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Ufuk F, Yitik AY, Sarilar B, Altinisik G. Patients With Post-COVID-19 Respiratory Condition: Chest Computed Tomography Findings and Pulmonary Function Tests and Comparison With Asymptomatic Participants. J Comput Assist Tomogr 2024; 48:415-423. [PMID: 38213073 DOI: 10.1097/rct.0000000000001577] [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] [Indexed: 01/13/2024]
Abstract
OBJECTIVE The aims of this study were to assess the chest computed tomography (CT) findings in post-COVID-19 respiratory condition (rPCC) patients and compare the findings with asymptomatic participants (APs). It also aimed to evaluate the relationship between CT findings and pulmonary function tests (PFTs) in rPCC patients. Finally, it aimed to compare the quantitative chest CT findings and PFT results of patients with rPCC and APs. METHODS We retrospectively enrolled consecutive patients with rPCC who underwent unenhanced chest CT and PFTs between June 2020 and September 2022. In addition, a control group (APs) was prospectively formed and underwent nonenhanced chest CT and PFTs. The presence and extent of abnormalities in unenhanced chest CT images were evaluated qualitatively and semiquantitatively in a blinded manner. We used fully automatic software for automatic lung and airway segmentation and quantitative analyses. RESULTS Sixty-three patients with rPCC and 23 APs were investigated. Reticulation/interstitial thickening and extent of parenchymal abnormalities on CT were significantly greater in the rPCC group than in the control group ( P = 0.001 and P = 0.004, respectively). Computed tomography extent score was significantly related to length of hospital stay, age, and intensive care unit stay (all P s ≤ 0.006). The rPCC group also had a lower 85th percentile attenuation lung volume ( P = 0.037). The extent of parenchymal abnormalities was significantly correlated with carbon monoxide diffusing capacity ( r = -0.406, P = 0.001), forced vital capacity (FVC) ( r = -0.342, P = 0.002), and forced expiratory volume in 1 second/FVC ( r = 0.427, P < 0.001) values. Pulmonary function tests revealed significantly lower carbon monoxide diffusing capacity ( P < 0.001), FVC ( P = 0.036), and total lung capacity ( P < 0.001) values in the rPCC group. CONCLUSIONS The rPCC is characterized by impaired PFTs, a greater extent of lung abnormalities on CT, and decreased 85th percentile attenuation lung volume. Advanced age, intensive care unit admission history, and extended hospital stay are risk factors for chest CT abnormalities.
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Affiliation(s)
- Furkan Ufuk
- From the Department of Radiology, University of Pamukkale, Denizli, Turkey
| | - Ahmet Yasin Yitik
- From the Department of Radiology, University of Pamukkale, Denizli, Turkey
| | - Burak Sarilar
- From the Department of Radiology, University of Pamukkale, Denizli, Turkey
| | - Goksel Altinisik
- Department of Pulmonology, University of Pamukkale, Denizli, Turkey
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Ufuk F, Kilicarslan E, Bir F, Altinisik G. Case 323: Minute Pulmonary Meningothelial-like Nodules. Radiology 2024; 310:e222512. [PMID: 38530178 DOI: 10.1148/radiol.222512] [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] [Indexed: 03/27/2024]
Abstract
HISTORY A 70-year-old woman with a 6-year history of asthma, a 12-year history of diabetes mellitus, and who did not smoke presented to the pulmonology clinic with dyspnea and cough. Chest CT performed 5 years earlier for similar symptoms revealed multiple pulmonary nodules. However, she was lost to follow-up before the work-up was concluded. Otherwise, her medical history was unremarkable. Family history included maternal endometrial cancer. Physical examination revealed partial oxygen saturation of 98%, respiratory rate of 18 breaths per minute, and heart rate of 77 beats per minute. Her breath sounds and other systemic findings were normal. Pulmonary function test results were as follows: forced expiratory volume in 1 second, 108% predicted (normal range, 80%-120%); total lung capacity, 72% predicted (normal range, 80%-120%); forced vital capacity, 101% predicted (normal range, 80%-120%); diffusing capacity for carbon monoxide, 69% predicted (normal range, 60%-120%); and forced midexpiratory flow, 85% predicted (normal range, 40%-160%). Complete blood count, erythrocyte sedimentation rate, C-reactive protein level, rheumatoid factor, and antinuclear antibody levels were within normal limits. The patient underwent volumetric thin-section CT of the chest using a multidetector CT scanner (Ingenuity Core 128; Philips Medical Systems) to evaluate lung nodules and pulmonary interstitium.
