BACKGROUND Classification of pleural fluids as transudate and exudate is important for diagnosis ... more BACKGROUND Classification of pleural fluids as transudate and exudate is important for diagnosis and treatment. Light's criteria are used worldwide to differentiate transudate and exudate. However, in some cases, the distinction between transudate and exudate pleural fluid is unclear. We investigated the serum and pleural fluid TAS, TOS, and OSI values of patients with pleural effusion, and their roles in differentiating transudate and exudate. METHODS Sixty-six patients hospitalized for pleural effusion between July 2018 and December 2020, and 33 healthy individuals, were prospectively analyzed. The patients were divided into exudate and transudate groups according to Light's criteria. Demographic and laboratory data, and serum TAS, TOS, and OSI values, were compared among the three groups (exudate, transudate, and control group). The pleural fluid TAS, TOS, and OSI values were compared between the exudate and transudate groups. RESULTS Although the serum TAS value was significantly higher in the control than exudate and transudate groups, the serum TOS and OSI values were significantly lower. There was no significant difference between the exudate and transudate groups in the serum TAS, TOS, or OSI values. Compared to the transudate group, the pleural fluid TAS value was significantly higher in the exudate group, whereas the pleural fluid OSI value was significantly lower. Multivariate logistic regression analysis identified pleural OSI as independent predictors of exudative pleural fluid. CONCLUSIONS Pleural fluid TAS and OSI values may be useful biomarkers for differentiating exudative and transudative fluid and as an adjunct to Light's criteria in suspicious cases.
Aim: Chronic obstructive pulmonary disease (COPD) is a disease characterized by irreversible airw... more Aim: Chronic obstructive pulmonary disease (COPD) is a disease characterized by irreversible airway flow limitation and chronic airway inflammation. We aimed to investigate the clinical importance of serum prolidase enzyme, which is an indicator of collagen degradation, and Carbonic anhydrase (CA) III enzyme, which has an important function in acid-base regulation, in patients with COPD Material and Method: In this study, 56 stable COPD patients and 32 healthy subjects without smoking history and comorbidities were included. Serum CA III and prolidase enzyme levels were compared between the two groups. Results: The statistical difference was not found between the two groups in terms of prolidase enzyme levels (p=0.831). There was a statistically significant increase in CA III levels in the COPD group (p=0.001). There were moderate positively correlation between CAIII with partial pressure of carbon dioxide in blood (pCO2) and negatively correlation between CA III with partial pressure of oxygen in blood (pO2) in COPD patients (r:0.302, p<0.025; r:-0.314, p:0.02). Conclusions: We think that there is an important clinical relationship between CA III and COPD, and therefore, CA III may be a candidate biomarker in the follow-up of COPD.
Background: Pulmonary embolism is a thromboembolic disease with high rates of morbidity and morta... more Background: Pulmonary embolism is a thromboembolic disease with high rates of morbidity and mortality. Monocyte-to-HDLcholesterol ratio (MHR) can show the inflammatory status of patients. The objective of this study was to investigate the relationship of monocyte-to-HDL-cholesterol ratio, which is a new marker in predicting the prognosis of cardiovascular diseases, with prognosis and Pulmonary Embolism Severity Index (PESI) test in patients with pulmonary embolism. Methods: Patients followed-up with the diagnosis of pulmonary embolism in our hospital between January 2016 and December 2018 were included in this study. Patients’ demographic data such as age and gender, vital findings, hemogram outcomes at admission, lipid profiles, liver function tests, renal function tests, electrolyte values and cardiac markers were recorded and analyzed. Patients’ pulmonary embolism (PE) clinical classes were determined and PESI test values were calculated. The correlations between monocyteto-HDL-cholesterol ratio, PE severity and PESI test were analyzed. Results: A total of 50 patients followed up in our hospital due to PE were included in the study. Of all patients 8% (n=4) were diagnosed with massive, 32% (n=16) sub-massive and 60% (n=30) non-massive PE. There was a positive correlation between MHR and PE severity, and MHR and PESI index, although these correlations were not statistically significant (r=0.011, p=0.940; r=0.043, p=0.767). Of all patients included in this study, one patient (2%) died in the hospital and 49 patients (98%) were discharged with recovery. Conclusions: Although there were positive correlations between monocyte-to-HDL-cholesterol ratio, which is an inexpensive marker easily available in all centers, and the severity of acute pulmonary embolism and PESI test, these correlations were not statistically significant. Monocyte-to-HDLcholesterol ratio may not be related to PE, however, further longitudinal studies are needed to clarify this finding.
