminase levels. A total of 22 patients with pulmonary tuberculosis were diagnosed radiologically and clinically. In two of 56 patients developed hepatotoxicity. Discussion: TB is a disease affecting the young population that seriousness of continued. Early diagnosis and treatment is particularly important for transmission of TB.Öğe Effect of cigarette smoking on nasal mucociliary transport rate: Rhinoscintigraphic evaluation with using 99mTc-macroaggregated albumin(Drunpp-Sarajevo, 2012) Dostbil, Zeki; Dag, Yusuf; Abakay, Abdurrahman; Bakir, Salih; Sezgi, Cengizhan; Abakay, Ozlem; Sen, HadiceObjectives: Cigarette smoking has harmful effects on mucociliary transport (MCT) in respiratory system. We aimed to investigate the association between nasal mucociliary transport rate (NMTR) and duration and amount of smoking in chronic cigarette smokers. Materials and Methods: Fifty four current cigarette smokers and 40 healthy non-smokers were included in this study. In all cases, we measured the NMTR using Tc-99m-macroaggregated albumin (Tc-99m-MAA) rhinoscintigraphy. Results: The mean NMTR of the smokers was lower than that of the healthy non-smoker controls (5.63 +/- 2.78; 9.44 +/- 2.09, respectively) (p<0.0001). There were not statistically significant correlation between NMTRs and year of smoking, and smoking pack-year in smokers (p>0.05; r=0.003, r=-0.2, respectively) whereas there was a statistically significant correlation between NMTRs and cigarettes per day in smokers (p=0.024; r=-0.307). Conclusions: Our findings demonstrated that cigarette smoking decreases the nasal NMTR in chronic term. Impaired mucociliary transport in respiratory system may have harmful effects on the human health. The degree of impairment in NMTRs in smokers may increase as the number of cigarettes per day increases.Öğe Factors affecting incidence of tuberculosis in Diyarbakir(Turkish Assoc Tuberculosis & Thorax, 2007) Tanrikulu, Abdullah Cetin; Abakay, Abdurrahman; Abakay, Ozlem; Alp, AdilLast decade, there have been important improvements about tuberculosis (Tbc) in the world. Today, 32% of world populations are infected by Tbc basil's, every year about 9 million people have been catching Tbc. We have purposed to determine the incidence of Tbc and the factors affect it, using rate of bacteriology in diagnosis, rate of treatment completion and to constitute an idea for innovation. Diyarbakir, standard monthly data forms used for informing of Tbc in tuberculosis control dispensary are investigated retrospectively among 1996-2004. The mean incidence of yearly Tbc is 37.77/100.000 and pulmonary Tbc is 30.11/100.000. In this period have been determined 3724 new Tbc patient; 2969 (79.7%) are pulmonary Tbc and 755 (20.3%) extrapulmonary Tbc. 842 patient (22.6%) of pulmonary Tbc are smear positive. Tbc pleurisy is the most common type of extrapulmonary Tbc in our series. 3354 (90.1%) of whole patients and 2624 (88.4%) with pulmonary Tbc had completed treatment. There is no data about the rate of cure. This is the most common problem Tbc control system. In 2005, cure rates will have been determined by the way of new form. 162 (4.4%) patient had abandoned treatment. Incidence of Tbc is higher than the incidence of Turkey. It was considered that at the first place highly growing population, the crowded family pattern sharing the same house and bad socioeconomic factors have been playing a major role. Furthermore, it was found that the rate of bacteriological diagnosis was low. In order to increasing of this rates should be carried out necessary studies, should be tried to diagnose all patients with bacteriological methods. End of the treatment cure should be tried to demonstrate by way of examination of sputum. The treatment process should be pursued by directly observed treatment strategy.Öğe FACTORS ASSOCIATED WITH MORTALITY AMONG TUBERCULOSIS PATIENTS IN SOUTHEAST TURKEY(Carbone Editore, 2015) Yilmaz, Sureyya; Taylan, Mahsuk; Sen, Hadice Selimoglu; Abakay, Ozlem; Demir, Melike; Kaya, Halide; Yilmaz, ZulfukarIntroduction: Tuberculosis (TB) is a disease caused by bacillus mycobacterium tuberculosis. Tuberculosis is a preventable and treatable disease that, despite the rapid advances in active therapy, continues to cause global mortality. In this study, we investigated the risk factors associated with mortality in patients undergoing treatment for TB. Materials and methods: Records of 2,450 tuberculosis patients who were followed-up with in tuberculosis dispensaries in the city of Diyarbakir, southeast Turkey, between January 2005 and December 2011 