1
|
Ceyhan B, Suner ZU, Kocakaya D, Yıldızeli ŞO, Eryüksel E. Impact of Anxiety, Depression, and Coping Strategies on Health-Related Quality of Life in Patients with Cystic Fibrosis. Thorac Res Pract 2024. [PMID: 38705998 DOI: 10.5152/thoracrespract.2024.23112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
OBJECTIVE With the significant increase in the life expectancy of cystic fibrosis (CF) patients, many individuals now reach adulthood and develop specific coping strategies to maintain their physical and mental well-being. This study aims to evaluate coping styles and their relationship with mental health and Health-Related Quality of Life (H-RQoL) in adult CF patients. MATERIALS AND METHODS Thirty adult CF patients completed the Hospital Anxiety and Depression Scale to assess anxiety and depression, the Cystic Fibrosis Questionnaire-Revised to evaluate quality of life, and the Brief Coping Orientation to Problems Experienced questionnaire to assess coping strategies. RESULTS Twelve individuals (40%) met the diagnostic criteria for being at risk of experiencing anxiety and/or depression. Anxiety risk group exhibited lower life quality scores in the domains of vitality, emotional functioning, and role limitations (P = .027, P = .001, and P = .001, respectively). Patients reporting depressive symptoms had lower scores in emotional functioning and role limitations domains of quality of life (P = .005 and P = .018, respectively). Multivariate analysis indicated that depression and anxiety scores were significant predictors of emotional quality of life. In terms of coping strategies, "acceptance" was the most commonly preferred, while "substance use" was the least preferred strategy among all participants. Patients at risk of anxiety and/or depression often chose "avoidance" as their coping strategy. CONCLUSION Anxiety and depressive symptoms are prevalent and associated with poorer H-RQoL in adult CF patients. These patients preferred to employ giving up strategy when dealing with the disease. Therefore, it is essential to screen adult CF patients for mental health risks and to work on improving their coping strategies.
Collapse
Affiliation(s)
- Berrin Ceyhan
- Department of Pulmonary Medicine and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Zeynep Uslu Suner
- Department of Pulmonary Medicine, Bahçeşehir University School of Medicine, İstanbul, Turkey
| | - Derya Kocakaya
- Department of Pulmonary Medicine and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Şehnaz Olgun Yıldızeli
- Department of Pulmonary Medicine and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Emel Eryüksel
- Department of Pulmonary Medicine and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| |
Collapse
|
2
|
Uslu NZ, Kocakaya D, Olgun Yıldızeli Ş, Eryüksel E, Keniş Coşkun Ö, Cimşit C, Karaketir ŞG, Ceyhan B. Relationship of muscle thickness, strength, and diaphragm function in adults with cystic fibrosis. Turk J Phys Med Rehabil 2023; 69:200-206. [PMID: 37671376 PMCID: PMC10475901 DOI: 10.5606/tftrd.2023.10361] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 09/01/2022] [Indexed: 09/07/2023] Open
Abstract
Objectives This study aimed to evaluate the muscle thickness, strength, and diaphragmatic function and relate them with clinical findings. Patients and methods The cross-sectional study was conducted with 54 participants (27 males, 27 females; mean age; 24.5±5.3 years; range, 18 to 45 years) between January 2017 and October 2017. Of the participants, 31 were adult CF patients, and 23 were age-and sex-matched controls. Patient demographics, 6-min walk distance, body mass index (BMI), and fat-free mass index (FFMI) were evaluated. Each patient underwent pulmonary function tests. Quadriceps femoris thickness and diaphragm thickening fraction were assessed by ultrasonography. Upper extremity strength was measured with a handheld dynamometer. Results There was no difference between the patients' and controls' BMI (p=0.052). However, patients' FFMI was lower than the controls' (p=0.010). The FFMI correlated with pulmonary function tests. Patients' both right and left quadriceps femoris muscles were thinner than the controls (p=0.001 and p=0.001, respectively). Patients with pancreatic insufficiency had thinner muscles than patients without pancreatic insufficiency. The control group had a stronger handgrip than CF patients (33.5±10.1 vs. 24.5±9.2 kg, p=0.003). Conclusion Peripheral muscle wasting and weakness and lower functional capacity are highly prevalent in CF patients.
Collapse
Affiliation(s)
- Nazlı Zeynep Uslu
- Pulmonary Medicine, Marmara University Medical Faculty, Istanbul, Türkiye
| | - Derya Kocakaya
- Pulmonary Medicine, Marmara University Medical Faculty, Istanbul, Türkiye
| | | | - Emel Eryüksel
- Pulmonary Medicine, Marmara University Medical Faculty, Istanbul, Türkiye
| | - Özge Keniş Coşkun
- Department of Physical Medicine and Rehabilitation, Marmara University Medical Faculty, Istanbul, Türkiye
| | - Canan Cimşit
- Department of Radiology, Marmara University Medical Faculty, Istanbul, Türkiye
| | | | - Berrin Ceyhan
- Pulmonary Medicine, Marmara University Medical Faculty, Istanbul, Türkiye
| |
Collapse
|
3
|
Sili U, Ay P, Bilgin H, Topuzoğlu A, Tükenmez-Tigen E, Ertürk-Şengel B, Yağçı-Çağlayık D, Balcan B, Kocakaya D, Olgun-Yıldızeli Ş, Gül F, Bilgili B, Can-Sarınoğlu R, Karahasan-Yağcı A, Mülazimoğlu-Durmuşoğlu L, Eryüksel E, Odabaşı Z, Direskeneli H, Karakurt S, Korten V. Factors Associated with 28-day Critical Illness Development During the First Wave of COVID-19. Infect Dis Clin Microbiol 2023; 5:94-105. [PMID: 38633015 PMCID: PMC10985825 DOI: 10.36519/idcm.2023.206] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/25/2023] [Indexed: 04/19/2024]
Abstract
Objective This study aimed to define the predictors of critical illness development within 28 days postadmission during the first wave of the COVID-19 pandemic. Materials and Methods We conducted a prospective cohort study including 477 PCR-positive COVID-19 patients admitted to a tertiary care hospital in Istanbul from March 12 to May 12, 2020. Results The most common presenting symptoms were cough, dyspnea, and fatigue. Critical illness developed in 45 (9.4%; 95% CI=7.0%-12.4%) patients. In the multivariable analysis, age (hazard ratio (HR)=1.05, p<0.001), number of comorbidities (HR=1.33, p=0.02), procalcitonin ≥0.25 µg/L (HR=2.12, p=0.03) and lactate dehydrogenase (LDH) ≥350 U/L (HR=2.04, p=0.03) were independently associated with critical illness development. The World Health Organization (WHO) ordinal scale for clinical improvement on admission was the strongest predictor of critical illness (HR=4.15, p<0.001). The patients hospitalized at the end of the study period had a much better prognosis compared to the patients hospitalized at the beginning (HR=0.14; p=0.02). The C-index of the model was 0.92. Conclusion Age, comorbidity number, the WHO scale, LDH, and procalcitonin were independently associated with critical illness development. Mortality from COVID-19 seemed to be decreasing as the first wave of the pandemic advanced. Graphic Abstract Graphic Abstract.