Objective: The distinction between COVID-19 and other respiratory infections can be difficult dur... more Objective: The distinction between COVID-19 and other respiratory infections can be difficult during the flu and winter seasons. The aim of this study is to detect bacterial/viral microorganisms in nasopharyngeal swab samples and to evaluate routine laboratory results of patients with PCR (-) but suspected covid 19. Methods: Between 1 July 2021 and 31 December 2021, 78 patients who were hospitalized and followed up in the suspected Covid service were included in the study. The patients were divided into two groups as those with and without growth on the respiratory panel. Laboratory, demographic and radiological data were compared between groups. Results: C-reactive protein (CRP) and ferritin levels were found to be statistically significantly higher in the group with growth on the respiratory panel compared to the group without growth (p= .05, p= .041, respectively). Reproduction was detected in nasopharyngeal swab samples taken in 56.4% of the patients. More than half of the patie...
Amaç: Bu çalışmanın amacı bilgisayarlı tomografi (BT) kılavuzluğunda transtorasik akciğer kesici ... more Amaç: Bu çalışmanın amacı bilgisayarlı tomografi (BT) kılavuzluğunda transtorasik akciğer kesici iğne biyopsilerinin tanısal etkinliğini ve komplikasyon oranlarını göstermektir.Materyal ve metod: Çalışmaya BT kılavuzluğunda transtorasik kesici iğne akciğer biyopsisi yapılan 50 hastanın 50 akciğer lezyonu dahil edildi. Hastaların 31̍ i erkek 19̍ u kadın ve yaş ortalaması 58,16 idi. Akciğer lezyonlarının yerleşimi, boyutu, morfolojik yapısı ve geçilen akciğer parankim uzunluğu, histopatolojik sonuçlar ve komplikasyon oranları elde edildi.Bulgular: Biyopsi sonucu 50 lezyonun 46 tanesinde tanısal sonuç elde edildi. Dört hastada alınan biyopsi materyali yetersiz bulundu. Tanısal sonuç elde edilen 46 lezyonun 30 ̍ unda malign bulgular, 16̍ sında benign bulgular elde edildi. İşlem sırasında ve sonrasında üç hastada pnömotoraks, dört hastada hemoraji ve üç hastada pnömotoraks ve hemoraji birlikte gelişti.Sonuç: BT kılavuzluğunda transtorasik kesici iğne akciğer biyopsisi güvenli ve akciğer ...
Aim: Chronic obstructive pulmonary disease (COPD) is a disease characterized by irreversible airw... more Aim: Chronic obstructive pulmonary disease (COPD) is a disease characterized by irreversible airway flow limitation and chronic airway inflammation. We aimed to investigate the clinical importance of serum prolidase enzyme, which is an indicator of collagen degradation, and Carbonic anhydrase (CA) III enzyme, which has an important function in acid-base regulation, in patients with COPD Methods : In this study, 56 stable COPD patients and 32 healthy subjects without smoking history and comorbidities were included. Serum CA III and prolidase enzyme levels were compared between the two groups. Results: The statistical difference was not found between the two groups in terms of prolidase enzyme levels (p=0.831). There was a statistically significant increase in CA III levels in the COPD group (p=0.001). There were moderate positively correlation between CAIII with partial pressure of carbon dioxide in blood (pCO2) and negatively correlation between CA III with partial pressure of oxyge...
