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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 AFFECTING FACTORS ON EARLY MORTALITY IN ELDERLY PATIENTS DIAGNOSED WITH PULMONARY EMBOLISM IN EMERGENCY DEPARTMENT(Gunes Kitabevi Ltd Sti, 2015) Zengin, Yilmaz; Gunduz, Ercan; Dursun, Recep; Icer, Mustafa; Durgun, Hasan Mansur; Taylan, Mahsuk; Guloglu, CahferIntroduction: The ratio of elderly people in Turkey is rapidly growing. It is known that pulmonary embolism and venous thrombolysis incidence increases with age. Despite the major advances in pulmonary embolism diagnosis and treatment, pulmonary embolism leads to higher mortality rates in the elderly. In the present study, evaluation of socio-demographic and clinical characteristics of elderly patients diagnosed with pulmonary embolism in the emergency department and determination of factors that affect early mortality have been targeted in order to decrease mortality. Materials and Method: Between January 1, 2009, and September 30, 2014, patients who were 65 years of age and older who had been admitted through the emergency department with suspected pulmonary embolism and whose pulmonary embolism diagnosis was finalized via computerized tomographic pulmonary angiography. Results: In the study, 87 (61.8%) were female and 52 (38.2%) were male. Thirteen patients (9.4%) died during the follow-up period. The analysis of the relationship between pulmonary embolism in elderly patients and early mortality revealed that there is a statistical correlation among immobility, syncope, tachycardia, hypotension, elevated Troponin-T, coronary arterial disease, cerebrovascular disease, pulmonary embolism with massive dimension, bilateral pulmonary embolism, Wells-likely pulmonary embolism, and modified Geneva-likely pulmonary embolism were statistically related factors(p values, respectively, were 0.002; 0.033; 0.000; 0.000; 0.000; 0.037; 0.011; 0.000; 0.030; 0.023; 0.018). Conclusion: Immobility, syncope, tachycardia, hypotension, elevated Troponin T, coronary arterial disease, cerebrovascular disease, pulmonary embolism with massive dimension, bilateral pulmonary embolism, Wells-likely pulmonary embolism, and modified Geneva-likely pulmonary embolism were determined as effective risk factors affecting the early mortality of elderly patients with pulmonary embolism.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 Bronchial atresia in an adult misdiagnosed as pulmonary mass(Turkish Assoc Tuberculosis & Thorax, 2017) Demir, Melike; Taylan, Mahsuk; Yilmaz, Sureyya; Dursun, Elif; Sezgi, Cengizhan; Isik, Recep[Abstract Not Available]Öğe A comparison of propofol-midazolam and midazolam alone for sedation in endobronchial ultrasound-guided transbronchial needle aspiration: a retrospective cohort study(Wiley, 2017) Oztas, Selahattin; Akturk, Ulku Aka; Alpay, Levent A.; Meydan, Burhan; Ogun, Hamza; Taylan, Mahsuk; Yalcinsoy, MuratObjectivesEndobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new, minimally invasive, bronchoscopic technique used in the evaluation of inthrathoracic lymph nodes.Use of sedation drugs before the procedure differs among centres. There is no standardization about sedation before EBUS-TBNA.We used a policy decision to shift from use of propofol with midazolam vs midazolam alone in a large tertiary hospital to evaluate the diagnostic yield and safety of EBUS-TBNA procedure. MethodsFiles of all the patients who were performed EBUS-TBNA between the dates of September 2010 and May 2014 were surveyed. All the EBUS-TBNA cases were performed under sedation of propofol and midazolam with an accompanying anesthesiologist in the beginning, however, sedation is applied with midazolam without an accompanying anesthesiologist after April 2013 due to changes in sedation policy. The diagnostic yield and complication rates were compared by chi-squared analysis between two groups. ResultsThe files of 340 EBUS-TBNA performed patients were evaluated. Of the patients 274 eligible patients were analysed. 