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Alparslan Bekir S, Sonkaya E, Ozbaki F, Aydogan Eroglu S, Sertcelik L, Duman D, Kavas M, Agca M, Erdem I, Ozmen I, Boga S, Hazar A, Sevim T, Turker H, Tuncay E, Gungor S, Karakurt Z. The utility of neutrophil-to-lymphocyte ratio determined at initial diagnosis in predicting disease stage and discriminating between active and stable disease in patients with sarcoidosis: cross-sectional study. Postgrad Med 2022; 134:603-608. [PMID: 35619233 DOI: 10.1080/00325481.2022.2082805] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate the utility of neutrophil-lymphocyte ratio (NLR) determined at initial diagnosis in predicting advanced disease stage and discriminating between active and stable disease in sarcoidosis. METHODS A total of 465 patients with biopsy-proven sarcoidosis (age: 47 years, 70.5% females) were included in this retrospective cross-sectional study. Data on patient demographics, sarcoidosis stage, clinical status (stable and active), anti-inflammatory treatments, complete blood count, and inflammatory markers including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and platelet/mean platelet volume (MPV) ratio were recorded. NLR values were compared by subgrouping the patients according to the stage of sarcoidosis and clinical status, while the receiver operating characteristics (ROC) curve was plotted to determine the role of NLR in the identification of disease activity with the calculation of area under the curve (AUC) and cut-off value via ROC analysis. RESULTS Overall, active, and stable disease was evident in 36 (7.8%) and 427 (92.2%) patients, respectively. Median NLR values were significantly higher in patients with active disease compared with stable disease (3.31 (2.34-4.31) vs. 2.29 (1.67- 3.23), p=0.005). Advanced sarcoidosis stage was associated with significantly higher NLR values at stages 0, I, II, III and IV, respectively (p=0.001). ROC analysis revealed a NLR cut-off value of ≥2.39 (AUC (95% CI): 0.70(0.62 - 0.79), p<0.001) to discriminate between active and stable clinic with a sensitivity of 72.0% and specificity of 52.0%. The significantly higher percentage of patients with active vs. stable disease had NLR values ≥ 2.39 (74.0 vs. 47.0%, p=0.002). CONCLUSION Our findings indicate the potential utility of on-admission NLR values to predict the risk of advanced disease stage and to discriminate between active and stable disease in sarcoidosis. Measured via a simple, readily available, and low-cost test, NLR seems to be a valuable marker for monitoring disease activity and progression.
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Affiliation(s)
- Sumeyye Alparslan Bekir
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Esin Sonkaya
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Fatma Ozbaki
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Selma Aydogan Eroglu
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Lale Sertcelik
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Dildar Duman
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Murat Kavas
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Meltem Agca
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Ipek Erdem
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Ipek Ozmen
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Sibel Boga
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Armagan Hazar
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Tulin Sevim
- Acıbadem Hospital Chest Diseases, Department of Pulmonary Disease, Istanbul, Turkey
| | - Hatice Turker
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Eylem Tuncay
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Sinem Gungor
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
| | - Zuhal Karakurt
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Disease, Istanbul, Turkey
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Durmus Kocak N, Oruc O, Boga S, Acar C, Kavas M, Aydogan Eroglu S, Gundogus B, Sogukpinar O, Bekir S, Oztin Guven AA, Akbay MO, Arinc S, Duman D, Takir HB, Yaman F, Ozbaki F, Sonkaya E, Bulbul EU, Anil Tokyay D, Dagyildizi L, Akturk UA, Oztas S, Ernam D, Gungor G, Adiguzel N, Yildiz T, Mocin OY, Gunen H, Yildiz R, Sevim T, Torun T. Use of Radiology, D-Dimer, and Mean Platelet Volume Combination as a Prognostic Marker in Hospitalized Coronavirus Disease-19 Patients. Front Med (Lausanne) 2022; 8:788551. [PMID: 35186972 PMCID: PMC8850409 DOI: 10.3389/fmed.2021.788551] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 12/31/2021] [Indexed: 01/08/2023] Open
Abstract