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Affiliation(s)
- Furkan Ufuk
- From the Departments of Radiology (F.U.), Pathology (E.K., F.B.), and Pulmonology (G.A.), University of Pamukkale, Denizli, Turkey
| | - Emel Kilicarslan
- From the Departments of Radiology (F.U.), Pathology (E.K., F.B.), and Pulmonology (G.A.), University of Pamukkale, Denizli, Turkey
| | - Ferda Bir
- From the Departments of Radiology (F.U.), Pathology (E.K., F.B.), and Pulmonology (G.A.), University of Pamukkale, Denizli, Turkey
| | - Goksel Altinisik
- From the Departments of Radiology (F.U.), Pathology (E.K., F.B.), and Pulmonology (G.A.), University of Pamukkale, Denizli, Turkey
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Ufuk F, Kilicarslan E, Bir F, Altinisik G. Case 323. Radiology 2023; 309:e222511. [PMID: 38015083 DOI: 10.1148/radiol.222511] [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] [Indexed: 11/29/2023]
Abstract
HISTORY A 70-year-old woman with a 6-year history of asthma, a 12-year history of diabetes mellitus, and who did not smoke presented to the pulmonology clinic with dyspnea and cough. Chest CT performed 5 years earlier for similar symptoms revealed multiple pulmonary nodules (Fig 1). However, she was lost to follow-up before the work-up was concluded. Otherwise, her medical history was unremarkable. Family history included maternal endometrial cancer. Physical examination revealed partial oxygen saturation of 98%, respiratory rate of 18 breaths per minute, and heart rate of 77 beats per minute. Her breath sounds and other systemic findings were normal. Pulmonary function test results were as follows: forced expiratory volume in 1 second, 108% predicted (normal range, 80%-120%); total lung capacity, 72% predicted (normal range, 80%-120%); forced vital capacity, 101% predicted (normal range, 80%-120%); diffusing capacity for carbon monoxide, 69% predicted (normal range, 60%-120%); and forced midexpiratory flow, 85% predicted (normal range, 40%-160%). Complete blood count, erythrocyte sedimentation rate, C-reactive protein level, rheumatoid factor, and antinuclear antibody levels were within normal limits. The patient underwent volumetric high-resolution CT of the chest using a multidetector CT scanner (Ingenuity Core 128; Philips Medical Systems) to evaluate lung nodules and pulmonary interstitium (Fig 2).