were reviewed retrospectively. Case definitions and treatment outcomes were classified according to WHO criteria. Results: Of the 2,450 registered TB patients, 1,339 were male (54.7%) and 1,111 were female (45.3%). Their mean age was 32.15 +/- 17.87 years, and 51 (2.1%) of them died. Mortality rates were higher in pulmonary TB (PTB) patients, males, relapse patients, category 2 patients, those >65 years old, TB meningitis patients, and patients who self-administered their therapy. According to Kaplan-Meier analysis, the mortality rates were significantly higher in patients aged >65 years, in those with Category II and in those TB meningitis. The significant independent risk factors for mortality during anti-TB treatment were advanced age, TB meningitis and gastrointestinal TB. Conclusion: Mortality was increased in the elderly, males, those with relapse, and in category II and extrapulmonary TB patients. Based on these data, we suggest that tuberculosis control programs should pay more attention to the high-risk groups determined in the current and previous studies. Treatment regimens for these risk groups should be considered for revision.Öğe High-risk mesothelioma relation to meteorological and geological condition and distance from naturally occurring asbestos(Springer, 2016) Abakay, Abdurrahman; Tanrikulu, Abdullah Cetin; Ayhan, Mustafa; Imamoglu, Mehmet Sefik; Taylan, Mahsuk; Kaplan, Muhammet Ali; Abakay, OzlemVery few studies have investigated the incidence and risk of malignant mesothelioma (MM) associated with distinct sources of asbestos exposure, especially exposure to naturally occurring asbestos (NOA). Subjects were MM, lung, and breast cancer patients who were diagnosed and followed in Diyarbakir Province between 2008 and 2013. The birthplaces of patients were displayed on a geologic map. Geological and meteorological effects on MM were analyzed by logistic regression. A total of 180 MM, 368 breast, and 406 lung cancer patients were included. The median distance from birthplace to ophiolites was 6.26 km for MM, 31.06 km for lung, and 34.31 km for breast cancer (p < 0.001). The majority of MM cases were seen within 20 km from NOA areas. The MM incidence inside of NOA was 1059/100.000, and out of NOA was 397/100.000; this difference was significant (p = 0.014). The largest concentration of MM residential areas was within +/- 30A degrees (34 residential areas 36.6 %) of the dominant wind direction. Most MM patients were found in or near the dominant wind direction, especially in the acute angle defined by the dominant wind direction. MM incidence was directly proportional to {[area of NOA (km(2))] * [cosine alpha of wind direction angle]} and was inversely proportional to the square of the distance (R = 0.291, p = 0.023). MM was higher near NOA and in the downwind direction. MM incidence and risk were affected by geological and meteorological factors.Öğe High-risk mesothelioma relation to meteorological and geological condition and distance from naturally occurring asbestos (vol 21, pg 82, 2016)(Springer, 2016) Abakay, Abdurrahman; Tanrikulu, Abdullah Cetin; Imamoglu, Mehmet Sefik; Ayhan, Mustafa; Taylan, Mahsuk; Kaplan, Muhammet Ali; Abakay, Ozlem[Abstract Not Available]Öğe INCREASED RATE OF OBSTRUCTIVE SLEEP APNEA SYNDROME IN PSORIASIS WITH NAIL INVOLVEMENT: A CASE-CONTROL STUDY(Carbone Editore, 2020) Ucmak, Derya; Abakay, OzlemIntroduction: Psoriasis is a chronic systemic inflammatory disease. Obstructive sleep apnea syndrome (OSAS) is a disorder that is characterized by obstructive apneas and hvpopneas due to repetitive collapse of the upper airway during sleep. Psoriasis and OSAS are associated with chronic inflammation and an abnormal immune response. We aimed to compare the prevalence of OSAS in psoriatic patients to healthy controls and determine whether certain clinical and laboratory parameters may be associated with OSAS in psoriatic patients. Material and Methods: A total of 30 patients who were diagnosed with psoriasis and 30 healthy controls were included in this prospective study. All participants were evaluated with nocturnal polysomnography. Data on demographic information, laboratory findings, anthmpometric measurements, Epworth Sleepiness Scale (ESS) score, Dermatology Life Quality Index (DLQI) score, Psoriasis Area and Severity Index (PASI) score were recorded. Results: The mean age of the patients was 36.8 +/- 12.6 years; and the mean age of the control group was 39.9 +/- 11.2 years. OSAS was diagnosed in nine (30%) of the psoriasis patients and two (6.7%) of the healthy controls (p=0.02). AHI (5.1 +/- 5.4 vs. 2.3 +/- 2.6, p=0.015), ESS scores (4.7 +/- 3.7 vs. 2.8 +/- 2.1, p=0.022), serum CRP levels (5.1 +/- 3.2 vs. 1.4 +/- 0.9 mg/dl, p<0.001) were higher in the psoriatic patients, compared to the control group, whereas HDL-cholesterol levels (37.6 +/- 8.6 vs. 44.9 +/- 10.8 mg/dl, p=0.005) showed the opposite. Psoriatic patients with OSAS had higher DLQI scores (p=0.001), PASI (p=0.042), Apnea-Hypopnea Index (AHI) (p<0.001 ), ESS scores (p<0.001 ) and serum CRP values (p<0.001) compared to those without OSAS. Eight patients with OSAS (88.9%) had nail involvement (p=0.020) compared to one patient (11.1%) without OSAS. Conclusions: Increased PASI and DLQI scores, CRP levels were observed in psoriatic patients and OSAS was increased in those with nail involvement. The early evaluation of psoriatic patients for the presence of OSAS may be useful in prevention of comorbidities.Öğe Is a complete blood cell count useful in determining the prognosis of pulmonary embolism?(Springer Wien, 2014) Sen, Hadice Selimoglu; Abakay, Ozlem; Tanrikulu, Abdullah Cetin; Sezgi, Cengizhan; Taylan, Mahsuk; Abakay, Abdurrahman; Kaya, HalidePulmonary embolism (PE) is the third cardiovascular cause of hospital admission, following acute coronary syndrome and stroke. Despite high-tech diagnostic methods and new treatment modalities, PEs continue to have a high mortality rate within the first 3 months. This study was designed to assess the additional prognostic value of a complete blood cell count, renal function markers, C-reactive protein, and simplified pulmonary embolism severity index (sPESI) scoring system in PE 100-day mortality. The study retrospectively enrolled 208 consecutive patients who were hospitalized with the diagnosis of an acute PE. The patients' demographic characteristics and clinical and laboratory parameters were recorded from the hospital electronic database and patient's case notes. The primary end point of the study was an adverse 100-day outcome, defined as death from any cause. The all-cause mortality in the first 100 days was 14.42 %. The mean age was 57.87 +/- 18.17 (range: 16-93) years. We included 79 (38 %) male and 129 (62 %) female individuals. Red cell distribution width (RDW) and sPESI were found to be statistically significant predictors of PE mortality by multivariate regression analysis. On multivariate regression analysis, RDW was associated with a 4.08-fold (95 % confidence interval: 1.229-13.335, P = 0.021) increase in PE mortality. The results of this study demonstrated that RDW and sPESI may be a useful guide in predicting 100-day mortality. The elevated RDW may alert physicians to possible poor prognosis.Öğe AN OVERVIEW OF THROMBOLYTIC TREATMENT FOR PULMONARY EMBOLISM: A SINGLE CENTRE EXPERIENCE(Carbone Editore, 2014) Sen, Hadice Selimoglu; Abakay, Ozlem; Sezgi, Cengizhan; Yilmaz, Sureyya; Taylan, Mahsuk; Kaya, Halide; Tanrikulu, Abdullah CetinIntroduction: A massive pulmonary embolism (MPE) has a poor prognosis and high mortality. Thrombolytic therapy is preferred in patients with life-threatening symptoms such as hypotension, cardiogenic shock, and right ventricular failure due to the risk of severe bleeding. Materials and methods: This is a retrospective analysis of patients who were hospitalized with the diagnosis of pulmonary embolism (PE) and given thrombolytic therapy in the chest diseases clinic of a tertiary university hospital between January 2008 and November 2013. Results: The subjects' mean age was 59.54 +/- 13.76 years. Fourteen of 39 patients who were treated with thrombolytic therapy were male (35.89%) and 25 (64.10%) were female. The symptoms experienced by the patients included dyspnea in 39 patients, chest pain in 35 patients, hemoptysis in 6 patients, syncope in 13 patients and cough in 10 patients. Risk factors were advanced age (> 60 years) in 19, immobilization in 19, malignancy in 3, major surgery in 11 patients. The in-hospital mortality analysis showed that 32 patients were discharged and 7 patients died. Four patients died from their pulmonary embolism and 3 patients died because of a major bleeding complication. Conclusions: Pulmonary embolism is a disease that may lead to death within hours secondary to acute right heart failure. Early diagnosis and treatment can be life saving. Thrombolytic therapy has been shown to improve hemodynamic parameters in the early period post-PE. An increased risk of bleeding is one of the most important drawbacks of thrombolytic therapy. Nonetheless, it can be a life-saving therapy in properly selected patients.
