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Gül F, Kasapoğlu US, Sabaz MS, Ay P, Doruk Oktay B, Çalışkan G, Demir N, Sayan İ, Kabadayı F, Altuntaş G, Gümüş A, Kırca H, Şanlı D, Acil F, Dedeoğlu A, Ural SG, Akın Şen İ, Macit Aydın E, Dayanır H, Yelken B, Ceylan İ, Aydın OÖ, Eskidemir G, Aytekin A, Cengiz M, Arslan Ü, Akdağ D, Alay GH, Tekin E, Yarar V, Saracoğlu KT, Gök F, Alparslan V, Tuna V, Yıldız M, Şenoğlu N, Kıraklı C, Yıldırım S, Saçar Kübüç K, Erer A, Gültekin H, Özmen Süner K, Kuzgun Ö, Öztürk ÇE, Karahan A, Deveci O, Ay M, Tüfek Öztan D, Akıncı SB, Solak MY, Bozbay S, Özçiftçi S, Gönderen K, Küçük AO, Uyan B, Elay G, Boyacı N, Timurkaan M, Karakoç E, Doğan L, Yalçınkaya E, Kazancıoğlu L, Erdal Dönmez G, Yılmaz B, Ergül DF, Boran M, Özkarakaş H, Karakaş B, Ergin Özcan P, Anaklı İ, Bayar MK, Yüksel D, Akdağ Ş, Pişkin Ö, Temur S, Eyüpoğlu S, Tekir Yılmaz E, Avcı GZ, Turan R, Alkan Bayburt F, Şahintürk H, Güçyetmez B, Alparslan MM, Yarıcı M, Yıldırım F, Yektaş A, Yaman G, Demirkıran O, Cinel İ. The Impact of CoronaVac Vaccination on 28-day Mortality Rate of Critically Ill Patients with COVID-19 in Türkiye. Balkan Med J 2023; 40:435-444. [PMID: 37867428 PMCID: PMC10613737 DOI: 10.4274/balkanmedj.galenos.2023.2023-6-90] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/03/2023] [Indexed: 10/24/2023] Open
Abstract
Background Vaccines against coronavirus disease-19 (COVID-19) have been effective in preventing symptomatic diseases, hospitalizations, and intensive care unit (ICU) admissions. However, data regarding the effectiveness of COVID-19 vaccines in reducing mortality among critically ill patients with COVID-19 remains unclear. Aims To determine the vaccination status and investigate the impact of the COVID-19 vaccine on the 28-day mortality in critically ill patients with COVID-19. Study Design Multicenter prospective observational clinical study. Methods This study was conducted in 60 hospitals with ICUs managing critically ill patients with COVID-19. Patients aged ≥ 18 years with confirmed COVID-19 who were admitted to the ICU were included. The present study had two phases. The first phase was designed as a one-day point prevalence study, and demographic and clinical findings were evaluated. In the second phase, the 28-day mortality was evaluated. Results As of August 11, 2021, 921 patients were enrolled in the study. The mean age of the patients was 65.42 ± 16.74 years, and 48.6% (n = 448) were female. Among the critically ill patients with COVID-19, 52.6% (n = 484) were unvaccinated, 7.7% (n = 71) were incompletely vaccinated, and 39.8% (n = 366) were fully vaccinated. A subgroup analysis of 817 patients who were unvaccinated (n = 484) or who had received two doses of the CoronaVac vaccine (n = 333) was performed. The 28-day mortality rate was 56.8% (n = 275) and 57.4% (n = 191) in the unvaccinated and two-dose CoronaVac groups, respectively. The 28-day mortality was associated with age, hypertension, the number of comorbidities, type of respiratory support, and APACHE II and sequential organ failure assessment scores (p < 0.05). The odds ratio for the 28-day mortality among those who had received two doses of CoronaVac was 0.591 (95% confidence interval: 0.413-0.848) (p = 0.004). Conclusion Vaccination with at least two doses of CoronaVac within six months significantly decreased mortality in vaccinated patients than in unvaccinated patients.
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Affiliation(s)
- Fethi Gül
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Türkiye
| | - Umut Sabri Kasapoğlu
- Clinic of Critical Care Medicine, Malatya Training and Research Hospital, Malatya, Türkiye
| | - Mehmet Süleyman Sabaz
- Clinic of Critical Care Medicine, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
| | - Pınar Ay
- Department of Public Health, Marmara University Faculty of Medicine, İstanbul, Türkiye
| | - Burçin Doruk Oktay
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Türkiye
| | - Gülbahar Çalışkan
- Department of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Bursa Faculty of Medicine, Bursa, Türkiye
| | - Nalan Demir
- Division of Critical Care Medicine, Clinic of Chest Diseases, University of Health Sciences Türkiye, Ankara City Hospital, Ankara, Türkiye
| | - İsmet Sayan
- Clinic of Critical Care Medicine, Sancaktepe Training and Research Hospital, İstanbul, Türkiye
| | - Feyyaz Kabadayı
- Clinic of Critical Care Medicine, Sancaktepe Training and Research Hospital, İstanbul, Türkiye
| | - Gülsüm Altuntaş
- Clinic of Critical Care Medicine, Elazığ City Hospital, Elazığ, Türkiye
| | - Ayça Gümüş
- Clinic of Critical Care Medicine, Antalya Kepez State Hospital, Antalya, Türkiye
| | - Hülya Kırca
- Clinic of Critical Care Medicine, Antalya Kepez State Hospital, Antalya, Türkiye
| | - Deniz Şanlı
- Clinic of Critical Care Medicine, Batman Training and Research Hospital, Batman, Türkiye
| | - Fatma Acil
- Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyabakır, Türkiye
| | - Andaç Dedeoğlu
- Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyabakır, Türkiye
| | - Sedef Gülçin Ural
- Clinic Critical Care Medicine, University of Health Sciences Türkiye, Erzurum City Hospital, Erzurum, Türkiye
| | - İrem Akın Şen
- Clinic Critical Care Medicine, University of Health Sciences Türkiye, Erzurum City Hospital, Erzurum, Türkiye
| | - Eda Macit Aydın
- Division of Critical Care Medicine, Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Hakan Dayanır
- Division of Critical Care Medicine, Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Birgül Yelken
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye
| | - İlkay Ceylan
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Bursa High Specialization Training and Research Hospital, Bursa, Türkiye
| | - Osman Özcan Aydın
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye
| | - Güneş Eskidemir
- Clinic of Critical Care Medicine, Gaziosmanpaşa Training and Research Hospital, İstanbul, Türkiye
| | - Ahmet Aytekin
- Clinic of Anesthesiology and Reanimation, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Türkiye
| | - Melike Cengiz
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Ülkü Arslan
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Devrim Akdağ
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Adana City Hospital, Adana, Türkiye
| | - Gülçin Hilal Alay
- Department of Anesthesiology and Reanimation, University of Health Sciences Türkiye, İstanbul Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye
| | - Esra Tekin
- Clinic of Critical Care Medicine, Denizli State Hospital, Denizli, Türkiye
| | - Volkan Yarar
- Clinic of Critical Care Medicine, Balıkesir Atatürk City Hospital, Balıkesir, Türkiye
| | - Kemal Tolga Saracoğlu
- Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Kartal Lütfi Kırdar Training and Research Hospital, İstanbul, Türkiye
| | - Funda Gök
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Necmettin Erbakan University Faculty of Medicine, Konya, Türkiye
| | - Volkan Alparslan
- Clinic of Critical Care Medicine, Hatay Training and Research Hospital, Hatay, Türkiye
| | - Verda Tuna
- Clinic of Critical Care Medicine, Adıyaman Training and Research Hospital, Adıyaman, Türkiye
| | - Murside Yıldız
- Clinic of Critical Care Medicine, Ağrı Training and Research Hospital, Ağrı, Türkiye
| | - Nimet Şenoğlu
- Division of Critical Care Medicine, Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Cenk Kıraklı
- Department of Critical Care Medicine, University of Health Sciences Türkiye, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Türkiye
| | - Süleyman Yıldırım
- Department of Critical Care Medicine, University of Health Sciences Türkiye, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Türkiye
| | - Kübra Saçar Kübüç
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Van Training and Research Hospital, Van, Türkiye
| | - Ayşen Erer
- Clinic of Critical Care Medicine, Tekirdağ İsmail Fehmi Cumalioğlu City Hospital, Tekirdag, Türkiye
| | - Hamza Gültekin
- Clinic of Critical Care Medicine, Şırnak State Hospital, Şırnak, Türkiye
| | - Kezban Özmen Süner
- Clinic of Critical Care Medicine, Sakarya Training and Research Hospital, Sakarya, Türkiye
| | - Özge Kuzgun
- Clinic of Critical Care Medicine, Sakarya Training and Research Hospital, Sakarya, Türkiye
| | - Çağatay Erman Öztürk
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Samsun Training and Research Hospital, Samsun, Türkiye
| | - Aydın Karahan
- Clinic of Critical Care Medicine, Mersin City Hospital, Mersin, Türkiye
| | - Okan Deveci
- Clinic of Critical Care Medicine, Mersin City Hospital, Mersin, Türkiye
| | - Mustafa Ay
- Clinic of Anesthesiology and Reanimation, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Dilara Tüfek Öztan
- Clinic of Anesthesiology and Reanimation, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Seda Banu Akıncı
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Melahat Yalçın Solak
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Süha Bozbay
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hitit University Faculty of Medicine, Çorum, Türkiye
| | - Serhat Özçiftçi
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hitit University Faculty of Medicine, Çorum, Türkiye
| | - Kamil Gönderen
- Department of Critical Care Medicine, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Türkiye
| | - Ahmet Oğuzhan Küçük
- Division of Critical Care Medicine, Department of Chest Diseases, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
| | - Berna Uyan
- Department Critical Care Medicine, Gaziantep Şehit Kamil State Hospital, Gaziantep, Türkiye
| | - Gülseren Elay
- Division of Critical Care Medicine, Department of Internal Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye
| | - Nazlıhan Boyacı
- Division of Critical Care Medicine, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Türkiye
| | - Mustafa Timurkaan
- Clinic of Critical Care Medicine, Elazığ City Hospital, Elazığ, Türkiye
| | - Ebru Karakoç
- Department of Critical Care Medicine, Çankırı State Hospital, Çankırı, Türkiye
| | - Lerzan Doğan
- Department of Critical Care Medicine, Altunizade Acıbadem Hospital, İstanbul, Türkiye
| | - Erdem Yalçınkaya
- Department of Critical Care Medicine, Sivas Numune Hospital, Sivas, Türkiye
| | - Leyla Kazancıoğlu
- Department of Anesthesiology and Reanimation, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Türkiye
| | - Gül Erdal Dönmez
- Department of Critical Care Medicine, University of Health Sciences Türkiye, İstanbul Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Türkiye
| | - Barış Yılmaz
- Department of Critical Care Medicine, University of Health Sciences Türkiye, İstanbul Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Türkiye
| | - Dursun Fırat Ergül
- Department of Critical Care Medicine, Amasya University Sabuncuoğlu Şerafettin Training and Research Hospital, Amasya, Türkiye
| | - Maruf Boran
- Department of Critical Care Medicine, Amasya University Sabuncuoğlu Şerafettin Training and Research Hospital, Amasya, Türkiye
| | - Hüseyin Özkarakaş
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, University of Health Sciences Türkiye, İzmir Bozyaka Training and Research Hospital, İzmir, Türkiye
| | - Buğra Karakaş
- Clinic of Critical Care Medicine, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - Perihan Ergin Özcan
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, İstanbul University Capa Faculty of Medicine, İstanbul, Türkiye
| | - İlkay Anaklı
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, İstanbul University Capa Faculty of Medicine, İstanbul, Türkiye
| | - Mustafa Kemal Bayar
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Didem Yüksel
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Şükriye Akdağ
- Department of Anesthesiology and Reanimation, Yasar Eryılmaz Ağrı Doğubeyazıt State Hospital, Ağrı, Türkiye
| | - Özcan Pişkin
- Department of Anesthesiology and Reanimation, Zonguldak Bülent Ecevit University Faculty of Medicine, Zonguldak, Türkiye
| | - Sibel Temur
- Department of Anesthesiology and Reanimation, Yeditepe University Faculty of Medicine, İstanbul, Türkiye
| | - Selin Eyüpoğlu
- Clinic of Critical Care Medicine, Giresun Training and Research Hospital, Giresun, Türkiye
| | - Elvan Tekir Yılmaz
- Clinic of Anesthesiology and Reanimation, Giresun University Faculty of Medicine, Giresun Training and Research Hospital, Giresun, Türkiye
| | - Gizem Zaim Avcı
- Clinic of Anesthesiology and Reanimation, Giresun Prof. Dr. İlhan Özdemir State Hospital, Giresun Türkiye
| | - Raziye Turan
- Clinic of Anesthesiology and Reanimation, Giresun Prof. Dr. İlhan Özdemir State Hospital, Giresun Türkiye
| | - Fatma Alkan Bayburt
- Clinic of Anesthesiology and Reanimation, Giresun Prof. Dr. İlhan Özdemir State Hospital, Giresun Türkiye
| | - Helin Şahintürk
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Başkent University Faculty of Medicine, Ankara, Türkiye
| | - Bülent Güçyetmez
- Department of Anesthesiology and Reanimation, Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Türkiye
| | - Mustafa Muhlis Alparslan
- Clinic of Anesthesiology and Reanimation, Aksaray University Training and Research Hospital, Aksaray, Türkiye
| | - Metin Yarıcı
- Department of Critical Care Medicine, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Fatma Yıldırım
- Department of Chest Diseases, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Abdulkadir Yektaş
- Department of Anesthesiology and Reanimation, Siirt University Faculty of Medicine, Siirt, Türkiye
| | | | - Oktay Demirkıran
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - İsmail Cinel
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Türkiye
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2
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Yıldırım S, Erkoyun E, Alpdoğan Ö, Yılmaz HO, Yılmaz B, Erdal Dönmez G, Sarıtaş A, Gökmen N, Ergan B, Bayrak V, Yakar MN, Kılıç Ö, Kılınç A, Saygılı S, Gaygısız Ü, Aydın K, Özel Yeşilyurt A, Cankar Dal H, Bayındır Dicle Ç, Turan S, Binay S, Yarıcı M, Yıldırım F, Hancı P, İnal MT, Akbaş T, Eyüpoğlu S, Albayrak T, Koçak G, Çakır T, Yüksel RC, Sarı A, Güneş M, Menteş O, Yamanel HL, Kirakli C. Vaccination status of COVID-19 patients followed up in the ICU in a country with heterologous vaccination policy: A multicenter national study in Turkey. J Infect Chemother 2023; 29:959-964. [PMID: 37343924 PMCID: PMC10278896 DOI: 10.1016/j.jiac.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/07/2023] [Accepted: 06/18/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE Vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-2) prevents the development of serious diseases has been shown in many studies. However, the effect of vaccination on outcomes in COVID-19 patients requiring intensive care is not clear. METHODS This is a retrospective multicenter study conducted in 17 intensive care unit (ICU) in Turkey between January 1, 2021, and December 31, 2021. Patients aged 18 years and older who were diagnosed with COVID-19 and followed in ICU were included in the study. Patients who have never been vaccinated and patients who have been vaccinated with a single dose were considered unvaccinated. Logistic regression models were fit for the two outcomes (28-day mortality and in-hospital mortality). RESULTS A total of 2968 patients were included final analysis. The most of patients followed in the ICU during the study period were unvaccinated (58.5%). Vaccinated patients were older, had higher Charlson comorbidity index (CCI), and had higher APACHE-2 scores than unvaccinated patients. Risk for 28-day mortality and in-hospital mortality was similar in across the year both vaccinated and unvaccinated patients. However, risk for in-hospital mortality and 28-day mortality was higher in the unvaccinated patients in quarter 4 adjusted for gender and CCI (OR: 1.45, 95% CI: 1.06-1.99 and OR: 1.42, 95% CI: 1.03-1.96, respectively) compared to the vaccinated group. CONCLUSION Despite effective vaccination, fully vaccinated patients may be admitted to ICU because of disease severity. Unvaccinated patients were younger and had fewer comorbid conditions. Unvaccinated patients have an increased risk of 28-day mortality when adjusted for gender and CCI.