Background Exposure to viral or bacterial pathogens increases the number of neutrophils with a re... more Background Exposure to viral or bacterial pathogens increases the number of neutrophils with a relative decrease in lymphocytes, leading to elevated neutrophil to lymphocyte ratio (NLR). This study aimed to investigate whether differences in NLR among real-time polymerase chain reaction (PCR)-positive and -negative patients presenting with a prediagnosis of COVID-19 pneumonia could be useful in the differential diagnosis. Methods The study included 174 patients admitted because of suspected COVID-19 infection between March and April 2020. Patients were divided into two groups: PCR-negative and PCR-positive. Hemogram, NLR, urea, creatinine, aspartate aminotransferase, alanine aminotransferase, bilirubin, ferritin, D-dimer, C-reactive protein, procalcitonin, troponin, and coagulation parameters were analyzed. Results On comparison of laboratory parameters between both groups at presentation, PCR-positive patients were significantly more likely to have leukopenia (p < 0.001), thrombocytopenia (p = 0.006), neutropenia (p < 0.001), lymphopenia (p = 0.001), and increased NLR (p = 0.003). Furthermore, PCR-positive patients showed significant elevations of ferritin (p = 0.012) and procalcitonin (p = 0.038) and significant lower potassium levels (p = 0.05). Conclusion COVID-19 pneumonia has become a major global health problem. Early diagnosis and treatment of these patients are crucial, as COVID-19 pneumonia shows a rapid progression in most cases. Thus, leukopenia, thrombocytopenia, elevated NLR, and elevated ferritin may be useful as supplementary diagnostic tests in these patients, which may allow early initiation of treatment and may contribute to preventing progression in patients with abnormal results.
Aim: Negative pressure pulmonary edema (NPPE) is a rare postoperative complication that arises du... more Aim: Negative pressure pulmonary edema (NPPE) is a rare postoperative complication that arises due to upper airway obstruction and appears within an hour of extubation. Case: The patient was a 19 years-old male with no chronic diseases or complaints in his preoperative assessment. Forty-five minutes after extubation, the patient reported dyspnea, hemoptysis, chest pain and oxygen saturation was 60%. Computer Tomography (CT) scans revealed bilateral infiltration and consolidation, more prominent in the central and apical regions. His bedside echocardiogram was normal. NPPE was considered in the diagnosis; oxygen support, intravenous furosemide, nebulized salbutamol and budosenide were administered in addition to noninvasive mechanical ventilation. Two hours later, the symptoms abated. His repeat X-ray taken after 12 hours showed reduction in lung infiltrates and patient was discharged after five days. Conclusion: Abrupt decrease in oxygen saturation after extubation, dyspnea, chest pain and hemoptysis point to negative pressure pulmonary edema; the patient must immediately be moved to the intensive care unit and promptly treated.
The course of COVID-19 infection due to SARS-CoV-2 is manifested by viral replication in the uppe... more The course of COVID-19 infection due to SARS-CoV-2 is manifested by viral replication in the upper respiratory tract with or without lung involvement and extrapulmonary systemic hyperinflammation syndrome. Because it has a wide clinical spectrum ranging from asymptomatic cases to multiorgan failure, early identification of prognostic biomarkers is crucial to distinguish patients at risk of developing more serious disease. Our aim is to investigate the relationship between the C-reactive protein to albumin ratio (CAR), a biomarker which has both prognostic and diagnostic importance, and COVID-19 infection.
Aim: The main objective of this study is to determine the profile of emergency consultations requ... more Aim: The main objective of this study is to determine the profile of emergency consultations requested from department of chest diseases in Turkey. Method: Total of 57 centers (PUPCEST Study Group) in Turkey were included in the study in a 3 months period from December 2017 to February 2018. We composed the preliminary report using the data analyzed from 25 centers during the first two months period. Results: 44% of 581 patients were female and 64% of the admissions were self applications. 85% of the patients had had previously diagnosed comorbidity. 34.7% of the complaints were dispnea. The most common radiological finding was consolidation (13%) on chest x-ray.63% of the cases were consulted with the need for hospitalization and 39% of the patients were presenting the flare ups of underlying pulmonary pathology. The most common diagnoses were COPD (19%) and pneumonia (12%). 11.7% of the patients were medically treated which was ordered by the chest disease physician. 35% of the patients were discharged home following initial assessment while 35% were hospitalized in ward. Consultations were considered as necessary and properly timed by the 69% of the chest diseases physicians. Invasive interventions and hospitalization in intensive care unit were infrequent. Conclusions: Majority of the patients were conservatively treated in emergency department and hospitalizations were predominantly on ward. It can be concluded that many of the admissions could be evaluated in daytime outpatient clinics which may lead to the decrease on emergency department admissions. Reorganization of outpatient clinics and arrangements on follow up visits may decrease the rate of emergency admissions
AMAÇ:Sigara, önlenebilir ölüm ve hastalıkların en sık nedenidir. Ülkemiz, Avrupa bölgesinde sigar... more AMAÇ:Sigara, önlenebilir ölüm ve hastalıkların en sık nedenidir. Ülkemiz, Avrupa bölgesinde sigara içme oranı yüksek ülkelerden biridir. Toplumsalbilinçlenme, eğitim ve sosyal durumlar nedeniyle sigara kullananların,sigara bırakma polikliniklerine başvuruları arttırmaktadır. Bu çalışmada, hem sigara polikliniğimizdeki sigara bırakma durumunu hem de sigara bırakma için 12 haftalık standart bir vareniklin rejimini ve 10 haftalık standart bir transdermal nikotin replasman tedavisi (NRT) rejiminin bırakma üzerindeki etkisini tartışmayı amaçladık. MATERYAL METOD: Bu çalışmaya Ocak 2015 ve Ocak 2018 yılları arasında sigara bırakma polikliniğine başvuran, sigara bırakma tedavisi başlanmış 845 hasta retrospektifolarak incelendi. BULGULAR: Çalışmaya dahil edilen hastalarda yaş ve cinsiyet açısından istatiksel olarak anlamlı sonuç elde edilmedi (p=0.622, p=0.241). Sigara bırakan gruptaFNBS 6.12±0.9 iken, sigara bırakmayan grupta 8.45±1.1 idi ve gruplar arasında istatiksel olarak anlamlı farkl...
