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Günay S, Parlak IS, Hezer H, Şeref Parlak EŞ, Umut MS, Hancıoğlu Z, Çelenk Ergüden H, Kocaman Y, Dalkıran A, Sertçelik Ü, Şerifoğlu İ, Akpınar E, Göktaş MF, Fidan M, Babahanoğlu B, Cander FS, Çıvgın E, Er M, Kılıç H, Argüder E, Tuğ T, Ünsal E, Hasanoğlu C, Günay İ, Babayiğit M, Ağca B, Karalezli A. Risk factors for the development of interstitial lung disease following severe COVID-19 pneumonia and outcomes of systemic corticosteroid therapy: 3-month follow-up. Sarcoidosis Vasc Diffuse Lung Dis 2023; 40:e2023029. [PMID: 37712369 PMCID: PMC10540725 DOI: 10.36141/svdld.v40i3.14418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/01/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND We aimed to evaluate the pulmonary involvement status, its related factors, and pulmonary function test (PFT) results in the first month follow-up in patients who were discharged for severe Covid-19 pneumonia, and to assess the efficacy of corticosteroid treatment on these parameters in severe pulmonary involvement patients. METHODS We retrospectively analyzed all consecutive patients who applied to our COVID-19 follow-up clinic at the end of the first month of hospital discharge. Functional and radiological differences were compared after 3 months of corticosteroid treatment in severe pulmonary involvement group. Results We analyzed 391 patients with "pulmonary parenchymal involvement" (PPIG) and 162 patients with "normal lung radiology" (NLRG). 122 patients in the PPIG (corticosteroid-required interstitial lung disease group (CRILD)) had severe pulmonary involvement with frequent symptoms and required corticosteroid prescription. Pulmonary involvement was more common in males and elder patients (P<0.001, for both). Being smoker and elderly were associated with a higher risk-ratio in predicting to be in PPIG (OR:2.250 and OR:1.057, respectively). Smokers, male and elderly patients, and HFNO2 support during hospitalization were risk factors for being a patient with CRILD (OR:2.737, OR:4.937, OR:4.756, and OR:2.872, respectively). After a three-months of methylprednisolone medication, a good response was achieved on radiological findings and PFT results in CRILD. CONCLUSIONS In conclusion, after severe COVID-19 pneumonia, persistent clinical symptoms and pulmonary parenchymal involvement would be inevitable in elder and smoker patients. Moreover, corticosteroid treatment in patients with severe parenchymal involvement was found to be effective in the improvement of radiological and functional parameters.
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Affiliation(s)
- Sibel Günay
- Department of Pulmonary Diseases, Ankara Bilkent City Hospital, Ankara, Turkiye .
| | | | - Habibe Hezer
- Department of Pulmonary Diseases, Ankara Bilkent City Hospital, Ankara, Turkiye .
| | | | - Melike Sanem Umut
- Department of Pulmonary Diseases, Ankara Bilkent City Hospital, Ankara, Turkiye .
| | - Zeynep Hancıoğlu
- Department of Pulmonary Diseases, Ankara Bilkent City Hospital, Ankara, Turkiye .
| | - Hülya Çelenk Ergüden
- Department of Pulmonary Diseases, Ankara Bilkent City Hospital, Ankara, Turkiye .
| | - Yasin Kocaman
- Department of Pulmonary Diseases, Ankara Bilkent City Hospital, Ankara, Turkiye .
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Çıvgın E, Parlak İS, Güneş YC, Bahadır GK, Karalezli A. Computed tomography findings in COVID-19 and atypical pneumonia: a comparative study. J Infect Dev Ctries 2023; 17:1063-1069. [PMID: 37699091 DOI: 10.3855/jidc.16698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 03/09/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION Computed tomography (CT) has an important role in the rapid diagnosis, treatment, and management of lower respiratory tract infections. This study aimed to explore different imaging characteristics between Coronavirus disease 2019 (COVID-19) and atypical pneumonia (non-COVID-19) on chest CT of patients admitted to the emergency department. METHODOLOGY CT features of 120 patients with positive Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcriptase-polymerase chain reaction (RT-PCR) and 83 patients with negative SARS-CoV-2 by RT-PCR but positive respiratory tract sample test results for other respiratory pathogens were retrospectively evaluated, findings were recorded and compared between the two groups. RESULTS Compared to non-COVID-19, COVID-19 patients were more likely to have a peripheral (60.5% vs. 23.8%, p < 0.001) and bilateral distribution (72.3% vs. 41.3%, p < 0.001), patchy consolidations (45% vs. 28.9%, p = 0.021), ground glass opacity (GGO) (94.2% vs. 83.1%, p = 0.011), crazy paving patterns (55% vs. 31.3%, p < 0.001); but less likely to have centrilobular nodules (15% vs. 62.7%, p < 0.001), pleural effusion (3.3% vs. 10.8%, p = 0.032), multifocal consolidations (7.5% vs. 21.7%, p = 0.003), and random distribution (1.7% vs. 46.3%, p < 0.001). CONCLUSIONS There were significant differences between the CT patterns of patients with COVID-19 and other atypical pneumonia. The presence of patchy consolidations, GGO, crazy paving patterns with typical peripheral, bilateral distribution, and absence of centrilobular nodules, pleural effusion, and multifocal consolidations may help to differentiate COVID-19 from atypical pneumonia.