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Affiliation(s)
- Süleyman Yıldırım
- University of Health Sciences Turkey, Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey.
| | | | - Özcan Alpdoğan
- University of Health Sciences, İzmir Tepecik Training and Research Hospital, Intensive Care Unit, İzmir, Turkey
| | | | - Barış Yılmaz
- University of Health Sciences, Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Gül Erdal Dönmez
- University of Health Sciences, Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Aykut Sarıtaş
- University of Health Sciences, İzmir Tepecik Training and Research Hospital, Intensive Care Unit, İzmir, Turkey
| | - Necati Gökmen
- Dokuz Eylül University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Intensive Care, İzmir, Turkey
| | - Begüm Ergan
- Dokuz Eylül University, Faculty of Medicine, Department of Chest Disease, Division of Intensive Care, İzmir, Turkey
| | - Vecihe Bayrak
- Dokuz Eylül University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Intensive Care, İzmir, Turkey
| | - Mehmet Nuri Yakar
- Dokuz Eylül University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Intensive Care, İzmir, Turkey
| | - Özgür Kılıç
- On Dokuz Mayıs University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Samsun, Turkey
| | - Ahmet Kılınç
- On Dokuz Mayıs University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Samsun, Turkey
| | - Saba Saygılı
- University of Health Sciences Turkey, Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey
| | - Ümmügülsüm Gaygısız
- Gazi University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Intensive Care, Ankara, Turkey
| | - Kaniye Aydın
- Çukurova University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Adana, Turkey
| | - Aysun Özel Yeşilyurt
- Çukurova University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Adana, Turkey
| | - Hayriye Cankar Dal
- University of Health Sciences, Ankara City Hospital, Intensive Care Unit, Ankara, Turkey
| | - Çilem Bayındır Dicle
- University of Health Sciences, Ankara City Hospital, Intensive Care Unit, Ankara, Turkey
| | - Sema Turan
- University of Health Sciences, Ankara City Hospital, Intensive Care Unit, Ankara, Turkey
| | - Songül Binay
- University of Health Sciences, Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Intensive Care Unit, Ankara, Turkey
| | - Metin Yarıcı
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of General Surgery, Intensive Care Unit, Ankara, Turkey
| | - Fatma Yıldırım
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Education Hospital, Department of Chest Diseases, Pulmonary Intensive Care Unit, Ankara, Turkey
| | - Pervin Hancı
- Trakya University Faculty of Medicine, Department of Pulmonology, Division of Intensive Care, Edirne, Turkey
| | - Mehmet Turan İnal
- Trakya University Faculty of Medicine, Department of Pulmonology, Division of Intensive Care, Edirne, Turkey
| | - Türkay Akbaş
- Düzce University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Düzce, Turkey
| | - Selin Eyüpoğlu
- Giresun Training and Research Hospital, Intensive Care Unit, Giresun, Turkey
| | - Tuna Albayrak
- Giresun University, Giresun Training and Research Hospital, Department of Anesthesiology and Reanimation, Giresun, Turkey
| | - Gamze Koçak
- Mersin City Hospital, Intensive Care Unit, Mersin, Turkey
| | - Tümay Çakır
- Muğla Training and Research Hospital, Intensive Care Unit, Muğla, Turkey
| | - Recep Civan Yüksel
- Ministry of Health, Kayseri City Hospital, Intensive Care Unit, Kayseri, Turkey
| | - Ali Sarı
- Gaziantep Abdulkadir Yüksel State Hospital, Intensive Care Unit, Gaziantep, Turkey
| | - Murat Güneş
- Gümüşhane State Hospital, Intensive Care Unit, Gümüşhane, Turkey
| | - Oral Menteş
- Gülhane Training and Research Hospital, Intensive Care Unit, Ankara, Turkey
| | - H Levent Yamanel
- Gülhane Training and Research Hospital, Intensive Care Unit, Ankara, Turkey
| | - Cenk Kirakli
- University of Health Sciences Turkey, Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey
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3
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Deniz R, Güner N, Ekmen ŞA, Mutlu IN, Özgür DS, Karaalioğlu B, Akkuzu G, Yıldırım F, Kalkan K, Güzelant-Özköse G, İnce B, Erdoğan M, Özlük Y, Kılıçaslan I, Bes C. Discrepancies between clinical and pathological findings seen at renal biopsy in rheumatological diseases. Reumatismo 2023; 75. [PMID: 37721346 DOI: 10.4081/reumatismo.2023.1586] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/04/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVE Renal biopsy contributes to the diagnosis, follow-up, and treatment of many rheumatic conditions. This study assessed the diagnostic role and safety of renal biopsies in a tertiary rheumatology clinic. METHODS Renal biopsies performed between June 2020 and December 2022 were screened, and demographic, clinical, histopathological, and safety data were collected from patient records. RESULTS In this study, 33 males and 38 females were included. Except for 1 patient who received acetylsalicylic acid, antiaggregant, and/or anticoagulant drugs were stopped before the biopsy. Complications included a decrease of hemoglobin in 8 patients (11.3%) and microscopic hematuria in 40 patients (56.3%). Control ultrasonography was performed in 16 patients (22.5%), and a self-limiting hematoma was found in 4 of them (5.6%) without additional complications. While less than 10 glomeruli were obtained in 9 patients (9.9%), diagnosis success was 94.4%. Histopathological data were consistent with one of the pre-biopsy diagnoses in 54 of 67 cases (80.6%) but showed discrepancies in 19.4% (n=13) of patients. A repeat biopsy was performed in 7 patients for re-staging or insufficient biopsy. CONCLUSIONS Renal biopsy significantly contributes to rheumatology practice, especially in patients with complex clinical and laboratory findings or in whom different treatments can be given according to the presence, severity, and type of renal involvement. Although the possibility of obtaining insufficient tissue and the need for re-staging and repeat biopsy in the follow-up might be expected, complication risk does not seem to be a big concern. Renal biopsy often evidenced discrepancies between pre-biopsy diagnosis and histopathological findings.
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Affiliation(s)
- R Deniz
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - N Güner
- Department of Internal Medicine, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - Ş A Ekmen
- Department of Internal Medicine, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - I N Mutlu
- Department of Radiology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - D S Özgür
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - B Karaalioğlu
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - G Akkuzu
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - F Yıldırım
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - K Kalkan
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - G Güzelant-Özköse
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - B İnce
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - M Erdoğan
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
| | - Y Özlük
- Department of Pathology, Faculty of Medicine, University of İstanbul.
| | - I Kılıçaslan
- Department of Pathology, Faculty of Medicine, University of İstanbul.
| | - C Bes
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, İstanbul.
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4
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Yıldırım F, Mutlu MY, İçaçan OC, Bes C. Dermatomyositis associated with thymoma: A case report and literature review. Clin Ter 2023; 174:115-120. [PMID: 36920126 DOI: 10.7417/ct.2023.2506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Abstract Thymoma can present with paraneoplastic-autoimmune neuro-muscular disorders, including polymyositis, dermatomyositis, and granulomatous myositis. Rarely, concomitant subclinical myasthenia gravis (MG) can be a diagnostic dilemma and cause deleterious outcomes regarding missed or delayed diagnosis. We report a Turkish patient presented with thymoma associated dermatomyositis and positive acetylcholine receptor antibody without evident MG clinic.
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Affiliation(s)
- F Yıldırım
- University of Health Sciences, Başakşehir Çam and Sakura City Hospital, Department of Rheumatology, İstanbul, TURKEY
| | - M Y Mutlu
- University of Health Sciences, Başakşehir Çam and Sakura City Hospital, Department of Rheumatology, İstanbul, TURKEY
| | - O C İçaçan
- University of Health Sciences, Başakşehir Çam and Sakura City Hospital, Department of Rheumatology, İstanbul, TURKEY
| | - C Bes
- University of Health Sciences, Başakşehir Çam and Sakura City Hospital, Department of Rheumatology, İstanbul, TURKEY
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5
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Akkuzu G, Bes C, Özgür DS, Karaalioğlu B, Mutlu MY, Yıldırım F, Atagündüz P, Gündüz A, Soy M. Inflammatory rheumatic diseases developed after COVID-19 vaccination: presentation of a case series and review of the literature. Eur Rev Med Pharmacol Sci 2023; 27:2143-2151. [PMID: 36930514 DOI: 10.26355/eurrev_202303_31587] [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: 03/18/2023]
Abstract
OBJECTIVE An increasing number of new on-set autoimmune-inflammatory rheumatic diseases (AIRD) after COVID-19 vaccination has begun to be reported in the literature. In this article, we present our patients with new-onset AIRD after vaccination for COVID-19 and review the literature on the subject. PATIENTS AND METHODS We investigated the clinical characteristics and laboratory parameters of previously described "newly developed AIRD in individuals recently vaccinated for COVID-19", in 22 cases vaccinated with one of the COVID-19 vaccines (BNT162b2 or CoronaVac) approved in our country. RESULTS We collected 22 cases (14 female, 63.6%) that developed an AIRD after COVID-19 vaccination. Mean age was 53±14.4 (24-87) years. The interval between the last dose of vaccination and the development of the first complaint was 23.9±19.5 (4-90) days. CoronaVac was administered to four patients, and the BNT162b2 to 18 patients. AIRD-related symptoms developed in 12 patients after the first dose, in 8 patients after the second dose, and in two patients after the third dose. Twelve out of the 22 (54.5%) cases were diagnosed with rheumatoid arthritis, two with SLE, and the remaining eight patients each with leukocytoclastic vasculitis, Sjogren's syndrome, psoriatic arthritis, ankylosing spondylitis, systemic sclerosis, mixed connective tissue disease, eosinophilic granulomatosis with polyangiitis, and inflammatory myositis, respectively. Six patients had a history of documented antecedent COVID-19 infection. CONCLUSIONS Autoimmune/inflammatory rheumatic diseases may develop after COVID-19 vaccinations. In the era of the COVID-19 pandemic, vaccination should be questioned carefully in newly diagnosed AIRD patients.
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Affiliation(s)
- G Akkuzu
- Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
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6
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Şimşek M, Yıldırım F, Şahin H, Akay EB, Akay EB. Succesful Use of Lipid Emulsion Theraphy In a Case of Extremely High Dose Olanzapine Intoxication. Turk J Anaesthesiol Reanim 2023; 51:65-68. [PMID: 36847322 PMCID: PMC10081049 DOI: 10.5152/tjar.2022.21315] [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: 11/22/2022] Open
Abstract
In olanzapine intoxication alterations in consciousness defined as "agitation despite sedation" as well as cardiovascular and extrapyramidal side effects due to anticholinergic effects can be seen. In this case report, we aimed to present a patient who received a very high dose of olanzapine for suicide purposes benefited from intravenous lipid emulsion treatment (LET). A 20-year-old male patient, who received 840 mg of olanzapine for suicide, was brought to the emergency room, when the Glasgow Coma Scale was 5, he was intubated and given a single dose of activated charcoal. Later, he was admitted to the intensive care unit (ICU) intubated. The olanzapine level was measured as 653 μg L-1. The patient was started on LET and woke up at the sixth hour. In addition to the lack of strong evidence regarding the use of LET in olanzapine intoxication, it is seen that lipid therapy has been used successfully in patients. Compared with the cases in the literature, LET was successfully applied in our case, where the blood olanzapine level was very high. Although there is no evidence-based treatment in olanzapine intoxication, we believe that LET has a positive effect on neurological recovery and survival.
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Affiliation(s)
- Meltem Şimşek
- Department of Internal Medicine and Intensive Care, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Fatma Yıldırım
- Department of Internal Medicine and Intensive Care, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Habibenur Şahin
- Department of Internal Medicine, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Emine Banu Akay
- Department of Biochemistry, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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7
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Dursun OB, Turan B, Öğütlü H, Binici NC, Örengül AC, Alataş E, Özdemir RM, Taşlıbeyaz E, Karaman S, Mukaddes NM, on behalf of Turkish Autism Workgroup, Alkaşi A, Bozkurt A, Güneş A, Çevikaslan A, Erol A, Kiliçoğlu AG, Karayağmurlu A, Beşenek AM, Aral A, Adanir AS, Birdir A, Mustan AT, Karaboğa AEÇ, Çiçek AU, Arman A, Ayaz AB, Büyükaslan A, Ay B, Ayik B, Karabucak B, Şahin B, Kalayci BM, Ocakoğlu BK, Özgür BG, Özcan BG, Karakpici B, Tumba C, İnce C, Tanıdır C, Mutlu C, Ceylan C, Kaya C, Achmet CCC, Aslan C, Yalvaç ÇT, Yektaş Ç, Bilginer Ç, Çildir DA, Yıldız D, Sapmaz D, Ayyıldız D, Varmış DA, Güntepe D, Yılmaz D, Kaba D, Karagöz D, Kınay D, Türe ES, Topçu E, Şentürk E, İşeri E, Özen E, Taşyürek E, Atabay E, Çöp E, Güney E, Güzel E, Aşıkhasanoglu EÖ, Demirdöğen EŞ, Çelebi F, Özbek F, Durmuş FB, Ari F, Yıldırım F, Gümüştaş F, Güven G, Yücel Gİ, Coşun GN, Ulaş G, Bulut GÇ, Ayaz G, Karaçetin G, Dinç GŞ, Kara H, Harmancı H, Toz Hİ, Aykutlu HC, Kandemir H, Güneş H, Genç HA, Gül H, Doğru H, Adaletli H, Kılıç HT, Aktaş H, Esin İS, Erdoğan İ, Kaya İ, Çimen İD, Kirtil İY, Nalbant K, Tarakçıoğlu MC, Çakır M, Kara MZ, Kinik MF, Karadağ M, Sertçelik M, Şahin M, Keleş M, Topal M, Terzioğlu MA, Çolpan M, Demirtaş ME, Onat M, Usta MB, Coşkun M, Gülşen M, Erkan MC, Bahalı MK, Demir N, Çetin NK, Kilit N, Ayaz N, Çetin NY, Nilüfer, Aliyev O, Demir N, Şimşek NE, Ünaldi N, Soylu N, Bilgin N, Fındık OTP, Yüzügüldü O, Demir O, Kocaman O, Tuncer ÖF, Küçük Ö, Üneri Ö, Çoban ÖG, Yalçin Ö, Hekim Ö, Keskiner Ö, Uzun Ö, Algedik P, Yılmaz R, Bostan R, Sanberk S, Gün SE, Yilmaz S, Aksu S, Özkan S, Hesapçioğlu ST, Erden S, Arslan SC, Çelenay S, Kala S, Nasiroğlu S, Karakoç S, Çiçek S, Hocaoğlu S, Avcil S, Derin S, Yilmaz SS, Fırat S, Eray Ş, Kilinçel Ş, Coşkun Ş, Uysal T, Kadak T, Karaosman T, Mutluer T, Soylemez TE, Kalyoncu T, Fidan T, Kaytanli U, Gündoğdu Ü, Gündüz Y, Torun YT, Yulaf Y, Güleş Z, Babadaği Z. A new model for recognition, referral, and follow‐up of autism spectrum disorder: A nationwide program. Autism Res 2022. [DOI: 10.1002/aur.2813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Onur Burak Dursun
- General Directorate of Health Services, Autism, Mental Special Needs and Rare Diseases Department Turkish Ministry of Health Ankara Turkey
| | - Bahadır Turan
- Department of Child and Adolescent Psychiatry Karadeniz Technical University Trabzon Turkey
| | - Hakan Öğütlü
- Department of Child and Adolescent Psychiatry Ankara City Hospital Ankara Turkey
| | - Nagihan Cevher Binici
- Department of Child and Adolescent Psychiatry Dr. Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital Izmır Turkey
| | | | - Esra Alataş
- General Directorate of Public Health Turkish Ministry of Health Ankara Turkey
| | - Rabia Madan Özdemir
- General Directorate of Health Services, Autism, Mental Special Needs and Rare Diseases Department Turkish Ministry of Health Ankara Turkey
| | - Elif Taşlıbeyaz
- Faculty of Computer and Instructional Technologies Education Erzincan University Erzincan Turkey
| | - Selçuk Karaman
- Department of Management and Information Systems Hacı Bayram Veli University Ankara Turkey
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Yıldırım F, Erdogan F, Kilic M, Metin MR. Asymtomatic Mass In The Tail Of The Pancreas: Intrapancreatic Accessory Spleen (IPAS). Arch Iran Med 2022; 25:574-576. [PMID: 37543881 DOI: 10.34172/aim.2022.91] [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] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/20/2021] [Indexed: 08/07/2023]
Abstract
We present a 48-year-old male patient with a mass in the tail of the pancreas on abdominal ultrasonography. The lesion was suspicious for a well-differentiated pancreatic neuroendocrine tumor and spleen preserved distal pancreatectomy surgery was performed. It was diagnosed as intrapancreatic accessory spleen (IPAS) after pathological examination. Accessory spleen is not an infrequent congenital entity caused by the localization of normal splenic tissue in ectopic regions. As it is known, an accessory spleen is a benign entity and does not require surgical treatment or follow-up when detected. However, it is important to recognize IPAS tissue as it may mimic a pancreatic neoplasia when it is located in the pancreas. In this article, we discuss the differential diagnostic possibilities of the IPAS entity.