IntroductionThe search for biomarkers that could help in predicting disease prognosis in the Coronavirus Disease-2019 (COVID-19) outbreak is still high on the agenda.ObjectiveTo find out the efficacy of D-dimer and mean platelet volume (MPV) combination as a prognostic marker in hospitalized COVID-19 patients with bilateral infiltration.Materials and MethodsStudy design: Retrospective observational cohort. Patients who were presented to our hospital between March 16, 2020 and June 07, 2020 were reviewed retrospectively. The primary outcome of the study was specified as the need for intensive care, while the secondary outcomes were duration of treatment and hospitalization. Receiver operator curve (ROC) analyzes were carried out to assess the efficacy of D-dimer and MPV parameters as prognostic markers.ResultsBetween the mentioned dates, 575 of 1,564 patients were found to be compatible with COVID-19, and the number of patients who were included in the study was 306. The number of patients who developed the need for intensive care was 40 (13.1%). For serum D-dimer levels in assessing the need for intensive care, the area under the curve (AUC) was found to be 0.707 (95% CI: 0.620–0.794). The AUC for MPV was 0.694 (95% CI: 0.585–0.803), when D-dimer was ≥1.0 mg/L. When patients with a D-dimer level of ≥1.0 mg/L were divided into two groups considering the MPV cut-off value as 8.1, the rate of intensive care transport was found to be significantly higher in patients with an MPV of ≥8.1 fL compared to those with an MPV of <8.1 fL (32.6 vs. 16.0%, p = 0.043). For the prognostic efficacy of the combination of D-dimer ≥ 1.0 mg/L and MPV ≥ 8.1 fL in determining the need for intensive care, following values were determined: sensitivity: 57.7%, specificity: 70.8%, positive predictive value (PPV): 32.0%, negative predictive value (NPV): 84.0%, and accuracy: 63.0%. When D-dimer was ≥1.0, the median duration of treatment in MPV <8.1 and ≥8.1 groups was 5.0 [interquartile range (IQR): 5.0–10.0] days for both groups (p = 0.64). The median length of hospital stay (LOS) was 7.0 (IQR: 5.0–10.5) days in the MPV <8.1 group, while it was 8.5 (IQR: 5.0–16.3) days in the MPV ≥ 8.1 group (p = 0.17).ConclusionIn COVID-19 patients with a serum D-dimer level of at least 1.0 mg/L and radiological bilateral infiltration at hospitalization, if the MPV value is ≥8.1, we could predict the need for intensive care with moderate efficacy and a relatively high negative predictive value. However, no correlation could be found between this combined marker and the duration of treatment and the LOS.
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Affiliation(s)
- Nagihan Durmus Kocak
- University of Health Sciences Sancaktepe Martyr Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey
- *Correspondence: Nagihan Durmus Kocak
| | - Ozlem Oruc
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sibel Boga
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Cem Acar
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Murat Kavas
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Selma Aydogan Eroglu
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Baran Gundogus
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Sogukpinar
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sumeyye Bekir
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Aysem Askim Oztin Guven
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Makbule Ozlem Akbay
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sibel Arinc
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Dildar Duman
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Huriye Berk Takir
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | | | - Fatma Ozbaki
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Esin Sonkaya
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Esra Usta Bulbul
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Dilem Anil Tokyay
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Lale Dagyildizi
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ulku Aka Akturk
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Selahattin Oztas
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Dilek Ernam
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Gokay Gungor
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Nalan Adiguzel
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Tekin Yildiz
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Yazicioglu Mocin
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Hakan Gunen
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Reyhan Yildiz
