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Öğe Effects of treatment regimens on survival in patients with malignant pleural mesothelioma.(2013) Abakay A.; Abakay O.; Tanrikulu A.C.; Sezgi C.; Sen H.; Kaya H.; Kucukoner M.In this study, we aimed to investigate the factors affecting the survival of patients with malignant pleural mesothelioma (MPM) according to their treatment regimens, including best supportive care (BSC), chemotherapy, surgical group and multimodality (MM) therapy. A retrospective analysis was performed on clinical data and treatment outcomes of 400 patients registered in our hospital with MPM between January 1989 and April 2010. Mean age (p < 0.001), presence of asbestos exposure (p = 0.0014), presence of smoking history (p < 0.001), Karnofsky performance status (p < 0.001), histological subtype (p = 0.034) and stage (p < 0.001) variables were found to be significantly different among the four treatment regimens. Mean survival time of all patients was 12.32 months. Mean survival time 10.5 months for the BSC group, 15.7 for the surgical group, 16.02 for the chemotherapy group, and 26.55 for the MM group. There were significant differences in mean survival time among the four treatment regimens. In addition, a significant difference was found in survival time between the two chemotherapy groups (p = 0.032). Mean survival time for cisplatin + gemcitabine was found to be 14.49 months and for cisplatin + pemetrexed, 18.34 months. The MM group had better survival rates than the other groups. The new chemotherapy combination, cisplatin + pemetrexed, can be helpful in improving survival time.Öğe An evaluation of cases of pneumonia that occurred secondary to hydrocarbon exposure in children.(2013) Sen V.; Kelekci S.; Selimoglu Sen H.; Yolbas I.; Günes A.; Abakay O.; Fuat Gurkan M.Hydrocarbon pneumonia is distinct among the types of childhood pneumonia in that it has a different pathogenesis and treatment and is preventable. In this study, the cases of 54 children with hydrocarbon pneumonia admitted to the Dicle University Medical Faculty Pediatric Chest Diseases Unit between the years 2006 and 2010 were analyzed retrospectively. The medical records of 54 patients diagnosed with pneumonia after ingesting/inhaling hydrocarbons were analyzed retrospectively. Age, sex, presenting symptoms, clinical status, radiological and laboratory findings and response to treatment and prognosis were noted. 35 (64.8%) of the patients were male, 19 (35.2%) were female and the ages of the patients ranged from 1 to 5 with an average of 2.49 ± 0.80. The etiologies of the pneumonia were thinner (33%), naphta (3.7%) and kerosene. In 49 of the patients (90.7%), the symptoms started to occur the day the patient was exposed to hydrocarbons. The average length of hospital stay was 4.0 ± 2.3 days. Six patients were treated in the intensive care unit (ICU), and one patient with hydrocarbon pneumonia due to kerosene ingestion died. Inhaled corticosteroids were administered to 18 patients who were progressively deteriorating and inhaled salbutamol was given to 16 patients with bronchospasm. Patients with radiological findings on their chest X-rays and auscultatory findings were found to have longer hospital stays (p < 0.05). To prevent chemical pneumonia, precautions must be taken to stop children under 5 years of age from using/abusing chemical substances. Although some cases of chemical pneumonia lead to death, with diligent care and treatment, the outcomes are promising. The patients in this study group responded well to treatment with inhaled corticosteroids and salbutamol.Öğe Factors associated with mortality among tuberculosis patients in southeast Turkey(A. CARBONE Editore, 2015) Yilmaz S.; Taylan M.; Sen H.S.; Abakay O.; Demir M.; Kaya H.; Yilmaz Z.Introduction: 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 The predictive value of CRP, CEA, IL-6, IL-8, and TNF? in the diagnosis of malignant pleural effusions(2012) Sen H.S.; Abakay O.; Dalli A.; Sezgi C.; Abakay A.; Coskunsel M.Aim: In this study, we investigated the potential utility of some simple, rapid, biochemical tests that detect the tumor markers interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor alpha (TNF?), C reactive protein (CRP), and carcinoembryonic antigen (CEA) in diagnosing malignant pleural effusions (MPEs) in exudative pleural fluids. Material and Methods: The study included 70 patients who had exudative PEs. The presence of CRP, CEA, IL-6, IL-8, and TNF? were investigated in the patients' pleural fluids. The cases were grouped into a malignant pleural effusion (PE) group (n = 27) and a benign PE group (n = 43) according to their etiological diagnosis, and the median levels of