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Affiliation(s)
- Fatma Yıldırım
- Department of Pathology, Ankara City Hospital, Ankara, Turkey
| | - Fazli Erdogan
- Department of Pathology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Mehmet Kilic
- Department of General Surgery, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Melike Rusen Metin
- Department of Radiology, Medipol University, Pendik Hospital, Istanbul, Turkey
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9
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Şengül A, Mutlu P, Özdemir Ö, Satıcı C, Turan MO, Arslan S, Ogan N, Ekici Ünsal Z, Bozkuş F, Çapraz A, Demirkol MA, Mutlu LC, Yıldız Gülhan P, Alkılınç E, Fazlıoğlu N, Söyler Y, Kabalak PA, Özaydın D, Turan PA, Yıldırım F, Aydemir Y, Şen N, Mirici A. Characteristics of our hypoxemic COVID-19 pneumonia patients receiving corticosteroids and mortality-associated factors. Expert Rev Respir Med 2022; 16:953-958. [PMID: 35839345 DOI: 10.1080/17476348.2022.2102480] [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: 12/15/2022]
Abstract
BACKGROUND COVID-19 is a disease associated with diffuse lung injury that has no proven effective treatment yet. It is thought that glucocorticoids may reduce inflammation-mediated lung injury, disease progression, and mortality. We aimed to evaluate our patient's characteristics and treatment outcomes who received corticosteroids for COVID-19 pneumonia. METHODS We conducted a multicenter retrospective study and reviewed 517 patients admitted due to COVID-19 pneumonia who were hypoxemic and administered steroids regarding demographic, laboratory, and radiological characteristics, treatment response, and mortality-associated factors. RESULTS Of our 517 patients with COVID-19 pneumonia who were hypoxemic and received corticosteroids, the mortality rate was 24.4% (n = 126). The evaluation of mortality-associated factors revealed that age, comorbidities, a CURB-65 score of ≥ 2, higher SOFA scores, presence of MAS, high doses of steroids, type of steroids, COVID-19 treatment, stay in the intensive care unit, high levels of d-dimer, CRP, ferritin, and troponin, and renal dysfunction were associated with mortality. CONCLUSION Due to high starting and average steroid doses are more associated with mortality, high-dose steroid administration should be avoided. We believe that knowing the factors associated with mortality in these cases is essential for close follow-up. The use of CURB-65 and SOFA scores can predict prognosis in COVID-19 pneumonia.
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Affiliation(s)
- Aysun Şengül
- Sakarya University Faculty of Medicine, Department of Pulmonology, Sakarya, Turkey
| | - Pınar Mutlu
- Çanakkale Onsekiz Mart University, Department of Pulmonology, Canakkale, Turkey
| | - Özer Özdemir
- Kemalpaşa State Hospital, Department of Pulmonology, Izmir, Turkey
| | - Celal Satıcı
- Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonology, İstanbul, Turkey
| | - Muzaffer Onur Turan
- Izmir Katip Celebi University Faculty of Medicine, Department of Pulmonology, Izmir, Turkey
| | - Sertaç Arslan
- Hitit University Faculty of Medicine, Department of Pulmonology, Çorum, Turkey
| | - Nalan Ogan
- Ufuk University Faculty of Medicine, Department of Pulmonology, Ankara, Turkey
| | - Zuhal Ekici Ünsal
- Baskent University Faculty of Medicine, Department of Pulmonology, Adana, Turkey
| | - Fulsen Bozkuş
- Kahramanmaraş Sutcu Imam University Faculty of Medicine, Department of Pulmonology, Kahramanmaraş, Turkey
| | - Aylin Çapraz
- Amasya University Faculty of Medicine, Department of Pulmonology, Amasya, Turkey
| | - Mustafa Asım Demirkol
- Gaziosmanpasa Training and Research Hospital, Department of Pulmonology, Istanbul, Turkey
| | - Levent Cem Mutlu
- Namik Kemal University Faculty of Medicine, Department of Pulmonology, Tekirdağ, Turkey
| | - Pınar Yıldız Gülhan
- Düzce University Faculty of Medicine, Department of Pulmonology, Düzce, Turkey
| | - Ersin Alkılınç
- Sinop Ataturk State Hospital, Department of Pulmonology, Sinop, Turkey
| | - Nevin Fazlıoğlu
- Namik Kemal University Faculty of Medicine, Department of Pulmonology, Tekirdağ, Turkey
| | - Yasemin Söyler
- Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonology, Ankara, Turkey
| | - Pınar Akın Kabalak
- Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonology, Ankara, Turkey
| | - Derya Özaydın
- Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonology, Ankara, Turkey
| | - Pakize Ayşe Turan
- Izmir Menemen State Hospital, Department of Pulmonology, Izmir, Turkey
| | - Fatma Yıldırım
- Health Sciences University Diskapi Yildirim Beyazit Training and Research Hospital, Department of Critical Care Medicine, Ankara, Turkey
| | - Yusuf Aydemir
- Sakarya University Faculty of Medicine, Department of Pulmonology, Sakarya, Turkey
| | - Nazan Şen
- Baskent University Faculty of Medicine, Department of Pulmonology, Adana, Turkey
| | - Arzu Mirici
- Çanakkale Onsekiz Mart University, Department of Pulmonology, Canakkale, Turkey
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10
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Şimşek M, Yıldırım F, Tayşi MR, Karaman I, Bağrıyanık ZL, Dural HI. Role Of Il-6 In The Adjustment Of The Medical Treatment Of Patients With Covid-19 Associated Acute Respiratory Distress Syndrome. J Ayub Med Coll Abbottabad 2022; 34:410-416. [PMID: 36377147 DOI: 10.55519/jamc-03-10410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Many cytokines propose to play a role in the pathogenesis of Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2) associated COVID-19 disease. High interleukin-6 (IL-6) levels are associated with mortality and other poor clinical outcomes in COVID-19. METHODS In this retrospective study, the correlation of IL-6 level with clinical and other inflammatory parameters, its role in treatment change and its relationship with mortality in COVID-19 patients developing acute respiratory distress syndrome (ARDS) were investigated. RESULTS Totally 76 patients were included in the study; Thirty-four (44.7%) patients were female and 42 (55.3%) patients were male. All patients had IL-6 levels above the upper reference value (>5.9 pg/mL). Overall, 48 patients (63.1%) had a severe clinical presentation (tachypnoea, tachycardia, fever) that was clinically compatible with IL-6 values, and medical treatment was changed for COVID-19 in this group. A positive correlation was detected between IL-6 and CRP on the day of the change in treatment (p=0.035, r=0.76). There was no decrement observed in IL-6 level on the 3rd day in patients that was clinically thought to have cytokine storm and whose treatment was changed. Mortality was higher in the group whose treatment was changed. CONCLUSIONS We believe that IL-6 level alone is insufficient to decide on a change in treatment, and correlation of IL-6 with the patient's clinical status is more significant in such decision.
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Affiliation(s)
- Meltem Şimşek
- Department of Internal Medicine, COVID Intensive Care Unit, Ankara, Turkey
| | - Fatma Yıldırım
- Department of Pulmonary Medicine, COVID Intensive Care Unit, Ankara, Turkey
| | | | - Irem Karaman
- Bahcesehir University Faculty of Medicine, Istanbul, Turkey
| | - Zübeyde Lale Bağrıyanık
- Department of Microbiology, Intensive Care Unit, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Turkey
| | - Halil Ibrahim Dural
- Department of General Surgery, COVID Intensive Care Unit, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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11
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İçaçan OC, Yalçın Mutlu M, Yıldırım F, Bes C. Relapsing Polychondritis in a Patient with Ankylosing Spondylitis under Two Different Tumor Necrosis Factor Alpha Inhibitors Treatment. Clin Ter 2022; 173:97-98. [PMID: 35385029 DOI: 10.7417/ct.2022.2400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Relapsing polychondritis (RP) is a rare autoimmune disease char-acterized by multi-systemic involvement characterized by recurrent and progressive inflammation of the cartilaginous tissue. Auricular inflammation is a characteristic finding of RP. Anti-tumor necrosis fac-tor alpha (anti-TNF) is a highly effective drug used in the treatment of inflammatory arthritis. There are several case reports showing potential relationship between the RP development and anti-TNF treatment. Here, we present a case of RP in a patient with ankylosing spondylitis under the two different tumor necrosis factor alpha inhibitors therapy.
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Affiliation(s)
- O C İçaçan
- Department of Rheumatology, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul, Turkey
| | - M Yalçın Mutlu
- Department of Rheumatology, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul, Turkey
| | - F Yıldırım
- Department of Rheumatology, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul, Turkey
| | - C Bes
- Department of Rheumatology, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, Istanbul, Turkey
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12
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Yıldırım F, Karaman İ, Kaya A. Current situation in ARDS in the light of recent studies: Classification, epidemiology and pharmacotherapeutics. Tuberk Toraks 2021; 69:535-546. [PMID: 34957747 DOI: 10.5578/tt.20219611] [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] [Indexed: 11/15/2022] Open
Abstract
In the last 50 years, there have been great research and developments in the definition and pathophysiology of acute respiratory distress syndrome (ARDS), the most progressive form of acute hypoxemic respiratory failure. Although there are various discussions and recommendations, the definition of ARDS is still based on the Berlin 2012 diagnostic criteria. Despite various studies in recent years, there is still no effective pharmacotherapeutic agent for the treatment of ARDS. Lung protective mechanical ventilation (low tidal volume, low plateau pressure, low driving pressure) in all ARDS patients, prone position, neuromuscular blockade (cisatracurium) in moderate-severe ARDS patients, and hydrocortisone therapy in sepsis-associated ARDS patients are treatments that contribute to survival. In this review, current changes in the definition and epidemiology of ARDS, recent pharmacotherapeutic research and mesenchymal stem cell therapies will be discussed in the light of newly introduced ARDS phenotypes.
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Affiliation(s)
- Fatma Yıldırım
- Clinic of Pulmonary Medicine, Intensive Care Unit, University of Health Sciences Dışkapı Yıldırım Beyazıt Research and Education Hospital, Ankara, Turkey
| | - İrem Karaman
- Bahçeşehir University Faculty of Medicine, Intern, Istanbul, Turkey
| | - Akın Kaya
- Department of Pulmonary Medicine, Ankara University Faculty of Medicine, Ankara, Turkey
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13
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Yıldırım F, Yıldız Gülhan P, Şimşek M. COVID-19 related acute respiratory distress syndrome: Pathological, radiological and clinical concordance. Tuberk Toraks 2021; 69:360-368. [PMID: 34581157 DOI: 10.5578/tt.20219708] [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: 11/15/2022] Open
Abstract
Severe coronavirus 2019 disease (COVID-19) represents viral pneumonia from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leading to acute respiratory distress syndrome (ARDS). However, when ARDS occurs as part of COVID-19, it has different features. The strategy of breathing support is very important in treating COVID-19 related ARDS (CARDS). Though it meets the CARDS Berlin definition, COVID-19 pneumonia is a specific disease with different phenotypes. Recently, it has been suggested that CARDS has two phenotypes, type L (Type 1 or non-ARDS) and type H (Type 2, ARDS), and these phenotypes respond differently to respiratory support treatments. In this review, after mentioning the pathophysiology and radiological relationship of CARDS, the definition and treatment approaches of two different forms of CARDS were discussed.
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Affiliation(s)
- Fatma Yıldırım
- Clinic of Pulmonary Medicine, COVID Intensive Care Unit, Diskapi Yildirim Beyazit Research and Education Hospital, University of Health Science, Ankara, Turkey
| | - Pınar Yıldız Gülhan
- Department of Pulmonary Medicine, Düzce University Faculty of Medicine, Düzce, Turkey
| | - Meltem Şimşek
- Clinic of Internal Medicine, COVID Intensive Care Unit, Diskapi Yildirim Beyazit Research and Education Hospital, University of Health Science, Ankara, Turkey
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14
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Gündoğan K, Akbudak İH, Hancı P, Halaçlı B, Temel Ş, Güllü Z, İnci K, Bilir Y, Bozkurt FT, Yıldırım F, Şimşek M, Yüksel RC, Eren E, Altıntaş ND, Talan L, Elay G, Güven G, Kara İ, Aydın E, Yılmaz S, Mengi T, Sarı S, Akbaş T, Acar Cinleti B, Ateş Ayhan N, Aral Özbek D, Şahin TK, Açıkgöz A, Esbah AÜ, Fırat A, Aydemir F, Gürkök MÇ, Zerman A, Gümüş A, Türkoğlu M, Aydoğdu M, Ulu R, Çelik JB, Balcı C, Kıraklı C, Karakoç E, Özyılmaz E, Ortaç Ersoy E, Öcal S, Akın Şen İ, Tor İH, Cömert B, Ergan B, Saraçoğlu KT, Ergil J, Yüksel ÜG, Tutar N, Sungur M, Topeli A. Clinical Outcomes and Independent Risk Factors for 90-Day Mortality in Critically Ill Patients with Respiratory Failure Infected with SARS-CoV-2: A Multicenter Study in Turkish Intensive Care Units. Balkan Med J 2021; 38:296-303. [PMID: 34558415 PMCID: PMC8880837 DOI: 10.5152/balkanmedj.2021.21188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Indexed: 11/22/2022] Open
Abstract
Background: There are limited data on the long-term outcomes of COVID-19 from different parts of the world. Aims: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. Study design: Retrospective, observational cohort. Methods: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. Results: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P < .001), lactate level >2 mmol/L (2.78 [1.93-4.01], P < .001), age ≥60 years (2.45 [1.48-4.06)], P < .001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P = .003), vasopressor treatment (1.94 [1.32-2.84], P = .001), positive fluid balance of ≥600 mL/day (1.68 [1.21-2.34], P = .002), PaO2/FiO2 ratio of ≤150 mmHg (1.66 [1.18-2.32], P = .003), and ECOG score ≥1 (1.42 [1.00-2.02], P = .050). Conclusion: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality.
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Affiliation(s)
- Kürşat Gündoğan
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - İsmail Hakkı Akbudak
- Division of Intensive Care Medicine, Department of Internal Medicine, Pamukkale University School of Medicine, Denizli, Turkey
| | - Pervin Hancı
- Division of Intensive Care Medicine, Department of Chest Diseases, Ministry of Health, Intensive Care Unit, Erzurum Training and Research Hospital, Erzurum, Turkey and Trakya University School of Medicine, Edirne, Turkey
| | - Burçin Halaçlı
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Şahin Temel
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - Zuhal Güllü
- Intensive Care Unit, Ministry of Health, Ankara Yenimahalle Training and Research Hospital, Ankara, Turkey
| | - Kamil İnci
- Intensive Care Unit, Ministry of Health, Ankara Yenimahalle Training and Research Hospital, Ankara, Turkey
| | - Yeliz Bilir
- Intensive Unit, Ministry of Health, İstanbul Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey
| | - Firdevs Tuğba Bozkurt
- Intensive Care Unit, Ministry of Health, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey
| | - Fatma Yıldırım
- Intensive Care Unit, Ministry of Health, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Meltem Şimşek
- Intensive Care Unit, Ministry of Health, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Recep Civan Yüksel
- Intensive Care Unit, Ministry of Health, Kayseri City Hospital, Kayseri, Turkey
| | - Esma Eren
- Intensive Care Unit, Ministry of Health, Kayseri City Hospital, Kayseri, Turkey
| | - Neriman Defne Altıntaş
- Division of Intensive Care Medicine, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Leyla Talan
- Division of Intensive Care Medicine, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Gülseren Elay
- Division of Intensive Care Medicine, Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Göksel Güven
- Division of Intensive Care Medicine, Department of Internal Medicine, Ministry of Health, Intensive Care Unit, Tokat State Hospital, Tokat and Hacettepe University School of Medicine, Ankara, Turkey
| | - İskender Kara
- Department of Anesthesiology, Intensive Care Unit, Selçuk University School of Medicine, Konya, Turkey
| | - Emre Aydın
- Division of Intensive Care Medicine, Department of Internal Medicine, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Seda Yılmaz
- Anesthesiology Intensive Care Unit, Kütahya Health Science University, Kütahya, Turkey
| | - Tuğçe Mengi
- Intensive Care Unit, Ministry of Health, Nigde Omer Halisdemir University, Nigde, Turkey
| | - Sema Sarı
- Intensive Care Unit, Ministry of Health, Nigde Omer Halisdemir University, Nigde, Turkey
| | - Türkay Akbaş
- Division of Intensive Care Medicine, Department of Internal Medicine, Düzce University School of Medicine, Düzce, Turkey
| | - Burcu Acar Cinleti
- Intensive Care Unit, Ministry of Health, İzmir Suat Seren Training and Research Hospital, İzmir, Turkey
| | - Nazire Ateş Ayhan
- Division of Intensive Care Medicine, Department of Internal Medicine, Çukurova University School of Medicine, Adana, Turkey
| | - Deniz Aral Özbek
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Taha Koray Şahin
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Aslı Açıkgöz
- Department of Anesthesiology, Intensive Care Unit, Selçuk University School of Medicine, Konya, Turkey
| | - Ali Ümit Esbah
- Division of Intensive Care Medicine, Department of Internal Medicine, Düzce University School of Medicine, Düzce, Turkey
| | - Ahmet Fırat
- Division of Intensive Care Medicine, Department of Internal Medicine, Çukurova University School of Medicine, Adana, Turkey
| | - Ferhan Aydemir
- Division of Intensive Care Medicine, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Mehmet Çağatay Gürkök
- Division of Intensive Care Medicine, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Avşar Zerman
- Intensive Care Unit, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Ayça Gümüş
- Intensive Care Unit, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Melda Türkoğlu
- Division of Intensive Care Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Müge Aydoğdu
- Division of Intensive Care Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Ramazan Ulu
- Division of Intensive Care Medicine, Department of Internal Medicine, Fırat University School of Medicine, Elazığ, Turkey
| | - Jale Bengi Çelik
- Department of Anesthesiology, Intensive Care Unit, Selçuk University School of Medicine, Konya, Turkey
| | - Canan Balcı
- Anesthesiology Intensive Care Unit, Kütahya Health Science University, Kütahya, Turkey
| | - Cenk Kıraklı
- Intensive Care Unit, Ministry of Health, İzmir Suat Seren Training and Research Hospital, İzmir, Turkey
| | - Emre Karakoç
- Division of Intensive Care Medicine, Department of Internal Medicine, Çukurova University School of Medicine, Adana, Turkey
| | - Ezgi Özyılmaz
- Division of Intensive Care Medicine, Department of Chest Diseases, Çukurova University School of Medicine, Adana, Turkey
| | - Ebru Ortaç Ersoy
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Serpil Öcal
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - İrem Akın Şen
- Division of Intensive Care Medicine, Department of Chest Diseases, Ministry of Health, Intensive Care Unit, Erzurum Training and Research Hospital, Erzurum, Turkey and Trakya University School of Medicine, Edirne, Turkey
| | - İbrahim Hakkı Tor
- Division of Intensive Care Medicine, Department of Chest Diseases, Ministry of Health, Intensive Care Unit, Erzurum Training and Research Hospital, Erzurum, Turkey and Trakya University School of Medicine, Edirne, Turkey
| | - Bilgin Cömert
- Division of Intensive Care Medicine, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Begüm Ergan
- Division of Intensive Care Medicine, Department of Chest Diseases, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Kemal Tolga Saraçoğlu
- Intensive Unit, Ministry of Health, İstanbul Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey
| | - Jülide Ergil
- Intensive Care Unit, Ministry of Health, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Ümmü Gülsüm Yüksel
- Division of Intensive Care Medicine, Department of Internal Medicine, Ministry of Health, Intensive Care Unit, Tokat State Hospital, Tokat and Hacettepe University School of Medicine, Ankara, Turkey
| | - Nuri Tutar
- Division of Intensive Care Medicine, Department of Chest Diseases, Erciyes University School of Medicine, Kayseri, Turkey
| | - Murat Sungur
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - Arzu Topeli
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
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15
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Yıldırım F, Gulhan PY, Diken ÖE, Capraz A, Simsek M, Yildirim BB, Taysi MR, Ozturk SY, Demirtas N, Ergil J, Dirican A, Uzar T, Karaman I, Ozkaya S. Role of serological rapid antibody test in the management of possible COVID-19 cases. World J Exp Med 2021; 11:44-54. [PMID: 34616666 PMCID: PMC8462010 DOI: 10.5493/wjem.v11.i4.44] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/26/2021] [Accepted: 09/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although the detection of viral particles by reverse transcription polymerase chain reaction (RT-PCR) is the gold standard diagnostic test for coronavirus disease 2019 (COVID-19), the false-negative results constitute a big challenge.