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Affiliation(s)
- Furkan Ufuk
- From the Departments of Radiology (F.U.), Pathology (E.K., F.B.), and Pulmonology (G.A.), University of Pamukkale, Denizli, Turkey
| | - Emel Kilicarslan
- From the Departments of Radiology (F.U.), Pathology (E.K., F.B.), and Pulmonology (G.A.), University of Pamukkale, Denizli, Turkey
| | - Ferda Bir
- From the Departments of Radiology (F.U.), Pathology (E.K., F.B.), and Pulmonology (G.A.), University of Pamukkale, Denizli, Turkey
| | - Goksel Altinisik
- From the Departments of Radiology (F.U.), Pathology (E.K., F.B.), and Pulmonology (G.A.), University of Pamukkale, Denizli, Turkey
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Babayigit C, Kokturk N, Kul S, Cetinkaya PD, Atis Nayci S, Argun Baris S, Karcioglu O, Aysert P, Irmak I, Akbas Yuksel A, Sekibag Y, Baydar Toprak O, Azak E, Mulamahmutoglu S, Cuhadaroglu C, Demirel A, Kerget B, Baran Ketencioglu B, Ozger HS, Ozkan G, Ture Z, Ergan B, Avkan Oguz V, Kilinc O, Ercelik M, Ulukavak Ciftci T, Alici O, Nurlu Temel E, Ataoglu O, Aydin A, Cetiner Bahcetepe D, Gullu YT, Fakili F, Deveci F, Kose N, Tor MM, Gunluoglu G, Altin S, Turgut T, Tuna T, Ozturk O, Dikensoy O, Yildiz Gulhan P, Basyigit I, Boyaci H, Oguzulgen IK, Borekci S, Gemicioglu B, Bayraktar F, Elbek O, Hanta I, Kuzu Okur H, Sagcan G, Uzun O, Akgun M, Altinisik G, Dursun B, Cakir Edis E, Gulhan E, Oner Eyuboglu F, Gultekin O, Havlucu Y, Ozkan M, Sakar Coskun A, Sayiner A, Kalyoncu AF, Itil O, Bayram H. The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort. Front Med (Lausanne) 2022; 9:894126. [PMID: 36117966 PMCID: PMC9471091 DOI: 10.3389/fmed.2022.894126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background and objectives Although several repurposed antiviral drugs have been used for the treatment of COVID-19, only a few such as remdesivir and molnupiravir have shown promising effects. The objectives of our study were to investigate the association of repurposed antiviral drugs with COVID-19 morbidity. Methods Patients admitted to 26 different hospitals located in 16 different provinces between March 11–July 18, 2020, were enrolled. Case definition was based on WHO criteria. Patients were managed according to the guidelines by Scientific Board of Ministry of Health of Turkey. Primary outcomes were length of hospitalization, intensive care unit (ICU) requirement, and intubation. Results We retrospectively evaluated 1,472 COVID-19 adult patients; 57.1% were men (mean age = 51.9 ± 17.7years). A total of 210 (14.3%) had severe pneumonia, 115 (7.8%) were admitted to ICUs, and 69 (4.7%) were intubated during hospitalization. The median (interquartile range) of duration of hospitalization, including ICU admission, was 7 (5–12) days. Favipiravir (n = 328), lopinavir/ritonavir (n = 55), and oseltamivir (n = 761) were administered as antiviral agents, and hydroxychloroquine (HCQ, n = 1,382) and azithromycin (n = 738) were used for their immunomodulatory activity. Lopinavir/ritonavir (β [95% CI]: 4.71 [2.31–7.11]; p = 0.001), favipiravir (β [95% CI]: 3.55 [2.56–4.55]; p = 0.001) and HCQ (β [95% CI]: 0.84 [0.02–1.67]; p = 0.046) were associated with increased risk of lengthy hospital stays. Furthermore, favipiravir was associated with increased risks of ICU admission (OR [95% CI]: 3.02 [1.70–5.35]; p = 0.001) and invasive mechanical ventilation requirement (OR [95% CI]: 2.94 [1.28–6.75]; p = 0.011). Conclusion Our findings demonstrated that antiviral drugs including lopinavir, ritonavir, and favipiravir were associated with negative clinical outcomes such as increased risks for lengthy hospital stay, ICU admission, and invasive mechanical ventilation requirement. Therefore, repurposing such agents without proven clinical evidence might not be the best approach for COVID-19 treatment.