Collapse
Affiliation(s)
- Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
- Equal contribution
| | - Pınar Ay
- Department of Public Health, Marmara University School of
Medicine, İstanbul, Turkey
- Equal contribution
| | - Hüseyin Bilgin
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
- Equal contribution
| | - Ahmet Topuzoğlu
- Department of Public Health, Marmara University School of
Medicine, İstanbul, Turkey
- Equal contribution
| | - Elif Tükenmez-Tigen
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
| | - Buket Ertürk-Şengel
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
| | - Dilek Yağçı-Çağlayık
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
| | - Baran Balcan
- Department of Pulmonary Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Derya Kocakaya
- Department of Pulmonary Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Şehnaz Olgun-Yıldızeli
- Department of Pulmonary Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Fethi Gül
- Department of Anesthesiology and Intensive Care, Marmara
University School of Medicine, İstanbul, Turkey
| | - Beliz Bilgili
- Department of Anesthesiology and Intensive Care, Marmara
University School of Medicine, İstanbul, Turkey
| | - Rabia Can-Sarınoğlu
- Department of Medical Microbiology, Marmara University School of
Medicine, İstanbul, Turkey
| | | | | | - Emel Eryüksel
- Department of Pulmonary Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Zekaver Odabaşı
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
| | - Haner Direskeneli
- Department of Internal Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Sait Karakurt
- Department of Pulmonary Medicine, Marmara University School of
Medicine, İstanbul, Turkey
| | - Volkan Korten
- Department of Infectious Diseases and Clinical Microbiology,
Marmara University School of Medicine, İstanbul, Turkey
| |
Collapse
|
4
|
Gülhan R, Eryüksel E, Gülçebi İdriz Oğlu M, Çulpan Y, Toplu A, Kocakaya D, Tigen E, Ertürk Şengel B, Sili U, Olgun Yıldızeli Ş, Balcan MB, Elçi A, Bulut C, Karaalp A, Yananlı HR, Güner AE, Hatipoğlu M, Karakurt S, Korten V, Ratnaraj N, Patsalos P, Ay P, Onat F. Pharmacokinetic characterization of favipiravir in patients with COVID-19. Br J Clin Pharmacol 2022; 88:3516-3522. [PMID: 35014080 DOI: 10.1111/bcp.15227] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 06/15/2021] [Revised: 12/17/2021] [Accepted: 12/31/2021] [Indexed: 11/28/2022] Open
Abstract
This prospective observational study describes the pharmacokinetic characteristics of favipiravir in adult patients hospitalized for mild to moderate COVID-19 with a positive RT-PCR test. Favipiravir was administered for 5 days, with a loading dose of 3200 mg and a maintenance dose of 1200 mg/day. Serial blood samples were collected on Day-2 and Day-4 of the therapy. Laboratory findings of the patients (n=21) and in-hospital mortality were recorded. Favipiravir concentrations exhibited substantial variability and a significant decrease during the treatment of COVID-19. The median favipiravir trough concentration (C0-trough ) on Day-2 was 21.26 (IQR, 8.37-30.78) μg/mL whereas it decreased significantly to 1.61 (IQR, 0.00-6.41) μg/mL on Day-4, the area under the concentration versus time curve decreased by 68.5%. Day-2-C0-trough of female patients was higher than male patients. Our findings indicate that favipiravir concentrations show significant variability during the treatment of COVID-19 and therapeutic drug monitoring may be necessary to maintain targeted concentrations.
Collapse
Affiliation(s)
- Rezzan Gülhan
- Department of Medical Pharmacology, Marmara University School of Medicine, Istanbul, Turkey
| | - Emel Eryüksel
- Department of Pulmonary Medicine and Critical Care, Marmara University School of Medicine, Istanbul, Turkey
| | | | - Yekta Çulpan
- Department of Medical Pharmacology, Marmara University School of Medicine, Istanbul, Turkey
| | - Aylin Toplu
- Department of Medical Pharmacology, Marmara University School of Medicine, Istanbul, Turkey
| | - Derya Kocakaya
- Department of Pulmonary Medicine and Critical Care, Marmara University School of Medicine, Istanbul, Turkey
| | - Elif Tigen
- Department of Infectious Disease and Clinical Microbiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Buket Ertürk Şengel
- Department of Infectious Disease and Clinical Microbiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Uluhan Sili
- Department of Infectious Disease and Clinical Microbiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Şehnaz Olgun Yıldızeli
- Department of Pulmonary Medicine and Critical Care, Marmara University School of Medicine, Istanbul, Turkey
| | - Mehmet Baran Balcan
- Department of Pulmonary Medicine and Critical Care, Marmara University School of Medicine, Istanbul, Turkey
| | - Abdullah Elçi
- Istanbul Health Directorate Public Health Laboratory-3, Istanbul, Turkey
| | - Cenk Bulut
- Istanbul Health Directorate Public Health Laboratory-3, Istanbul, Turkey
| | - Atila Karaalp
- Department of Medical Pharmacology, Marmara University School of Medicine, Istanbul, Turkey
| | - Hasan Raci Yananlı
- Department of Medical Pharmacology, Marmara University School of Medicine, Istanbul, Turkey
| | | | | | - Sait Karakurt
- Department of Pulmonary Medicine and Critical Care, Marmara University School of Medicine, Istanbul, Turkey
| | - Volkan Korten
- Department of Infectious Disease and Clinical Microbiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Neville Ratnaraj
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, United Kingdom
| | - Philip Patsalos
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, United Kingdom
| | - Pınar Ay
- Department of Public Health, Marmara University School of Medicine, Istanbul, Turkey
| | - Filiz Onat
- Department of Medical Pharmacology, Marmara University School of Medicine, Istanbul, Turkey.,Department of Medical Pharmacology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| |
Collapse
|
5
|
Bekir M, Karakoç Aydıner E, Yıldızeli ŞO, Öğülür İ, Kocakaya D, Barış S, Eryüksel E, Özen A, Ceyhan BB. Primary Immun Deficiency in Patients with Non-Cystic Fibrosis Bronchiectasis and Its Relationship with Clinical Parameters. Turk Thorac J 2021; 22:37-44. [PMID: 33646102 DOI: 10.5152/turkthoracj.2020.19077] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 03/08/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Bronchiectasis is characterized by chronic respiratory infection. The role of immunodeficiency in this disease is poorly studied in relation to clinical indices. The primary aim of this study was to determine the frequency of these neglected altered immune status by evaluating immunoglobulins, lymphocyte subsets, complement levels, and neutrophil function, and to assess its relationship with clinical parameters in adult patients with non-cystic fibrosis bronchiectasis (NCFB). MATERIAL AND METHODS A total of 74 (30 men and 44 women with a mean age of 47±17 years) adult patients with stable NCFB were enrolled in this study. The bronchiectasis severity index (BSI) and FACED (F:FEV1, A: Age, C: Chronic colonization, E: Extension, D: Dyspnea) scores were assessed. Peripheral blood samples were collected for the detection of total IgG, IgA, IgM, IgE, and IgG subclasses and C3 and C4 levels. The counts of CD3, CD4, CD8, CD19, CD16/56 expressing peripheral blood lymphocytes and neutrophil oxidative function were evaluated. RESULTS In the study population, BSI and FACED severity index scores increased with longer duration of the disease (p=0.01 and p=0.040, respectively). Of the 74 patients, 27 (37%) showed humoral aberrations. The number of male patients were higher in this group (p=0.03). High serum total IgE levels were associated with high scores in BSI (moderate-severe group versus mild group, p=0.030). Patients with bronchiectasis demonstrated lower CD3+ T cell count, lower CD4+ T helper cell percentage, and lower CD4+ T cell count (p=0.031, p=0.030, p=0.029, respectively) than healthy subjects. A significant negative correlation was found between the percentage and count of CD16/56+ natural killer (NK) cells and the number of exacerbations within the past year (r=-0.230, p=0.049 and r=-0.264, p=0.023, respectively). CONCLUSION Humoral aberrations in adult patients with NCFB were found to be frequent. IgE levels were related to high scores for disease severity indices. Furthermore, patients with low percentage and counts of NK cells had higher rates of exacerbations. These results emphasize the importance of immune function assessment in adult patients with NCFB.
Collapse
Affiliation(s)
- Melahat Bekir
- Department of Pulmonary Medicine and Critical Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Elif Karakoç Aydıner
- Department of Pediatric Immunology and Allergy, Marmara University School of Medicine, İstanbul, Turkey
| | - Şehnaz Olgun Yıldızeli
- Department of Pulmonary Medicine and Critical Care, Marmara University School of Medicine, İstanbul, Turkey
| | - İsmail Öğülür
- Department of Pediatric Immunology and Allergy, Marmara University School of Medicine, İstanbul, Turkey
| | - Derya Kocakaya
- Department of Pulmonary Medicine and Critical Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Safa Barış
- Department of Pediatric Immunology and Allergy, Marmara University School of Medicine, İstanbul, Turkey
| | - Emel Eryüksel
- Department of Pulmonary Medicine and Critical Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Ahmet Özen
- Department of Pediatric Immunology and Allergy, Marmara University School of Medicine, İstanbul, Turkey
| | - Berrin Bağcı Ceyhan
- Department of Pulmonary Medicine and Critical Care, Marmara University School of Medicine, İstanbul, Turkey
| |
Collapse
|
6
|
Olgun Yıldızeli Ş, Tufan A, Bozkurtlar E, Arıkan H, Kocakaya D, Eryüksel E, Ceyhan B, Karakurt S. Endobronchial ultrasound transbronchial needle aspiration in elderly patients: safety and performance outcomes EBUS-TBNA in elderly. Aging Male 2020; 23:507-512. [PMID: 30457426 DOI: 10.1080/13685538.2018.1538337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
AIM Complication rates are low and endobronchial ultrasound guided needle aspiration (EBUS-TBNA) is generally regarded as a safe procedure, but there is a very limited number of studies evaluating the efficacy and safety of the procedure in advanced ages. The aim of this study is to assess the safety and performance outcomes of EBUS-TBNA in elderly. METHODS It was a retrospective observational study; patients who received EBUS-TBNA between September 2016 and January 2018 were evaluated. We analyzed patient's characteristics, doses of midazolam, and lidocaine used, regions of lymph node biopsies, and complications. Also, functionality and general physical status of patients over 65 years of age were evaluated. RESULTS During study period 132 cases of EBUS-TBNA were evaluated. 39 (29.5%) cases were aged 70 years, and over. There were more comorbidities in older group. Performance status of older group was worse. Furthermore, when evaluated according to American College of Cardiology (ACC)/American Heart Association (AHA) and American Society of Anesthesiologists (ASA), the older group was found to be composed of the riskier patients. When patients aged between 65 and 69, and over 70 compared, older patient's Barthel, EQ 5-D, SGA, and G8 scores were found to be worse. Despite that, there was no difference in the frequency, and types of complications between both groups. Diagnostic performance was not different between age groups. CONCLUSIONS Independent from comorbidities, general health status, and functionality EBUS-TBNA procedure in 70-year-old and over patients is a safe minimally invasive procedure.