AIM The course of infection due to SARS-CoV-2 is manifested by viral replication in the upper res... more AIM The course of infection due to SARS-CoV-2 is manifested by viral replication in the upper respiratory tract with or without lung involvement and extrapulmonary systemic hyperinflammation syndrome. Because it has a wide clinical spectrum ranging from asymptomatic cases to multiorgan failure, early identification of prognostic biomarkers is crucial to distinguish patients at risk of developing more serious disease. Our aim is to investigate the relationship between the biomarker CAR, which has both prognostic and diagnostic importance, and Covid 19 infection. MATERİALS AND METHODS Between 1 June 2021 and 1 September 2021, 215 patients who were followed up in the pandemic service and intensive care unit for Covid 19 pneumonia were retrospectively analyzed. The demographic and routine laboratory data of the patients and the parameters accepted as new inflammatory biomarkers such as NLR, PLR, LMR and CAR were compared between the service-intensive care unit and exitus-discharged grou...
Obstrüktif uyku apne sendromu (OUAS) uyku esnasında hipofarenks bölgesinde tam veya kısmi daralma... more Obstrüktif uyku apne sendromu (OUAS) uyku esnasında hipofarenks bölgesinde tam veya kısmi daralmasıyla ve oksijen saturasyonundaki (SO2) düşme sonrasında solunum çabası ve intratorasik basıncın negatifleşmesi ile karakterize bir sendromdur. Horlama, gündüz aşırı uykululuk hali ve tanıklı apne OUAS'da en çok gözlenen semptomlardır. Polisomnografi (PSG), OUAS tanısı için kullanılan altın standart bir yöntemdir. Bir yıl boyunca uyku laboratuvarında takip edilen hastalarımızı değerlendirmeyi amaçladık. Araçlar ve Yöntem: Çalışmamıza 1 Ocak 2018-1 Ocak 2019 zaman aralığında uyku laboratuvarımızda yatan 111 hasta dahil edildi. Hastalar 4 gruba ayrılarak demografik ve klinik bulguları karşılaştırıldı. Bulgular: Hastaların yaş ortalaması 46.55±11.18 yıl idi. Hipertansiyon (HT) görülme sıklığı açısından ağır OUAS grubunda, diğer gruplara kıyasla anlamlı farklılık mevcuttu (p=0.025). Vücut kitle indeksi (VKİ) ağır OUAS grubunda, diğer gruplara göre istatiksel olarak daha yüksek bulundu (p<0.001). Ayrıca ağır OUAS grubundaki hastalarda hem rapid eye movement (REM) uyku süresi hemde SO2 düzeyi diğer gruptaki hastalara göre istatiksel olarak anlamlı düşük saptandı (p=0.034, p<0.001). Sonuç: Hastalarımızın çoğu, VKİ >30kg/m2 olan olgularda ağır OUAS olarak saptanmıştır. Uyku laboratuvarları ve polisomnografi, bu hastalığın tanısında önemli rol oynamaktadır. Özellikle Obezite ve HT tanılı olguların OUAS açısından sorgulanması gerekmektedir.