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Affiliation(s)
- Cenk Babayigit
- Department of Pulmonary Medicine, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey
| | - Nurdan Kokturk
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Seval Kul
- Department of Biostatistics, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Pelin Duru Cetinkaya
- Department of Pulmonary Medicine, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
- Department of Pulmonary Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Sibel Atis Nayci
- Department of Pulmonary Medicine, Faculty of Medicine, Mersin University, Yenişehir, Turkey
| | - Serap Argun Baris
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | - Oguz Karcioglu
- Department of Pulmonary Medicine, Halil Şıvgın Cubuk State Hospital, Ankara, Turkey
| | - Pinar Aysert
- Department of Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ilim Irmak
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Aycan Akbas Yuksel
- Department of Pulmonary Medicine, Faculty of Medicine, Ufuk University, Ankara, Turkey
| | - Yonca Sekibag
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Oya Baydar Toprak
- Department of Pulmonary Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Emel Azak
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | - Sait Mulamahmutoglu
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Caglar Cuhadaroglu
- Department of Pulmonary Medicine, Faculty of Medicine, Altunizade Acibadem Hospital, Acibadem University, Istanbul, Turkey
| | - Aslihan Demirel
- Department of Infectious Disease, Kadıköy Florence Nightingale Hospital, Istanbul, Turkey
| | - Bugra Kerget
- Department of Pulmonary Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | | | - Hasan Selcuk Ozger
- Department of Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Gulcihan Ozkan
- Department of Pulmonary Medicine, Acibadem Maslak Hospital, Istanbul, Turkey
- Operating Room Services Department, Vocational School, Nişantaşı University, Istanbul, Turkey
| | - Zeynep Ture
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Begum Ergan
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Vildan Avkan Oguz
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Oguz Kilinc
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Merve Ercelik
- Department of Pulmonary Medicine, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Tansu Ulukavak Ciftci
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ozlem Alici
- Department of Infectious Disease, Turkiye Gazetesi Private Hospital, Istanbul, Turkey
| | - Esra Nurlu Temel
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Ozlem Ataoglu
- Department of Pulmonary Medicine, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Asena Aydin
- Department of Pulmonary Medicine, Kestel State Hospital, Bursa, Turkey
| | | | - Yusuf Taha Gullu
- Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Fusun Fakili
- Department of Pulmonary Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Figen Deveci
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazıg˘, Turkey
| | - Neslihan Kose
- Department of Pulmonary Medicine, Bilecik Training and Research Hospital, Bilecik, Turkey
| | - Muge Meltem Tor
- Department of Pulmonary Medicine, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Gulsah Gunluoglu
- Department of Pulmonary Medicine, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Sedat Altin
- Department of Pulmonary Medicine, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, University of Health Science, Istanbul, Turkey
| | - Teyfik Turgut
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazıg˘, Turkey
| | - Tibel Tuna
- Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Onder Ozturk
- Department of Pulmonary Medicine, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Oner Dikensoy
- Department of Pulmonary Medicine, Faculty of Medicine, Taksim, Acibadem University, Istanbul, Turkey
| | - Pinar Yildiz Gulhan
- Department of Pulmonary Medicine, Faculty of Medicine, Düzce University, Düzce, Turkey
| | - Ilknur Basyigit
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | - Hasim Boyaci
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, İzmit, Turkey
| | | | - Sermin Borekci
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Bilun Gemicioglu
- Department of Pulmonary Disease, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Firat Bayraktar
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Osman Elbek
- Department of Pulmonary Medicine, Kadıköy Florence Nightingale Hospital, Istanbul, Turkey
| | - Ismail Hanta
- Department of Pulmonary Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Hacer Kuzu Okur
- Department of Pulmonary Medicine, Faculty of Medicine, Altunizade Acibadem Hospital, Acibadem University, Istanbul, Turkey
| | - Gulseren Sagcan
- Department of Pulmonary Medicine, Faculty of Medicine, Altunizade Acibadem Hospital, Acibadem University, Istanbul, Turkey
| | - Oguz Uzun
- Department of Pulmonary Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Metin Akgun
- Department of Pulmonary Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Goksel Altinisik
- Department of Pulmonary Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Berna Dursun
- Department of Pulmonary Medicine, Ankara Memorial Hospital, Ankara, Turkey
| | - Ebru Cakir Edis