152 patients who fulfilled the inclusion criteria were analysed in propofol-midazolam (P) sedated group and 122 patients were analysed in midazolam (M) group. There is no statistically significant difference between two different sedated groups in terms of age and gender. Diagnostic value was detected as 77.6% in P group and 85.7% in M group and the difference was not statistically significant. No difference between complication rates of both groups was observed. ConclusionBoth sedation-types for performing EBUS-TBNA showed similar diagnostic value and complication rates in our study. Propofol with midazolam application requires with an accompanying anaesthesiologist, therefore, it increases cost. EBUS-TBNA procedures had been performed in safe with no decrease in diagnostic yield under moderate sedation.Öğe Do Meteorological Changes Have an Effect on The Occurence of Spontaneous Pneumothorax?(Bilimsel Tip Publishing House, 2016) Oruc, Menduh; Sahin, Atalay; Dursun, Recep; Taylan, Mahsuk; Erbey, Ahmet; Meteroglu, Fatih; Ozturk, BulentOBJECTIVES: Spontaneous pneumothorax refers to the leakage of air into the space between the parietal and the visceral layers of the pleura. It occurs with or without a known lung disease. We aimed to investigate the effects of atmospheric pressure, humidity, and temperature changes on the incidence of spontaneous pneumothorax (SP). MATERIAL AND METHODS: This study included 551 patients with spontaneous pneumothorax retrospectively screened between January 2009 and December 2013. The medical data of the patients were accessed via their medical records on the hospital automation system. The atmospheric pressure, temperature, humidity rate, amount of precipitation, and wind velocity on the day of spontaneous pneumothorax were obtained from the data provided by the general directorate of meteorology. The three consecutive days on which at least 2 cases of SP presented were collectively considered as a cluster. The study data were analyzed with the SPSS version 15 software package, using the Chi-square and the Student's t tests. A p value less than 0.05 was considered statistically significant. RESULTS: Of the 552 patients included in the study, 89.3% had primary spontaneous pneumothorax and 10.7% had secondary spontaneous pneumothorax. Ninety-two percent of the patients were male and 8% were female. The mean age was 24 years. Clustering was observed in 71.7% of the study population. No significant differences were observed between yearly and monthly SP incidences. There were, however, differences between the days with SP and the days without SP with respect to atmospheric pressure, ambient temperature, wind velocity, and humidity rate. The differences between the atmospheric pressures were not statistically significant, although the differences between the ambient temperature and the humidity rate were statistically significant (p=0.05). CONCLUSION: We determined that the changes in the ambient temperature and the humidity rate affected the rate of spontaneous pneumothorax by altering the meteorological conditions.Öğe Effect of human development index parameters on tuberculosis incidence in Turkish provinces(J Infection Developing Countries, 2016) Taylan, Mahsuk; Demir, Melike; Yilmaz, Sureyya; Kaya, Halide; Sen, Hadice Selimoglu; Oruc, Menduh; Icer, MustafaIntroduction: A country's development level is measured with a quantitative parameter called the human development index (HDI). The present study researched the effects of HDI parameters (such as healthcare standards, income, and education level) on the incidence of tuberculosis. Methodology: HDI data of 36 provinces of Turkey and the tuberculosis surveillance data were obtained from the Ministry of Development and the Ministry of Health, respectively. The associations between the incidence of tuberculosis and other HDI parameters were analyzed. Results: Higher population density (n/km(2)) (CI = 0.05 to 0.40) and higher relapse rate of tuberculosis (CI = 0.36 to 1.48) were identified to be independent predicting factors that increased the incidence of tuberculosis, whereas higher gross national product (CI =- 0.06 to 0.00), the population that holds a green Medicare card(CI=-0.58 to -0.04), increased general practitioners per 100,000 people (CI=-0.66 to -0.01), female population (CI = -0.70 to -0.06), married population (CI = -1.34 to -0.03), were found to be significant negative predicting factors that were relevant to the incidence (protective against tuberculosis). Conclusions: Tuberculosis is a disease that is affected by multiple factors, including the components of HDI. Improvement of income level, facilitation of access to health services via health insurance, urbanization with lower population density strategy, and provision of enough general practitioners may be useful in reducing the incidence of TB' in provinces of developing countries such as Turkey.