Collapse
Affiliation(s)
- Şehnaz Olgun Yıldızeli
- Department of Pulmonary and Critical Care Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Aslı Tufan
- Department Internal Medicine Division of Geriatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Emine Bozkurtlar
- Department of Pathology, Marmara University School of Medicine, Istanbul, Turkey
| | - Hüseyin Arıkan
- Department of Pulmonary and Critical Care Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Derya Kocakaya
- Department of Pulmonary and Critical Care Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Emel Eryüksel
- Department of Pulmonary and Critical Care Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Berrin Ceyhan
- Department of Pulmonary and Critical Care Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Sait Karakurt
- Department of Pulmonary and Critical Care Medicine, Marmara University School of Medicine, Istanbul, Turkey
| |
Collapse
|
7
|
Kasapoğlu US, Olgun Yıldızeli Ş, Arıkan H, Erer A, Kabadayı F, Yalçınkaya E, Aslan M, Cimşit NÇ, Eryüksel E, Karakurt S. Comparison of neutrophil to lymphocyte ratio with other prognostic markers affecting 30 day mortality in acute pulmonary embolism. Tuberk Toraks 2020; 67:179-189. [PMID: 31709949 DOI: 10.5578/tt.68519] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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 Identifying the prognostic factors for patients with acute pulmonary embolism (APE) play a critical role in determining of the treatment strategy and to reduce mortality. The aim of this study is to evaluate the prognostic value of Neutrophil to Lymphocyte Ratio (NLR) and compare NLR with other prognostic factors in APE. Materials and Methods We retrospectively examined 550 cases of acute pulmonary embolism diagnosed by spiral computed tomographic angiography. A receiver operating characteristics (ROC) curve was used to determine the sensitivity and specificity of parameters and the optimal cut-off value for predicting mortality. Significance of each prognostic factors selected by univariate analysis confirmed using Cox regression model. Result Baseline NLR, Platelet to Lymphocyte Ratio (PLR), N-terminal pro-Brain Natriuretic Peptide (NT-proBNP), and D-dimer values respectively were found significantly high in patients who died within 30 days (p< 0.05). Patients with high-risk status and sPESI > 2 points had a significantly higher short-term mortality rate (p< 0.05). Short-time mortality was found significantly higher in patients with NLR > 7.3 (p< 0.05). Cox regression analysis indicated that patient risk status and sPESI score were independent prognostic factors (p< 0.05). However, NLR was not found as a predictor of mortality in APE (p> 0.05). After the subgroup analysis of the study, in patients without comorbid diseases NLR, patient’s risk status, sPESI score were found the predictor of mortality in APE (p< 0.05). Conclusions NLR maybe a useful prognostic factor for patients without comorbid diseases in short time of mortality in APE.
Collapse
Affiliation(s)
- Umut Sabri Kasapoğlu
- Department of Chest Diseases and Intensive Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Şehnaz Olgun Yıldızeli
- Department of Chest Diseases and Intensive Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Hüseyin Arıkan
- Department of Chest Diseases and Intensive Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ayşen Erer
- Department of Chest Diseases and Intensive Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Feyyaz Kabadayı
- Department of Chest Diseases and Intensive Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Erdem Yalçınkaya
- Department of Chest Diseases and Intensive Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Melek Aslan
- Department of Chest Diseases and Intensive Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nuri Çağatay Cimşit
- Department of Radiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Emel Eryüksel
- Department of Chest Diseases and Intensive Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Sait Karakurt
- Department of Chest Diseases and Intensive Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| |
Collapse
|
8
|
Olgun Yıldızeli Ş, Kasapoğlu US, Arıkan H, Çimşit C, Çimşit NÇ, Süzer Aslan M, Kocakaya D, Eryüksel E, Ceyhan B, Karakurt S. Pleural effusion as an indicator of short term mortality in acute pulmonary embolism. Tuberk Toraks 2019; 66:185-196. [PMID: 30479225 DOI: 10.5578/tt.67203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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 Pulmonary embolism (PE) is known as one of the major causes of cardiovascular morbidity and mortality. Identification of high risk patients for short term and long-term mortality is crucial. The purpose of this study is to demonstrate the prognostic importance of simplified pulmonary embolism severity index (sPESI), radiological investigations and comorbidities in terms of short-term mortality by simultaneous assessment of sPESI score, pulmonary computed tomography (CT) angiography findings and underlying comorbidities in patients diagnosed with acute pulmonary embolism. Materials and Methods We retrospectively evaluated 570 patients diagnosed with acute PE confirmed by computer tomography pulmonary angiography (CTPA). Comorbidities were recorded, pulmonary embolism severity index scores were calculated and CTPA data were evaluated as predictors for short-term mortality. Result The study population consisted of 570 patients, 292 (51.2%) patients were female and 74 patients (12.9%) died within 30 days due to PE diagnosis. In univariate analysis male gender (p= 0.031), congestive heart failure (CHF)(p< 0.029), main pulmonary artery involvement (p= 0.045), presence of pleural effusion (p= 0.001) and pericardial effusion (p= 0.004) at time of diagnosis and high risk sPESI group (p< 0.001) had a significant influence on mortality. In the multivariate analysis, pleural effusions (HR, 1.67; CI, 1.05-2.66; p< 0.030) and sPESI high risk group (HR, 9.56; CI, 4.71-19.43; p< 0.001) were remained significant and independent prognostic factors for survival. Conclusions The present study underlined that presence of pleural effusion at the time of diagnosis in patients with massive pulmonary embolism and a high sPESI score in other patients were significant predictors of short-term mortality.
