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    The Predictive Value Of CRP, CEA, IL-6, IL-8, And TNF? In The Diagnosis Of Malignant Pleural Effusions
    (Drunpp-Sarajevo, 2012) Sen, Hadice Selimoglu; Abakay, Ozlem; Dalli, Ayse; Sezgi, Cengizhan; Abakay, Abdurrahman; Coskunsel, Mehmet
    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 alpha), 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 alpha 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 alpha 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 alpha 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.
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    Pulmonary Function in Patients with End-Stage Renal Disease: Effects of Hemodialysis and Fluid Overload
    (Int Scientific Information, Inc, 2016) Yilmaz, Sureyya; Yildirim, Yasar; Yilmaz, Zulfukar; Kara, Ali Veysel; Taylan, Mahsuk; Demir, Melike; Coskunsel, Mehmet
    Background: Respiratory system disorders are one of the most prevalent complications in end-stage renal disease patients on hemodialysis. However, the pathogenesis of impaired pulmonary functions has not been completely elucidated in these patients. We designed a study to investigate acute effects of hemodialysis treatment on spirometry parameters, focusing on the relationship between pulmonary function and fluid status in hemodialysis patients. Material/Methods: We enrolled 54 hemodialysis patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status before and 30 min after the midweek of hemodialysis (HD). Overhydration (OH)/extracellular water (ECW)% ratio was used as an indicator of fluid status. Fluid overload was defined as OH/ECW 3 7%. Spirometry was performed before and after hemodialysis. Results: Forced vital capacity (FVC), FVC%, and forced expiratory volume in the first second (FEV1) levels were significantly increased after hemodialysis. FVC, FVC%, FEV1, FEV1%, mean forced expiratory flow between 25% and 75% of the FVC (FEF25-75), FEF25-75%, peak expiratory flow rate (PEFR), and PEFR% were significantly lower in patients with fluid overload than in those without. OH/ECW ratio was negatively correlated with FVC, FVC%, FEV1, FEV1%, FEF25-75, FEF25-75%, PEFR, and PEFR%. Stepwise multiple regression analysis revealed that male sex and increased ultrafiltration volume were independently associated with higher FVC, whereas increased age and OH/ECW ratio were independently associated with lower FVC. Conclusions: Fluid overload is closely associated with restrictive and obstructive respiratory abnormalities in HD patients. In addition, hemodialysis has a beneficial effect on pulmonary function tests, which may be due to reduction of volume overload.