Öğe Evaluation of New Biomarkers in the Prediction of Malignant Mesothelioma in Subjects with Environmental Asbestos Exposure(Springer, 2016) Demir, Melike; Kaya, Halide; Taylan, Mahsuk; Ekinci, Aysun; Yilmaz, Sureyya; Teke, Fatma; Sezgi, CengizhanThe purpose of this study was to investigate the potential value of certain biomarkers in predicting the presence of malignant pleural mesothelioma (MPM) in individuals environmentally exposed to asbestos. This prospective study investigated three groups; a control group composed of 41 healthy subjects, an asbestos exposure group consisting of 48 individuals, and a MPM group consisting of 42 patients. Serum levels of soluble mesothelin-related peptide (SMRP), thioredoxin-1 (TRX), epidermal growth factor receptor (EGFR), fibulin-3, syndecan-1 (SDC-1), and mesothelin were determined. Benign pleural plaques were present in 27 (58.3 %) of the individuals in the asbestos exposure group. The asbestos exposure group had significantly higher mean TRX, SMRP, and mesothelin levels compared to the control group (p = 0.023, p = 0.011, and p < 0.001, respectively). Compared to the asbestos exposure group, the MPM group had significantly higher mean EGFR, TRX, SMRP, and fibulin-3 levels (p = 0.041, p = 0.023, p = 0.002, and p = 0.001, respectively), and significantly lower mean SDC-1 levels (p = 0.002). Unlike the other biomarkers, SMRP and TRX levels increased in a graded fashion among the control, asbestos exposure, and MPM groups, respectively. Area under the curve values for SMRP and TRX were 0.86 and 0.72, respectively (95 % CI 0.79-0.92 and p < 0.001 for SMRP, and 95 % CI 0.62-0.81 and p < 0.001 for TRX). The cut-off value for SMRP was 0.62 nmol/l (sensitivity: 97.6 %, specificity: 68.9 %, positive predictive value (PPV): 56.2 %, and negative predictive value (NPV): 98.3 %) and for TRX was 156.67 ng/ml (sensitivity: 92.9 %, specificity: 77.6 %, PPV: 41.4 %, and NPV: 92.1 %). The combination of the biomarkers reached a sensitivity of 100 %, but had lower specificity (as high as 27.7 %). Serum biomarkers may be helpful for early diagnosis of MPM in asbestos-exposed cases. SMRP and TRX increased in a graded fashion from the controls to asbestos exposure and MPM groups. These two seem to be the most valuable biomarkers for the diagnosis of MPM, both individually and in combination.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 Social Anxiety and Poor Quality of Life in Patients With Pulmonary Tuberculosis(Lippincott Williams & Wilkins, 2015) Kibrisli, Erkan; Bez, Yasin; Yilmaz, Ahmet; Aslanhan, Hamza; Taylan, Mahsuk; Kaya, Halide; Tanrikulu, Abdullah CetinPulmonary tuberculosis (PT) has been previously related with various psychosocial adverse consequences including stigmatization and social isolation. Social anxiety is a psychiatric condition that may be associated with social isolation and fear of social exclusion. To date no study has investigated social anxiety and its impact on quality of life (QoL) among patients with PT. Therefore, we aimed to determine the severity of social anxiety in a group of patients with PT. Among patients who were recently discharged from hospital with the diagnosis of PT 94 patients and 99 healthy control subjects who had similar demographical features have been included in the study. A psychiatrist interviewed all participants and a semistructured interview form, which was prepared by the authors, Liebowitz Social Anxiety Scale (LSAS), and Short Form-36 were administered to them. Patients with PT showed higher levels of performance avoidance and social avoidance than healthy control subjects. They reported lower QoL scores across all dimensions. Among patients women showed higher levels of LSAS subscale scores and total score. Fear of social exclusion was predicted by perceived illness severity and emotional role difficulty. On the other hand, perceived illness severity was predicted by fear of exclusion and sedimentation level. PT patients seem to experience higher levels of social anxiety and associated fear of social exclusion that add to their worse QoL during the earlier months of their disease. Among them fear of social exclusion is related with perceived illness severity.