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Affiliation(s)
- Esra Çıvgın
- Department of Radiology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - İzzet Selçuk Parlak
- Department of Radiology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Yasin Celal Güneş
- Department of Radiology, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Gülsüm Kübra Bahadır
- Department of Radiology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ayşegül Karalezli
- Department of Pulmoner Medicine, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
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Argüder E, Fidan M, Tekdemir H, Mendi BAR, Fidan A, Cankar Dal H, Özden Sertçelik Ü, Şerifoğlu İ, Günay S, Kazancı D, Turan S, Kılıç H, Hasanoğlu HC, Karalezli A. Comparison of clinical and radiological characteristics of COVID-19 patients with and without pneumothorax and/or pneumediastinum. Tuberk Toraks 2022; 70:279-286. [DOI: 10.5578/tt.20229707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Sül S, Kaderli A, Karalezli A, Kaya C. Comparison of decentration, tilt and lenticular astigmatism of ıntraocular lens between sutured and sutureless scleral fixation techniques. J Fr Ophtalmol 2021; 44:1174-1179. [PMID: 34226085 DOI: 10.1016/j.jfo.2020.12.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate at six months the intraocular lens (IOL) decentration, tilt and lenticular astigmatism between foldable sutured and sutureless scleral fixation IOLs compared to conventional phacoemulsification surgery. METHODS We retrospectively reviewed records for 22 eyes with sutureless scleral fixation, 16 eyes with sutured scleral fixation and 23 eyes with conventional phacoemulsification. IOL decentration and angle of IOL tilt were compared on Scheimpflug images 6 months after surgery. Lenticular astigmatism is described as the difference between refractive and net corneal astigmatism. RESULTS The angle of tilt in both meridians was significantly lower in the sutureless group than in the sutured group (P=0.008 horizontally and P=0.002 vertically). IOL decentration did not show a significant difference between the three groups in either horizontal or vertical meridians (P˃0.05). Lenticular astigmatism was significantly lower in the sutureless and control groups than in the sutured group (P=0.003 and P<0.001). CONCLUSION In addition to being relatively quick and easy to perform, the sutureless scleral fixation technique showed superior results in terms of IOL tilt and lenticular astigmatism at the six-month follow-up compared to the sutured technique.
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Affiliation(s)
- S Sül
- Mugla Sitki Kocman University, Ophthalmology Department, Kötekli, Mugla, Turkey
| | - A Kaderli
- Mugla Sitki Kocman University, Ophthalmology Department, Kötekli, Mugla, Turkey.
| | - A Karalezli
- Mugla Sitki Kocman University, Ophthalmology Department, Kötekli, Mugla, Turkey
| | - C Kaya
- Mugla Sitki Kocman University, Ophthalmology Department, Kötekli, Mugla, Turkey
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Okumuş N, Demirtürk N, Çetinkaya RA, Güner R, Avcı İY, Orhan S, Konya P, Şaylan B, Karalezli A, Yamanel L, Kayaaslan B, Yılmaz G, Savaşçı Ü, Eser F, Taşkın G. Evaluation of the effectiveness and safety of adding ivermectin to treatment in severe COVID-19 patients. BMC Infect Dis 2021; 21:411. [PMID: 33947344 DOI: 10.21203/rs.3.rs-224203/v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/15/2021] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES An effective treatment option is not yet available for SARS-CoV2, which causes the COVID-19 pandemic and whose effects are felt more and more every day. Ivermectin is among the drugs whose effectiveness in treatment has been investigated. In this study; it was aimed to investigate the presence of gene mutations that alter ivermectin metabolism and cause toxic effects in patients with severe COVID-19 pneumonia, and to evaluate the effectiveness and safety of ivermectin use in the treatment of patients without mutation. MATERIALS AND METHODS Patients with severe COVID19 pneumonia were included in the study, which was planned as a prospective, randomized, controlled, single-blind phase 3 study. Two groups, the study group and the control group, took part in the study. Ivermectin 200 mcg/kg/day for 5 days in the form of a solution prepared for enteral use added to the reference treatment protocol -hydroxychloroquine + favipiravir + azithromycin- of patients included in the study group. Patients in the control group were given only reference treatment with 3 other drugs without ivermectin. The presence of mutations was investigated by performing sequence analysis in the mdr1/abcab1 gene with the Sanger method in patients included in the study group according to randomization. Patients with mutations were excluded from the study and ivermectin treatment was not continued. Patients were followed for 5 days after treatment. At the end of the treatment and follow-up period, clinical response and changes in laboratory parameters were evaluated. RESULTS A total of 66 patients, 36 in the study group and 30 in the control group were included in the study. Mutations affecting ivermectin metabolism was detected in genetic tests of six (16.7%) patients in the study group and they were excluded from the study. At the end of the 5-day follow-up period, the rate of clinical improvement was 73.3% (22/30) in the study group and was 53.3% (16/30) in the control group (p = 0.10). At the end of the study, mortality developed in 6 patients (20%) in the study group and in 9 (30%) patients in the control group (p = 0.37). At the end of the follow-up period, the average peripheral capillary oxygen saturation (SpO2) values of the study and control groups were found to be 93.5 and 93.0%, respectively. Partial pressure of oxygen (PaO2)/FiO2 ratios were determined as 236.3 ± 85.7 and 220.8 ± 127.3 in the study and control groups, respectively. While the blood lymphocyte count was higher in the study group compared to the control group (1698 ± 1438 and 1256 ± 710, respectively) at the end of the follow-up period (p = 0.24); reduction in serum C-reactive protein (CRP), ferritin and D-dimer levels was more pronounced in the study group (p = 0.02, p = 0.005 and p = 0.03, respectively). CONCLUSIONS According to the findings obtained, ivermectin can provide an increase in clinical recovery, improvement in prognostic laboratory parameters and a decrease in mortality rates even when used in patients with severe COVID-19. Consequently, ivermectin should be considered as an alternative drug that can be used in the treatment of COVID-19 disease or as an additional option to existing protocols.