Collapse
Affiliation(s)
- Şehnaz Olgun Yıldızeli
- Department of Chest Diseases and Critical Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Umut Sabri Kasapoğlu
- Department of Chest Diseases and Critical Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Hüseyin Arıkan
- Department of Chest Diseases and Critical Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Canan Çimşit
- Department of Radiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Nuri Çagatay Çimşit
- Department of Radiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Melek Süzer Aslan
- Department of Chest Diseases and Critical Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Derya Kocakaya
- Department of Chest Diseases and Critical Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Emel Eryüksel
- Department of Chest Diseases and Critical Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Berrin Ceyhan
- Department of Chest Diseases and Critical Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Sait Karakurt
- Department of Chest Diseases and Critical Care, Faculty of Medicine, Marmara University, Istanbul, Turkey
| |
Collapse
|
9
|
Arıkan H, Duman D, Kargın F, Ergin G, Horne R, Karakurt S, Eryüksel E. Author's Reply. Turk Thorac J 2018; 19:232. [PMID: 30455996 DOI: 10.5152/turkthoracj.2018.181826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hüseyin Arıkan
- Department of Chest Diseases and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Dildar Duman
- Department of Pulmonology University of Health Sciences, Süreyyapaşa Chest Diseases and Cheast Surgery Training and Research Hospital, İstanbul, Turkey
| | - Feyza Kargın
- Department of Pulmonology University of Health Sciences, Süreyyapaşa Chest Diseases and Cheast Surgery Training and Research Hospital, İstanbul, Turkey
| | - Gülbin Ergin
- Department of Physiotherapy and Rehabilitation, Lefke European University Faculty of Health Sciences, Lefka, Cyprus
| | - Rob Horne
- UCL School of Pharmacy, Centre for Behavioural Medicine, University College London, United Kingdom
| | - Sait Karakurt
- Department of Chest Diseases and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Emel Eryüksel
- Department of Chest Diseases and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| |
Collapse
|
10
|
Ediboğlu Ö, Moçin ÖY, Özyılmaz E, Saltürk C, Önalan T, Seydaoğlu G, Çelikel T, Arıkan H, Ataman S, Kıraklı C, Özçelik Z, Kultufan S, Kara İ, Kara A, Dağlı E, Bülbül SD, Kahveci K, Dinçer M, Şenoğlu N, Özkarakaş H, Bahar İ, Cengiz M, Ramazanoğlu A, Çelik B, Gaygısız Ü, Kır G, Bindal A, Akan B, Turan IÖ, Yıldırım F, Başarık B, Ulukan ZA, Efe S, Sungur M, Temel Ş, İzdeş S, Hoşgün D, Karadeniz N, Tuncay E, Gökşenoğlu NÇ, Irmak İ, Datlı U, Zerman A, Akdağ D, Özdemir L, Elay G, Karaçayır Y, Topeli A, Hancı P, Kaya EK, Güven P, Sazak H, Aydemir S, Aygencel G, Aydemir Y, Doğanay Z, Kömürcü Ö, Hancı V, Karakoç E, Sözütek D, Coşkun G, Ateş G, Tiryaki C, Soytürk AN, Girgin NK, Çalışkan G, Bıyıklı O, Gökmen N, Koca U, Çiledağ A, Süner KÖ, Cinel İ, Arslantaş MK, Gül F, Ergün R, Yılmaz N, Altıntaş D, Talan L, Yalçınsoy M, Güllü MN, Özcan PE, Orhun G, Savran Y, Tokur ME, Akpınar S, Şen P, Gürsel G, Şerifoğlu İ, Gedik E, Balbay ÖA, Akbaş T, Cesur S, Yolacan H, Sağmen SB, Ekren PK, Bacakoğlu F, Ergan B, Günay E, Sarıaydın M, Sağlam DA, Karakurt S, Eryüksel E, Öztuna F, Mürtezaoğlu ESA, Cinemre H, Nalbant A, Yağmurkaya Ö, Mandal T, İkidağ B. Current Statement of Intensive Care Units in Turkey: Data obtained from 67 Centers. Turk Thorac J 2018; 19:209-215. [PMID: 30322437 PMCID: PMC6196900 DOI: 10.5152/turkthoracj.2018.170104] [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] [Received: 12/13/2017] [Accepted: 02/17/2018] [Indexed: 01/28/2023]
Abstract
OBJECTIVES We aimed to obtain information about the characteristics of the ICUs in our country via a point prevalence study. MATERIAL AND METHODS This cross-sectional study was planned by the Respiratory Failure and Intensive Care Assembly of Turkish Thoracic Society. A questionnaire was prepared and invitations were sent from the association's communication channels to reach the whole country. Data were collected through all participating intensivists between the October 26, 2016 at 08:00 and October 27, 2016 at 08:00. RESULTS Data were collected from the 67 centers. Overall, 76.1% of the ICUs were managed with a closed system. In total, 35.8% (n=24) of ICUs were levels of care (LOC) 2 and 64.2% (n=43) were LOC 3. The median total numbers of ICU beds, LOC 2, and LOC 3 beds were 12 (8-23), 14 (10-25), and 12 (8-20), respectively. The median number of ventilators was 12 (7-21) and that of ventilators with non-invasive ventilation mode was 11 (6-20). The median numbers of patients per physician during day and night were 3.9 (2.3-8) and 13 (9-23), respectively. The median number of patients per nurse was 2.5 (2-3.1); 88.1% of the nurses were certified by national certification corporation. CONCLUSION In terms of the number of staff, there is a need for specialist physicians, especially during the night and nurses in our country. It was thought that the number of ICU-certified nurses was comparatively sufficient, yet the target was supposed to be 100% for this rate.
Collapse
Affiliation(s)
- Özlem Ediboğlu
- Department of Intensive Care Unit, Health Sciences University, İzmir Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Turkey
| | - Özlem Yazıcıoğlu Moçin
- Department of Intensive Care Unit, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Ezgi Özyılmaz
- Department of Intensive Care Unit, Çukurova University School of Medicine Balcalı Hospital, Adana, Turkey
| | - Cüneyt Saltürk
- Department of Intensive Care Unit, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Tuğba Önalan
- Department of Intensive Care Unit, İzmir Çiğli District Hospital, İzmir, Turkey
| | - Gülşah Seydaoğlu
- Clinic of Biostatistics, Çukurova University School of Medicine, Adana, Turkey
| | - Turgay Çelikel
- Department of Intensive Care Unit, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey
| | - Hüseyin Arıkan
- Department of Intensive Care Unit, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey
| | - Sena Ataman
- Department of Intensive Care Unit, Health Sciences University, İzmir Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Turkey
| | - Cenk Kıraklı
- Department of Intensive Care Unit, Health Sciences University, İzmir Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Turkey
| | - Zerrin Özçelik
- Department of Intensive Care Unit, Balıkesir State Hospital, Balıkesir, Turkey
| | - Sema Kultufan
- Department of Intensive Care Unit, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
| | - İskender Kara
- Clinic of Intensive Care Unit, Konya Numune Hospital, Konya, Turkey
| | - Atilla Kara
- Clinic of Intensive Care Unit, Sivas Numune Hospital, Sivas, Turkey
| | - Emine Dağlı
- Clinic of Intensive Care Unit, Tarsus State Hospital, Mersin, Turkey
| | - Selma Duru Bülbül
- Clinic of Intensive Care Unit, Tarsus State Hospital, Mersin, Turkey
| | - Kadriye Kahveci
- Clinic of Intensive Care Unit, Ankara Ulus State Hospital, Ankara, Turkey
| | - Metin Dinçer
- Clinic of Intensive Care Unit, Ankara Ulus State Hospital, Ankara, Turkey
| | - Nimet Şenoğlu
- Clinic of Intensive Care Unit, Health Sciences University, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Hüseyin Özkarakaş
- Clinic of Intensive Care Unit, Health Sciences University, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - İlhan Bahar
- Clinic of Intensive Care Unit, Van Training and Research Hospital, Van, Turkey
| | - Melike Cengiz
- Clinic of Intensive Care Unit, Akdeniz University Hospital, Antalya, Turkey
| | - Atilla Ramazanoğlu
- Clinic of Intensive Care Unit, Akdeniz University Hospital, Antalya, Turkey
| | - Burcu Çelik
- Clinic of Intensive Care Unit, Akdeniz University Hospital, Antalya, Turkey
| | - Ümmügülsün Gaygısız
- Clinic of Intensive Care Unit, Erzurum District Training and Research Hospital, Erzurum, Turkey
| | - Gülay Kır
- Department of Intensive Care Unit, University of Health Sciences Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Ahmet Bindal
- Clinic of Intensive Care Unit, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Belgin Akan
- Clinic of Intensive Care Unit, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Işıl Özkoçak Turan
- Clinic of Intensive Care Unit, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Fatma Yıldırım
- Clinic of Intensive Care Unit, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Burcu Başarık
- Clinic of Intensive Care Unit, Denizli State Hospital, Denizli, Turkey
| | - Zeliha Arslan Ulukan
- Clinic of Intensive Care Unit, Medicana International İstanbul Hospital, İstanbul, Turkey
| | - Serdar Efe
- Department of Intensive Care Unit, Trakya University Health Research and Application Hospital, Edirne, Turkey
| | - Murat Sungur
- Department of Intensive Care Unit, Erciyes University School of Medicine, Kayseri, Turkey
| | - Şahin Temel
- Department of Intensive Care Unit, Erciyes University School of Medicine, Kayseri, Turkey
| | - Seval İzdeş
- Clinic of Intensive Care Unit, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Derya Hoşgün
- Clinic of Intensive Care Unit, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Nurhan Karadeniz
- Clinic of Intensive Care Unit, Manisa State Hospital, Manisa, Turkey
| | - Eylem Tuncay
- Department of Intensive Care Unit, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Nezihe Çiftarslan Gökşenoğlu
- Department of Intensive Care Unit, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - İlim Irmak
- Department of Intensive Care Unit, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Utku Datlı