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 Histopathological and Biochemical Effects of Ecballium elaterium on Sepsis-Induced Lung Injury(Taylor & Francis Inc, 2016) Demir, Melike; Taylan, Mahsuk; Kaya, Halide; Ekinci, Aysun; Arslan, Demet; Aslan, Emel; Keles, AysenurPurpose: The aim of this study was to investigate the role of Ecballium elaterium (EE) on sepsis-induced lung injury. Materials and Methods: A total of 30 male rats were divided into three groups as follows: control, sepsis, and treatment groups (sepsis + EE) with each group containing 10 rats. A rat model of sepsis induced by cecal ligation and puncture (CLP) was used. In the treatment group, rats were injected intraperitoneally with 2.5mg/kg EE after CLP. Interleukin-6 (IL-6), tumor necrosis factor (TNF)-, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) values after a 24-hr period were measured via cardiac puncture. Animals were harvested after the procedure and biochemical analysis was done and histopathological changes of the tissue sections of lungs were examined thereafter. Results: A statistically significant decrease was observed in the IL-6 (p < .05), TNF- (p < .05), and TOS (p < .01) levels in the sera of the treatment group compared to those of the sepsis group. Following the treatment, the TOS (p = .01) and OSI (p < .05) levels in the lung tissue of rats indicated a statistically significant decrease compared to those of the sepsis group. The histopathological follow-up undertaken after the administration of the EE treatment to septic rats showed significantly lower values of alveolar wall thickness (p < .001), interstitial edema (p = .018), and neutrophil infiltration (p = .047). Conclusion: EE treatment may have beneficial effects on sepsis-induced lung injury, and therefore has potential for clinical use.Öğe The impact of anti-smoking laws on high school students in Ankara, Turkey(Soc Brasileira Pneumologia Tisiologia, 2015) Demir, Melike; Karadeniz, Gulistan; Demir, Fikri; Karadeniz, Cem; Kaya, Halide; Yenibertiz, Derya; Taylan, Mahsuk[Abstract Not Available]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 LATE-BREAKING ABSTRACT: The effect of volume overload on pulmonary hypertension in hemodialysis patients(European Respiratory Soc Journals Ltd, 2015) Yilmaz, Sureyya; Yildirim, Yasar; Taylan, Mahsuk; Demir, Melike; Yilmaz, Zulfukar; Kara, Aliveysel; Aydin, Fatma[Abstract Not Available]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.Öğe Oxidative Status and Acute Phase Reactants in Patients with Environmental Asbestos Exposure and Mesothelioma(Hindawi Publishing Corporation, 2014) Sezgi, Cengizhan; Taylan, Mahsuk; Sen, Hadice Selimoglu; Evliyaoglu, Osman; Kaya, Halide; Abakay, Ozlem; Abakay, AbdurrahmanBackground and Objectives. The aim of this study was to investigate inflammatory indicators and oxidative status in patients with asbestos exposure with and without mesothelioma and to compare results with data from healthy subjects. Methods. Eighty people with exposure to environmental asbestos and without any disease, 46 mesothelioma patients, and a control group of 50 people without exposure to environmental asbestos were enrolled in this prospective study. Serum total oxidant level (TOL), total antioxidant capacity (TAC), and oxidative stress index (OSI), CRP, transferrin, ceruloplasmin, alpha-1 antitrypsin, ferritin, and copper levels were measured. Results. Mesothelioma group exhibited higher TOL, OSI, alpha 1-antitrypsin, ferritin and copper levels as compared to the other groups (P < 0.001, P = 0.007, P < 0.0001, P < 0.001, and P < 0.001, resp.). Transferrin was lower in the mesothelioma group than in the other two groups (P < 0.001). The asbestos group had higher TOL, TAC, alpha 1-antitrypsin, and transferrin levels (P < 0.001, P < 0.001, P < 0.001, and P < 0.001, resp.), as well as lower OSI and ferritin levels as compared to the control group (P < 0.001 and P < 0.001). Conclusions. We believe that elevated acute phase reactants and oxidative stress markers (TOL and OSI) in the mesothelioma group can be used as predictive markers for the development of asbestos-related malignancy.