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Affiliation(s)
- Nurullah Okumuş
- Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - Neşe Demirtürk
- Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Rıza Aytaç Çetinkaya
- Haydarpasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Rahmet Güner
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - İsmail Yaşar Avcı
- Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Semiha Orhan
- Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Petek Konya
- Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Bengü Şaylan
- Haydarpasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Ayşegül Karalezli
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Levent Yamanel
- Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Bircan Kayaaslan
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Gülden Yılmaz
- Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Ümit Savaşçı
- Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Fatma Eser
- Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Gürhan Taşkın
- Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
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Abstract
Behcet's disease is a chronic inflammatory multi-systemic vasculitis. Recurrent oral and genital aphthous ulcers, uveitis, arthritis, arterial aneurysms, venous thrombosis, gastrointestinal system lesions and skin lesions can be seen. Large, medium or small arteries and veins may be involved. While venous lesions cause occlusion, arterial lesions can cause both occlusion and aneurysm. Major forms of pulmonary involvement include pulmonary artery aneurysm, arterial and venous thrombosis, pulmonary infarction, recurrent pneumonia, and pleurisy. In Behcet's disease, pulmonary thromboembolism (PE) is often associated with endothelial damage. Neutrophils play an important role in the pathogenesis of thrombosis. Coagulation components such as fibrinogen, thrombin, factor Xa and factor VIIa activate the inflammatory cascade and induce vascular events. It is important to understand the pathogenesis of vascular events in determining the effective treatment strategy. Here we present a patient with Behcet's disease who was presented with pulmonary embolism and was investigated for the etiology of thrombosis.
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Affiliation(s)
- Seray Abuzaina
- Department of Chest Diseases, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Sevil Pempeci
- Department of Chest Diseases, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Emine Argüder
- Department of Chest Diseases, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Ayşegül Karalezli
- Department of Chest Diseases, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - H Canan Hasanoğlu
- Department of Chest Diseases, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
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Arguder E, Abuzaina O, Karalezli A. Nitrofurantoin-related interstitial lung disease: Case report and literature review. Eurasian J Pulmonol 2021. [DOI: 10.4103/ejop.ejop_7_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Argüder E, Yanık Üstüner G, Ekici R, Kılıç H, Erten Ş, Karalezli A. Tuberculosis risk in patients with rheumatologic disease treated with biologic drugs. Tuberk Toraks 2020; 68:236-244. [PMID: 33295721 DOI: 10.5578/tt.69967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction The risk of tuberculosis is higher in cases who have used antiTNF treatments. However, it is not clearly known whether there is a relationship between other biologic agents and the risk of developing tuberculosis or not. We aimed to investigate the prevalence of active tuberculosis among patients with rheumatic disease treated with biologic drugs. Materials and Methods The study was performed at a tertiary referral center from January 2015 to December 2019. A total of 2000 patients with rheumatic diseases were screened and 461 patients were enrolled in the study due to regular records. They were underwent LTBI screening tests and were followedup at least 1 year after TNF inhibitor treatment initiation. Result The median age of all patients was 48 (min-max: 19-80). 283 patients (61.3%) were female and 178 (38.7%) were male. The most common diseases were ankylosing spondylitis (67.2%), rheumatoid arthritis (26%) and psoriatic arthritis (5.2%). Anti-TNF treatments were given to 85.2% of all cases and other biologic treatments were given to 14.8%. Tuberculin skin test was applied to 429 patients and 70.4% positivity was found. Quantiferon-TB test was applied to 93 patients and 20.4% positivity was found. 320 patients were treated for LTBI due to positive tuberculin skin test and/or positive quantiferon-TB test. TB was developed in only one patient out of 393 patients who were treated with anti-TNF treatments and the the prevalence of TB development was found 255/100.000. Conclusions The incidence of tuberculosis was quite low in our patients with rheumatic disease who were receiving anti-TNF treatment compared to previous studies. Also, in patients who were using other biological treatments, no TB cases were developed.
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Affiliation(s)
- Emine Argüder
- Department of Chest Diseases, Faculty of Medicine Yildirim Beyazit University, Ankara, Turkey
| | | | - Remzi Ekici
- Clinic of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | - Hatice Kılıç
- Department of Chest Diseases, Faculty of Medicine Yildirim Beyazit University, Ankara, Turkey
| | - Şükran Erten
- Department of Rheumatology, Faculty of Medicine Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Ayşegül Karalezli
- Department of Chest Diseases, Faculty of Medicine Yildirim Beyazit University, Ankara, Turkey
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Kilic H, Argüder E, Çağlar A, Uğurlu M, Hasanoğlu HC, Karalezli A. Follow-Up of Patients Who Underwent A Psychiatric Consultation at The Smoking Cessation Polyclinic. Ankara Med J 2020. [DOI: 10.5505/amj.2020.37974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Argüder E, Kılıç H, Civak M, Kacar D, Kaya G, Yılmaz A, Kayaaslan B, Karakaş Uğurlu G, Ateş İ, Güner R, Karalezli A. Anxiety and Depression Levels in Hospitalized Patients due to Covid-19 Infection. Ankara Med J 2020. [DOI: 10.5505/amj.2020.80775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Hezer H, Karalezli A. The Effect of Psychological Dependence on Smoking Urge and Nicotine Withdrawal Symptoms. Ankara Medical Journal 2019. [DOI: 10.17098/amj.651955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Hezer H, Kiliç H, Abuzaina O, Hasanoǧlu HC, Karalezli A. Long-term results of low-dose tissue plasminogen activator therapy in acute pulmonary embolism. J Investig Med 2019; 67:1142-1147. [DOI: 10.1136/jim-2019-001042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2019] [Indexed: 01/20/2023]
Abstract
Recombinant tissue plasminogen activator (rt-PA) is the most commonly used thrombolytic agent in patients with high risk and intermediate to high mortality risk acute pulmonary embolism (PE). Clinical trials have shown early efficacy and safety of low-dose rt-PA. This study investigated the effects of low-dose rt-PA treatment on acute PE in long-term prognosis, recurrence of pulmonary thromboembolism, or the development of late complications. In this study, 48 patients undergoing low-dose rt-PA for the relative contraindications of thrombolytic therapy and 48 patients undergoing standard-dose therapy were evaluated retrospectively. Long-term follow-up investigated the chronic PE, recurrence, and causes of morbidity and mortality.In both treatment groups, embolism-induced mortality and overall mortality rates were similar in the first 30 days (p=1.000, p=0.714, respectively). Overall mortality rates in long-term follow-up were 41.7% in the low-dose treatment group and 16.7% in the standard-dose treatment group (p=0.013). The mortality rate at the first year was higher in the low-dose-treated group (p=0.011) and most of the deaths were due to accompanying comorbidities. There was no difference in PE recurrence and duration of recurrence between the groups (p=0.598, p=0.073, respectively). Intracranial hemorrhage due to therapy developed in one patient in both groups.Low-dose thrombolytic therapy in acute PE reduces PE-related mortality in the early period. Long-term follow-up showed that thrombolytic therapy did not affect mortality rates independently of the dose and PE recurrence.