BACKGROUND Classification of pleural fluids as transudate and exudate is important for diagnosis ... more BACKGROUND Classification of pleural fluids as transudate and exudate is important for diagnosis and treatment. Light's criteria are used worldwide to differentiate transudate and exudate. However, in some cases, the distinction between transudate and exudate pleural fluid is unclear. We investigated the serum and pleural fluid TAS, TOS, and OSI values of patients with pleural effusion, and their roles in differentiating transudate and exudate. METHODS Sixty-six patients hospitalized for pleural effusion between July 2018 and December 2020, and 33 healthy individuals, were prospectively analyzed. The patients were divided into exudate and transudate groups according to Light's criteria. Demographic and laboratory data, and serum TAS, TOS, and OSI values, were compared among the three groups (exudate, transudate, and control group). The pleural fluid TAS, TOS, and OSI values were compared between the exudate and transudate groups. RESULTS Although the serum TAS value was significantly higher in the control than exudate and transudate groups, the serum TOS and OSI values were significantly lower. There was no significant difference between the exudate and transudate groups in the serum TAS, TOS, or OSI values. Compared to the transudate group, the pleural fluid TAS value was significantly higher in the exudate group, whereas the pleural fluid OSI value was significantly lower. Multivariate logistic regression analysis identified pleural OSI as independent predictors of exudative pleural fluid. CONCLUSIONS Pleural fluid TAS and OSI values may be useful biomarkers for differentiating exudative and transudative fluid and as an adjunct to Light's criteria in suspicious cases.
Aim: Chronic obstructive pulmonary disease (COPD) is a disease characterized by irreversible airw... more Aim: Chronic obstructive pulmonary disease (COPD) is a disease characterized by irreversible airway flow limitation and chronic airway inflammation. We aimed to investigate the clinical importance of serum prolidase enzyme, which is an indicator of collagen degradation, and Carbonic anhydrase (CA) III enzyme, which has an important function in acid-base regulation, in patients with COPD Material and Method: In this study, 56 stable COPD patients and 32 healthy subjects without smoking history and comorbidities were included. Serum CA III and prolidase enzyme levels were compared between the two groups. Results: The statistical difference was not found between the two groups in terms of prolidase enzyme levels (p=0.831). There was a statistically significant increase in CA III levels in the COPD group (p=0.001). There were moderate positively correlation between CAIII with partial pressure of carbon dioxide in blood (pCO2) and negatively correlation between CA III with partial pressure of oxygen in blood (pO2) in COPD patients (r:0.302, p<0.025; r:-0.314, p:0.02). Conclusions: We think that there is an important clinical relationship between CA III and COPD, and therefore, CA III may be a candidate biomarker in the follow-up of COPD.
Background: Pulmonary embolism is a thromboembolic disease with high rates of morbidity and morta... more Background: Pulmonary embolism is a thromboembolic disease with high rates of morbidity and mortality. Monocyte-to-HDLcholesterol ratio (MHR) can show the inflammatory status of patients. The objective of this study was to investigate the relationship of monocyte-to-HDL-cholesterol ratio, which is a new marker in predicting the prognosis of cardiovascular diseases, with prognosis and Pulmonary Embolism Severity Index (PESI) test in patients with pulmonary embolism. Methods: Patients followed-up with the diagnosis of pulmonary embolism in our hospital between January 2016 and December 2018 were included in this study. Patients’ demographic data such as age and gender, vital findings, hemogram outcomes at admission, lipid profiles, liver function tests, renal function tests, electrolyte values and cardiac markers were recorded and analyzed. Patients’ pulmonary embolism (PE) clinical classes were determined and PESI test values were calculated. The correlations between monocyteto-HDL-cholesterol ratio, PE severity and PESI test were analyzed. Results: A total of 50 patients followed up in our hospital due to PE were included in the study. Of all patients 8% (n=4) were diagnosed with massive, 32% (n=16) sub-massive and 60% (n=30) non-massive PE. There was a positive correlation between MHR and PE severity, and MHR and PESI index, although these correlations were not statistically significant (r=0.011, p=0.940; r=0.043, p=0.767). Of all patients included in this study, one patient (2%) died in the hospital and 49 patients (98%) were discharged with recovery. Conclusions: Although there were positive correlations between monocyte-to-HDL-cholesterol ratio, which is an inexpensive marker easily available in all centers, and the severity of acute pulmonary embolism and PESI test, these correlations were not statistically significant. Monocyte-to-HDLcholesterol ratio may not be related to PE, however, further longitudinal studies are needed to clarify this finding.