- Department of Chest Diseases Immunology and Allergy Diseases Science, Faculty of Medicine, Ankara, Turkey
| | - Tulin Sevim
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Tulay Torun
- University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
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Eroglu S, Sonkaya E. Evaluation of smoking behaviour according to gender, symptoms and diagnoses at a pulmonology outpatient visit. Med-Science 2022. [DOI: 10.5455/medscience.2022.07.168] [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: 11/06/2022] Open
Abstract
Smoking during the hours prior to an examination in a pulmonology outpatient clinic may provide valuable information regarding patients’ smoking behaviour. The objective of our study was to examine the association of gender, symptoms, and current diagnoses with active smoking status and smoking on the day of outpatient visits. This was a retrospective, observational, cross-sectional study. A total of 1863 patients were included. Symptoms, diagnoses, smoking history, and the last smoking time prior to the outpatient clinic visit were recorded. Males were more likely to be active or ex-smokers, while females were more likely to be non-smokers (p<0.001, for all). The rate of continued smoking was higher in younger patients (p<0.001), patients with chest/back pain (p=0.003), and in women (p<0.001), whereas smoking cessation was more common in COPD (p<0.001) and bronchiectasis patients (p=0.002), sputum producing patients (p=0.02), and men (p<0.001). A total of 66.9 % (n=420) of the active smoking group smoked on the day of the outpatient clinic visit. The median value of the smoking duration before the examination was 60 minutes (64.5%, n=271) on the day of the outpatient clinic visit. Smoking behaviour was significantly more common within the last 24 hours (p<0.001) and on the day of the clinic visit among female smokers (p<0.001). Patients with COPD, bronchiectasis, or sputum production were significantly less likely to smoke on the day of outpatient visit (p<0.001, p=0.05, and p=0.004, respectively), while younger patients, asthmatic patients, and those with chest/back pain were significantly more likely to smoke on outpatient visit day (p<0.001, p=0.02, p<0.001, respectively). Thus, female gender and pain emerged as the most important determinants of smoking behaviour on the outpatient visit day. The success of anti-smoking campaigns may be positively impacted by paying more attention to gender differences, specific patient groups, and appropriate management of existing symptoms.
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Duman D, Sonkaya E, Yıldırım E, Gıdık E, Tanülkü U, Saltürk C, Karakurt Z. Association of Inflammatory Markers with Mortality in Patients Hospitalized with Non-massive Pulmonary Embolism. Turk Thorac J 2021; 22:24-30. [PMID: 33646100 DOI: 10.5152/turkthoracj.2021.190076] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 02/28/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Pulmonary embolism (PE) is a serious pathology with high rates of morbidity and mortality. Studies regarding the efficacy of new inflammatory markers as a predictor of mortality in PE have thus far been limited. This study aimed to evaluate the predictive value of platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), platelet/mean platelet volume (PLT/MPV), and C-reactive protein (CRP) on short-term and long-term mortality in patients with PE. MATERIAL AND METHODS A retrospective, observational cohort study was carried out in a tertiary teaching hospital. Patients with PE hospitalized in the pulmonology ward were enrolled. Their characteristics, hemogram parameters, PLR, NLR, CRP levels, PLT/MPV on admission, and mortality were recorded. The predictive accuracies of inflammatory markers were determined through receiver operating characteristic curves. The risk factors for mortality were further analyzed with Cox regression analysis. RESULTS A total of 828 patients with PE were included in the study. The 1-month mortality was 1%, and the 1-year mortality was 8.5%. An NLR value above 6 was associated with an almost 13-fold increase in short-term (30-day) mortality. We found that an NLR above 3.15 and age were independent risk factors for long-term (1-year) mortality. The other inflammatory markers, namely PLR and CRP, were not found to be associated with long-term mortality. CONCLUSION PE is a serious condition in the elderly. Elevated NLR values appear to be a good and feasible predictor of inflammation, which can be correlated with higher mortality over both the short-term and long-term periods.