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Hasanoğlu C, Argüder E, Kılıç H, Parlak ES, Karalezli A. Atrial fibrillation, an obscured cause of pulmonary embolism can be revealed by adding to Wells criteria. J Investig Med 2019; 67:1042-1047. [PMID: 31064774 DOI: 10.1136/jim-2018-000914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2019] [Indexed: 11/03/2022]
Abstract
Among the various clinical scoring methods used for the prediagnosis of pulmonary embolism (PE), Wells criteria is the most common. It relies on the findings and story of deep venous thrombosis (DVT), PE and malignancy. It is known that atrial fibrillation (AF) is a risk factor for PE like as DVT or malignancy. We aimed to evaluate the possibility of diagnosing more patients with PE by including AF in the Wells criteria. This prospective study included 250 patients admitted to the emergency department with PE findings. Wells scoring and Wells scoring with AF were performed for each patient. Out of 250 patients, 165 patients were diagnosed as PE. Wells score was >4 in 61.8% of patients with PE and 28.2% of patients without PE. Out of false negative 63 patients with PE, 21 of them had AF. According to Wells scoring with AF the score of 148 (89.7%) patients with PE diagnosis was ≥3, whereas the score of 45 (52.9%) patients without PE was ≥3. AF was detected in 15.8% of patients with PE. The sensitivity of Wells score with AF was significantly higher than that of the Wells score (p<0.001). As a result, when AF, which is one of an important PE cause such as DVT and malignancy, was added to the Wells criteria, an additional correct PE estimate was obtained in 46 patients. We recommend using Wells score with AF since prediagnosing more PE is more valuable than having some false negative PE predictions.
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Affiliation(s)
- Canan Hasanoğlu
- Chest Diseases, Yildirim Beyazit Universitesi Tip Fakultesi, Ankara, Turkey
| | - Emine Argüder
- Chest Diseases, Yildirim Beyazit Universitesi Tip Fakultesi, Ankara, Turkey
| | - Hatice Kılıç
- Chest Diseases, Yildirim Beyazit Universitesi Tip Fakultesi, Ankara, Turkey
| | - Ebru Sengul Parlak
- Chest Diseases, Ankara Ataturk Egitim ve Arastirma Hastanesi, Ankara, Turkey
| | - Ayşegül Karalezli
- Chest Diseases, Yildirim Beyazit Universitesi Tip Fakultesi, Ankara, Turkey
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Argüder E, Parlak E, Hezer H, Karalezli A, Hasanoğlu HC. Repeated Thrombolytic Treatment for Recurrent Pulmonary Thromboembolism: A Report of 2 Cases and a Literature Review. Turk Thorac J 2019; 20:61-65. [PMID: 30664427 DOI: 10.5152/turkthoracj.2018.18020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/03/2018] [Indexed: 11/22/2022]
Abstract
We present 2 cases of pulmonary thromboembolism (PTE). The first case, a 50-year-old man, was admitted to the emergency department because of sudden onset dyspnea and left side chest pain. He was diagnosed with intermediate-risk (submassive) PTE, and thrombolytic treatment was commenced. The patient fully recovered, but 5 days later, he was diagnosed with a new, high-risk PTE. The second patient, a 23-year-old woman, presented with syncope, dyspnea, and chest pain for 2 days. She was diagnosed with high-risk (massive) PTE. Thrombolytic treatment was commenced, and the patient fully recovered, too. But the later patient was also diagnosed with a new PTE 4 days later. We applied repeated thrombolytic treatment in the patients due to repeated PTE. The first patient fully recovered and was discharged from the hospital, but the second patient died because of gastrointestinal bleeding and renal insufficiency. A repeated thrombolytic treatment could be an alternative treatment for these patients, considering treatment's risks.