Objective: The distinction between COVID-19 and other respiratory infections can be difficult dur... more Objective: The distinction between COVID-19 and other respiratory infections can be difficult during the flu and winter seasons. The aim of this study is to detect bacterial/viral microorganisms in nasopharyngeal swab samples and to evaluate routine laboratory results of patients with PCR (-) but suspected covid 19. Methods: Between 1 July 2021 and 31 December 2021, 78 patients who were hospitalized and followed up in the suspected Covid service were included in the study. The patients were divided into two groups as those with and without growth on the respiratory panel. Laboratory, demographic and radiological data were compared between groups. Results: C-reactive protein (CRP) and ferritin levels were found to be statistically significantly higher in the group with growth on the respiratory panel compared to the group without growth (p= .05, p= .041, respectively). Reproduction was detected in nasopharyngeal swab samples taken in 56.4% of the patients. More than half of the patie...
Amaç: Bu çalışmanın amacı bilgisayarlı tomografi (BT) kılavuzluğunda transtorasik akciğer kesici ... more Amaç: Bu çalışmanın amacı bilgisayarlı tomografi (BT) kılavuzluğunda transtorasik akciğer kesici iğne biyopsilerinin tanısal etkinliğini ve komplikasyon oranlarını göstermektir.Materyal ve metod: Çalışmaya BT kılavuzluğunda transtorasik kesici iğne akciğer biyopsisi yapılan 50 hastanın 50 akciğer lezyonu dahil edildi. Hastaların 31̍ i erkek 19̍ u kadın ve yaş ortalaması 58,16 idi. Akciğer lezyonlarının yerleşimi, boyutu, morfolojik yapısı ve geçilen akciğer parankim uzunluğu, histopatolojik sonuçlar ve komplikasyon oranları elde edildi.Bulgular: Biyopsi sonucu 50 lezyonun 46 tanesinde tanısal sonuç elde edildi. Dört hastada alınan biyopsi materyali yetersiz bulundu. Tanısal sonuç elde edilen 46 lezyonun 30 ̍ unda malign bulgular, 16̍ sında benign bulgular elde edildi. İşlem sırasında ve sonrasında üç hastada pnömotoraks, dört hastada hemoraji ve üç hastada pnömotoraks ve hemoraji birlikte gelişti.Sonuç: BT kılavuzluğunda transtorasik kesici iğne akciğer biyopsisi güvenli ve akciğer ...
Aim: Chronic obstructive pulmonary disease (COPD) is a disease characterized by irreversible airw... more Aim: Chronic obstructive pulmonary disease (COPD) is a disease characterized by irreversible airway flow limitation and chronic airway inflammation. We aimed to investigate the clinical importance of serum prolidase enzyme, which is an indicator of collagen degradation, and Carbonic anhydrase (CA) III enzyme, which has an important function in acid-base regulation, in patients with COPD Methods : In this study, 56 stable COPD patients and 32 healthy subjects without smoking history and comorbidities were included. Serum CA III and prolidase enzyme levels were compared between the two groups. Results: The statistical difference was not found between the two groups in terms of prolidase enzyme levels (p=0.831). There was a statistically significant increase in CA III levels in the COPD group (p=0.001). There were moderate positively correlation between CAIII with partial pressure of carbon dioxide in blood (pCO2) and negatively correlation between CA III with partial pressure of oxyge...