- Clinic of Intensive Care Unit, Kütahya Evliya Çelebi Training and Research Hospital, Kütahya, Turkey
| | - Avşar Zerman
- Clinic of Intensive Care Unit, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Devrim Akdağ
- Department of Intensive Care Unit, Çukurova University School of Medicine Balcalı Hospital, Adana, Turkey
| | - Levent Özdemir
- Clinic of Intensive Care Unit, Dörtyol State Hospital, Hatay, Turkey
| | - Gülseren Elay
- Clinic of Intensive Care Unit, Gaziantep Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Yücel Karaçayır
- Clinic of Intensive Care Unit, Muğla Sıtkı Koçman University Training and Research Hospital, Muğla, Turkey
| | - Arzu Topeli
- Department of Intensive Care Unit, Hacettepe University School of Medicine Hospital, Ankara, Turkey
| | - Pervin Hancı
- Department of Intensive Care Unit, Hacettepe University School of Medicine Hospital, Ankara, Turkey
| | - Esat Kıvanç Kaya
- Department of Intensive Care Unit, Hacettepe University School of Medicine Hospital, Ankara, Turkey
| | - Pınar Güven
- Clinic of Intensive Care Unit, Bolu İzzet Baysal State Hospital, Bolu, Turkey
| | - Hilal Sazak
- Clinic of Intensive Care Unit, Ankara Atatürk Chest Diseases and Surgery Training and Research Hospital, Ankara, Turkey
| | - Semih Aydemir
- Clinic of Intensive Care Unit, Ankara Atatürk Chest Diseases and Surgery Training and Research Hospital, Ankara, Turkey
| | - Gülbin Aygencel
- Department of Intensive Care Unit, Gazi University School of Medicine Hospital, Ankara, Turkey
| | - Yusuf Aydemir
- Clinic of Intensive Care Unit, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Zahide Doğanay
- Clinic of Intensive Care Unit, Samsun Training and Research Hospital, Samsun, Turkey
| | - Özgür Kömürcü
- Clinic of Intensive Care Unit, Samsun Training and Research Hospital, Samsun, Turkey
| | - Volkan Hancı
- Department of Post-op Anesthesia Care Unit, Dokuz Eylül University School of Medicine Hospital, İzmir, Turkey
| | - Emre Karakoç
- Department of Intensive Care Unit, Çukurova University School of Medicine Balcalı Hospital, Adana, Turkey
| | - Didem Sözütek
- Department of Intensive Care Unit, Çukurova University School of Medicine Balcalı Hospital, Adana, Turkey
| | - Güven Coşkun
- Clinic of Intensive Care Unit, Afyonkarahisar State Hospital, Afyon, Turkey
| | - Güngör Ateş
- Clinic of Intensive Care Unit, Memorial Diyarbakır Hospital, Diyarbakır, Turkey
| | - Civan Tiryaki
- Clinic of Intensive Care Unit, Memorial Diyarbakır Hospital, Diyarbakır, Turkey
| | - Ayşe Nur Soytürk
- Department of Intensive Care Unit, Uludağ University School of Medicine Hospital, Bursa, Turkey
| | - Nermin Kelebek Girgin
- Department of Intensive Care Unit, Uludağ University School of Medicine Hospital, Bursa, Turkey
| | - Gülbahar Çalışkan
- Department of Intensive Care Unit, Uludağ University School of Medicine Hospital, Bursa, Turkey
| | - Oben Bıyıklı
- Clinic of Intensive Care Unit, İzmir Central Hospital, İzmir, Turkey
| | - Necati Gökmen
- Department of Intensive Care Unit, Dokuz Eylül University School of Medicine Hospital, İzmir, Turkey
| | - Uğur Koca
- Department of Intensive Care Unit, Dokuz Eylül University School of Medicine Hospital, İzmir, Turkey
| | - Aydın Çiledağ
- Department of Intensive Care Unit, Ankara University School of Medicine Hospital, Ankara, Turkey
| | - Kezban Özmen Süner
- Clinic of Intensive Care Unit, Konya Training and Research Hospital, Konya, Turkey
| | - İsmail Cinel
- Clinic of Intensive Care Unit, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey
| | - Mustafa Kemal Arslantaş
- Clinic of Intensive Care Unit, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey
| | - Fethi Gül
- Clinic of Intensive Care Unit, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey
| | - Recai Ergün
- Clinic of Intensive Care Unit, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Nafiye Yılmaz
- Clinic of Intensive Care Unit, Atatürk University Health Research and Application Hospital, Erzurum, Turkey
| | - Defne Altıntaş
- Department of Intensive Care Unit, Ankara University School of Medicine Hospital, Ankara, Turkey
| | - Leyla Talan
- Department of Intensive Care Unit, Ankara University School of Medicine Hospital, Ankara, Turkey
| | - Murat Yalçınsoy
- Department of Intensive Care Unit, İnönü University School of Medicine Hospital, Malatya, Turkey
| | - Mehmet Nezir Güllü
- Clinic of Intensive Care Unit, Health Sciences University, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Perihan Ergin Özcan
- Department of Intensive Care Unit, İstanbul University Istanbul School of Medicine Hospital, İstanbul, Turkey
| | - Günseli Orhun
- Department of Intensive Care Unit, İstanbul University Istanbul School of Medicine Hospital, İstanbul, Turkey
| | - Yusuf Savran
- Department of Intensive Care Unit, Dokuz Eylül University School of Medicine Hospital, İzmir, Turkey
| | - Murat Emre Tokur
- Department of Intensive Care Unit, Dokuz Eylül University School of Medicine Hospital, İzmir, Turkey
| | - Serdar Akpınar
- Clinic of Intensive Care Unit, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Pelin Şen
- Department of Intensive Care Unit, İstanbul Başkent University Hospital, İstanbul, Turkey
| | - Gül Gürsel
- Department of Intensive Care Unit, Gazi University School of Medicine Hospital, Ankara, Turkey
| | - İrem Şerifoğlu
- Department of Intensive Care Unit, Ankara Başkent University Hospital, Ankara, Turkey
| | - Ender Gedik
- Department of Intensive Care Unit, Ankara Başkent University Hospital, Ankara, Turkey
| | - Öner Abidin Balbay
- Clinic of Intensive Care Unit, Düzce University Health Research and Application Hospital, Düzce, Turkey
| | - Türkay Akbaş
- Clinic of Intensive Care Unit, Düzce University Health Research and Application Hospital, Düzce, Turkey
| | - Sinem Cesur
- Clinic of Intensive Care Unit, Düzce University Health Research and Application Hospital, Düzce, Turkey
| | - Hülya Yolacan
- Clinic of Intensive Care Unit, Eskişehir Yunus Emre State Hospital, Eskişehir, Turkey
| | - Seda Beyhan Sağmen
- Clinic of Intensive Care Unit, Health Sciences University, Dr. Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, Turkey
| | - Pervin Korkmaz Ekren
- Department of Intensive Care Unit, Ege University School of Medicine Hospital, İzmir, Turkey
| | - Feza Bacakoğlu
- Department of Intensive Care Unit, Ege University School of Medicine Hospital, İzmir, Turkey
| | - Begüm Ergan
- Department of Intensive Care Unit, Dokuz Eylül University School of Medicine Hospital, İzmir, Turkey
| | - Ersin Günay
- Clinic of Intensive Care Unit, Afyon Kocatepe University Ahmed Necdet Sezer Research and Application Hospital, Afyon, Turkey
| | - Muzaffer Sarıaydın
- Clinic of Intensive Care Unit, Afyon Kocatepe University Ahmed Necdet Sezer Research and Application Hospital, Afyon, Turkey
| | - Dursun Ali Sağlam
- Clinic of Intensive Care Unit, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Sait Karakurt
- Clinic of Intensive Care Unit, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey
| | - Emel Eryüksel
- Clinic of Intensive Care Unit, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey
| | - Funda Öztuna
- Department of Intensive Care Unit, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | | | - Hakan Cinemre
- Clinic of Intensive Care Unit, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Ahmet Nalbant
- Clinic of Intensive Care Unit, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Öznur Yağmurkaya
- Clinic of Intensive Care Unit, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Tuğba Mandal
- Department of Intensive Care Unit, Adıyaman University School of Medicine Hospital, Adıyaman, Turkey
| | - Belgin İkidağ
- Clinic of Intensive Care Unit, American Hospital, Gaziantep, Turkey
| |
Collapse
|
11
|
Arıkan H, Duman D, Kargın F, Ergin G, Horne R, Karakurt S, Eryüksel E. Cross-cultural Adaptation and Validation of Beliefs about Medicines Questionnaire on Asthma and Chronic Obstructive Pulmonary Disease Patients. Turk Thorac J 2018; 19:36-40. [PMID: 29404184 DOI: 10.5152/turkthoracj.2017.17040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 09/28/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Inadequate adaptation to long-term treatment of chronic illnesses is the most common reason for the inability to obtain the benefits medications can provide. Treatment compliance is influenced by several factors. Beliefs about Medicines Questionnaire (BMQ) developed by Horne et al. in 1999 to evaluate the cognitive representation of medicines have many validation studies, which resulted in good psychometric properties. The aim of the present study was to evaluate the reliability and validity of the BMQ Turkish translation in patients with asthma and chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS Fifty asthma and 50 COPD patients participated in this methodological study. The scale was adapted to Turkish through translation, comparison with other language versions, back translation, and a pre-test. The structural validity was assessed using factor analysis. RESULTS Similar to the original scale, factor analysis confirmed that BMQ had a four-factor structure that accounts for 58.23% of the total variance. The BMQ showed an acceptable internal consistency (Cronbach's alpha coefficient: specific-necessity, 0.832: specific-concerns, 0.722; general-harm, 0.792; and general-overuse, 0.682). The factor analysis revealed the same patterns for all questions between the Turkish and original scales. CONCLUSION The psychometric properties of the BMQ were consistent with those reported in the original study. We found that the Turkish translation of BMQ is a valid and reliable tool for assessing medicine-related beliefs in patients with asthma and COPD.