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Affiliation(s)
- Dildar Duman
- Department of Chest Diseases, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Esin Sonkaya
- Department of Chest Diseases, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Elif Yıldırım
- Department of Chest Diseases, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Erman Gıdık
- Department of Chest Diseases, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Uğurcan Tanülkü
- Department of Chest Diseases, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Cüneyt Saltürk
- Department of Chest Diseases, Gaziosmanpasa Hospital of Yeni Yüzyıl University, İstanbul, Turkey
| | - Zuhal Karakurt
- Department of Chest Diseases, University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
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Aydogan Eroglu S, Yildiz T, Sonkaya E, Kavas M, Ozbaki F, Sertçelik L, Sen A, Sevim T. Diagnosis distribution in cases with granulomatous inflammation in lung, pleura, and lymph node biopsies: an experience from a tertiary level single center chest diseases and thoracic surgery hospital. Sarcoidosis Vasc Diffuse Lung Dis 2021; 38:e2021048. [PMID: 35115754 PMCID: PMC8787379 DOI: 10.36141/svdld.v38i4.11914] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/20/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND Granulomatous inflammation is found in a wide range of diseases, and most commonly associated with sarcoidosis and tuberculosis. Granulomas are pathologically classified into two main groups; necrotic and non-necrotic. OBJECTIVES The aim of this study was to evaluate the radiological, laboratory, and pathological findings of a large patient population with granuloma in biopsy samples, to determine the final diagnostic distribution. METHODS This study was designed as a retrospective, descriptive, observational, cross-sectional study. It was conducted in patients with granulomatous inflammation detected in lung, pleural, mediastinal, hilar, and/or peripheral lymph node biopsies. Demographic information, radiological, microbiological, and laboratory results of the patients were obtained via the information processing system of the hospital. The diagnoses recorded were re-evaluated by at least two experienced clinicians and the final diagnosis distributions were made. RESULTS A total of 392 patients were included in the study. Non-necrotizing inflammation was detected in 268 patients, and necrotizing granulomatous inflammation was found in 124 patients. The most common cause of non-necrotizing inflammation was sarcoidosis, and tuberculosis in the case of necrotizing inflammation. A total of 77.2% of sarcoidosis patients had non-necrotizing inflammation and 54.3% of the tuberculosis patients had necrotizing inflammation. In the diagnosis distribution of granulomatous inflammation sarcoidosis, mycobacterium infections (especially tuberculosis), sarcoid reaction due to malignancy, pneumoconiosis, granulomatosis with polyangiitis and hypersensitivity pneumonitis were detected, respectively. A total of 392 patients were diagnosed with 13 different diseases. In 15 patients (3.8%) no specific diagnosis could be made. CONCLUSIONS The diagnosis of granulomatous inflammation detected in biopsy samples is common for clinicians and a differential diagnosis is difficult in many cases. A patient's clinical findings, laboratory results, and radiological appearance, should be evaluated in detail and a final diagnosis only made following a multidisciplinary discussion. The presence of necrosis in tissue samples alone is not a reliable finding for a final diagnosis.
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Affiliation(s)
- Selma Aydogan Eroglu
- University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Tekin Yildiz
- University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Esin Sonkaya
- University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Murat Kavas
- University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Fatma Ozbaki
- University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Lale Sertçelik
- University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Aycim Sen
- University of Health Sciences Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
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Akyıl FT, Ağca M, Öztürk H, Sonkaya E, Erdem İ, Bülbül EU, Özbaki F, Yıldız R, Bekir SA, Sevim T. Correlation between the Diagnostic Yield from the Bronchoalveolar Lavage Fluid Analysis and Clinicoradiological Findings in Sarcoidosis. Turk Thorac J 2019; 21:21-26. [PMID: 30986174 DOI: 10.5152/turkthoracj.2018.180140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 10/18/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The diagnosis of sarcoidosis is frequently challenging, requiring a search for less invasive, more reliable diagnostic methods. The bronchoalveolar lavage fluid (BALF) analysis has been used in the differential diagnosis of sarcoidosis for many years with a wide sensitivity and specificity rates. The objective of the study is to investigate whether diagnostic performance of the BALF analysis is altered by clinicoradiological findings of patients with sarcoidosis. MATERIALS AND METHODS The present study is a retrospective, single-center, observational study, designed in a sarcoidosis outpatient clinic in a training hospital. Patients who had undergone the bronchoalveolar lavage BAL procedure at diagnosis were included in the study. Demographics, clinical and detailed chest X-ray, and high-resolution computed tomography (HRCT) findings at diagnosis were recorded. According to the diagnostic performance, the BALF results were grouped as "diagnostic" and "non-diagnostic," and recorded parameters were compared between the groups. RESULTS Considering the BALF analysis of all the 257 patients, the mean lymphocyte ratio was 41±17.5 (5-80), and the mean CD4/CD8 was 5.5±4.7 (0.1-24.7). The BALF analysis was diagnostic in 56% (n=145) of patients. Diagnostic performance of the procedure did not correlate with any of the demographic data, smoking status, spirometric findings, chest X-ray staging, HRCT findings, and tomography scoring. Extrapulmonary involvement was significantly more frequent in the diagnostic group (66% vs. 34%, p=0.006). CONCLUSION BALF results signal sarcoidosis in more than half of the patients. The diagnostic role of BALF is greater in patients with extrapulmonary involvement.
