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Öğe Affecting factors on early mortality in elderly patients diagnosed with pulmonary embolism in emergency department(Geriatrics Society, 2015) Zengin Y.; Gündüz E.; Dursun R.; İçer M.; Durgun H.M.; Taylan M.; Güloğlu C.Introduction: 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. © 2015, Geriatrics Society. All rights reserved.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 Fibulin-3 as a diagnostic biomarker in patients with malignant mesothelioma(Asian Pacific Organization for Cancer Prevention, 2015) Kaya H.; Demir M.; Taylan M.; Sezgi C.; Tanrikulu A.C.; Yilmaz S.; Bayram M.Background: New tumour biomarkers are being intensely investigated for malignant mesothelioma (MM). Fibulin-3 is produced in MM but its role remains uncertain. The aim of this study was to evaluate the validity of measuring serum fibulin-3 in the diagnosis and prognosis of MM. Materials and Methods: This prospective study was performed on 43 patients and 40 healthy controls who were admitted to our hospital between January 2012 and January 2014. Data from MM patients, including demographic and clinical features, routine laboratory data, levels of serum fibulin-3, and treatment outcomes were defined as potential prognostic factors. The receiver operating characteristic (ROC) curve for fibulin-3 was used to detect the cut-off value with highest sensitivity and specificity. Univariate survival analysis was performed using the Kaplan-Meier method in patients with MM. Afterwards, the possible factors identified with univariate analyses were entered into the cox regression analysis. Results: Our results revealed that patients with MM had significantly higher serum levels of fibulin-3 than controls. The results showed that the best cut-off point was 36.6 ng/ml with an AUC (area under the curve)=0.976, sensitivity=93.0% and specificity=90.0. In our study, the initial significant poor prognostic factors were advanced stage, high white blood cell count, high platelet count, high C-reactive protein (p<0.05 for each variable). Later, according to multivariate analysis the results showed only advanced stage as significant parameter (p=0.040). Conclusions: We determined that real use for serum fibulin-3 was not for prognosis but for diagnosis in MM. Also advanced stage was associated with poor MM prognosis.Öğe An overview of thrombolytic treatment for pulmonary embolism: A single Centre experience(Acta Medica Mediterranea, 2014) Şen H.S.; Abakay Ö.; Sezgi C.; Yilmaz S.; Taylan M.; Kaya H.; Tanrikulu A.C.Introduction: 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 Prick test results and total ige levels of Asthma patients in a university hospital(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Çil B.; Kabak M.; Hocanlı İ.; Topçu A.F.; Taylan M.Respiratory allergies are currently on the rise and affect all age groups. Aeroallergens play a major role in the pathogenesis of respiratory allergic diseases, especially in asthma and allergic rhinitis. Skin prick tests and specific blood tests can b e used to safely ascertain allergen-specific IgE. When correctly implemented, aeroallergens such as house mites, pollens, and pet allergens can be determined. Skin tests are widely used to assess sensitivity to allergens due to their relatively easy application and safety. The present study aims to delineate a regional allergen profile and compare this profile with that of other regions of the country. Furthermore, a comparison of total IgE elevation and prick test positivity was made to assess the sensitivity and specificity of total IgE levels. One hundred and sixty seven patients over 18 years of age that applied to either in-or out-patient clinics, that had a diagnosis of asthma according to the criteria of GINA (the Global Initiative for Asthma) and had been attack-free for at least one month were included. Forty one patients were male and 124 were female. The prick test was positive in 18.7%. Pollens (41.9%), mite (22.5%) and cochroach were the most frequently detected allergens. Those that had serum IgE levels higher than the serum reference value had sign ificantly higher rate of prick test positivity (p=0.029). The present study demonstrates inter-regional variability of allergen profiles and the direct correlation between total IgE elevation and prick test positivity. In cases where prick tests are not available, allergen sensitivity can be determined by total IgE levels. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.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.Öğe The value of new inflammatory parameters in Malignant mesothelioma prognosis(Acta Medica Mediterranea, 2015) Tanrikulu A.C.; Hocanli I.; Yilmaz A.; Meteroglu F.; Taylan M.; Demir M.; Kaya H.Aim: Malignant mesothelioma (MM) has a poor prognosis. Inflammation is associated with MM prognosis and symptoms. Several inflammatory markers were investigated to estimate MM prognosis. We investigated the role of available inflammatory index and markers for MM prognosis. We developed the advanced mesothelioma index (AMI) to assess the degree of inflammation in MM. Materials and methods: We performed a retrospective study of 202 MM patients (116, male, 86 female) evaluated at Dicle University. Demographic parameters and laboratory data were collected. The AMI was calculated as Body Mass Index*serum albumin value (g/dl)/platelet-to-lymphocyte ratio. Results: The mean age of patients was 59.04 years. A total of 135 (66.8%) patients showed epithelial-type histopathological subtypes and 177 patients had pleural MM. The mean survival time was 13.1±11.5 months in the all MM patients. Twenty-four potential prognostic factors were associated with a poor outcome and then analyzed in the univariate analysis. Eighteen of them were definitely associated with a poor prognosis. These 18 potential prognostic factors were analyzed in the multivariate analysis. Based on the results of the multivariate analysis, only patients with an AMI<0.5 had an associated poor prognosis. An AMI<0.5 increased the mortality rate by 10.47. Furthermore, low AMI was associated with other bad inflammatory markers (such as high platelet count, high C reactive protein level, low Body Mass Index, low albumin and low hemoglobin). Conclusion: Our findings indicate that the AMI can be used to assess the degree of systemic inflammation.