Collapse
Affiliation(s)
- Hüseyin Arıkan
- Department of Chest Diseases and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Dildar Duman
- Department of Pulmonology University of Health Sciences, Süreyyapaşa Chest Diseases and Cheast Surgery Training and Research Hospital, İstanbul, Turkey
| | - Feyza Kargın
- Department of Pulmonology University of Health Sciences, Süreyyapaşa Chest Diseases and Cheast Surgery Training and Research Hospital, İstanbul, Turkey
| | - Gülbin Ergin
- Department of Physiotherapy and Rehabilitation, Lefke European University Faculty of Health Sciences, Lefka, Cyprus
| | - Rob Horne
- UCL School of Pharmacy, Centre for Behavioural Medicine, University College London, United Kingdom
| | - Sait Karakurt
- Department of Chest Diseases and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Emel Eryüksel
- Department of Chest Diseases and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| |
Collapse
|
12
|
Eryüksel E, Cimşit C, Bekir M, Cimsit Ç, Karakurt S. Diaphragmatic Thickness Fraction in Subjects at High-Risk for COPD Exacerbations. Respir Care 2017; 62:1565-1570. [PMID: 28874613 DOI: 10.4187/respcare.05646] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Ultrasound-based diaphragmatic thickness fraction is a reflection of the size and function of the diaphragm. This study aimed to examine the value of this measurement in identifying patients with COPD who are at high risk for the development of symptoms and exacerbations. METHODS This cross-sectional study included 53 subjects with COPD. Respiratory function test results, ultrasonography-based diaphragmatic thickness, symptom scores (modified Medical Research Council dyspnea scale); COPD Assessment Test results, and number of previous exacerbations and admissions were recorded. RESULTS Only age showed an inverse and weak relation with percent thickness fraction (r = -0.37, P = .006). None of the other variables tested correlated significantly with percent thickness fraction. No association was found between percent thickness fraction and exacerbation frequency, modified Medical Research Council dyspnea scale and COPD Assessment Test symptom scores, or Global Initiative for Chronic Obstructive Lung Disease ABCD risk/symptom assessments. CONCLUSIONS Diaphragmatic thickness fraction measurements based on diaphragmatic ultrasound assessment in subjects with COPD seemed to be unable to identify subjects at high risk of symptoms and exacerbations as defined by the Global Initiative for Chronic Obstructive Lung Disease ABCD composite disease index.
Collapse
Affiliation(s)
- Emel Eryüksel
- Department of Pulmonary and Critical Care, School of Medicine, Marmara University, Istanbul, Turkey
| | - Canan Cimşit
- Department of Radiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Melahat Bekir
- Department of Pulmonary and Critical Care, School of Medicine, Marmara University, Istanbul, Turkey
| | - Çagatay Cimsit
- Department of Radiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Sait Karakurt
- Department of Pulmonary and Critical Care, School of Medicine, Marmara University, Istanbul, Turkey
| |
Collapse
|
13
|
Yıldızeli ŞO, Balcan B, Eryüksel E, Ceyhan BB, Karakurt S, Çelikel T. Influence of Statin Therapy on Exacerbation Frequency in Patients with Chronic Obstructive Pulmonary Disease. Turk Thorac J 2017; 18:29-32. [PMID: 29404156 DOI: 10.5152/turkthoracj.2017.16051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 12/04/2016] [Accepted: 02/15/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Chronic obstructive pulmonary disease (COPD) is an inflammatory disease, in which chronic and systemic inflammation plays an important role. By decreasing neutrophil infiltration and cytokine production, statins have anti-inflammatory mechanisms. MATERIALS AND METHODS Fifty-seven patients who had diagnosis of chronic obstructive pulmonary disease according to GOLD guideline were included in the study; 20 of them were statin users. Statin users group were patients being under medication with regular simvastatin, atorvastatin or rosuvastatin 20 mg per day for at least the past 1 year. RESULTS There was statistically no significant difference between patients with or without statin treatment with respect to; age, female-male ratio, COPD severity level, medication used for COPD, pulmonary function tests results and smoking habits. COPD exacerbation frequency in patients using statins was significantly less than patients not using statins (p<0.05). Patient number with COPD exacerbation, antibiotic treatment and outpatient clinic administration and outpatient clinic administration frequency was significantly lower in statin using patients (p<0.05). CONCLUSION COPD patients receiving statins have a lower frequency of COPD exacarbations, hospital administration and antibiotic treatment compared to patients not receiving statins.
Collapse
Affiliation(s)
- Şehnaz Olgun Yıldızeli
- Department of Pulmonolgy and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Baran Balcan
- Department of Pulmonolgy, Başkent University School of Medicine, Ankara, Turkey
| | - Emel Eryüksel
- Department of Pulmonolgy and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Berrin Bağcı Ceyhan
- Department of Pulmonolgy and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Sait Karakurt
- Department of Pulmonolgy and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| | - Turgay Çelikel
- Department of Pulmonolgy and Intensive Care, Marmara University School of Medicine, İstanbul, Turkey
| |
Collapse
|
14
|
Balcan B, Olgun Ş, Akbaş T, Eryüksel E, Karakurt S. Level of adrenomedullin in cases with adrenal defficiency and its relation to mortality in patients with sepsis. Tuberk Toraks 2016; 64:191-197. [PMID: 28393725 DOI: 10.5578/tt.10568] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The aim of this study was to determine the prognostic value of adrenomedullin, after evaluation of adrenal function in sepsis patients. We also evaluated other prognostic factors such as APACHE II score, proBNP, and CRP and their prediction in mortality. MATERIALS AND METHODS This is a prospective, observational study. We enrolled 48 patients, who were admitted to the intensive care unit due to sepsis according to surviving sepsis campaign criteria. RESULT ADM median value was 60.8 ng/L in patients with normal adrenal function, and 20.1 ng/L in patients who had adrenal deficiency. With adequate adrenal response there was a linear and statistically significant relationship between adrenomedullin and mortality (p< 0.001). The median ADM level was 41.7 ng/L among non-survivors and 13.9 ng/L among survivors (p< 0.001). The median APACHE II score was 27.8 in non-survivors and 16.9 in survivors (p= 0.001). We also done ROC curve analysis; when ADM level was > 30.19 ng/L (sensitivity: 73.0%, specificity: 100%), APACHE II score was > 21 (sensitivity: 93.3%, specificity: 84.8%), and proBNP > 3736 pg/mL (sensitivity: 73.3%, specificity: 93.9%). CONCLUSIONS Without evaluation of adrenal function adrenomedullin should not be used, in predicting mortality of sepsis.
Collapse
Affiliation(s)
- Baran Balcan
- Clinic of Chest Diseases, Baskent University Istanbul Hospital, Istanbul, Turkey.
| | | | | | | | | |
Collapse
|
15
|
Amin P, Fox-Robichaud A, Divatia JV, Pelosi P, Altintas D, Eryüksel E, Mehta Y, Suh GY, Blanch L, Weiler N, Zimmerman J, Vincent JL. The Intensive care unit specialist: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care 2016; 35:223-8. [PMID: 27444985 DOI: 10.1016/j.jcrc.2016.06.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 06/12/2016] [Indexed: 01/24/2023]
Abstract
The role of the critical care specialist has been unequivocally established in the management of severely ill patients throughout the world. Data show that the presence of a critical care specialist in the intensive care unit (ICU) environment has reduced morbidity and mortality, improved patient safety, and reduced length of stay and costs. However, many ICUs across the world function as "open ICUs," in which patients may be admitted under a primary physician who has not been trained in critical care medicine. Although the concept of the ICU has gained widespread acceptance amongst medical professionals, hospital administrators and the general public; recognition and the need for doctors specializing in intensive care medicine has lagged behind. The curriculum to ensure appropriate training around the world is diverse but should ideally meet some minimum standards. The World Federation of Societies of Intensive and Critical Care Medicine has set up a task force to address issues concerning the training, functions, roles, and responsibilities of an ICU specialist.