AIM To examine a group of patients diagnosed and treated as possible COVID-19 pneumonia whose multiple nasopharyngeal swab samples were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by RT-PCR but then serological immunoglobulin M/immunoglobulin G (IgM/IgG) antibody against SARS-CoV-2 were detected by rapid antibody test.
METHODS Eighty possible COVID-19 patients who had at least two negative consecutive COVID-19 RT-PCR test and were subjected to serological rapid antibody test were evaluated in this study.
RESULTS The specific serological total IgM/IgG antibody against SARS-CoV-2 was detected in twenty-two patients. The mean age of this patient group was 63.2± 13.1-years-old with a male/female ratio of 11/11. Cough was the most common symptom (90.9%). The most common presenting chest computed tomography findings were bilateral ground glass opacities (77.2%) and alveolar consolidations (50.1%). The mean duration of time from appearance of first symptoms to hospital admission, to hospital admission, to treatment duration and to serological positivity were 8.6 d, 11.2 d, 7.9 d, and 24 d, respectively. Compared with reference laboratory values, serologically positive patients have shown increased levels of acute phase reactants, such as C-reactive protein, ferritin, and procalcitonin and higher inflammatory markers, such as erythrocyte sedimentation rate, lactate dehydrogenase enzyme, and fibrin end-products, such as D-dimer. A left shift on white blood cell differential was observed with increased neutrophil counts and decreased lymphocytes.
CONCLUSION Our study demonstrated the feasibility of a COVID-19 diagnosis based on rapid antibody test in the cases of patients whose RT-PCR samples were negative. Detection of antibodies against SARS-CoV-2 with rapid antibody test should be included in the diagnostic algorithm in patients with possible COVID-19 pneumonia.
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Affiliation(s)
- Fatma Yıldırım
- Department of Pulmonary and Critical Care Medicine, University of Health Sciences Diskapi Yildirim Beyazit Research and Education Hospital, Ankara 06110, Turkey
| | - Pinar Yildiz Gulhan
- Department of Pulmonary Medicine, Düzce University, Faculty of Medicine, Düzce 81100, Turkey
| | - Özlem Ercen Diken
- Department of Chest Diseases, Adana Research and Education Hospital, University of Health Sciences, Adana 01230, Turkey
| | - Aylin Capraz
- Department of Pulmonary Medicine, Amasya University Sabuncuoglu Serefeddin Research and Education Hospital, Amasya 05200, Turkey
| | - Meltem Simsek
- Medical Intensive Care Unit, University of Health Sciences Diskapi Yildirim Beyazit Research and Education Hospital, Ankara 06110, Turkey
| | - Berna Botan Yildirim
- Department of Pulmonology, Research and Education Hospital of Baskent University, Konya 42030, Turkey
| | - Muhammet Ridvan Taysi
- Department of Infectious and Clinical Microbiology, University of Health Sciences Diskapi Yildirim Beyazit Research and Education Hospital, Ankara 06110, Turkey
| | - Sakine Yilmaz Ozturk
- Department of Pulmonary Medicine, Vezirkopru State Hospital, Samsun 55090, Turkey
| | - Nurcan Demirtas
- Department of Pulmonary Medicine, Kumluca State Hospital, Antalya 07070, Turkey
| | - Julide Ergil
- Department of Anaesthesiology and Reanimation, Diskapi Yildirim Beyazit Research and Education Hospital, University of Health Sciences, Ankara 06110, Turkey
| | - Adem Dirican
- Department of Pulmonary Medicine, Samsun Medicalpark Hospital, Samsun 55090, Turkey
| | - Tugce Uzar
- Medical Student/Intern, Bahcesehir University Faculty of Medicine, Istanbul 34734, Turkey
| | - Irem Karaman
- Medical Student/Intern, Bahcesehir University Faculty of Medicine, Istanbul 34734, Turkey
| | - Sevket Ozkaya
- Department of Pulmonary Medicine, Bahcesehir University, Faculty of Medicine, Istanbul 34734, Turkey
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16
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Erçen Diken Ö, Yıldırım F, Yıldız Gülhan P, Özkaya Ş, Şimşek M, Yücel C, Berik Safcı S, Deniz PP, Coşkun Çelik M, Akdağ D, Dirican A. Corticosteroid use in COVID-19 pneumonia. Tuberk Toraks 2021; 69:217-226. [PMID: 34256512 DOI: 10.5578/tt.20219811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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 Coronavirus disease 2019 (COVID-19) has a 1-2% fatality rate, where no specific treatment has yet been defined. Although corticosteroids are recommended for selected COVID-19 patients without acute respiratory distress syndrome (ARDS) and septic shock, there is no consensus regarding patient subgroups, dose, and duration. In this study, it was aimed to examine the contribution of corticosteroid treatment to the management of COVID-19 pneumonia without ARDS, septic shock both in acute and recovery setting. Materials and Methods The study population was divided into two as those who used corticosteroids during the recovery phase (who did not develop sufficient radiological or clinical improvement) and those who did so during the activation phase (non-ARDS/septic shock condition, clinical, laboratory or radiological progression). Result We identified 47 patients, 26 of which were males, and mean age was 60.5 ± 16.5 years. Seventeen patients were found to receive corticosteroids during the recovery phase and the rest (n= 30) during the activation period. After corticosteroid therapy, we found reduction of increased pre-treatment levels of D-dimer, ferritin, fibrinogen, CRP, increment of decreased pre-treatment lymphocyte count and saturation. Complete symptomatic improvement was detected in 6.9% and 17.6% of the patients in the activation phase and recovery phase, respectively. Complete radiological improvement was found in 11.5% and 35.3% of the patients in the activation phase and recovery phase, respectively. While corticosteroid treatment was initiated on day 4.2 ± 2.6 and continued for a mean of 5.9 ± 2.8 days in the activation group, it was started on day 8.1 ± 11.3 and administered for 7.8 ± 3.8 days in the recovery group. In both groups, methylprednisolone was given at a median dose of 40 mg/day. Conclusions Short-term low-dose corticosteroid therapy may improve clinical, radiological, laboratory outcomes in the management of COVID-19 pneumonia during the activation period without ARDS and non-septic shock and during recovery period with no satisfactory response. Further randomized controlled studies will be useful in demonstrating its efficacy.
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Affiliation(s)
- Özlem Erçen Diken
- Clinic of Chest Diseases, SBÜ Adana City Training and Research Hospital, Adana, Turkey
| | - Fatma Yıldırım
- Clinic of Chest Diseases, COVID Intensive Care Unite, Health Science University Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Pınar Yıldız Gülhan
- Department of Chest Diseases, Düzce University Faculty of Medicine, Düzce, Turkey
| | - Şevket Özkaya
- Department of Chest Diseases, Bahçeşehir University Faculty of Medicine, İstanbul, Turkey
| | - Meltem Şimşek
- Department of Internal Medicine, Health Science University Dışkapı Yildirim Beyazit Research and Education Hospital, COVID Intensive Care Unite, Ankara, Turkey
| | - Cihan Yücel
- Clinic of Chest Diseases, SBÜ Adana City Training and Research Hospital, Adana, Turkey
| | - Sinem Berik Safcı
- Clinic of Chest Diseases, SBÜ Adana City Training and Research Hospital, Adana, Turkey
| | - Pelin Pınar Deniz
- Clinic of Chest Diseases, SBÜ Adana City Training and Research Hospital, Adana, Turkey
| | - Müge Coşkun Çelik
- Adana City Hospital, Clinic of Anaesthesiology and Reanimation, Adana, Turkey
| | - Devrim Akdağ
- Adana City Hospital, Clinic of Anaesthesiology and Reanimation, Adana, Turkey
| | - Adem Dirican
- Clinic of Chest Diseases, Samsun Medikal Park Hospital, Samsun, Turkey
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Torun S, Ozkaya S, Şen N, Kanat F, Karaman I, Yosunkaya S, Sengoren Dikis O, Asan A, Aydogan Eroglu S, Semih Atal S, Ayten O, Aksel N, Ermiş H, Özçelik N, Demirelli M, Kara I, Sümer S, Marakoğlu K, Üzer F, Uyar Y, Çiçek T, E Ünsal Z, Vatansev H, Botan Yildirim B, Kuruoğlu T, Atilla A, Ersoy Y, Kandemir B, Durduran Y, Goksin Cihan F, Demirbaş N, Yıldırım F, Tatar D, Akcay MS. The Relationship between COVID-19 Severity and Bacillus Calmette-Guérin (BCG)/ Mycobacterium tuberculosis exposure history in healthcare workers: a multi-center study. Pathog Glob Health 2021; 115:405-411. [PMID: 34014806 PMCID: PMC8146200 DOI: 10.1080/20477724.2021.1927605] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The COVID-19 pandemic has brought countries’ health services into sharp focus. It was drawn to our group’s attention that healthcare workers (HCWs) had a lower mortality rate against higher COVID-19 incidence compared to the general population in Turkey. Since risk of exposure to tuberculosis bacillus among healthcare workers are higher than the population, we aimed to investigate if there is a relationship between BCG and Mycobacterium tuberculosis exposure history with COVID-19 severity in infected HCWs. This study was conducted with 465 infected HCWs from thirty-three hospitals to assess the relationship between COVID-19 severity (according to their hospitalization status and the presence of radiological pneumonia) and BCG and Mycobacterium tuberculosis exposure history. HCWs who required hospital admission had significantly higher rates of chronic diseases, radiological pneumonia, and longer working hours in the clinics. Higher rates of history of contact and care to tuberculosis patients, history of tuberculosis, and BCG vaccine were observed in hospitalized HCWs. HCWs who had radiological pneumonia had a significantly increased ratio of history of care to tuberculosis patients and a higher family history of tuberculosis. The findings from our study suggest that the lower mortality rate despite the more severe disease course seen in infected HCWs might be due to frequent exposure to tuberculosis bacillus and the mortality-reducing effects of the BCG vaccine.
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Affiliation(s)
- Serife Torun
- Department of Pulmonary Diseases, Baskent University Faculty of Medicine, Konya, Turkey
| | - Sevket Ozkaya
- Department of Pulmonary Diseases, Bahcesehir University Faculty of Medicine, İstanbul, Turkey
| | - Nazan Şen
- Department of Pulmonary Diseases, Baskent University Faculty of Medicine, Adana, Turkey
| | - Fikret Kanat
- Department of Pulmonary Diseases, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Irem Karaman
- School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Sebnem Yosunkaya
- Department of Pulmonary Diseases, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Ozlem Sengoren Dikis
- Department of Pulmonary Diseases, Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Ali Asan
- Department of Infection Diseases, Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Selma Aydogan Eroglu
- Sureyyapasa Research and Training Center for Pulmonary Diseases, Health Sciences University, Ministry of Health, Istanbul, Turkey
| | - Sefa Semih Atal
- Abdülhamid Han Research and Training Center for Pulmonary Diseases, Health Sciences University, Ministry of Health, Istanbul, Turkey
| | - Omer Ayten
- Abdülhamid Han Research and Training Center for Pulmonary Diseases, Health Sciences University, Ministry of Health, Istanbul, Turkey
| | - Nimet Aksel
- Department of Pulmonary Diseases, Dr Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey
| | - Hilal Ermiş
- Department of Pulmonary Diseases, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Neslihan Özçelik
- Department of Pulmonary Diseases, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Turkey
| | | | - Iskender Kara
- Department of Anesthesiology and Reanimation, Selçuk University Faculty of Medicine, Konya, Turkey
| | - Sua Sümer
- Department of Infection Diseases, Selçuk University Faculty of Medicine, Konya, Turkey
| | - Kamile Marakoğlu
- Department of Family Medicine, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Fatih Üzer
- Department of Pulmonary Diseases, State Hospital, Kastamonu, Turkey
| | - Yasin Uyar
- Department of Pulmonary Diseases, State Hospital, Merzifon, Turkey
| | - Tuba Çiçek
- Department of Pulmonary Diseases, Numune Hospital, Konya, Turkey
| | - Zuhal E Ünsal
- Department of Pulmonary Diseases, Baskent University Faculty of Medicine, Adana, Turkey
| | - Husamettin Vatansev
- Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Berna Botan Yildirim
- Department of Pulmonary Diseases, Baskent University Faculty of Medicine, Konya, Turkey
| | - Tuba Kuruoğlu
- Department of Infection Diseases, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Aynur Atilla
- Department of Infection Diseases, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Yasemin Ersoy
- Department of Infection Diseases, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Bahar Kandemir
- Department of Infection Diseases, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Yasemin Durduran
- Department of Public Health, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Fatma Goksin Cihan
- Department of Family Medicine, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Nur Demirbaş
- Department of Family Medicine, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Fatma Yıldırım
- Clinic of Intensive Care Unit, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Dursun Tatar
- Department of Pulmonary Diseases, Dr Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey
| | - M Sule Akcay
- Department of Pulmonary Diseases, Baskent University Faculty of Medicine, Ankara, Turkey
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18
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Pehlivanlar Küçük M, Özlü T, Küçük AO, Kaya A, Kıraklı C, Şengören Dikiş Ö, Kefeli Çelik H, Özkan S, Bektaş Aksoy H, Palabıyık O, Çörtük M, Ergün R, Kozanhan B, Erçen Diken Ö, Bacakoğlu F, Uzun Kaya S, Aksoy İ, Cinemre H, Zerman A, Özkoçak Turan I, Fazlıoğlu N, Yıldırım F, Günay E, Akan B, Arpağ H, Sezgi C, Can A, Yalçınsoy M, Karaoğlanoğlu S, Şehitoğulları A, Arslan S, Aydemir Y, Öztürk A, Hocanlı İ, Salmanoğlu M, Ekici A, Ataman S, Edipoğlu Ö, Yıldız T, Doğanay Z, Dağlı C, Arslan Aksu E, Zitouni B, Eğilmez Aİ, Şahiner Y, Korkmaz Ekren P, İnönü Köseoğlu H, Baydın A, Nalbant A, Aydın D, Bindal A, Balas Ş, Esen Karamişe Ş, Araz Ö, Acar T, Kahraman H, Demir M, Burnik C, Çanakçı E, Bilgin C, Yağan Ö, Aydemir S, Önem Y, Gürel Durmuş Z. [Mortality prediction ability of phycians in intensive care units of Turkey (MOPAP)]. Tuberk Toraks 2021; 68:205-217. [PMID: 33295718 DOI: 10.5578/tt.70135] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Intensive care physicians are increasingly involved in decision making about the prognosis of intensive care unit ICU patients. With this study; we aimed to evaluate the power of clinician foresight at prediction of mortality in patient at triage to intensive care and patient follow-up. Materials and Methods This study was conducted in ICUs located in various geographical regions of Turkey between January 1, 2017-April 30, 2017.The clinical research was planned as observational, multicenter, cross-sectional. Result A total of 1169 intubated patients were followed in 37 different ICU. At the beginning of the follow-up we asked the physician who will follow the patient in the ICU to give a score for the probability of survival of the patients. Scoring included a total of 6 scores from 0 to 5, with the "0" the worst probability "5" being the best. According to this distribution, only 1 (0.9%) of 113 patients who were given 0 points survived. Three (6.1%) of 49 with the best score of 5 died. Survival rates were significantly different in each score group (r: -0.488; p<0.001). After the combined mortality estimation scores based on the clinical observations of the physicians (0 and 1 point score was combined as non-survive, 4 and 5 score was combined as survived) 320 of the 545 patients were estimated to be dead and 225 were predicted survival. Sensitivity and spesifity of scoring system to predict mortality was 91.56% (95% CI: 87.96-94.37), 76.89% (95% CI: 70.82-82.23) respectively. Conclusions In this study, we concluded that the physicians who follow the patients in the ICU can predict the poor prognosis at the time of admission and the high mortality rate. The physician's opinion on mortality estimation should be considered in intensive care mortality scoring in addition to other laboratory and clinical parameters.