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Affiliation(s)
- Emine Argüder
- Department of Chest Diseases, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - Ebru Parlak
- Clinic of Chest Diseases, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Habibe Hezer
- Clinic of Chest Diseases, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Ayşegül Karalezli
- Department of Chest Diseases, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - H Canan Hasanoğlu
- Department of Chest Diseases, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
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Babaoğlu E, Karalezli A, Er M, Hasanoğlu HC, Öztuna D. Exhaled carbon monoxide is a marker of heavy nicotine dependence. Turk J Med Sci 2016; 46:1677-1681. [PMID: 28081308 DOI: 10.3906/sag-1601-140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 04/02/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM Exhaled CO level provides an objective measure of a patient's smoking status. The relationship between CO levels and nicotine dependence is controversial. The aim of this study is to evaluate the relationship between exhaled CO levels and nicotine dependence as well as to demonstrate that exhaled CO levels may be used as a marker of nicotine dependence. MATERIALS AND METHODS Two hundred eighty-nine patients (132 females, 157 males) were included in the study. Smoking duration, the age of smoking initiation, exhaled CO levels, and Fagerström Test for Nicotine Dependence (FTND) scores were recorded. The relationship between FTND scores and exhaled CO levels was investigated. RESULTS There was a statistically significant correlation between FTND score and exhaled CO levels (P < 0.001). We found that a cut-off score of 7.5 ppm for exhaled CO may be useful as a marker for heavy smoking. The sensitivity and specificity of this cut-off score for exhaled CO was 69.3% and 49.3%, respectively (P < 0.001). CONCLUSION We found that exhaled CO levels significantly correlated with FTND scores. For patients who are unable to provide reliable answers to questions in the FTND, exhaled CO measurements may be used as an alternative test for estimating the status of heavy smoking.
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Affiliation(s)
- Elif Babaoğlu
- Department of Chest Diseases, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Ayşegül Karalezli
- Department of Chest Diseases, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Mükremin Er
- Department of Chest Diseases, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Hatice Canan Hasanoğlu
- Department of Chest Diseases, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Derya Öztuna
- Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, Turkey
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16
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Babaoglu E, Kilic H, Hezer H, Dag O, Parlak E, Senturk A, Karalezli A, Alisik M, Erel O, Hasanoglu HC. Comparison of thiol/disulphide homeostasis parameters in patients with COPD, asthma and ACOS. Eur Rev Med Pharmacol Sci 2016; 20:1537-1543. [PMID: 27160126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Chronic obstructive pulmonary disease (COPD), asthma and asthma-COPD overlap syndrome (ACOS) are obstructive pulmonary disorders with different manifestations. Status of oxidation in tissues is important in obstructive pulmonary disorders. Smoking, acute exacerbations of COPD and asthma were associated with a marked imbalance in oxidant or antioxidant status due to increased oxidative stress in tissues and blood. Oxidative conditions may cause a reversible formation of mixed disulphides among protein thiol groups. The aim of this study was to compare parameters related with thiol/disulphide homeostasis in patients with COPD, asthma and ACOS. PATIENTS AND METHODS Patients (n= 135, 69 females, 66 males) who were referred with a diagnosis of COPD, asthma or ACOS were included in the study. Thiol/ disulphide homeostasis parameters in blood were analysed by a newly established method that measures the exact thiol/ disulphide status in the body. RESULTS The patients with COPD, asthma or ACOS were similar for demographic parameters other than age and number of cigarettes smoked. Measured thiol/disulphide homeostasis parameters were similar among these patient groups. When these biochemical measurements were adjusted for age and number of cigarettes by using regression analysis, similarity for thiol/disulphide homeostasis parameters among patient groups persisted. CONCLUSIONS To best of our knowledge, this is the first study to compare thiol/disulphide homeostasis parameters in COPD, asthma and ACOS patients. Similarity of thiol/disulphide homeostasis parameters among these patient groups supports the current view of Dutch hypothesis that COPD, asthma and ACOS share similar pathophysiological features but display different clinical manifestations.
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Affiliation(s)
- E Babaoglu
- Department of Chest Diseases, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
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17
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Canan Hasanoğlu H, Hezer H, Karalezli A, Argüder E, Kiliç H, Şentürk A, Er M, Soytürk AN. Half-Dose Recombinant Tissue Plasminogen Activator Treatment in Venous Thromboembolism. J Investig Med 2015; 62:71-7. [DOI: 10.2310/jim.0000000000000014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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18
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Şentürk A, Maraş Y, Argüder E, Karalezli A, Hasanoğlu HC, Öğüt T, Baştuğ S, Karabekir E. What type of different clinical manifestations can cardiac sarcoidosis present? Rheumatol Int 2014; 35:1103-6. [PMID: 25429793 DOI: 10.1007/s00296-014-3183-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 11/18/2014] [Indexed: 11/25/2022]
Abstract
Cardiac sarcoidosis is an infiltrative, granulomatous inflammatory disease of the myocardium. Generally, it can be difficult to diagnose cardiac sarcoidosis clinically because of the non-specific nature of its clinical manifestations. This property can be based on the presence of any clinical evidence of sarcoidosis in the other organs. We present two cases of cardiac sarcoidosis so as to demonstrate its different clinical manifestations. The first patient displayed no cardiac symptoms; the electrocardiogram showed an incidental right bundle branch block. Her cardiac magnetic resonance imaging (CMRI) revealed late-phase opaque material enhancement involving the inferior and inferoseptal segment of the left ventricle. The second patient was severely symptomatic in terms of cardiac involvement, and a transthoracic echocardiogram revealed global hypokinesia and septal brightness; his ejection fraction decreased to 45%. These cases highlighted the challenges encountered in the diagnosis and treatment of cardiac sarcoidosis. CMRI should be considered in all patients who have suspected findings for cardiac involvement.