Collapse
Affiliation(s)
- Pravin Amin
- Bombay Hospital Institute of Medical Sciences, Mumbai, India.
| | | | | | | | | | | | | | - Gee Young Suh
- Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Lluís Blanch
- Universitat Autònoma de Barcelona, CIBERes, Parc Taulí Hospital, Sabadell, Spain
| | | | | | | |
Collapse
|
16
|
Balcan B, Olgun Ş, Torlak F, Sağmen SB, Eryüksel E, Karakurt S. Determination of Factors Affecting Mortality of Patients with Sepsis in a Tertiary Intensive Care Unit. Turk Thorac J 2015; 16:128-132. [PMID: 29404090 DOI: 10.5152/ttd.2015.4510] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 10/26/2014] [Accepted: 02/25/2015] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Sepsis is a disease with high mortality that is frequently observed in intensive care units. This study aimed to determine the risk factors affecting mortality of patients with sepsis who were followed up in the intensive care unit (ICU). We aimed to contribute to literature by evaluating the relationship between mortality and pro-brain natriuretic peptide (pro-BNP9), C-reactive protein (CRP), thrombocyte count, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, duration of hospitalization in the intensive care unit, and the presence of multidrug-resistant microorganism. MATERIAL AND METHODS Patients hospitalized in ICU because of the diagnosis of sepsis and septic shock between December 2010 and June 2012 were included in this retrospective study. RESULTS A total of 141 patients, including 74 male (52.5%) and 67 female (47.5%) patients, were involved in the study, and the median age was 66.8±17.9 years. Sixty-nine patients (48.9%) were discharged from the ICU; however, 72 patients (51.1%) were exitus. Multidrug-resistant microorganism was detected in 34 patients (24.1%). The patients' median SOFA score was 9.16±3.16, median APACHE-II score was 24.9±7.83, and median duration of hospitalization in the ICU was 8.44±11.61 days. It was found that mortality rate significantly increased in patients with the APACHE-II score of 24.5 and over, SOFA score of 8.5 and over, pro BNP value of 7241 ng/L and over, and CRP value of 96.5 mg/dL and over. Mortality rate was detected to be higher in patients undergoing invasive mechanical ventilation than in patients undergoing non-invasive mechanical ventilation. When thrombocyte count and mortality were associated with each other, it was found that the median value was 86000 mg/dL in exitus patients, whereas it was 185000 mg/dL in patients discharged from the ICU. CONCLUSION It was revealed that increased APACHE-II score, increased SOFA score, increased pro BNP score, increased CRP, the presence of multidrug-resistant microorganism, and decreased thrombocyte count elevated the rate of mortality. However, no relationship was observed between the duration of hospitalization in the ICU and mortality.
Collapse
Affiliation(s)
- Baran Balcan
- Department of Chest Diseases, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Şehnaz Olgun
- Department of Chest Diseases, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Fatih Torlak
- Department of Public Health, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Seda Beyhan Sağmen
- Department of Chest Diseases, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Emel Eryüksel
- Department of Chest Diseases, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Sait Karakurt
- Department of Chest Diseases, Marmara University Faculty of Medicine, İstanbul, Turkey
| |
Collapse
|
17
|
Kosar F, Uysal P, Dalar L, Eryüksel E, Kekecoglu A, Akbas T. Prognosis of Patients With Active Tuberculosis Requiring Intensive Care Unit. Chest 2014. [DOI: 10.1378/chest.1923880] [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: 11/01/2022] Open
|
18
|
Dalar L, Eryüksel E, Koşar F, Karasulu AL, Urer N, Sökücü SN, Altın S. Central airway obstruction due to malignant fibrous histiocytoma metastasis in a case with Mounier-Kuhn syndrome. Tuberk Toraks 2012; 60:167-71. [PMID: 22779939 DOI: 10.5578/tt.2458] [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] [Indexed: 11/15/2022] Open
Abstract
Malign fibrous histiocytoma is one of the most observed soft tissue sarcomas seen in the adults. The most common metastasis region is the lung and metastasis. Mounier-Kuhn syndrome is characterized by the highly dilatation of the trachea and bronchi. We may encounter with the major airway obstruction in the endoluminal or extraluminal lung and mediastinal masses or those with both components together. In this article, we would like to highlight the occurrence of a rare seen clinical situation secondary to the giant mediastinal malign fibrous histiocytoma metastasis and the clinical difficulties experienced in resolving of the main airway obstruction caused by the mass. Since the lack of the similar studies conducted previously, we found the case worth presenting.
Collapse
Affiliation(s)
- Levent Dalar
- Clinic of 7th Chest Diseases, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey.
| | | | | | | | | | | | | |
Collapse
|
19
|
Abstract
BACKGROUND: Unplanned extubation is quite common in intensive care unit (ICU) patients receiving mechanical ventilatory support. The present study aimed to investigate the effectiveness of noninvasive positive pressure ventilation (NPPV) in patients with unplanned extubation. MATERIALS AND METHODS: A total of 15 patients (12 male, age: 57 ± 24 years, APACHE II score: 19 ± 7) monitored at the medical ICU during the year 2004 who developed unplanned extubation were included in the study. NPPV was tried in all of them following unplanned extubation. Indications for admission to the ICU were as follows: nine patients with pneumonia, three with status epilepticus, one with gastrointestinal bleeding, one with cardiogenic pulmonary edema and one with diffuse alveolar bleeding. RESULTS: Eleven of the patients (74%) were at the weaning period at the time of unplanned extubation. Among these 11 patients, NPPV was successful in 10 (91%) and only one (9%) was reintubated due to the failure of NPPV. The remaining four patients (26%) had pneumonia and none of them were at the weaning period at the time of extubation, but their requirement for mechanical ventilation was gradually decreasing. Unfortunately, an NPPV attempt for 6–8 h failed and these patients were reintubated. CONCLUSIONS: Patients with unplanned extubation before the weaning criteria are met should be intubated immediately. On the other hand, when extubation develops during the weaning period, NPPV may be an alternative. The present study was conducted with a small number of patients, and larger studies on the effectiveness of NPPV in unplanned extubation are warranted for firm conclusions.
Collapse
Affiliation(s)
- Emel Eryüksel
- Department of Pulmonary and Critical Care, Marmara University Hospital, Turkey.
| | | | | |
Collapse
|
20
|
Eryüksel E, Abul Y, Karakurt S, Akbaş T, Mülazımoğlu L, Çelikel T. Severe respiratory failure secondary to Varicella zoster pneumonia. J Clin Exp Invest 2010. [DOI: 10.5799/ahinjs.01.2010.02.0023] [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: 11/23/2022] Open
|
21
|
Ozben B, Eryüksel E, Tanrikulu AM, Papila-Topal N, Celikel T, Başaran Y. Acute exacerbation impairs endothelial function in patients with chronic obstructive pulmonary disease. Turk Kardiyol Dern Ars 2010; 38:1-7. [PMID: 20215835] [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: 05/28/2023] Open
Abstract
OBJECTIVES The effect of acute exacerbation of chronic obstructive pulmonary disease (COPD) on brachial artery flow-mediated dilation (FMD) has not been examined. The aim of this study was to assess the endothelial function of COPD patients during acute exacerbations. STUDY DESIGN The study included 30 consecutive patients (8 women, 22 men; mean age 64.2+/-10.9 years) who experienced acute exacerbation of COPD, defined according to the Anthonisen criteria (increased dyspnea, sputum, and sputum purulence). All patients received the same antibiotic and bronchodilator treatment. Endothelial function was assessed by brachial artery ultrasonography within the first 48 hours and after complete resolution of exacerbation symptoms. Flow-mediated dilation was defined as both the maximum absolute and maximum percentage changes in the vessel diameter during reactive hyperemia. The results were compared with those of 20 age-and sex-matched controls without COPD. RESULTS The patient and control groups were similar in terms of age, gender, hypertension, diabetes, hyperlipidemia, coronary artery disease, heart rate, and blood pressure. Parameters of FMD during acute exacerbation were significantly lower than those obtained after recovery (absolute change: 0.23+/-0.12 mm vs. 0.38+/-0.17 mm, p<0.001; percentage change: 6.44+/-3.99% vs. 10.42+/-4.86%, p<0.001) and than those of the control group (absolute change: 0.36+/-0.13 mm, p=0.001; percentage change: 9.77+/-3.83%, p=0.003). Flow-mediated dilation increased significantly after recovery, yielding similar values to those of the controls. Improvements in FMD were significant in both sexes. CONCLUSION Acute COPD exacerbation is associated with worsening endothelial function, increasing the risk for cardiovascular morbidity.