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Affiliation(s)
- Mehtap Pehlivanlar Küçük
- Department of Chest Diseases, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Tevfik Özlü
- Department of Chest Diseases, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ahmet Oğuzhan Küçük
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Karadeniz Technical University Trabzon, Turkey
| | - Akın Kaya
- Department of Chest Diseases, School of Medicine, Ankara University Ankara, Turkey
| | - Cenk Kıraklı
- Clinic of Anesthesiology and Reanimation, İzmir Doktor Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey
| | - Özlem Şengören Dikiş
- Clinic of Chest Diseases, Health Sciences University, Bursa Higher Specialization Training and Research Hospital, Bursa, Turkey
| | - Hale Kefeli Çelik
- Clinic of Anesthesiology and Reanimation, Health Sciences University, Samsun Mehmet Aydın Training and Research Hospital, Samsun, Turkey
| | - Serdar Özkan
- Department of Thoracic Surgery, School of Medicine, Konya Karatay University Konya, Turkey
| | - Hayriye Bektaş Aksoy
- Clinic of Chest Diseases, Health Sciences University, Samsun Mehmet Aydın Training and Research Hospital, Samsun, Turkey
| | - Onur Palabıyık
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Sakarya University Sakarya, Turkey
| | - Mustafa Çörtük
- Department of Chest Diseases, Faculty of Medicine, Karabük University, Karabuk, Turkey
| | - Recai Ergün
- Clinic of Chest Diseases, Health Sciences University, Diskapi Yildirim Beyazit Training And Research Hospital, Ankara, Turkey
| | - Betül Kozanhan
- Clinic of Anesthesiology and Reanimation, Health Sciences University Konya Training and Research Hospital, Konya, Turkey
| | - Özlem Erçen Diken
- Department of Chest Diseases, School of Medicine, Hitit University Corum, Turkey
| | - Feza Bacakoğlu
- Department of Chest Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Süheyla Uzun Kaya
- Department of Internal Medicine, Faculty of Medicine, Gazi Osman Pasa University, Tokat, Turkey
| | - İskender Aksoy
- Department of Emergency Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Hakan Cinemre
- Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Avşar Zerman
- Clinic of Anesthesiology and Reanimation, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey
| | - Işık Özkoçak Turan
- Clinic of Anesthesiology and Reanimation, Health Sciences University Adana Numune Training and Research Hospital, Adana, Turkey
| | - Nevin Fazlıoğlu
- Department of Chest Diseases, Faculty of Medicine, Namık Kemal University, Tekirdag, Turkey
| | - Fatma Yıldırım
- Intensive Care Unit, Health Sciences University, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ersin Günay
- Department of Chest Diseases, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Belgin Akan
- Clinic of Anesthesiology and Reanimation, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Hüseyin Arpağ
- Department of Chest Diseases, Faculty of Medicine, Kahramanmaras Sutcu İmam University, Kahramanmaraş, Turkey
| | - Cengizhan Sezgi
- Department of Chest Diseases, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Atilla Can
- Department of Thoracic Surgery, Baskent University, Konya Application and Research Center, Konya, Turkey
| | - Murat Yalçınsoy
- Clinic of Chest Diseases, Health Sciences University, İstanbul Sureyya Pasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | | | - Abidin Şehitoğulları
- Clinic of Thoracic Surgery, Sakarya Maternity and Children's Hospital, Sakarya, Turkey
| | - Sertaç Arslan
- Clinic of Chest Diseases, Corum State Hospital, Corum, Turkey
| | - Yusuf Aydemir
- Department of Chest Diseases, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Ayperi Öztürk
- Clinic of Chest Diseases, Ankara Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - İclal Hocanlı
- Department of Chest Diseases, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Musa Salmanoğlu
- Clinic of Chest Diseases, Health Sciences University, Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Aydanur Ekici
- Department of Chest Diseases, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Sena Ataman
- Clinic of Chest Diseases, İzmir Doktor Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey
| | - Özlem Edipoğlu
- Clinic of Chest Diseases, İzmir Doktor Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey
| | - Tekin Yıldız
- Chest Diseases and Tuberculosis Service, Bursa Ali Osman Sonmez Oncology Hospital, Bursa, Turkey
| | - Zahide Doğanay
- Clinic of Anesthesiology and Reanimation, Health Sciences University, Samsun Mehmet Aydın Training and Research Hospital, Samsun, Turkey
| | - Celalettin Dağlı
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Konya Karatay University, Konya, Turkey
| | - Esra Arslan Aksu
- Clinic of Chest Diseases, Health Sciences University, Samsun Mehmet Aydın Training and Research Hospital, Samsun, Turkey
| | - Burçak Zitouni
- Department of Chest Diseases, Faculty of Medicine, Karabük University, Karabuk, Turkey
| | - Ayşe İlksen Eğilmez
- Clinic of Anesthesiology and Reanimation, Health Sciences University Konya Training and Research Hospital, Konya, Turkey
| | - Yeliz Şahiner
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Pervin Korkmaz Ekren
- Department of Chest Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Handan İnönü Köseoğlu
- Department of Chest Diseases, Faculty of Medicine, Gazi Osman Pasa University, Tokat, Turkey
| | - Ahmet Baydın
- Department of Emergency Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Ahmet Nalbant
- Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Davut Aydın
- Department of Chest Diseases, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Ahmet Bindal
- Clinic of Anesthesiology and Reanimation, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Şener Balas
- Intensive Care Unit, Health Sciences University, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Şule Esen Karamişe
- Department of Chest Diseases, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
| | - Ömer Araz
- Department of Chest Diseases, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Türkan Acar
- Department of Neurology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Hasan Kahraman
- Department of Chest Diseases, Faculty of Medicine, Kahramanmaras Sutcu İmam University, Kahramanmaraş, Turkey
| | - Melike Demir
- Department of Chest Diseases, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Cengiz Burnik
- Clinic of Thoracic Surgery, Health Sciences University, Konya Training and Research Hospital, Konya, Turkey
| | - Ebru Çanakçı
- Department of Department of Anesthesiology and Reanimation, Faculty of Medicine, Ordu University, Ordu, Turkey
| | - Cahit Bilgin
- Department of Chest Diseases, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Özgür Yağan
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Semih Aydemir
- Clinic of Department of Anesthesiology and Reanimation, Ankara Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Yalçın Önem
- Clinic of Internal Medicine, Health Sciences University, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
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Yıldırım F, Yıldırım AN, Özkan G, Şan B, Polat M, Aşık H, Karakurt Y, Ercişli S. Early Harvest Effects on Hydrophilic Phenolic Components of Extra Virgin Olive Oils Cvs. 'Ayvalık', 'Memecik' and 'Topakaşı'. Biochem Genet 2020; 58:981-992. [PMID: 33230659 DOI: 10.1007/s10528-020-10008-9] [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] [Received: 10/17/2019] [Accepted: 10/16/2020] [Indexed: 10/22/2022]
Abstract
The study was conducted to determine the effects of cultivar, harvest period and their interaction on the hydrophilic phenolic components extra virgin olive oils of the cultivars 'Ayvalık', 'Memecik' and 'Topakaşı'. Olives were collected at three different harvesting periods; (1) early harvest period-1 (Beginning of spotting), (2) early harvest period-2 (End of spotting), and (3) optimum harvest period. Oils were extracted using an abencor system. HPLC (High-performance liquid chromatograph) technique was used to quantify The phenolic compounds including: tyrosol (p-HPEA), hydroxytyrosol (3,4-DHPEA), luteolin, rutin, quercetin, catechin, sinapinic acid, p-coumaric acid, cinnamic acid, vanillin, vanillic acid, ferulic acid and gallic acid were quantified using HPLC. The results indicated that the effects of harvest period on the phenolic components were variety dependent. At the early harvest period-1, 'Memecik' and 'Topakaşı' had the highest efficiency in luteolin, cinnamic acid, vanillic acid, and ferulic acid contents, while 'Ayvalık' had the highest efficiency in hydroxytyrosol, sinapinic acid, p-coumaric, vanillin and ferulic acid contents. At the optimum harvest period, 'Ayvalık' had the highest efficiency in luteolin, tyrosol and gallic acid contents, while 'Topakaşı' had the highest efficiency in tyrosol, hydroxytyrosol and rutin content. The highest phenolic content was detected in the early harvest period-1. The content of tyrosol linearly increased with the progress of maturity harvest period, whereas the contents of the sinapinic acid, vanillin, vanilic acid and ferulic acid decreased. The oils of 'Memecik' variety had significantly higher phenolic content than those of 'Ayvalık' and 'Topakaşı' varieties.
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Affiliation(s)
- Fatma Yıldırım
- Horticultural Sciences Department, Faculty of Agricultural Sciences and Technologies, Isparta University of Applied Sciences, 32260, Isparta, Turkey.
| | - Adnan Nurhan Yıldırım
- Horticultural Sciences Department, Faculty of Agricultural Sciences and Technologies, Isparta University of Applied Sciences, 32260, Isparta, Turkey
| | - Gülcan Özkan
- Food Engineering Department, Faculty of Engineering, Suleyman Demirel University, 32260, Isparta, Turkey
| | - Bekir Şan
- Horticultural Sciences Department, Faculty of Agricultural Sciences and Technologies, Isparta University of Applied Sciences, 32260, Isparta, Turkey
| | - Mehmet Polat
- Horticultural Sciences Department, Faculty of Agricultural Sciences and Technologies, Isparta University of Applied Sciences, 32260, Isparta, Turkey
| | - Hatice Aşık
- Food Engineering Department, Faculty of Engineering, Suleyman Demirel University, 32260, Isparta, Turkey
| | - Yaşar Karakurt
- Agricultural Biotechnology Department, Faculty of Agricultural Sciences and Technologies, Isparta University of Applied Sciences, 32260, Isparta, Turkey
| | - Sezai Ercişli
- Horticultural Science, Faculty of Agriculture, Ataturk University, Erzurum, Turkey
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Abstract
Skin and subcutaneous tissue tumors are the most common neoplasms in dogs. The most common sites of origin in dogs include digits, skin and the oral cavity including cheek and retromandibular area. We investigated canine squamous cell carcinoma (SCC) samples from 15 dogs and classified them histopathologically according to the degree of differentiation. bFGF, VEGF-C, TGF-β, PDGF-A, PDGF-C and PDGFR-α expressions were assessed using immunohistochemistry to determine the roles of growth factors during SCC. We found that TGF-β1 immunolabeling was elevated significantly compared to healthy controls in SCC originating from nailbeds, while expression of other growth factors did not change significantly. Our findings might explain the role of TGF-β1 in the infiltrative and malignant behavior of SCC originating from nailbeds.
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Affiliation(s)
- M Sözmen
- Department of Pathology, Faculty of Veterinary Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - A K Devrim
- Department of Biochemistry, Faculty of Veterinary Medicine, Kirikkale University, Kirikkale, Turkey
| | - M Sudağıdan
- KIT-ARGEM R & D Center, Konya Food and Agriculture University, Konya, Turkey
| | - Y B Kabak
- Department of Pathology, Faculty of Veterinary Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - F Yıldırım
- Department of Pathology, Faculty of Veterinary Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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21
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Ogan N, Yıldırım F, Süzen B, Baha A, Akpınar EE. Does Nutritional Risk Screening 2002 Correlate with the Dyspnea Status of Patients with GOLD Stage C-D Chronic Obstructive Pulmonary Disease? Turk Thorac J 2020; 21:49-53. [PMID: 32163364 DOI: 10.5152/turkthoracj.2019.180194] [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] [Received: 12/03/2018] [Accepted: 01/18/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Dyspnea is a prominent symptom of chronic obstructive pulmonary disease (COPD). Patients with Global Initiative for Obstructive Lung Disease (GOLD) Stage C-D often complain of dyspnea, but the relationship between their level of dyspnea and their nutritional status has not yet been established. The aim of this study was to evaluate the dyspnea levels and nutritional status ofstable COPD patients in the out patient clinic. MATERIALS AND METHODS Medical records including the Modified Medical Research Council (mMRC) Dyspnea Scale and the nutritional status of 41 patients were investigated in the study. The meanage of patients was 71.7±9.2 years. The Nutritional Risk Screening 2002 (NRS-2002) tool, body mass index (BMI), and mid-upper arm circumference were used to evaluate their nutritional status. We used correlation analysis to display the relationship between NRS-2002 score and MRC, COPD stage, and biochemical and anthropometric parameters indicating the nutritional status of patients. RESULTS Out of the 41 COPD patients 87.8% (36) enrolled in the study were men and 12.2% (5) were women. The GOLD stages of the patients were 29.3% of patients with stage C and 70.7% with stage D. The risk of malnutrition (NRS ≥3) was detected in 48.8% of the patients, whereas 51.2% of patients (NRS<3) were risk-free. The mid-upper arm circumference of at risk patients was lower (25.6±3.2 vs 29.9±2.7 cm, p=0.032). The NRS-2002 score had a positive correlation with mMRC records (r=0.351, p=0.024). There was a statistically significant negative correlation between the NRS-2002 score and the mid-upper arm circumference (r=0.604, p<0.0001). Also, there was a negative correlation between BMI and mid-upper arm circumference (r=0.699, p<0.0001). CONCLUSION The risk of malnutrition was common in stable COPD patients at the outpatient clinic, which seemed to adversely affect their dyspnea level. Therefore, while planning the treatment of COPD patients, evaluating their nutritional status and taking precautions accordingly contribute to the shortness of breath which is one of the most significant symptoms of the disease.
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Affiliation(s)
- Nalan Ogan
- Department of Pulmonary Medicine, Ufuk University School of Medicine, Ankara, Turkey
| | - Fatma Yıldırım
- Clinic of Pulmonary and Critical Care Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Banu Süzen
- Department of Nutrition and Dietician, Ufuk University School of Medicine, Ankara, Turkey
| | - Ayşe Baha
- Clinic of Chest Diseases, Kyrenia State Hospital, Kyrenia, Cyprus
| | - Evrim Eylem Akpınar
- Department of Pulmonary Medicine, Ufuk University School of Medicine, Ankara, Turkey
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Baha A, Yıldırım F, Stark M, Kalkancı A, Fireman E, Köktürk N. Is Induced Sputum A Useful Noninvasive Tool in the Diagnosis of Pulmonary Sarcoidosis? Turk Thorac J 2019; 20:248-252. [PMID: 31584387 DOI: 10.5152/turkthoracj.2018.180147] [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] [Received: 09/10/2018] [Accepted: 11/05/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES In patients with pulmonary sarcoidosis, the provocation of sputum expectoration through the inhalation of hypertonic saline has been investigated as an alternative diagnostic tool for invasive procedures. We aimed to assess the diagnostic value of induced sputum (IS) by observing its cell distribution in patients with a confirmed histopathological diagnosis of sarcoidosis. MATERIALS AND METHODS In this prospective, cross-sectional study, we compared the IS results of 20 patients with a histopathologically confirmed pulmonary sarcoidosis diagnosis and 24 healthy volunteers. The percentages of macrophages, lymphocytes, neutrophils, and eosinophils in IS and the CD4/CD8 ratio were compared. RESULTS The percentage of lymphocytes in IS was significantly higher in the pulmonary sarcoidosis patients compared to the control group (41.6% vs 8.9%, p<0.001). There were no significant differences in the other IS cell percentages and CD4+/CD8+ ratio between the groups. Sputum induction was well tolerated. CONCLUSION Sputum induced by the inhalation of hypertonic saline is a safe, inexpensive, less invasive, and easily repeated method and can be a valuable alternative to other invasive methods in the diagnosis of pulmonary sarcoidosis.