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Affiliation(s)
| | - Meltem Ağca
- Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Hatice Öztürk
- Department of Radiology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Esin Sonkaya
- Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - İpek Erdem
- Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Esra Usta Bülbül
- Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Fatma Özbaki
- Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Reyhan Yıldız
- Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Sümeyye Alparslan Bekir
- Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Tülin Sevim
- Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
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Ocakli B, Özmen I, Sonkaya E, Sertçelik L, Boga S, Türker H, Ocakli Ö, Yasar S, Günes PB, Sen A, Karakurt Z. An Uncommon Coexistence of Sarcoidosis and Cutaneous Leukocytoclastic Vasculitis in an Adult. Indian J Dermatol 2019; 64:486-489. [PMID: 31896849 PMCID: PMC6862359 DOI: 10.4103/ijd.ijd_291_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The skin is the second most commonly involved organ after pulmonary system in sarcoidosis, a multisystemic granulomatous disease. Cutaneous small-vessel vasculitis (leukocytoclastic vasculitis [LCV]) is a disorder characterized by neutrophilic inflammation of small blood vessels. Although the skin is the organ where LCV is seen most frequently, extracutaneous involvements are also seen. Herein, we present a coexistence of sarcoidosis and cutaneous LCV, which is an uncommon condition in adult.
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Affiliation(s)
- Birsen Ocakli
- Chest Diseases Clinic, Respiratory Intensive Care Unit, Istanbul Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Ipek Özmen
- Chest Diseases Clinic, Respiratory Intensive Care Unit, Istanbul Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Esin Sonkaya
- Chest Diseases Clinic, Respiratory Intensive Care Unit, Istanbul Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Lale Sertçelik
- Chest Diseases Clinic, Respiratory Intensive Care Unit, Istanbul Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Sibel Boga
- Chest Diseases Clinic, Respiratory Intensive Care Unit, Istanbul Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Hatice Türker
- Chest Diseases Clinic, Respiratory Intensive Care Unit, Istanbul Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Özer Ocakli
- Division of Ear, Nose and Throat Diseases, Istanbul Tuzla State Hospital, Istanbul, Turkey
| | - Sirin Yasar
- Division of Dermatology, Istanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Pembegül Binbir Günes
- Division of Pathology, Istanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Ayçim Sen
- Division of Pathology, Istanbul Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Zuhal Karakurt
- Chest Diseases Clinic, Respiratory Intensive Care Unit, Istanbul Süreyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Sciences University, Istanbul, Turkey
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Duman D, Bekir S, Altunbey S, Güngör S, Koç EN, Berk A, Sonkaya E, Eroğlu S, Hazar A. PET/CT findings in sarcoidosis: Analysis of 53 cases. Medeni Med J 2017. [DOI: 10.5222/mmj.2017.014] [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: 11/05/2022] Open
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Arai O, Ucar Y, Yalcin A, Aydin Y, Sonkaya E, Eroglu A, Akgun M. Do Atmospheric Changes and the Synodic Lunar Cycle Affect the Development of Spontaneous Pneumothorax? Acta Chir Belg 2015; 115:284-7. [PMID: 26324030 DOI: 10.1080/00015458.2015.11681113] [Citation(s) in RCA: 4] [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] [Indexed: 10/21/2022]
Abstract
BACKGROUND Pneumothorax is defined as air in pleural space. The etiology of spontaneous pneumothorax (SP) is still under investigation and, despite many studies, remains uncertain. The aim of this study was to investigate the effects of the lunar cycle and daily weather changes on SP development. METHODS The data of patients admitted to our clinic with SP were analysed retrospectively. The daily atmospheric pressure, relative ratio of humidity and temperature in degrees Celsius of each day were obtained. The mean values for each day, from the first to the 29th day, of the synodic lunar cycle (SLC) were calculated for the five-year study period. The attacks were allocated to the appropriate day of an ideal 29-day SLC, irrespective of the calendar date. RESULTS A total of 131 patients who were admitted to our hospital with SP (130 males and 1 female with an average age of 32.4±12.2) were included in this study. The number of patients with SP showed a statistically significant correlation with mean atmospheric pressure (p=0.005), relative humidity (p=0.007) and outdoor temperature (p=0.02) but not with the SLC. CONCLUSIONS SP is significantly influenced by weather-related factors. Changes in atmospheric pressure, humidity and outdoor temperature had obvious effects on the development of SP. However, the SLC had no effect on SP.