Collapse
Affiliation(s)
- Beste Ozben
- Department of Cardiology, Medicine Faculty of Marmara University, Istanbul, Turkey.
| | | | | | | | | | | |
Collapse
|
22
|
Eryüksel E, Gün D, Odabaşi Z, Karakurt S, Celikel T. Acute respiratory distress syndrome in Plasmodium falciparum malaria. Southeast Asian J Trop Med Public Health 2009; 40:1179-1182. [PMID: 20578450] [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: 05/29/2023]
Abstract
Acute respiratory distress syndrome (ARDS) as a complication of malaria infection is rare but with a very high mortality rate. We report the case of a patient who developed high fever, then respiratory distress during a trip to Haiti who was admitted to our hospital and diagnosed with malaria. During recovery the patient developed ARDS in the hospital.
Collapse
Affiliation(s)
- Emel Eryüksel
- Pulmonary and Critical Care, Marmara University Hospital, Istanbul, Turkey.
| | | | | | | | | |
Collapse
|
23
|
Eryüksel E, Ceyhan BB, Bircan R, Avşar M, Cirakoğlu B. Angiotensin converting enzyme gene polymorphism in Turkish asthmatic patients. J Asthma 2009; 46:335-8. [PMID: 19484664 DOI: 10.1080/02770900802660972] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Asthma is a chronic inflammatory disease of the airways. Several candidate genes have been identified with a potential role in the pathogenesis of asthma, including the angiotensin converting enzyme (ACE) gene. We aimed to investigate the frequency of an ACE gene polymorphism in Turkish asthmatic patients and to determine its impact on clinical parameters and disease severity. Ninety-seven asthmatic patients (M/F 25/72, mean age 39 +/- 13 years) and 96 healthy subjects (M/F 26/70, mean age 38 +/- 12 years) were included. At baseline, all participants completed a questionnaire on demographics, symptoms, triggering factors, severity of asthma, and the presence of atopism. Blood samples were obtained from all patients and genomic DNA was isolated. The frequency of the ACE genotypes (I = insertion and D = deletion) among asthmatics and controls were compared: asthmatics showed a 40.2% prevalence of the DD genotype (n = 39), ID was 45.4% (n = 44), and II was 14.4% (n = 14.4). In the control subjects, the frequency of DD was 18.8% (n = 18), ID was 50% (n = 48) and II was 31.3% (n = 30). The DD ACE genotype was significantly more frequent in asthmatics compared with controls (p < 0.001). Asthmatics with the ID ACE genotype showed a higher frequency of drug allergies, although this was not statistically significant (p = 0.08). Asthmatics with the DD genotype appeared to have a higher incidence of asthmatic episode exacerbations due to viral infections, but again this was not statistically significant (p = 0.08). Patients with mild or moderate-severe asthma had similar frequencies of these mutations. We found a higher frequency of the ACE DD gene mutation in Turkish asthmatic patients compared with non-asthmatics, suggesting that this ACE gene polymorphism may be a risk factor for asthma but does not increase the severity of the disease.
Collapse
Affiliation(s)
- Emel Eryüksel
- Pulmonary and Critical Care Medicine, Marmara University Hospital, Istanbul, Turkey.
| | | | | | | | | |
Collapse
|
24
|
Eryüksel E, Karakurt S, Balci M, Celikel T. Non-invasive positive pressure ventilation for a severe legionella pneumonia case. Tuberk Toraks 2009; 57:348-351. [PMID: 19787476] [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: 05/28/2023] Open
Abstract
Legionella pneumonia has a serious clinical course and requires treatment at intensive care unit. The need for mechanical ventilation is one of the determinants of prognosis. Mortality rate is higher in patients treated with mechanical ventilation. Non-invasive positive pressure ventilation (NPPV) provides mechanical ventilation without endotracheal intubation and decreases the incidence of ventilator associated pneumonia. It is a treatment modality for patients with hypoxia due to community acquired pneumonia. The present case was admitted to intensive care unit with a diagnosis of legionella pneumonia, and his hypoxemic respiratory failure was successfully treated with NPPV.
Collapse
Affiliation(s)
- Emel Eryüksel
- Department of Chest Diseases and Intensive Care, Faculty of Medicine, Marmara University, Istanbul, Turkey.
| | | | | | | |
Collapse
|
25
|
Bihl MP, Laule-Kilian K, Bubendorf L, Rutherford RM, Baty F, Kehren J, Eryüksel E, Staedtler F, Yang JQ, Goulet S, Gilmartin JJ, Tamm M, Brutsche MH. Progressive pulmonary sarcoidosis--a fibroproliferative process potentially triggered by EGR-1 and IL-6. Sarcoidosis Vasc Diffuse Lung Dis 2006; 23:38-50. [PMID: 16933469] [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: 05/11/2023]
Abstract
BACKGROUND AND AIM OF THE WORK Sarcoidosis is a chronic granulomatous disorder of unknown etiology. In most patients the disease is self-limited, although for reasons unclear, others progress or die from progressive organ fibrosis. Growth factors have been implicated in the pathogenesis of other fibrotic lung conditions. We have, therefore, examined the relationship between growth factor expression and disease phenotype in sarcoidosis. METHODS Adopting a target gene approach utilizing gene expression arrays, growth factor gene expression profile was analyzed in the peripheral blood of 12 patients and 12 healthy controls. Expression, functional activity and the effect of oligonucleotide antisense treatment on selected proteins differentially expressed in progressive sarcoidosis were then tested in vitro on primary human lung fibroblasts. RESULTS Genes regulating angiogenesis were preferentially upregulated in the self-limited form of disease, while early growth response-1 and interleukin-6 were predominantly activated in progressive sarcoidosis. Increased expression of early growth response-1 in sarcoid lung was confirmed by immunohistochemistry. Stimulated human fibroblasts also rapidly expressed interleukin-6 and early growth response-1 and these proteins were found to mediate serum-induced fibroblast proliferation as proliferation could be significantly abrogated with interleukin-6 and early growth response-1 antisense oligonucelotides. CONCLUSION We conclude that progressive pulmonary sarcoidosis is characterized by a fibroproliferative dysregulation potentially triggered by early growth response-1 and interleukin-6. Our disease model underlines the inability of steroids to prevent ongoing fibroproliferation in the lung.
Collapse
Affiliation(s)
- Michel P Bihl
- Respiratory Medicine and Pulmonary Cell Research and Institute for Pathology, University Hospital, Basel, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
In the year 2000, the Human Genome Project Consortium presented the first complete draft of the human genome together with Celera Genetics. Since then, the so-called "post-genome era" has started. Microarrays are capable of profiling gene expression patterns of tens of thousands of genes in a single experiment and thus allow a systematic analysis of DNA and RNA variation. They seem likely to become a standard tool of both molecular biology research and clinical diagnostics. These prospects have attracted great interest and investment from both the public and private sectors. This review introduces the principle of microarray technology and gives an overview of its current and future potential in clinical medicine.
Collapse
Affiliation(s)
- Ladina Joos
- Division of Respiratory Medicine and Pulmonary Research Laboratory, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland
| | | | | |
Collapse
|
27
|
Joos L, Eryüksel E, Brutsche MH. Functional genomics and gene microarrays--the use in research and clinical medicine. Swiss Med Wkly 2003; 133:31-8. [PMID: 12596084 DOI: 10.4414/smw.2003.10007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In the year 2000, the Human Genome Project Consortium presented the first complete draft of the human genome together with Celera Genetics. Since then, the so-called "post-genome era" has started. Microarrays are capable of profiling gene expression patterns of tens of thousands of genes in a single experiment and thus allow a systematic analysis of DNA and RNA variation. They seem likely to become a standard tool of both molecular biology research and clinical diagnostics. These prospects have attracted great interest and investment from both the public and private sectors. This review introduces the principle of microarray technology and gives an overview of its current and future potential in clinical medicine.
Collapse
Affiliation(s)
- Ladina Joos
- Division of Respiratory Medicine and Pulmonary Research Laboratory, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland
| | | | | |
Collapse
|