- Department of Pulmonary Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Erkmen Gulhan
- Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Fusun Oner Eyuboglu
- Department of Pulmonary Medicine, School of Medicine, Başkent University, Ankara, Turkey
| | - Okkes Gultekin
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Yavuz Havlucu
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Metin Ozkan
- Department of Pulmonary Medicine, Ankara Memorial Hospital, Ankara, Turkey
| | - Aysin Sakar Coskun
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Abdullah Sayiner
- Department of Pulmonary Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
| | - A. Fuat Kalyoncu
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Oya Itil
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Hasan Bayram
- Department of Pulmonary Medicine, Koç University School of Medicine, Istanbul, Turkey
- Koç University Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
- *Correspondence: Hasan Bayram,
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Gunduz Gurkan C, Karadogan D, Ufuk F, Cure O, Altinisik G. Management of Patients with Connective Tissue Disease-associated Interstitial Lung Diseases During the COVID-19 Pandemic. Turk Thorac J 2022; 22:346-352. [PMID: 35110253 DOI: 10.5152/turkthoracj.2021.20172] [Citation(s) in RCA: 2] [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: 11/22/2022]
Abstract
The novel coronavirus disease (COVID-19) is similar to connective tissue disease-associated interstitial lung diseases (CTD-ILD) in many aspects. However, patients with CTD-ILD have required particular attention during the pandemic since they are at high risk due to -immunosuppressive treatments. Thus, prompt decisions for diagnosis and treatment initiation have become more important than earlier for these patients during the pandemic. Radiological perspectives have become inevitable for the differential diagnosis of this group ¬during the pandemic, particularly to obtain rapid and accurate results that allow the physicians to start treatment immediately. However, in addition to radiological images, a definitive diagnosis also requires access to extensive information regarding patient history, including characteristics of comorbidities, and clinical and serological findings. Consequently, the differential diagnosis of COVID-19 and CTD-ILD can yield accurate treatment regimens that differ greatly between the 2 diseases, and also prevent the spread of the outbreak with COVID-19 patients treated under isolation.
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Affiliation(s)
- Canan Gunduz Gurkan
- Department of Chest Diseases, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Dilek Karadogan
- Department of Chest Diseases, Recep Tayyip Erdogan University, School of Medicine, Rize, Turkey
| | - Furkan Ufuk
- Department of Radiology, Pamukkale University,School of Medicine, Denizli, Turkey
| | - Osman Cure
- Department of Internal Diseases Rheumatology Subdivision, Recep Tayyip Erdogan University, School of Medicine, Rize, Turkey
| | - Goksel Altinisik
- Department of Chest Diseases, Pamukkale University, School of Medicine, Denizli, Turkey
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Ugurlu E, Pekel G, Akbulut S, Cetin N, Durmus S, Altinisik G. Choroidal vascularity index and thickness in sarcoidosis. Medicine (Baltimore) 2022; 101:e28519. [PMID: 35119002 PMCID: PMC8812671 DOI: 10.1097/md.0000000000028519] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 12/11/2021] [Indexed: 01/04/2023] Open
Abstract
Sarcoidosis is a multisystem granulomatous disease which is observed worldwide. Sarcoidosis is one of the common causes of ocular inflammation. The choroidal vascularity index, defined as the ratio of the luminal area to the total choroidal area, is used as one of the biomarkers for assessing the choroid vascular state. We aimed to compare choroidal vascularity index and thickness measurements between sarcoidosis patients and healthy controls.Thirty-one patients with sarcoidosis and 31 age-gender matched healthy participants were recruited in this cross-sectional and comparative study. Choroidal vascularity index was defined as the ratio of luminal area to total choroidal area after binarization on optical coherence tomography images. Anterior segment examinations included central corneal thickness, corneal volume, anterior chamber depth, anterior chamber volume, and iridocorneal angle. Spectral-domain optical coherence tomography was used to measure peripapillary retinal nerve fiber layer thickness, choroidal thickness, and retinal vessel caliber.The mean choroidal vascularity index value was 61.6% in sarcoidosis patients and 62.4% in healthy controls (P = .69). The choroidal vascularity index and thickness were significantly correlated in both sarcoidosis (r = 0.41, P = .026) and control groups (r = 0.51, P = .006). Both the sarcoidosis and control groups had similar measured values for central corneal thickness, corneal volume, anterior chamber depth, anterior chamber volume, and iridocorneal angle (P > .05). Mean retinal nerve fiber layer, retinal arteriole and venule caliber, and choroidal thickness measurements did not differ significantly between the groups (P > .05).Sarcoidosis patients in quiescent period have similar choroidal vascularity index and thickness with healthy controls.