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Affiliation(s)
- Ayşegül Şentürk
- Department of Chest Disease, Atatürk Training and Research Hospital, Ankara, Turkey
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19
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Sentürk A, Hezer H, Karalezli A, Argüder E, Kılıç H, Hazanoğlu HC. [Importance of polymerase chain reaction in patients with histopathological diagnosis of granulomatous disease by EBUS-TBNA: a preliminary report]. Tuberk Toraks 2013; 60:355-64. [PMID: 23289466 DOI: 10.5578/tt.4116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Transbronchial needle aspiration (TBNA) by the guide of endobronchial ultrasonography (EBUS) is a diagnostic method which may be used in diagnosing benign granulomatous diseases in contemporary practice. In this study, we planned to evaluate the diagnostic value of TBNA by the guide of EBUS for benign granulamatous diseases and to investigate the impact of cytological, microbiologic and tuberculosis (TB)-polimerase chain reaction (PCR) results in specimens. MATERIALS AND METHODS Thirty-four patients (20 female, 14 male) who had EBUS-TBNA and histopathological diagnosis of granülamatous inflammatory reaction were included in the study. The mean age of patients was 49.62 ± 12.72 years (26-72). The specimens provided by EBUS-TBNA were evaluated for pathologic, microbiologic, and molecular (TB-PCR) examinations. RESULTS As a result of clinical, radiological and laboratory studies of the patients with granulomatous inflammation, 13 (38.2%) patients had TB, 21 (61.7%) patients had sarcoidosis. Diagnoses of histopathological granuloma were established by EBUS-TBNA in 30 (88.2%) patients among patients with isolated mediastinal lymphadenopathies. Seven of mediastinal TB lymphadenopathies patients were TB-PCR positive. The sensitivity of PCR was 54% and the specificity was 100%, general efficiency of the test was found to be 82%. CONCLUSION In cases with granulomatosis lymphadenopathies, TB-PCR specimens which achieved by EBUS-TBNA results provided important contribution for the TB diagnosis. Therefore, we thought that TB-PCR is a diagnostic method to be studied in the cases who investigating for mediastinal lymphadenopathies.
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Affiliation(s)
- Ayşegül Sentürk
- Clinic of Chest Diseases, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
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20
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Abstract
INTRODUCTION Cigarette smoking is just important problem of public health. In the present study, our aim; was to determine to factors that increasing tendency to smoking cessation, the cases who are involved to policlinic of smoking cessation. MATERIALS AND METHODS Two hundred-forty five cigarette smokers were included in this study. It was recorded demographic signs, the novel of cigarette smoking, the degree of knowledge about the harmful of smoking in their opinion, the reason of starting to cigarette. It was evaluated that the principle reason to come to policlinic of smoking cessation and the other reasons. RESULTS There were 53.9% male, 46.1% female in our study. Median (min-max) age was 45 (21-73) in females, 42 (20-75) in males. When evaluating the state of education; there was 35.9% primary school, 31.4% high school, 7.3% academy, 25.3% university graduates. 97.1% in all participants have used only cigarette smoking from tobacco products. Primarily reasons were 44% the fear of deterioration of health, 16.3% to be better model for their children, 9.8% to have disease at the time and 6.9% breathlessness for smoking cessation. Secondary reasons were of smoking harm to the environment, economic reasons, bad smell, being a good example of the environment and recommended by a physician. CONCLUSION The most of cases are want to quit smoking because of smoking harm to their health. Specially, parents wish to quit smoking because of they don't want to be bad model for their children. As a result; it is given to necessary support to participants who are this awareness in policlinics of smoking cessation. However, we think that it was necessity that should be continue increase of the therapy to growing to these awareness for the smokers who couldn't be enough awareness and who didn't think of quit smoking.
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Affiliation(s)
- Emine Argüder
- Clinic of Chest Diseases, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
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21
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Kanbay A, Hasanoğlu HC, Karalezli A, Aykun G, Yülek F. Forgotten but an important risk factor for pulmonary embolism: ophthalmic surgery. Tuberk Toraks 2011; 59:101-2. [PMID: 21554239 DOI: 10.5578/tt.2323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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22
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Hasanoğlu HC, Karalezli A, Tanrıverdio E, Gümüş M, Aydın M. A mass of myxofibrosarcoma in the lung. Tuberk Toraks 2011; 59:73-76. [PMID: 21554234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Fibrosarcoma is a mesenchymal tumor constituted by malignant fibroblasts. Myxofibrosarcoma is one of the fibrosarcoma variants that mostly develops from dermal/subcutaneous tissues. The most common locations are the limbs, with rare occurrences in the chest, head, and neck. Since, to best of our knowledge, there is no such report in English literature, we hereby present a case of lung myxofibrosarcoma. A 47-year-old man who had chest pain for 4 months was admitted to our clinic. The chest X-ray revealed a homogeneous density in the left upper lung. His chest computed tomography (CT) scan showed a solid mass lesion of 52 x 58 mm in size at the apical segment of the left upper lobe. There was tumor invasion at the second and third ribs. CT-guided fine-needle tru-cut lung biopsy was performed. Histopathological evaluation result was high grade myxofibrosarcoma. Surgery was conducted. Myxofibrosarcoma is a surgically curable disease. However, local recurrences occur in 50% to 60% of the cases. Therefore, chemotherapy and/or radiotherapy is the suggested approach following surgery.