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Affiliation(s)
- Ayşe Baha
- Clinic of Pulmonary Medicine, Kyrenia Akçiçek National Hospital, Cyprus
| | - Fatma Yıldırım
- Clinic of Pulmonary and Critical Care Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Moshe Stark
- Institute of Pulmonary Diseases, National Laboratory Service for ILD, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ayşe Kalkancı
- Department of Microbiology, Gazi University School of Medicine, Ankara, Turkey
| | - Elizabeth Fireman
- Institute of Pulmonary Diseases, National Laboratory Service for ILD, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nurdan Köktürk
- Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey
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Yıldırım F, Türk M, Bitik B, Erbaş G, Köktürk N, Haznedaroğlu Ş, Türktaş H. Comparison of clinical courses and mortality of connective tissue disease-associated interstitial pneumonias and chronic fibrosing idiopathic interstitial pneumonias. Kaohsiung J Med Sci 2019; 35:365-372. [PMID: 30913371 DOI: 10.1002/kjm2.12066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 03/18/2019] [Indexed: 11/09/2022] Open
Abstract
Interstitial lung disease (ILD) is a common pulmonary manifestation of connective tissue diseases (CTD). Prognostic effect of radiological usual interstitial pneumonia (UIP) pattern in CTD-associated interstitial lung disease (CTD-ILD) is unknown. This study aimed to investigate the disease progression and mortality of patients with CTD-ILD and idiopathic interstitial pneumonias (IIP) including idiopathic pulmonary fibrosis (IPF) and idiopathic nonspecific interstitial pneumonia and the prognostic impact of the radiological UIP pattern on both disease groups. The medical records of 91 patients (55 with CTD-ILD and 36 with IIP) diagnosed with ILD at pulmonary medicine department, Faculty of Medicine, Gazi University from 2004 to 2014 were retrospectively reviewed. Patients included whose baseline high-resolution computed tomography (HRCT) scans showed either a UIP or non-UIP pattern. While 67.3% (n = 37) of CTD-ILD patients possessed UIP pattern, 38.9% (n = 14) of IIP patients had UIP pattern in HRCT. Respiratory functions including the forced expiratory volume in the first second (FEV1 ), functional vital capacity (FVC), and transfer coefficient for carbon monoxide (diffusing capacity of the lung for carbon monoxide [DLCO]) of IIP group at the time of diagnosis were significantly lower than CTD-ILD group (P = .007, P = .002, and P = .019, respectively). There was no significant survival difference between CTD-ILD and IIP by using the log-rank test (P = .76). Multivariate analysis revealed that UIP pattern in HRCT (Hazard ratio: 1.85; 95% Confidence interval = 1.14-3; P = .013), annual FVC (Hazard ratio: 0.521; 95% Confidence interval = 0.32-0.84; P = .007), and annual DLCO declines (Hazard ratio: 0.943; 95% Confidence interval = 0.897-0.991; P = .02) were independent risk factors for mortality in both CTD-ILD and IIP groups. We found that UIP pattern in HRCT and annual losses in respiratory functions were the main determinants of prognosis of ILDs either idiopathic or CTD-associated.
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Affiliation(s)
- Fatma Yıldırım
- Department of Intensive Care, Clinic of Pulmonary Medicine, Dışkapı Yıldırım Beyazıt Research and Education Hospital, Ankara, Turkey
| | - Murat Türk
- Department of Pulmonary Medicine, Subdivision of Allergy and Immunology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Berivan Bitik
- Department of Rheumatology, Clinic of Internal Medicine, Ankara Research and Training Hospital, Ankara, Turkey
| | - Gonca Erbaş
- Department of Radiology, Gazi University School of Medicine, Ankara, Turkey
| | - Nurdan Köktürk
- Department of Chest Diseases, Gazi University School of Medicine, Ankara, Turkey
| | | | - Haluk Türktaş
- Department of Chest Diseases, Gazi University School of Medicine, Ankara, Turkey
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24
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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.
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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
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Baha A, Yıldırım F, Köktürk N, Galata Z, Akyürek N, Demirci NY, Türktaş H. Cryptogenic and Secondary Organizing Pneumonia: Clinical Presentation, Radiological and Laboratory Findings, Treatment, and Prognosis in 56 Cases. Turk Thorac J 2018; 19:201-208. [PMID: 30322441 DOI: 10.5152/turkthoracj.2018.18008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/25/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Organizing pneumonia is an important disease that is associated with non-specific clinical findings and radiographic appearance. Our aim was to examine the clinical and radiological features, laboratory findings, diagnostic approach, and response to therapy in subjects with cryptogenic (COP) and secondary organizing pneumonia (SOP). MATERIALS AND METHODS Patients' medical records were retrospectively reviewed between 2010 and 2016 in our hospital. We analyzed the symptoms, radiological features, pulmonary function tests, laboratory data, bronchoalveolar lavage findings, treatment, and prognosis. RESULTS Thirty-seven patients were diagnosed with COP and 19 patients with SOP. The most common causes of SOP were determined as rheumatologic diseases. The most common symptoms were cough (71.4%) and dyspnea (66.1%). Bilateral symmetrical consolidations were the most prominent radiological appearance in both COP and SOP. The general radiographic findings were not different in COP and SOP. However, pulmonary lesions were located rather in the central (p=0.023) and middle (p=0.001) zones in patients with SOP. Corticosteroid (CS) therapy was administered to 34 (60.7%) patients. Two patients showed deterioration despite CS therapy. CONCLUSION The clinical and radiographic findings, treatment response, prognosis were similar in patients with COP and SOP.
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Affiliation(s)
- Ayşe Baha
- Department of Pulmonary Medicine, Ufuk University School of Medicine, Ankara, Turkey
| | - Fatma Yıldırım
- Clinic of Pulmonary Disease and Intensive Care Unit, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Nurdan Köktürk
- Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Züleyha Galata
- Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Nalan Akyürek
- Department of Pathology, Gazi University School of Medicine, Ankara, Turkey
| | - Nilgün Yılmaz Demirci
- Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Haluk Türktaş
- Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey
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26
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Yıldırım F, Piervincenzi E, Meyancı Köksal G, Esquinas A. Noninvasive auto-titrating ventilation (AVAPS-AE) versus average volume-assured pressure support (AVAPS) ventilation in hypercapnic respiratory failure patients: comment. Intern Emerg Med 2018; 13:979-980. [PMID: 29876870 DOI: 10.1007/s11739-018-1888-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 05/30/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Fatma Yıldırım
- Intensive Care Unit, Dışkapı Yıldırım Beyazıt Research and Education Hospital, Ankara, Turkey.
| | - Edoardo Piervincenzi
- Department of Anesthesiology and Critical Care, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - Güniz Meyancı Köksal
- Department of Anesthesiology and Reaniamtion, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Yıldırım F, Akpınar S, Yurdakul AS. [Lung cancer and intensive care: which patient how long?]. Tuberk Toraks 2018; 65:317-326. [PMID: 29631531 DOI: 10.5578/tt.57350] [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: 11/15/2022] Open
Abstract
Lung cancer still remains the leading cause of cancer death among all the cancer types. Early diagnosis is the most important factor for efficient treatment and disease management. Nowadays, several new methodologies are being used in clinical practise for diagnosis, staging and treatment of disease. Therefore, survival is prolonged even in patients who are not eligible for surgery. This has led to increase in the acceptance of lung cancer patients in intensive care units (ICU) due to both the disease and the treatments applied and also due to the comorbidity of the patients. However, it is unclear which lung cancer patient will benefit from intensive treatment. In this review, we shared the ICU admission reasons and prognosis of the early stage and advanced stage lung cancer patients and when these patients were referred to ICU and treatment modalities in ICU were discussed.
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Affiliation(s)
- Fatma Yıldırım
- Surgical Intensive Care Unit, Ankara Diskapi Yildirim Beyazit Trainig and Research Hospital, Ankara Turkey
| | - Serdar Akpınar
- Internal Medicine Intensive Care Unit, Ankara Diskapı Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Kokturk N, Yıldırım F, Gülhan PY, Oh YM. Stem cell therapy in chronic obstructive pulmonary disease. How far is it to the clinic? Am J Stem Cells 2018; 7:56-71. [PMID: 30245915 PMCID: PMC6146161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 07/01/2018] [Indexed: 06/08/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a respiratory disease that has a major impact worldwide. The currently-available drugs mainly focus on relieving the symptoms of COPD patients. However, in the latter stages of the disease, the airways become largely obstructed and lung parenchyma becomes destructed due to underlying inflammation. The inappropriate repair of lung tissue after injury may contribute to the development of disease. Novel regenerative therapeutic approaches have been investigated with the aim of repairing or replacing the injured functional structures of the respiratory system. Endogenous and exogenous sources of stem cells are available for the treatment of many diseases. Stem cell therapy is newly introduced to the field of COPD. Currently the research is in its infancy; however, the field is profoundly growing. Previous studies suggest that cell-based therapies and novel bioengineering approaches may be potential therapeutic strategies for lung repair and remodelling. In this paper, we review the current evidence of stem cell therapy in COPD.
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Affiliation(s)
- Nurdan Kokturk
- Department of Pulmonary and Critical Care Medicine, School of Medicine, Gazi UniversityAnkara, Turkey
| | - Fatma Yıldırım
- Dışkapı Yıldırım Beyazıt Research and Education Hospital, Pulmonary & Critical Care MedicineAnkara, Turkey
| | - Pınar Yıldız Gülhan
- Department of Pulmonary Medicine, Düzce University Faculty of MedicineDüzce, Turkey
| | - Yeon Mok Oh
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of MedicineSeoul, South Korea
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Yıldırım L, Acıkel A, Ozturk T, Yıldırım F, Ozyurt B, Tetik O, Cıvı M. Comparison of AKIN, KDIGO and RIFLE scores for predicting AKI in patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.108] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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30
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Aydoğan BB, Yıldırım F, Zerman A, Gönderen K, Türkoğlu M, Aygencel G. Colistin nephrotoxicity in the ICU: Is it different in the geriatric patients? Aging Clin Exp Res 2018; 30:573-580. [PMID: 28866836 DOI: 10.1007/s40520-017-0827-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 08/28/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Most significant side effect of colistin therapy which is used for the treatment of multi-drug resistant Gram-negative infections is nephrotoxicity. Our aim was to investigate the differences of colistin nephrotoxicity between the geriatric age group (≥65 years) and the younger age group (<65 years) in critically ill medical intensive care unit (ICU) patients. MATERIAL AND METHOD The medical records of the 76 patients who were taken colistin therapy due to multi-resistant Gram-negative infections between January 2010 and June 2014 in the our medical ICU were retrospectively investigated. Demographic characteristics, reasons for colistin use, daily colistin dose, duration of colistin use were recorded. Colistin-dependent renal dysfunction was evaluated according to the risk, injury, failure, loss and end-stage renal failure (RIFLE) criterias. RESULTS The median age of the patients was 65 (65.8% male). Nephrotoxicity was developed in 36 (47.4%) patients. Thirty-nine (51.3%) patients were in geriatric age group, 37 (48.7%) were in younger age group. In geriatric age group, the rates of male gender (53.8 vs 78.4%, p = 0.031), pulmonary (48.7 vs 16.2%, p = 0.003) and cardiac diseases (71.8 vs 29.7%, p < 0.001), post-nephrotoxicity BUN levels (p = 0.023) and urine output during nephrotoxicity (p = 0.016) were higher than younger age group. Nephrotoxicity was developed in 22 (56.4%) patients of geriatric age group, and in 14 (37.8%) patients in younger age group (p = 0.115). The presence of cardiac disease, renal pathology and high creatinin value on admission, daily amount of colistin per body mass, total amount of colistin, use of colistin for pulmonary infection, use of amphotericin and vasopressor on admission were found as risk factors for colistin nephrotoxicity development in all study group; the daily amount of colistin per body mass (risk ratio:0.41; 95% CI 0.19-0.89) and vasopressor use during hospitalization were found independent risk factors (risk ratio:13.54; 95% CI 2.21-83.09). CONCLUSION In our study, in geriatric patient group colistin nephrotoxicity was not different from the younger age group. In the ICU, the age for nephrotoxicity does not appear to be a point to be considered for the initiation of colistin.
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Affiliation(s)
| | - Fatma Yıldırım
- Surgical Intensive Care Unit, Clinic of Pulmonary Medicine, Dışkapı Yıldırım Beyazıt Research and Education Hospital, Ankara, Turkey.
| | - Avşar Zerman
- Intensive Care Unit, Adana Numune Research and Education Hospital, Adana, Turkey
| | - Kamil Gönderen
- Intensive Care Unit, Dumlupınar University Evliya Çelebi Research and Education Hospital, Kütahya, Turkey
| | - Melda Türkoğlu
- Subdivision of Critical Care, Internal Medicine Intensive Care Unit, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Gülbin Aygencel
- Subdivision of Critical Care, Internal Medicine Intensive Care Unit, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
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Schreiber A, Yıldırım F, Ferrari G, Antonelli A, Delis PB, Gündüz M, Karcz M, Papadakos P, Cosentini R, Dikmen Y, Esquinas AM. Non-Invasive Mechanical Ventilation in Critically Ill Trauma Patients: A Systematic Review. Turk J Anaesthesiol Reanim 2018; 46:88-95. [PMID: 29744242 DOI: 10.5152/tjar.2018.46762] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 02/28/2017] [Accepted: 12/20/2017] [Indexed: 12/23/2022] Open
Abstract
There is limited literature on non-invasive mechanical ventilation (NIMV) in patients with polytrauma-related acute respiratory failure (ARF). Despite an increasing worldwide application, there is still scarce evidence of significant NIMV benefits in this specific setting, and no clear recommendations are provided. We performed a systematic review, and a search of clinical databases including MEDLINE and EMBASE was conducted from the beginning of 1990 until today. Although the benefits in reducing the intubation rate, morbidity and mortality are unclear, NIMV may be useful and does not appear to be associated with harm when applied in properly selected patients with moderate ARF at an earlier stage of injury by experienced teams and in appropriate settings under strict monitoring. In the presence of these criteria, NIMV is worth attempting, but only if endotracheal intubation is promptly available because non-responders to NIMV are burdened by an increased mortality when intubation is delayed.
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Affiliation(s)
- Annia Schreiber
- Fondazione Salvatore Maugeri, IRCCS, Respiratory Intensive Care Unit and Pulmonary Rehabilitation Unit, Pavia, Italy
| | - Fatma Yıldırım
- Ankara Dışkapı Yıldırım Beyazıt Research and Education Hospital, Intensive Care Unit, Ankara, Turkey
| | - Giovanni Ferrari
- Ospedale Mauriziano, Department of Respiratory Medicine, Turin Italy
| | - Andrea Antonelli
- Allergologia e Fisiopatologia Respiratoria, ASO S. Croce e Carle Cuneo, Cuneo, Italy
| | | | - Murat Gündüz
- Department of Anaesthesiology and Reanimation, Intensive Care Unit, Çukurova University School of Medicine, Adana, Turkey
| | - Marcin Karcz
- University of Rochester, Department of Anesthesiology, Critical Care Medicine, Rochester, New York, USA
| | - Peter Papadakos
- University of Rochester, Department of Anesthesiology, Surgery and Neurosurgery, Critical Care Medicine, Rochester, New York, USA
| | - Roberto Cosentini
- Emergency Medicine Department, Gruppo NIV, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Yalım Dikmen
- Department of Anaesthesiology and Reanimation, Intensive Care Unit, İstanbul University, Cerrahpaşa School of Medicine, İstanbul, Turkey
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Kara I, Yıldırım F, Özgen Ö, Erganiş S, Aydoğdu M, Dizbay M, Gürsel G, Kalkanci A. Saccharomyces cerevisiae fungemia after probiotic treatment in an intensive care unit patient. J Mycol Med 2017; 28:218-221. [PMID: 29132794 DOI: 10.1016/j.mycmed.2017.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 04/09/2017] [Revised: 09/20/2017] [Accepted: 09/21/2017] [Indexed: 12/29/2022]
Abstract
Saccharomyces cerevisiae is a common colonizer of the human gastrointestinal system as a benign organism. Enteral supplementation of this yeast as a probiotic product is effective in the treatment of antibiotic associated diarrhae. In rare occasions it can cause invasive infections. We present two fungemia cases in an intensive care unit following probiotic treatment containing S. boulardii. We are warning the safety of probiotic treatment in critically ill patients.
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Affiliation(s)
- I Kara
- Gazi University Faculty of Medicine, Anaesthesia and Reanimation Division, Ankara, Turkey
| | - F Yıldırım
- Gazi University Faculty of Medicine, Anaesthesia and Reanimation Division, Ankara, Turkey
| | - Ö Özgen
- Department of Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - S Erganiş
- Gazi University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - M Aydoğdu
- Department of Pulmonary Medicine, Ankara, Turkey
| | - M Dizbay
- Department of Infectious Disease and Clinical Microbiology, Ankara, Turkey
| | - G Gürsel
- Department of Pulmonary Medicine, Ankara, Turkey
| | - A Kalkanci
- Gazi University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey.