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Affiliation(s)
- Erhan Ugurlu
- Department of Pulmonology, Pamukkale University, Denizli, Turkey
| | - Gokhan Pekel
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| | - Selen Akbulut
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| | - Nazli Cetin
- Department of Pulmonology, Pamukkale University, Denizli, Turkey
| | - Sinan Durmus
- Department of Pulmonology, Pamukkale University, Denizli, Turkey
| | - Goksel Altinisik
- Department of Pulmonology, Pamukkale University, Denizli, Turkey
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Ufuk F, Altinisik G, Karasu U. Pleuroparenchymal fibroelastosis in a patient with systemic sclerosis. Rheumatology (Oxford) 2021; 60:3958-3959. [PMID: 33367850 DOI: 10.1093/rheumatology/keaa879] [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: 11/13/2022] Open
Affiliation(s)
- Furkan Ufuk
- Department of Radiology, University of Pamukkale, Denizli, Turkey
| | - Goksel Altinisik
- Department of Chest Disease, University of Pamukkale, Denizli, Turkey
| | - Ugur Karasu
- Department of Rheumatology, University of Pamukkale, Denizli, Turkey
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Kokturk N, Babayigit C, Kul S, Duru Cetinkaya P, Atis Nayci S, Argun Baris S, Karcioglu O, Aysert P, Irmak I, Akbas Yuksel A, Sekibag Y, Baydar Toprak O, Azak E, Mulamahmutoglu S, Cuhadaroglu C, Demirel A, Kerget B, Baran Ketencioglu B, Ozger HS, Ozkan G, Ture Z, Ergan B, Avkan Oguz V, Kilinc O, Ercelik M, Ulukavak Ciftci T, Alici O, Nurlu Temel E, Ataoglu O, Aydin A, Cetiner Bahcetepe D, Gullu YT, Fakili F, Deveci F, Kose N, Tor MM, Gunluoglu G, Altin S, Turgut T, Tuna T, Ozturk O, Dikensoy O, Yildiz Gulhan P, Basyigit I, Boyaci H, Oguzulgen IK, Borekci S, Gemicioglu B, Bayraktar F, Elbek O, Hanta I, Kuzu Okur H, Sagcan G, Uzun O, Akgun M, Altinisik G, Dursun B, Cakir Edis E, Gulhan E, Oner Eyuboglu F, Gultekin O, Havlucu Y, Ozkan M, Sakar Coskun A, Sayiner A, Kalyoncu AF, Itil O, Bayram H. The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients. Respir Med 2021; 183:106433. [PMID: 33957434 PMCID: PMC8079263 DOI: 10.1016/j.rmed.2021.106433] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 01/08/2023]
Abstract
The COVID-19-related death rate varies between countries and is affected by various risk factors. This multicenter registry study was designed to evaluate the mortality rate and the related risk factors in Turkey. We retrospectively evaluated 1500 adults with COVID-19 from 26 centers who were hospitalized between March 11 and July 31, 2020. In the study group, 1041 and 459 cases were diagnosed as definite and highly probable cases, respectively. There were 993 PCR-positive cases (66.2%). Among all cases, 1144 (76.3%) were diagnosed with non-severe pneumonia, whereas 212 (14.1%) had severe pneumonia. Death occurred in 67 patients, corresponding to a mortality rate of 4.5% (95% CI:3.5–5.6). The univariate analysis demonstrated that various factors, including male sex, age ≥65 years and the presence of dyspnea or confusion, malignity, chronic obstructive lung disease, interstitial lung disease, immunosuppressive conditions, severe pneumonia, multiorgan dysfunction, and sepsis, were positively associated with mortality. Favipiravir, hydroxychloroquine and azithromycin were not associated with survival. Following multivariate analysis, male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were found to be independent risk factors for mortality. Among the biomarkers, procalcitonin levels on the 3rd-5th days of admission showed the strongest associations with mortality (OR: 6.18; 1.6–23.93). This study demonstrated that the mortality rate in hospitalized patients in the early phase of the COVID-19 pandemic was a serious threat and that those patients with male sex, severe pneumonia, multiorgan dysfunction, malignancy, sepsis and interstitial lung diseases were at increased risk of mortality; therefore, such patients should be closely monitored.