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Karaguzel H, Guven S, Karalezli A, Erdol H. Bilateral serous retinal detachment in a woman with HELLP syndrome HELLP syndrome and retinal detachment. J OBSTET GYNAECOL 2009; 29:246-8. [PMID: 19358039 DOI: 10.1080/01443610902736916] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H Karaguzel
- Karadeniz Technical University, Trabzon, Turkey
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24
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Kucukerdonmez C, Karalezli A, Akova YA, Borazan M. Amniotic membrane transplantation using fibrin glue in pterygium surgery: a comparative randomised clinical trial. Eye (Lond) 2009; 24:558-66. [DOI: 10.1038/eye.2009.136] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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25
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Sevgili S, Hasanoğlu HC, Karalezli A, Er M. [Bronchial reversibility in the patients with bronchiectasis]. Tuberk Toraks 2009; 57:38-47. [PMID: 19533436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Pulmonary infections during childhood is an important factor in bronchiectasis ethiology. This disease sometimes may be confused with asthma in diagnosis. Because of bronchial obstruction, the bronchiectasis patients can be misdiagnosed as asthmatic. In this study we aimed to show the obstructive pattern and reversibility percentage in bronchiectasis. The 107 bronchiectasis patients that diagnosed with high resolution computed tomography scanning were included to the study. As a control group 40 volunteers that have no respiratory symptom were chosen randomly. There were 64 (59.81%) men and 43 (40.19%) women patients with a mean age of 48.89 +/- 14.33 years. In control group 40 healthy individuals with a mean age of 43.60 +/- 11.41 were present. The spirometry was done to measure FEV(1), FVC, FEF(25-75%) and reversibility of all 107 individuals and control group. Also diffusion capacity and lung volumes of patients and control group were measured. In the study group 78 (72.90%) patients had obstructive, 26 (24.30%) patients had mixed and 3 (2.80%) patients had restrictive pulmonary function abnormality. Reversibility percentage was recorded as positive for 39 patients in FEV(1) (36.45%) and as positive (> 20%) for 63 patients in FEF(25-75%) (58.9%). In this group mean reversibility percentage in FEV(1) was 19.51 +/- 6.59 and in FEF(25-75%) was 38.62 +/- 26.49. In control group reversibility ratio was 0% for FEV(1). We determined reversibility ratio as 36.45% for FEV(1) and as 58.9% for FEF(25-75%) in our study group, so bronchial reversibility is shown frequently in patients with bronchiectasis. Unfortunately bronchiectasis is often misdiagnosed and some patients are treated for presumed asthma for years. Therefore differential diagnosis of bronchiectasis and asthma should not only be evaluated by reversibility but also by radiologically.
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Karalezli A, Kucukerdonmez C, Akova YA, Altan-Yaycioglu R, Borazan M. Fibrin glue versus sutures for conjunctival autografting in pterygium surgery: a prospective comparative study. Br J Ophthalmol 2008; 92:1206-10. [DOI: 10.1136/bjo.2008.139600] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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27
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Borazan M, Karalezli A, Akova YA, Algan C, Oto S. Comparative clinical trial of topical anaesthetic agents for cataract surgery with phacoemulsification: lidocaine 2% drops, levobupivacaine 0.75% drops, and ropivacaine 1% drops. Eye (Lond) 2007; 22:425-9. [PMID: 17828144 DOI: 10.1038/sj.eye.6702973] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To assess the safety and efficacy of topical lidocaine, levobupivacaine, and ropivacaine in cataract surgery with phacoemulsification. METHODS One hundred and five patients scheduled for cataract surgery with topical anaesthesia were randomly allocated into 3 groups of 35 patients each to receive eye drops of lidocaine 2%, levobupivacaine 0.75%, or ropivacaine 1% every 5 min starting 30 min before surgery. Patients graded their pain using a 0-10-point verbal pain score (VPS) at different stages of the procedure. The levels of patient and surgeon satisfaction, the duration of surgery, complications, and the need for supplemental anaesthesia were recorded. RESULTS There was no significant difference in duration of surgery and demographic variables among the groups. At the intraoperative period, end of surgery, and postoperative first hour the mean VPS in the lidocaine group was significantly higher than the others (P<0.01), but no significant difference was found between the levobupivacaine and ropivacaine groups. At incision and 24 h after surgery, it was not significantly different among the groups. Surgeon and patient satisfaction scores were significantly better in the levobupivacaine and ropivacaine groups than in the lidocaine group (P<0.01). CONCLUSIONS Topical anaesthesia with levobupivacaine and ropivacaine were safe, feasible and more effective than lidocaine in cataract surgery. Levobupivacaine and ropivacaine provided sufficient and long-lasting analgesia without the need of supplemental anaesthesia for each patient.
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Affiliation(s)
- M Borazan
- Department of Ophthalmology, Başkent University School of Medicine, Ankara, Turkey.
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Kaya S, Karalezli A, Balkan E, Cakiroğlu E, Hasanoğlu HC. Endobronchial hamartoma removed by flexible fiberoptic bronchoscopy via electrocautery. Tuberk Toraks 2006; 54:273-6. [PMID: 17001546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
Hamartomas are the most common benign tumors of the lung. It is most common peripherally in the parenchyma as solitary nodule or endobronchial lesion. Endobronchial form may cause obstruction of airway, atelectasis and recurrent pneumonia. Endobronchial hamartomas may be treated by surgical intervention or bronchoscopic excision (with rigid or flexible procedures). We are presenting a case of endobronchial hamartoma successfully treated with bronchoscopic electrocautery without a need for surgical removal.
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Affiliation(s)
- Selda Kaya
- Department of Pulmonary Medicine, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
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Karalezli A, Sevgili S, Ernam Turgut D, Hasanoğlu A, Hasanoğlu HC. Pulmonary embolism in a patient with Klippel-Trenaunay-Weber syndrome. Tuberk Toraks 2006; 54:281-7. [PMID: 17001548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
Klippel-Trenaunay-Weber syndrome (KTWS) is a congenital disorder characterized by cutaneous capillary malformations, venous-lymphatic anomalies, hypertrophy of soft tissue and bone in the area of increased vascularity and arteriovenous fistulas with shunting. In this article we report the case of a 25 year old man with KTWS who had multiple surgical operations because of arteriovenous malformations. He admitted with pulmonary embolism attack to the hospital although he was taking prophylactic heparin treatment. We evaluate the risk of pulmonary embolism in patients with KTWS, being aware of the risk of deep venous thrombosis in progress of the disease and the importance of early diagnosis in prognosis.