Background Exposure to viral or bacterial pathogens increases the number of neutrophils with a re... more Background Exposure to viral or bacterial pathogens increases the number of neutrophils with a relative decrease in lymphocytes, leading to elevated neutrophil to lymphocyte ratio (NLR). This study aimed to investigate whether differences in NLR among real-time polymerase chain reaction (PCR)-positive and -negative patients presenting with a prediagnosis of COVID-19 pneumonia could be useful in the differential diagnosis. Methods The study included 174 patients admitted because of suspected COVID-19 infection between March and April 2020. Patients were divided into two groups: PCR-negative and PCR-positive. Hemogram, NLR, urea, creatinine, aspartate aminotransferase, alanine aminotransferase, bilirubin, ferritin, D-dimer, C-reactive protein, procalcitonin, troponin, and coagulation parameters were analyzed. Results On comparison of laboratory parameters between both groups at presentation, PCR-positive patients were significantly more likely to have leukopenia (p < 0.001), thrombocytopenia (p = 0.006), neutropenia (p < 0.001), lymphopenia (p = 0.001), and increased NLR (p = 0.003). Furthermore, PCR-positive patients showed significant elevations of ferritin (p = 0.012) and procalcitonin (p = 0.038) and significant lower potassium levels (p = 0.05). Conclusion COVID-19 pneumonia has become a major global health problem. Early diagnosis and treatment of these patients are crucial, as COVID-19 pneumonia shows a rapid progression in most cases. Thus, leukopenia, thrombocytopenia, elevated NLR, and elevated ferritin may be useful as supplementary diagnostic tests in these patients, which may allow early initiation of treatment and may contribute to preventing progression in patients with abnormal results.
Aim: Negative pressure pulmonary edema (NPPE) is a rare postoperative complication that arises du... more Aim: Negative pressure pulmonary edema (NPPE) is a rare postoperative complication that arises due to upper airway obstruction and appears within an hour of extubation. Case: The patient was a 19 years-old male with no chronic diseases or complaints in his preoperative assessment. Forty-five minutes after extubation, the patient reported dyspnea, hemoptysis, chest pain and oxygen saturation was 60%. Computer Tomography (CT) scans revealed bilateral infiltration and consolidation, more prominent in the central and apical regions. His bedside echocardiogram was normal. NPPE was considered in the diagnosis; oxygen support, intravenous furosemide, nebulized salbutamol and budosenide were administered in addition to noninvasive mechanical ventilation. Two hours later, the symptoms abated. His repeat X-ray taken after 12 hours showed reduction in lung infiltrates and patient was discharged after five days. Conclusion: Abrupt decrease in oxygen saturation after extubation, dyspnea, chest pain and hemoptysis point to negative pressure pulmonary edema; the patient must immediately be moved to the intensive care unit and promptly treated.
The course of COVID-19 infection due to SARS-CoV-2 is manifested by viral replication in the uppe... more The course of COVID-19 infection due to SARS-CoV-2 is manifested by viral replication in the upper respiratory tract with or without lung involvement and extrapulmonary systemic hyperinflammation syndrome. Because it has a wide clinical spectrum ranging from asymptomatic cases to multiorgan failure, early identification of prognostic biomarkers is crucial to distinguish patients at risk of developing more serious disease. Our aim is to investigate the relationship between the C-reactive protein to albumin ratio (CAR), a biomarker which has both prognostic and diagnostic importance, and COVID-19 infection.
Aim: The main objective of this study is to determine the profile of emergency consultations requ... more Aim: The main objective of this study is to determine the profile of emergency consultations requested from department of chest diseases in Turkey. Method: Total of 57 centers (PUPCEST Study Group) in Turkey were included in the study in a 3 months period from December 2017 to February 2018. We composed the preliminary report using the data analyzed from 25 centers during the first two months period. Results: 44% of 581 patients were female and 64% of the admissions were self applications. 85% of the patients had had previously diagnosed comorbidity. 34.7% of the complaints were dispnea. The most common radiological finding was consolidation (13%) on chest x-ray.63% of the cases were consulted with the need for hospitalization and 39% of the patients were presenting the flare ups of underlying pulmonary pathology. The most common diagnoses were COPD (19%) and pneumonia (12%). 11.7% of the patients were medically treated which was ordered by the chest disease physician. 35% of the patients were discharged home following initial assessment while 35% were hospitalized in ward. Consultations were considered as necessary and properly timed by the 69% of the chest diseases physicians. Invasive interventions and hospitalization in intensive care unit were infrequent. Conclusions: Majority of the patients were conservatively treated in emergency department and hospitalizations were predominantly on ward. It can be concluded that many of the admissions could be evaluated in daytime outpatient clinics which may lead to the decrease on emergency department admissions. Reorganization of outpatient clinics and arrangements on follow up visits may decrease the rate of emergency admissions
AMAÇ:Sigara, önlenebilir ölüm ve hastalıkların en sık nedenidir. Ülkemiz, Avrupa bölgesinde sigar... more AMAÇ:Sigara, önlenebilir ölüm ve hastalıkların en sık nedenidir. Ülkemiz, Avrupa bölgesinde sigara içme oranı yüksek ülkelerden biridir. Toplumsalbilinçlenme, eğitim ve sosyal durumlar nedeniyle sigara kullananların,sigara bırakma polikliniklerine başvuruları arttırmaktadır. Bu çalışmada, hem sigara polikliniğimizdeki sigara bırakma durumunu hem de sigara bırakma için 12 haftalık standart bir vareniklin rejimini ve 10 haftalık standart bir transdermal nikotin replasman tedavisi (NRT) rejiminin bırakma üzerindeki etkisini tartışmayı amaçladık. MATERYAL METOD: Bu çalışmaya Ocak 2015 ve Ocak 2018 yılları arasında sigara bırakma polikliniğine başvuran, sigara bırakma tedavisi başlanmış 845 hasta retrospektifolarak incelendi. BULGULAR: Çalışmaya dahil edilen hastalarda yaş ve cinsiyet açısından istatiksel olarak anlamlı sonuç elde edilmedi (p=0.622, p=0.241). Sigara bırakan gruptaFNBS 6.12±0.9 iken, sigara bırakmayan grupta 8.45±1.1 idi ve gruplar arasında istatiksel olarak anlamlı farkl...