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Affiliation(s)
- Nurdan Kokturk
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Cenk Babayigit
- Department of Pulmonary Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.
| | - Seval Kul
- Department of Biostatistics, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.
| | - Pelin Duru Cetinkaya
- Department of Pulmonary Medicine, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey.
| | - Sibel Atis Nayci
- Department of Pulmonary Medicine, Faculty of Medicine, Mersin University, Mersin, Turkey.
| | - Serap Argun Baris
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
| | - Oguz Karcioglu
- Department of Pulmonary Medicine, Halil Sıvgın Cubuk State Hospital, Ankara, Turkey.
| | - Pinar Aysert
- Department of Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Ilim Irmak
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Aycan Akbas Yuksel
- Department of Pulmonary Medicine, Faculty of Medicine, Ufuk University, Ankara, Turkey.
| | - Yonca Sekibag
- Department of Pulmonary Disease, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Oya Baydar Toprak
- Department of Pulmonary Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | - Emel Azak
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Kocaeli University, Kocaeli Turkey.
| | - Sait Mulamahmutoglu
- Department of Pulmonary Disease, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Caglar Cuhadaroglu
- Department of Pulmonary Medicine, Altunizade Acibadem Hospital, Istanbul, Turkey.
| | - Aslihan Demirel
- Department of Infectious Disease, Kadikoy Florence Nightingale Hospital, Istanbul, Turkey.
| | - Bugra Kerget
- Department of Pulmonary Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
| | | | - Hasan Selcuk Ozger
- Department of Infectious Disease, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Gulcihan Ozkan
- Department of Pulmonary Medicine, Maslak Acibadem Hospital, Istanbul, Turkey; Operating Room Services Department, Nisantasi University, Vocational School, Istanbul, Turkey.
| | - Zeynep Ture
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
| | - Begum Ergan
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Vildan Avkan Oguz
- Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Oguz Kilinc
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Merve Ercelik
- Department of Pulmonary Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey.
| | - Tansu Ulukavak Ciftci
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Ozlem Alici
- Department of Infectious Disease, Faculty of Medicine, Turkiye Gazetesi Private Hospital, Istanbul, Turkey.
| | - Esra Nurlu Temel
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
| | - Ozlem Ataoglu
- Department of Pulmonary Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey.
| | - Asena Aydin
- Department of Pulmonary Medicine, Kestel State Hospital, Bursa, Turkey.
| | | | - Yusuf Taha Gullu
- Department of Pulmonary Medicine, Faculty of Medicine, On Dokuz Mayis University, Samsun, Turkey.
| | - Fusun Fakili
- Department of Pulmonary Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.
| | - Figen Deveci
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazig, Turkey.
| | - Neslihan Kose
- Department of Pulmonary Medicine, Bilecik Training and Research Hospital, Bilecik, Turkey.
| | - Muge Meltem Tor
- Department of Pulmonary Medicine, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey.
| | - Gulsah Gunluoglu
- Department of Pulmonary Medicine, University of Health Science, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey.