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Affiliation(s)
- Ayşegül Karalezli
- Department of Pulmonary Diseases, Ankara Atatürk Educational and Research Hospital, Ankara, Turkey
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Abstract
While the trend of cigarette consumption in some developed countries is on the decline, it has been noted that in many developing countries, smoking is on the increase. Compared to developed countries, there are more male smokers than female smokers in these countries. The aim of this study was to investigate the prevalence and characteristics of the smoking habit in patients having lung cancer (LC) and to find out if there is any relationship with the smoking habit and the pathological diagnosis in our patient population. This hospital-based study was carried out between 1990 and 1996 in two major medical centres. LC was diagnosed in 1046 patients, 966 of whom were males (93%), and the remaining 80 (7%) of whom were females. Upon diagnosing the male patients, it was noted that 83% were current smokers (CS), 12% were ex-smokers (ES defined as abstinence from smoking at least for 1 year), and the remaining 5% were non-smokers (NS). In the female population the findings were as follows, 16% were CS; 8% were ES, and 76% were NS. The period of abstinence in the ES was 10 years or less in 77% of the patients. Among the male patients, squamous cell carcinoma was the most common tumor type seen in the CS group (46%) while adenocarcinoma (45%) was the most commonly seen tumor in the NS group. On the other hand, in the females, CS, the most commonly noted tumor types were small cell (54%), and adenocarcinoma (39%) was most frequently found in NS group. These results indicate that ES patients having LC in this study was quite low. On the other hand, in contrast to the findings of many other studies, from developed countries, the majority of male LC patients were in the CS group, however the majority of female LC patients were in the NS group. This smoking habit data obtained from our LC patients suggests that, similar to underdeveloped or developing countries, smoking cessation rates are very low in men during the past decade, and interestingly smoking rates may increase in women in the near future in our country.
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Affiliation(s)
- G Gürsel
- Gazi University School of Medicine, Department of Pulmonary Diseases, Besevler, Ankara, Turkey
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Atasever T, Gündoğdu C, Vural G, Kapucu LO, Karalezli A, Unlü M. Evaluation of pentavalent Tc-99m DMSA scintigraphy in small cell and nonsmall cell lung cancers. Nuklearmedizin 1997; 36:223-7. [PMID: 9394361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AIM The purpose of this study was to evaluate the clinical usefulness of Tc-99m (V) DMSA in patients suspected of lung cancer and determine whether this agent may have value in differentiation between small cell (SCLC) and non-small cell (NSCLC) lung carcinoma. METHODS Thirty-six patients with clinical and radiological suspicion of primary lung carcinoma were injected 450-600 MBq of Tc-99m (V) DMSA intravenously. Whole body and planar anterior, posterior thorax images were obtained 4-5 h after injection of the radioactive complex. RESULTS Histopathological results confirmed 23 NSCLC, 10 SCLC and 1 metastatic lung carcinoma and 2 lung abscess. Nineteen of the 23 (82%) NSCLC and all of the 10 (100%) SCLC cases showed Tc-99m (V) DMSA uptake. Single metastatic lung cancer also accumulated radiotracer. Lung abscess did not show uptake. Lesion/Nonlesion (L/N) ratio of SCLC (1.59 +/- 0.32) and NSCLC (1.43 +/- 0.19) tumour types did not show statistical difference (p > 0.05). Tc-99m (V) DMSA whole body imaging also showed bone metastases. CONCLUSION Tc-99m (V) DMSA is a noninvasive and cheap imaging method to detect malignant lung cancers and their bone metastases but, differentiation of SCLC and NSCLC is not possible.
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Affiliation(s)
- T Atasever
- Gazi University, Faculty of Medicine, Nuclear Medicine Department, Ankara, Turkey
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Gündoğdu C, Vural G, Kapucu LÖ, Karalezli A, Ünlü M, Atasever T. Evaluation of Pentavalent Tc-99m DMSA Scintigraphy in Small Cell and Nonsmall Cell Lung Cancers. Nuklearmedizin 1997. [DOI: 10.1055/s-0038-1629830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Aim: The purpose of this study was to evaluate the clinical usefulness of Tc-99m (V) DMSA in patients suspected of lung cancer and determine whether this agent may have value in differentiation between small cell (SCLC) and non-small cell (NSCLC) lung carcinoma. Methods: Thirty-six patients with clinical and radiological suspicion of primary lung carcinoma were injected 450-600 MBq of Tc-99m (V) DMSA intravenously. Whole body and planar anterior, posterior thorax images were obtained 4-5 h after injection of the radioactive complex. Results: Histo-pathological results confirmed 23 NSCLC, 10 SCLC and 1 metastatic lung carcinoma and 2 lung abscess. Nineteen of the 23 (82%) NSCLC and all of the 10 (100%) SCLC cases showed Tc-99m (V) DMSA uptake. Single metastatic lung cancer also accumulated radiotracer. Lung abscess did not show uptake. Lesion/Nonlesion (L/N) ratio of SCLC (1.59 ± 0.32) and NSCLC (1.43 ± 0.19) tumour types did not show statistical difference (p >0.05). Tc-99m (V) DMSA whole body imaging also showed bone metastases. Conclusion: Tc-99m (V) DMSA is a noninvasive and cheap imaging method to detect malignant lung cancers and their bone metastases but, differentiation of SCLC and NSCLC is not possible.
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