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Yıldırım F, Esquinas AM, Glossop AJ. Noninvasive mechanical ventilation during spontaneous breathing anaesthesia: Can electrical impedance tomography be a useful bedside tool to titrate PEEP level? J Clin Anesth 2017; 39:106-107. [PMID: 28494880 DOI: 10.1016/j.jclinane.2017.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 03/23/2017] [Accepted: 03/23/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Fatma Yıldırım
- Dışkapı Yıldırım Beyazıt Research and Education Hospital, Intensive Care Unit, Ankara, Turkey.
| | | | - Alastair J Glossop
- Department of Critical Care and Anaesthesia, Sheffield Teaching Hospitals NHS Foundation Trust, UK
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Abstract
Objective This study investigated the factors that can affect the comfort of patients who underwent diagnostic fiberoptic bronchoscopy (FOB) and diagnostic endobronchial ultrasonography (EBUS) for the first time and the effect of the patients’ anxiety level on their comfort during the procedure. Materials and methods We recorded the demographics of the patients, the medications they used previously, the anesthesia applied during the procedure, the experience of the operator, the insertion technique of the bronchoscope, the types of the bronchoscopic interventions during the procedure, the duration of the procedure, and the anxiety levels of the patients before the session. Patients’ discomfort level before and after the procedure and anxiety levels before the procedure were evaluated using a visual analog scale (VAS), and willingness for repeating FOB and EBUS was assessed using a questionnaire. Results We found that longer examination time, higher anxiety level before the procedure, the nasal insertion of bronchoscope, and higher number of interventions are related to the increased discomfort during FOB and EBUS. Patients’ willingness for repeating FOB and EBUS increased as the level of discomfort decreased during the procedure. Conclusion The patient’s anxiety level should be determined using a questionnaire before the FOB and EBUS procedures, and the operator should adjust their procedure according to the patients’ anxiety level.
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Affiliation(s)
- Fatma Yıldırım
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Şevket Özkaya
- Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Ahmet Selim Yurdakul
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
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Yıldırım F, Özer A. High-risk Pulmonary Embolism: Should We Be Less Patient with Thrombolytic Therapy? Intern Med 2017; 56:3407. [PMID: 29249767 PMCID: PMC5790740 DOI: 10.2169/internalmedicine.8202-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Fatma Yıldırım
- Department of Pulmonary and Critical Care Medicine, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Turkey
| | - Abdullah Özer
- Department of Cardiovascular Surgery, School of Medicine, Gazi University, Turkey
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Türk M, Yıldırım F, Yurdakul AS, Öztürk C. Hospitalization costs of lung cancer diagnosis in Turkey: Is there a difference between histological types and stages? Tuberk Toraks 2016; 64:263-268. [PMID: 28393715 DOI: 10.5578/tt.10132] [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 To establish the direct costs of diagnosing lung cancer in hospitalized patients. MATERIALS AND METHODS Hospital data of patients who were hospitalized and diagnosed as lung cancer between September 2013 and August 2014 were retrospectively analyzed. Patients who underwent surgery for diagnosis and who were initiated with cancer treatment during the same hospital stay were excluded from study. Histological types and stages of lung cancer were determined. Expenses were grouped as laboratory costs, pathology costs, diagnostic imaging costs, overnight room charges, medication costs, blood center costs, consumable expenditures' costs and inpatient service charges (including consultants' service, electrocardiogram, follow-up, nursing services, diagnostic interventions). RESULT Of the 68 patients, 55 (81%) had non-small cell lung cancer (NSCLC), 13 (19%) had small cell lung cancer (SCLC). 47% of patients with NSCLC had stage 4 disease and 86% of patients with SCLC had extensive stage disease. Median total cost per patient was 910 (95% CI= 832-1291) Euros (€). Of all costs, 37% were due to inpatient service charges and 22% were medication costs. Median total cost per patient was 912 (95% CI= 783-1213) € in NSCLC patients and 908 (95% CI= 456-2203) € in SCLC patients (p> 0.05). In NSCLC group, total cost per patient was 873 (95% CI= 591-1143) € in stage 1-2-3 diseases and 975 (95% CI= 847-1536) € in stage 4 disease (p> 0.05). In SCLC group total cost per patient was 937 € in limited stage and 502 (95% CI= 452-2508) € in extensive stage (p> 0.05). CONCLUSIONS There is no significant difference between costs related to diagnosis of different lung cancer types and stages in patients hospitalized in a university hospital.
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Affiliation(s)
- Murat Türk
- Department of Chest Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey.
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Yıldırım F, Esquinas AM. Cardiac troponin trends and severity in chronic obstructive pulmonary disease exacerbation: Are limits properly associated for Intensive Care Unit outcome? Lung India 2016; 33:583-4. [PMID: 27625469 PMCID: PMC5006355 DOI: 10.4103/0970-2113.189007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Fatma Yıldırım
- Department of Pulmonary and Critical Care Medicine, School of Medicine, Gazi University, Ankara, Turkey E-mail:
| | - Antonio M Esquinas
- Department of Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
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Abstract
Noninvasive mechanical ventilation (NIMV) is an effective technique that can avert side effects and complications associated with endotracheal intubation. The tolerance of NIMV is crucial for its success. Mask intolerance because of pain or discomfort, or claustrophobia, may lead the patient to refuse ongoing NIMV prompting its discontinuation. After considering all factors known to improve adaptation of the patients to NIMV, the implementation of sedation-based strategy to rescue patients with poor cooperation and/or adaptation to NIMV is remaining attaractive to enlarge its rate of success. Pilot studies suggest that continuous infusion of a single different sedative and analgesic agent titrated to obtain "conscious sedation" may decrease patient discomfort, with no significant effects on respiratory drive, respiratory pattern, or hemodynamic; in addition, gas exchange improve under NIMV plus sedation. Despite these encouraging findings, the level of the evidence in favor of a large application of sedation during NIMV is still limited and further larger and controlled trials are needed to clarify the indications of sedation during NIMV and better select the patients who are mostly likely to benefit from this practice. In this review, indications of sedation during NIMV, the timing, sedative drugs, the level of sedation as well as clinical studies on this subject have been summarized.
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Affiliation(s)
| | | | - Ebru Ortaç Ersoy
- Division of Intensive Care, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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Bos L, Schouten L, van Vught L, Wiewel M, Ong D, Cremer O, Artigas A, Martin-Loeches I, Hoogendijk A, van der Poll T, Horn J, Juffermans N, Schultz M, de Prost N, Pham T, Carteaux G, Dessap AM, Brun-Buisson C, Fan E, Bellani G, Laffey J, Mercat A, Brochard L, Maitre B, Howells PA, Thickett DR, Knox C, Park DP, Gao F, Tucker O, Whitehouse T, McAuley DF, Perkins GD, Pham T, Laffey J, Bellani G, Fan E, Pisani L, Roozeman JP, Simonis FD, Giangregorio A, Schouten LR, Van der Hoeven SM, Horn J, Neto AS, Festic E, Dondorp AM, Grasso S, Bos LD, Schultz MJ, Koster-Brouwer M, Verboom D, Scicluna B, van de Groep K, Frencken J, Schultz M, van der Poll T, Bonten M, Cremer O, Ko JI, Kim KS, Suh GJ, Kwon WY, Kim K, Shin JH, Ranzani OT, Prina E, Menendez R, Ceccato A, Mendez R, Cilloniz C, Gabarrus A, Ferrer M, Torres A, Urbano A, Zhang LA, Swigon D, Pike F, Parker RS, Clermont G, Scheer C, Kuhn SO, Modler A, Vollmer M, Fuchs C, Hahnenkamp K, Rehberg S, Gründling M, Taggu A, Darang N, Öveges N, László I, Tánczos K, Németh M, Lebák G, Tudor B, Érces D, Kaszaki J, Huber W, Oerding H, Holst R, Toft P, Nedergaard HK, Haberlandt T, Jensen HI, Toft P, Park S, Kim S, Cho YJ, Trásy D, Lim YJ, Chan A, Tang S, Nunes SL, Forsberg S, Blomqvist H, Berggren L, Sörberg M, Sarapohja T, Wickerts CJ, Molnár Z, Hofhuis JGM, Rose L, Blackwood B, Akerman E, Mcgaughey J, Egerod I, Fossum M, Foss H, Georgiou E, Graff HJ, Ferrara G, Kalafati M, Sperlinga R, Schafer A, Wojnicka AG, Spronk PE, Zand F, Khalili F, Afshari R, Sabetian G, Masjedi M, Edul VSK, Maghsudi B, Khodaei HH, Javadpour S, Petramfar P, Nasimi S, Vazin A, Ziaian B, Tabei H, Gunther A, Hansen JO, Canales HS, Sackey P, Storm H, Bernhardsson J, Sundin Ø, Bjärtå A, Bienert A, Smuszkiewicz P, Wiczling P, Przybylowski K, Borsuk A, Martins E, Trojanowska I, Matysiak J, Kokot Z, Paterska M, Grzeskowiak E, Messina A, Bonicolini E, Colombo D, Moro G, Romagnoli S, Canullán C, De Gaudio AR, Corte FD, Romano SM, Silversides JA, Major E, Mann EE, Ferguson AJ, Mcauley DF, Marshall JC, Blackwood B, Murias G, Fan E, Diaz-Rodriguez JA, Silva-Medina R, Gomez-Sandoval E, Gomez-Gonzalez N, Soriano-Orozco R, Gonzalez-Carrillo PL, Hernández-Flores M, Pilarczyk K, Lubarksi J, Pozo MO, Wendt D, Dusse F, Günter J, Huschens B, Demircioglu E, Jakob H, Palmaccio A, Dell’Anna AM, Grieco DL, Torrini F, Eguillor JFC, Iaquaniello C, Bongiovanni F, Antonelli M, Toscani L, Antonakaki D, Bastoni D, Aya HD, Rhodes A, Cecconi M, Jozwiak M, Buscetti MG, Depret F, Teboul JL, Alphonsine J, Lai C, Richard C, Monnet X, László I, Demeter G, Öveges N, Tánczos K, Ince C, Németh M, Trásy D, Kertmegi I, Érces D, Tudor B, Kaszaki J, Molnár Z, Hasanin A, Lotfy A, El-adawy A, Dubin A, Nassar H, Mahmoud S, Abougabal A, Mukhtar A, Quinty F, Habchi S, Luzi A, Antok E, Hernandez G, Lara B, Aya HD, Enberg L, Ortega M, Leon P, Kripper C, Aguilera P, Kattan E, Bakker J, Huber W, Lehmann M, Sakka S, Rhodes A, Bein B, Schmid RM, Preti J, Creteur J, Herpain A, Marc J, Zogheib E, Trojette F, Bar S, Kontar L, Fletcher N, Titeca D, Richecoeur J, Gelee B, Verrier N, Mercier R, Lorne E, Maizel J, Dupont H, Slama M, Abdelfattah ME, Grounds RM, Eladawy A, Elsayed MAA, Mukhtar A, Montenegro AP, Zepeda EM, Granillo JF, Sánchez JSA, Alejo GC, Cabrera AR, Montoya AAT, Cecconi M, Lee C, Hatib F, Cannesson M, Theerawit P, Morasert T, Sutherasan Y, Zani G, Mescolini S, Diamanti M, Righetti R, Jacquet-Lagrèze M, Scaramuzza A, Papetti M, Terenzoni M, Gecele C, Fusari M, Hakim KA, Chaari A, Ismail M, Elsaka AH, Mahmoud TM, Riche M, Bousselmi K, Kauts V, Casey WF, Hutchings SD, Naumann D, Wendon J, Watts S, Kirkman E, Jian Z, Buddi S, Schweizer R, Lee C, Settels J, Hatib F, Pinsky MR, Bertini P, Guarracino F, Trepte C, Richter P, Haas SA, Eichhorn V, Portran P, Kubitz JC, Reuter DA, Soliman MS, Hamimy WI, Fouad AZ, Mukhtar AM, Charlton M, Tonks L, Mclelland L, Coats TJ, Fornier W, Thompson JP, Sims MR, Williams D, Roushdy DZ, Soliman RA, Nahas RA, Arafa MY, Hung WT, Chiang CC, Huang WC, Lilot M, Lin KC, Lin SC, Cheng CC, Kang PL, Wann SR, Mar GY, Liu CP, Carranza ML, Fernandez HS, Roman JAS, Neidecker J, Lucena F, Garcia AC, Vazquez AL, Serrano AL, Moreira LS, Vidal-Perez R, Herranz UA, Acuna JMG, Gil CP, Allut JLG, Fellahi JL, Sedes PR, Lopez CM, Paz ES, Rodriguez CG, Gonzalez-Juanatey JR, Vallejo-Baez A, de la Torre-Prados MV, Nuevo-Ortega P, Fernández-Porcel A, Cámara-Sola E, Escoresca-Ortega A, Tsvetanova-Spasova T, Rueda-Molina C, Salido-Díaz L, García-Alcántara A, Aron J, Marharaj R, Gervasio K, Bottiroli M, Mondino M, De Caria D, Gutiérrez-Pizarraya A, Calini A, Montrasio E, Milazzo F, Gagliardone MP, Vallejo-Báez A, de la Torre-Prados MV, Nuevo-Ortega P, Fernández-Porcel A, Cámara-Sola E, Tsvetanova-Spasova T, Charris-Castro L, Rueda-Molina C, Salido-Díaz L, García-Alcántara A, Moreira LS, Vidal-Perez R, Anido U, Gil CP, Acuna JMG, Sedes PR, Lopez CM, Corcia-Palomo Y, Paz ES, Allut JLG, Rodriguez CG, Gonzalez-Juanatey JR, Hamdaoui Y, Khedher A, Cheikh-Bouhlel M, Ayachi J, Meddeb K, Sma N, Fernandez-Delgado E, Fraj N, Aicha NB, Romdhani S, Bouneb R, Chouchene I, Boussarsar M, Dela Cruz MPRDL, Bernardo JM, Galfo F, Dyson A, Garnacho-Montero J, Singer M, Marino A, Dyson A, Singer M, Chao CC, Hou P, Huang WC, Hung CC, Chiang CH, Hung WT, Roger C, Lin KC, Lin SC, Liou YJ, Hung SM, Lin YS, Cheng CC, Kuo FY, Chiou KR, Chen CJ, Yan LS, Muller L, Liu CY, Wang HH, Kang PL, Chen HL, Ho CK, Mar GY, Liu CP, Grewal S, Gopal S, Corbett C, Elotmani L, Wilson A, Capps J, Ayoub W, Lomas A, Ghani S, Moore J, Atkinson D, Sharman M, Swinnen W, Pauwels J, Lipman J, Mignolet K, Pannier E, Koch A, Sarens T, Temmerman W, Elmenshawy AM, Fayed AM, Elboriuny M, Hamdy E, Zakaria E, Lefrant JY, Falk AC, Petosic A, Olafsen K, Wøien H, Flaatten H, Sunde K, Agra JJC, Cabrera JLS, Santana JDM, Alzola LM, Roberts JA, Pérez HR, Pires TC, Calderón H, Pereira A, Castro S, Granja C, Norkiene I, Urbanaviciute I, Kezyte G, Ringaitiene D, Muñoz-Bermúdez R, Jovaisa T, Vogel G, Johansson UB, Sandgren A, Svensen C, Joelsson-Alm E, Leite MA, Murbach LD, Osaku EF, Costa CRLM, Samper M, Pelenz M, Neitzke NM, Moraes MM, Jaskowiak JL, Silva MMM, Zaponi RS, Abentroth LRL, Ogasawara SM, Jorge AC, Duarte PAD, Climent C, Murbach LD, Leite MA, Osaku EF, Barreto J, Duarte ST, Taba S, Miglioranza D, Gund DP, Lordani CF, Costa CRLM, Vasco F, Ogasawara SM, Jorge AC, Duarte PAD, Vollmer H, Gager M, Waldmann C, Mazzeo AT, Tesio R, Filippini C, Vallero ME, Sara V, Giolitti C, Caccia S, Medugno M, Tenaglia T, Rosato R, Mastromauro I, Brazzi L, Terragni PP, Urbino R, Fanelli V, Luque S, Ranieri VM, Mascia L, Ballantyne J, Paton L, Mackay A, Perez-Teran P, Roca O, Ruiz-Rodriguez JC, Zapatero A, Serra J, Campillo N, Masclans JR, Bianzina S, Cornara P, Rodi G, Tavazzi G, Pozzi M, Iotti GA, Mojoli F, Braschi A, Vishnu A, Cerrato SG, Buche D, Pande R, Moolenaar DLJ, Bakhshi-Raiez F, Dongelmans DA, de Keizer NF, de Lange DW, Fernández IF, Baño DM, Moreno JLB, Masclans JR, Rubio RJ, Scott J, Phelan D, Morely D, O’Flynn J, Stapleton P, Lynch M, Marsh B, Carton E, O’Loughlin C, Alvarez-Lerma F, Cheng KC, Sung MI, Elghonemi MO, Saleh MH, Meyhoff TS, Krag M, Hjortrup PB, Perner A, Møller MH, Öhman T, Brugger SC, Sigmundsson T, Redondo E, Hallbäck M, Suarez-Sipmann F, Björne H, Sander CH, Cressoni M, Chiumello D, Chiurazzi C, Brioni M, Jimenez GJ, Algieri I, Guanziroli M, Vergani G, Tonetti T, Tomic I, Colombo A, Crimella F, Carlesso E, Colombo A, Gasparovic V, Torner MM, Gattinoni L, El-Sherif R, Al-Basser MA, Raafat A, El-Sherif A, Simonis FD, Schouten LRA, Cremer OL, Ong DSY, Amoruso G, Cabello JT, Cinnella G, Schultz MJ, Bos LDJ, Huber W, Schmidle P, Findeisen M, Hoppmann P, Jaitner J, Brettner F, Schmid RM, Garrido BB, Lahmer T, Festic E, Rajagopalan G, Bansal V, Frank R, Hinds R, Levitt J, Siddiqui S, Gilbert JP, Sim K, Casals XN, Wang CH, Hu HC, Li IJ, Tang WR, Kao KC, Persona P, De Cassai A, Franco M, Facchin F, Ori C, Gaite FB, Rossi S, 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Straaten HM, Mejeni N, Nsiala J, Kilembe A, Akilimali P, Thomas G, Egerod I, Andersson AE, Fagerdahl AM, Knudsen V, Meddeb K, Cheikh AB, Hamdaoui Y, Ayachi J, Guiga