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Ucar EY, Araz O, Meral M, Sonkaya E, Saglam L, Kaynar H, Gorguner AM, Akgun M. Two different dosages of nebulized steroid versus parenteral steroid in the management of COPD exacerbations: a randomized control trial. Med Sci Monit 2014; 20:513-20. [PMID: 24675102 PMCID: PMC3976199 DOI: 10.12659/msm.890210] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 01/16/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The study aimed to compare the efficacy and safety of nebulized steroid (NS) with systemic corticosteroids (SC) and to determine optimal NS dose in the treatment of patients with COPD exacerbations requiring hospitalization. MATERIAL AND METHODS The study was a randomized, parallel design trial. Eligible patients (n=86) were randomly allocated to 1 of the 3 treatment groups: parenteral corticosteroid (PS) (n=33), 4 mg (NB) (n=27), or 8 mg NB (n=26). Partial pressure of arterial oxygen (PaO2), carbon dioxide (PaCO2), pH, and oxygen saturation (SaO2) were evaluated at baseline, 24 h, 48 h, and discharge. Airway obstruction (forced vital capacity [FVC] and forced expiratory volume 1 s [FEV1]) was evaluated at admission and discharge. RESULTS There were no significant differences between the groups for all parameters at all time periods, except for higher FEV1 value in the 8-mg NB group at baseline. In groups, significant differences were determined for FVC, FEV1, PaO2, and SaO2 (p<0.001), but not for PaCO2 and pH, in comparison to their baseline values. As adverse events, hyperglycemia and oral moniliasis were observed in the PS group (n=4) and in the NB groups (n=5), respectively, and treatment change was required in 9 patients (2 patients in the PS group and 7 patients in the NB groups) (p=0.57). CONCLUSIONS Nebulized budesonide may be used as an alternative to SC because of its equal effectiveness and lesser systemic adverse effects. The choice of optimal dosage needs to be evaluated carefully because adverse effect and dropout rates varied according to dosage. However, there is a need for further studies including more severe cases and evaluating long-term outcomes or relapses comparing the 3 arms.
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Baydas G, Donder E, Kiliboz M, Sonkaya E, Tuzcu M, Yasar A, Nedzvetskii VS. Neuroprotection by alpha-lipoic acid in streptozotocin-induced diabetes. Biochemistry (Mosc) 2005; 69:1001-5. [PMID: 15521814 DOI: 10.1023/b:biry.0000043542.39691.95] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Glial cells provide structural and metabolic support for neurons, and these cells become reactive to any insult to the central nervous system. The streptozotocin (STZ) rat model was used to study glial reactivity and the prevention of gliosis by alpha-lipoic acid (alpha-LA) administration. The expression of glial fibrillary acidic protein (GFAP), S100B protein, and neuron specific enolase (NSE) was determined as well as lipid peroxidation (LPO) and glutathione (GSH) levels in some brain tissues. Western blot analyses showed GFAP, S100B, and NSE levels significantly increased under STZ-induced diabetes in brain, and LPO level increased as well. Administration of alpha-LA reduced the expression both of glial and neuronal markers. In addition, alpha-LA significantly prevented the increase in LPO levels found in diabetic rats. GSH levels were increased by the administration of alpha-LA. This study suggests that alpha-LA prevents neural injury by inhibiting oxidative stress and suppressing reactive gliosis.
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Affiliation(s)
- G Baydas
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, 23119, Turkey.
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