AIM The course of infection due to SARS-CoV-2 is manifested by viral replication in the upper res... more AIM The course of infection due to SARS-CoV-2 is manifested by viral replication in the upper respiratory tract with or without lung involvement and extrapulmonary systemic hyperinflammation syndrome. Because it has a wide clinical spectrum ranging from asymptomatic cases to multiorgan failure, early identification of prognostic biomarkers is crucial to distinguish patients at risk of developing more serious disease. Our aim is to investigate the relationship between the biomarker CAR, which has both prognostic and diagnostic importance, and Covid 19 infection. MATERİALS AND METHODS Between 1 June 2021 and 1 September 2021, 215 patients who were followed up in the pandemic service and intensive care unit for Covid 19 pneumonia were retrospectively analyzed. The demographic and routine laboratory data of the patients and the parameters accepted as new inflammatory biomarkers such as NLR, PLR, LMR and CAR were compared between the service-intensive care unit and exitus-discharged grou...
Obstrüktif uyku apne sendromu (OUAS) uyku esnasında hipofarenks bölgesinde tam veya kısmi daralma... more Obstrüktif uyku apne sendromu (OUAS) uyku esnasında hipofarenks bölgesinde tam veya kısmi daralmasıyla ve oksijen saturasyonundaki (SO2) düşme sonrasında solunum çabası ve intratorasik basıncın negatifleşmesi ile karakterize bir sendromdur. Horlama, gündüz aşırı uykululuk hali ve tanıklı apne OUAS'da en çok gözlenen semptomlardır. Polisomnografi (PSG), OUAS tanısı için kullanılan altın standart bir yöntemdir. Bir yıl boyunca uyku laboratuvarında takip edilen hastalarımızı değerlendirmeyi amaçladık. Araçlar ve Yöntem: Çalışmamıza 1 Ocak 2018-1 Ocak 2019 zaman aralığında uyku laboratuvarımızda yatan 111 hasta dahil edildi. Hastalar 4 gruba ayrılarak demografik ve klinik bulguları karşılaştırıldı. Bulgular: Hastaların yaş ortalaması 46.55±11.18 yıl idi. Hipertansiyon (HT) görülme sıklığı açısından ağır OUAS grubunda, diğer gruplara kıyasla anlamlı farklılık mevcuttu (p=0.025). Vücut kitle indeksi (VKİ) ağır OUAS grubunda, diğer gruplara göre istatiksel olarak daha yüksek bulundu (p<0.001). Ayrıca ağır OUAS grubundaki hastalarda hem rapid eye movement (REM) uyku süresi hemde SO2 düzeyi diğer gruptaki hastalara göre istatiksel olarak anlamlı düşük saptandı (p=0.034, p<0.001). Sonuç: Hastalarımızın çoğu, VKİ >30kg/m2 olan olgularda ağır OUAS olarak saptanmıştır. Uyku laboratuvarları ve polisomnografi, bu hastalığın tanısında önemli rol oynamaktadır. Özellikle Obezite ve HT tanılı olguların OUAS açısından sorgulanması gerekmektedir.
Uploads
Papers by iclal hocanlı