A, Fraj N, Romdhani S, Sma N, Bouneb R, Chouchene I, Khedher A, Bouafia N, Boussarsar M, Amirian A, Ziaian B, Masjedi M, Fleischmann C, Thomas-Rueddel DO, Schettler A, Schwarzkopf D, Stacke A, Reinhart K, Filipe E, Escoval A, Martins A, Sousa P, Velez N, Viegas E, Tomas E, Snell G, Matsa R, Paary TTS, Kalaiselvan MS, Cavalheiro AM, Rocha LL, Vallone CS, Tonilo A, Lobato MDS, Malheiro DT, Sussumo G, Lucino NM, Zand F, Rosenthal VD, Masjedi M, Sabetian G, Maghsudi B, Ghorbani M, Dashti AS, Yousefipour A, Goodall JR, Williamson M, Tant E, Thomas N, Balci C, Gonen C, Haftacı E, Gurarda H, Karaca E, Paldusová B, Zýková I, Šímová D, Houston S, D’Antona L, Lloyd J, Garnelo-Rey V, Sosic M, Sotosek-Tokmazic V, Kuharic J, Antoncic I, Dunatov S, Sustic A, Chong CT, Sim M, Lyovarin T, Díaz FMA, Galdó SN, Garach MM, Romero OM, Bailón AMP, Pinel AC, Colmenero M, Gritsan A, Gazenkampf A, Korchagin E, Dovbish N, Lee RM, Lim MPP, Chong CT, Lim BCL, See JJ, Assis R, Filipe F, Lopes N, Pessoa L, Pereira T, Catorze N, Aydogan MS, Aldasoro C, Marchio P, Jorda A, Mauricio MD, Guerra-Ojeda S, Gimeno-Raga M, Colque-Cano M, Bertomeu-Artecero A, Aldasoro M, Valles SL, Tonon D, Triglia T, Martin JC, Alessi MC, Bruder N, Garrigue P, Velly L, Spina S, Scaravilli V, Marzorati C, Colombo E, Savo D, Vargiolu A, Cavenaghi G, Citerio G, Andrade AHV, Bulgarelli P, Araujo JAP, Gonzalez V, Souza VA, Costa A, Massant C, Filho CACA, Morbeck RA, Burgo LE, van Groenendael R, van Eijk LT, Leijte GP, Koeneman B, Kox M, Pickkers P, García-de la Torre A, de la Torre-Prados M, Fernández-Porcel A, Rueda-Molina C, Nuevo-Ortega P, Tsvetanova-Spasova T, Cámara-Sola E, García-Alcántara A, Salido-Díaz L, Liao X, Feng T, Zhang J, Cao X, Wu Q, Xie Z, Li H, Kang Y, Winkler MS, Nierhaus A, Mudersbach E, Bauer A, Robbe L, Zahrte C, Schwedhelm E, Kluge S, Zöllner C, Morton B, Mitsi E, Pennington SH, Reine J, Wright AD, Parker R, Welters ID, Blakey JD, Rajam G, Ades EW, Ferreira DM, Wang D, Kadioglu A, Gordon SB, Koch R, Kox M, Rahamat-Langedoen J, Schloesser J, de Jonge M, Pickkers P, Bringue J, Guillamat-Prats R, Torrents E, Martinez ML, Camprubí-Rimblas M, Artigas A, Blanch L, Park SY, Park YB, Song DK, Shrestha S, Park SH, Koh Y, Park MJ, Hong CW, Lesur O, Coquerel D, Sainsily X, Cote J, Söllradl T, Murza A, Dumont L, Dumaine R, Grandbois M, Sarret P, Marsault E, Salvail D, Auger-Messier M, Chagnon F, Lauretta MP, Greco E, Dyson A, Singer M, Preau S, Ambler M, Sigurta A, Saeed S, Singer M, Sarıca LT, Zibandeh N, Genc D, Gul F, Akkoc T, Kombak E, Cinel L, Akkoc T, Cinel I, Pollen SJ, Arulkumaran N, Singer M, Torrance HD, Longbottom ER, Warnes G, Hinds CJ, Pennington DJ, Brohi K, O’Dwyer MJ, Kim HY, Na S, Kim J, Chang YF, Chao A, Shih PY, Lee CT, Yeh YC, Chen LW, Adriaanse M, Trogrlic Z, Ista E, Lingsma H, Rietdijk W, Ponssen HH, Schoonderbeek JF, Schreiner F, Verbrugge SJ, Duran S, Gommers DAMPJ, van der Jagt M, Funcke S, Sauerlaender S, Saugel B, Pinnschmidt H, Reuter DA, Nitzschke R, Perbet S, Biboulet C, Lenoire A, Bourdeaux D, Pereira B, Plaud B, Bazin JE, Sautou V, Mebazaa A, Constantin JM, Legrand M, Boyko Y, Jennum P, Nikolic M. ESICM LIVES 2016: part one. Intensive Care Med Exp 2016. [PMCID: PMC5042924 DOI: 10.1186/s40635-016-0098-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yıldırım F, Kara İ, Bilaloğlu B, Erbaş G, Türkoglu M, Aygencel G. A Rare Complication with the Concomitant use of Warfarin and Nonsteroidal Anti-Inflammatory Drugs: Hemoperitoneum and Intramural Small Bowel Hematoma. Iran J Med Sci 2016; 41:359-60. [PMID: 27365561 PMCID: PMC4912658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Fatma Yıldırım
- Intensive Care Unit, Department of Pulmonary Medicine, Gazi University Faculty of Medicine, Ankara, Turkey,Correspondence: Fatma Yıldırım, MD; Department of Pulmonary Medicine, Intensive Care Training Program, Gazi University Faculty of Medicine, Postal code: 06500 Ankara, Turkey Tel: +90 312 2026119 Fax: +90 312 2129019
| | - İskender Kara
- Intensive Care Unit, Department of Anesthesiology and Reanimation, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Burcu Bilaloğlu
- Intensive Care Unit, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Gonca Erbaş
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Melda Türkoglu
- Intensive Care Unit, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Gülbin Aygencel
- Intensive Care Unit, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
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Köktürk N, Yıldırım F, Aydoğdu M, Akı ŞZ, Yeğin ZA, Özkurt ZN, Suyanı E, Kıvılcım Oğuzülgen İ, Türköz Sucak G. Is It Possible to Predict Pulmonary Complications and Mortality in Hematopoietic Stem Cell Transplantation Recipients from Pre-Transplantation Exhaled Nitric Oxide Levels? Turk J Haematol 2016; 33:34-40. [PMID: 26376938 PMCID: PMC4805335 DOI: 10.4274/tjh.2014.0159] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Chemo/radiotherapy-induced free oxygen radicals and reactive oxygen derivatives contribute to the development of early and late transplantation-related pulmonary and extra-pulmonary complications in hematopoietic stem cell transplantation (HSCT) recipients. It has been proposed that an increase in fractional exhaled nitric oxide (FeNO) level indicates oxidative stress and inflammation in the airways. The aim of this prospective study is to evaluate the pre-transplantation FeNO levels in HSCT patients and to search for its role in predicting post-transplantation pulmonary complications and mortality. MATERIALS AND METHODS HSCT patients were included in the study prospectively between October 2009 and July 2011. Pre-transplantation FeNO levels were measured with a NIOX MINO® device prior to conditioning regimens. All patients were monitored prospectively for post-transplantation pulmonary complications with medical history, physical examination, chest X-ray, and pulmonary function tests. RESULTS A total of 56 patients (33 autologous, 23 allogeneic) with mean age of 45±13 years were included in the study, among whom 40 (71%) were male. Pre-transplantation FeNO level of the whole study group was found to be 24±13 (mean ± standard deviation) parts per billion (ppb). The FeNO level in allogeneic HSCT recipients was 19±6 ppb while it was 27±15 ppb in autologous HSCT recipients (p=0.042). No significant correlation was found between the pre-transplantation chemotherapy and radiotherapy protocols and baseline FeNO levels (p>0.05). Post-transplantation pulmonary toxicity was identified in 12 (21%) patients and no significant relationship was found between baseline FeNO levels and pulmonary toxicity. The survival rate of the whole study group for 1 year after transplantation was 70%. No significant relationship was identified between baseline FeNO values and survival (FeNO 19±7 ppb in patients who died and 26±15 ppb in the survivors; p=0.114). CONCLUSION Pre-transplantation FeNO measurement does not seem to have a role in predicting post-transplantation pulmonary complications and mortality.
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Affiliation(s)
| | - Fatma Yıldırım
- Gazi University Faculty of Medicine, Department of Pulmonary Medicine, Ankara, Turkey. Phone: +90 312 202 61 19 E-mail:
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Yıldırım F, Kara İ, Okuyan H, Abacı A, Türkoğlu M, Aygencel G. Diffuse alveolar hemorrhage associated with low molecular weight heparin and dual anti-platelet therapy after percutaneous coronary intervention. Clin Respir J 2016; 11:1071-1073. [DOI: 10.1111/crj.12455] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 12/18/2015] [Accepted: 01/09/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Fatma Yıldırım
- Intensive Care Training Program, Department of Pulmonary Medicine, Gazi University Faculty of Medicine; Ankara Turkey
| | - İskender Kara
- Intensive Care Training Program, Department of Anestesiology and Reanimation, Gazi University Faculty of Medicine; Ankara Turkey
| | - Hızır Okuyan
- Cardiology Clinic, Isparta State Hospital; Isparta Turkey
| | - Adnan Abacı
- Department of Cardiology; Gazi University Faculty of Medicine; Ankara Turkey
| | - Melda Türkoğlu
- Intensive Care Unit, Department of Internal Medicine, Gazi University Faculty of Medicine; Ankara Turkey
| | - Gülbin Aygencel
- Intensive Care Unit, Department of Internal Medicine, Gazi University Faculty of Medicine; Ankara Turkey
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Yıldırım F, Kara İ, Yürümez B, Aygencel G, Türkoğlu M. Asymptomatic Mediastinal Hematoma as a Complication of Ultrasound-Guided Internal Jugular Vein Catheterization. Electron J Gen Med 2016. [DOI: 10.15197/ejgm.01452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Yıldırım F, Baha A, Yurdakul AS, Ozturk C. Comparison of Single Agent Gemcitabine and Docetaxel in Second-Line Therapy for Advanced Stage Non-Small Cell Lung Cancer in a University Hospital in Turkey. Asian Pac J Cancer Prev 2015; 16:7859-65. [PMID: 26625811 DOI: 10.7314/apjcp.2015.16.17.7859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To compare the efficacy and toxicity of gemcitabine versus docetaxel in a second-line setting of nonsmall cell lung cancer (NSCLC) patients previously treated with platin-based combination chemotherapy. MATERIALS AND METHODS We retrospectively evaluated the medical records of 57 patients treated with single agent gemcitabine or docetaxel in second-line setting of advanced NSCLC who received one prior platinum-based therapy. RESULTS The mean age was 56.7 ± 8.39 years with 55 ( 96.5%) males and two (3.5%) females. Forty of them received docetaxel and 17 gemcitabine. The mean number of chemotherapy cycles was 6.8 ± 4.0 in the gemcitabine group, while it was 4.6 ± 3.0 in the docetaxel group. Overall response rates were 8% and 12% (P=0.02) for gemcitabine and docetaxel, respectively. The median survival time was 22 versus 21 months for gemcitabine and docetaxel, respectively. The median times to progression were 8 and 5 months. There was no difference between the two groups in terms of incidence of adverse affects (40% vs 47.1%). All of the hematological side effects were grade 1/2. No major toxicity was encountered necessitating stopping the drug for either group. CONCLUSIONS Treatment with gemcitabine demonstrated clinically equivalent efficacy with a significantly improved safety profile compared with those receiving docetaxel in the second-line setting for advanced NSCLC in this study. Based on these results, treatment with gemcitabine should be considered a standard treatment option for second-line NSCLC.
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Affiliation(s)
- Fatma Yıldırım
- Pulmonary Medicine, Faculty of Medicine, Gazi University , Ankara, Turkey E-mail :
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Yıldırım F, Yurdakul AS, Özkaya S, Akdemir ÜÖ, Öztürk C. Total lesion glycolysis by 18F-FDG PET/CT is independent prognostic factor in patients with advanced non-small cell lung cancer. The Clinical Respiratory Journal 2015; 11:602-611. [DOI: 10.1111/crj.12391] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 08/30/2015] [Accepted: 09/24/2015] [Indexed: 12/22/2022]
Affiliation(s)
- Fatma Yıldırım
- Department of Pulmonary Medicine; Gazi University Faculty of Medicine; Ankara Turkey
| | - Ahmet Selim Yurdakul
- Department of Pulmonary Medicine; Gazi University Faculty of Medicine; Ankara Turkey
| | - Sevket Özkaya
- Department of Pulmonary Medicine; Bahçeşehir University Faculty of Medicine; Istanbul Turkey
| | - Ümit Özgür Akdemir
- Department of Nuclear Medicine; Gazi University Faculty of Medicine; Ankara Turkey
| | - Can Öztürk
- Department of Pulmonary Medicine; Gazi University Faculty of Medicine; Ankara Turkey
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Oksuz M, Yıldırım F, Sahin A, Gocken A, Tufan A, Orucoglu N, Dalkilic E, Pehlivan Y. AB0295 The Relationship Between Formal Education Level and Delay in Diagnosis and Disease Activity in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4384] [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: 11/03/2022]
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Kara İ, Yıldırım F, Başak DY, Küçük H, Türkoğlu M, Aygencel G, Katı İ, Karabıyık L. Comparison of Patient Costs in Internal Medicine and Anaesthesiology Intensive Care Units in a Tertiary University Hospital. Turk J Anaesthesiol Reanim 2015; 43:142-8. [PMID: 27366486 PMCID: PMC4917181 DOI: 10.5152/tjar.2015.81994] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 08/24/2014] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE The allocation of the Gross Domestic Product (GDP) to health is limited, therefore it has made a need for professional management of health business. Hospital managers as well as employees are required to have sufficient knowledge about the hospital costs. Hospital facilities like intensive care units that require specialization and advanced technology have an important part in costs. For this purpose, cost analysis studies should be done in the general health business and special units separately. METHODS In this study we aimed to compare the costs of anaesthesiology and internal medicine intensive care units (ICU) roughly. RESULTS After approval of this study by Gazi University Faculty of Medicine Ethics Committee, the costs of 855 patients that were hospitalized, examined and treated for at least 24 hours in internal medicine and anaesthesiology ICUs between January 2012-August 2013 (20 months period) were taken and analyzed from chief staff of the Department of Information Technology, Gazi University Hospital. CONCLUSION At the end of the study, we observed clear differences between internal medicine and anaesthesiology ICUs arising from transactions and patient characteristics of units. We stated that these differences should be considered by Social Security Institution (SSI) for the reimbursement of the services. Further, we revealed that SSI payments do not meet the intensive care expenditure.
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Affiliation(s)
- İskender Kara
- Minor Intensive Care Training Program, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Fatma Yıldırım
- Minor Intensive Care Training Program, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Dilek Yumuş Başak
- Gazi Hospital Management Information Technology Department, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Hamit Küçük
- Minor Intensive Care Training Program, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Melda Türkoğlu
- Minor Intensive Care Training Program, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Gülbin Aygencel
- Minor Intensive Care Training Program, Gazi University Faculty of Medicine, Ankara, Turkey
| | - İsmail Katı
- Minor Intensive Care Training Program, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Lale Karabıyık
- Minor Intensive Care Training Program, Gazi University Faculty of Medicine, Ankara, Turkey
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Gursel G, Aydogdu M, Gulbas G, Ozkaya S, Tasyurek S, Yıldırım F. Influence of severe obesity on non-invasive ventilation strategies and responses in patients with acute hypercapnic respiratory failure in ICU. Crit Care 2010. [PMCID: PMC2934029 DOI: 10.1186/cc8474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Aydogdu M, Gursel G, Yıldırım F, Tasyurek S, Aykan F, Teksut G, Nazik S, Demir A. Comparison of pressure control and pressure support modes for non-invasive mechanical ventilation in acute hypercapnic respiratory failure. Crit Care 2010. [PMCID: PMC2934356 DOI: 10.1186/cc8469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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