CRP, CEA, IL-6, IL-8, and TNF? in the two groups were compared. Results: The levels of pleural fluid CEA and IL-6 were significantly higher in the malignant PE group compared with the benign PE group (p <0.01 and p = 0.002, respectively). A meaningful difference was not found between the median value of the pleural fluid CRP IL-8 and TNF? levels in the two groups (p >0.05). We used Roc curve analysis to determine the sensitivity and specificity of CEA as a marker of malignant pleural effusion. When the CEA cut-off point was 1 ng/ml, the sensitivity was found to be 85%, and the specificity was found to be 51%. When the CEA cutoff point was 17 ng/ml, the sensitivity was 29%, and the specificity was 97%. Conclusion: Although the number of cases in the study is low, our findings suggested that CEA and IL-6 may be useful in distinguishing whether exudative PEs are malignant or benign.Öğe Pulmonary findings in patients with fascioliasis(Acta Medica Mediterranea, 2013) Sezgi C.; Cicek M.; Sen H.S.; Kaya H.; Taylan M.; Abakay A.; Abakay O.Aim: Fasciola hepatica (FH) is sporadically found in the humans and causes disease by involving the bile ducts. However, it is rarely localized ectopically in the lungs; typical and atypical involvement of lung have been shown. The aim of this study is to investigate pulmonary findings for clinical, radiologic and laboratory in patients with fascioliasis. Materials and methods: All patients included in this study were diagnosed with fascioliasis. Diagnosis of fascioliasis was made by IgG antibody detection with ELISA, detection of parasite eggs with stool examination, radiologic images and clinical findings and laboratory parameters. Diseases involving in the differential diagnosis of lung involvement were individually evaluated when an abnormality was detected on chest radiography. Additional biochemical and microbiologic tests were performed. Thoracic computed tomography (CT), fiberoptic bronchoscopy and thoracentesis were performed. When other diseases were eliminated, the patient was diagnosed with fascioliasis. Results: Lung involvement was detected in 3 out of 56 patients (5.35%). The most prominent symptoms were right hypochondrial pain, chest pain, cough and dyspnea. Hepatomegaly and pulmonary rales were the most common physical examination findings. On radiologic imaging of the lung, ground-glass densities were detected in one patient, infiltration in one and pleural effusion was detected in the other. Conclusion: Although Fasciola hepatica may only affect the lungs rarely, the presence of respiratory symptoms and physical examination findings in the acute period of diagnosis should suggest lung abnormality.Öğe Spinal tuberculosis: A retrospective chart review(Acta Medica Mediterranea, 2014) Sezgi C.; Taylan M.; Kaya H.; Sen H.S.; Abakay O.; Bulut M.; Abakay A.Aims: Background and objectives: This study aimed to investigate the clinical characteristics, diagnostic methods, and therapeutic outcomes in patients with spinal tuberculosis (TB) in Southeastern Turkey Methods: Patients diagnosed with spinal TB at Dicle University Hospital, Diyarbakir, Turkey, between October 2005 to December 2010 were enrolled in the study retrospectively. Patients were evaluated for the following: Clinical presentation, underlying diseases, laboratory results, imaging findings, medical therapies, and treatment outcomes Results: A total of 23 patients including 14 men and 9 women with spinal TB, also known as Pott's disease, were enrolled. The study subjects' ages ranged from 17 to 69 years with a mean age of 38.4 years. Patients most often presented with back pain (69.5%, n=16) and fever (56.5%, n=13), and the most frequent physical finding was spinal tenderness (91.3%). Only 17.4% of the patients demonstrated neurological deficits and no paraplegia was observed. The time interval between onset of symptoms and treatment initiation was 3.2 months. Of all the patients, 47.8% exhibited Pott's disease in the thoracolumbar region while 34.8% only had thoracic involvement. On average, 2.5 vertebrae were diseased in this cohort. Furthermore, 82.6% of the patients had paraspinal and psoas abscesses. All patients were treated with anti-TB therapy. However, 26.1% required additional surgery, and one patient with miliary TB died. The mean treatment course lasted for 12.3 months. Conclusions: It may be possible to refine methods of spinal TB detection and diagnosis by studying thoracolumbar pathology in young adults with Pott's disease in endemic countries such as Turkey. By studying the clinical progression of this disease, the delay between symptom onset and diagnosis may be decreased so that complications such as paraplegia and surgical interventions are avoided.