| | - Sedat Altin
- Department of Pulmonary Medicine, University of Health Science, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey.
| | - Teyfik Turgut
- Department of Pulmonary Medicine, Faculty of Medicine, Firat University, Elazig, Turkey.
| | - Tibel Tuna
- Department of Pulmonary Medicine, Faculty of Medicine, On Dokuz Mayis University, Samsun, Turkey.
| | - Onder Ozturk
- Department of Pulmonary Medicine, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
| | - Oner Dikensoy
- Department of Pulmonary Medicine, Faculty of Medicine, Taksim, Acibadem University, Istanbul, Turkey.
| | - Pinar Yildiz Gulhan
- Department of Pulmonary Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey.
| | - Ilknur Basyigit
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
| | - Hasim Boyaci
- Department of Pulmonary Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
| | - I Kivilcim Oguzulgen
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.
| | - Sermin Borekci
- Department of Pulmonary Disease, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Bilun Gemicioglu
- Department of Pulmonary Disease, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Firat Bayraktar
- Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Osman Elbek
- Department of Pulmonary Medicine, Kadikoy Florence Nightingale Hospital, Istanbul, Turkey.
| | - Ismail Hanta
- Department of Pulmonary Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey.
| | - Hacer Kuzu Okur
- Department of Pulmonary Medicine, Altunizade Acibadem Hospital, Istanbul, Turkey.
| | - Gulseren Sagcan
- Department of Pulmonary Medicine, Altunizade Acibadem Hospital, Istanbul, Turkey.
| | - Oguz Uzun
- Department of Pulmonary Medicine, Faculty of Medicine, On Dokuz Mayis University, Samsun, Turkey.
| | - Metin Akgun
- Department of Pulmonary Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
| | - Goksel Altinisik
- Department of Pulmonary Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
| | - Berna Dursun
- Department of Pulmonary Medicine, Ankara Memorial Hospital, Ankara, Turkey.
| | - Ebru Cakir Edis
- Department of Pulmonary Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey.
| | - Erkmen Gulhan
- Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
| | - Fusun Oner Eyuboglu
- Department of Pulmonary Medicine, Baskent University, School of Medicine, Ankara, Turkey.
| | - Okkes Gultekin
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
| | - Yavuz Havlucu
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
| | - Metin Ozkan
- Department of Pulmonary Medicine, Ankara Memorial Hospital, Ankara, Turkey.
| | - Aysin Sakar Coskun
- Department of Pulmonary Medicine, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
| | - Abdullah Sayiner
- Department of Pulmonary Medicine, Faculty of Medicine, Ege University, Izmir, Turkey.
| | - Ali Fuat Kalyoncu
- Department of Pulmonary Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Oya Itil
- Department of Pulmonary Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Hasan Bayram
- Department of Pulmonary Medicine, Koc University Research Center for Translational Medicine (KUTTAM), Koc University School of Medicine, Istanbul, Turkey.
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George PM, Spagnolo P, Kreuter M, Altinisik G, Bonifazi M, Martinez FJ, Molyneaux PL, Renzoni EA, Richeldi L, Tomassetti S, Valenzuela C, Vancheri C, Varone F, Cottin V, Costabel U. Progressive fibrosing interstitial lung disease: clinical uncertainties, consensus recommendations, and research priorities. The Lancet Respiratory Medicine 2020; 8:925-934. [DOI: 10.1016/s2213-2600(20)30355-6] [Citation(s) in RCA: 129] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/17/2022]
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Ufuk F, Demirci M, Altinisik G, Karasu U. Quantitative analysis of Sjogren's syndrome related interstitial lung disease with different methods. Eur J Radiol 2020; 128:109030. [DOI: 10.1016/j.ejrad.2020.109030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/13/2020] [Accepted: 04/19/2020] [Indexed: 11/15/2022]
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Turktas H, Okumus G, Uzun O, Ozdemir Kumbasar O, Altinisik G, Bingol Z, Borekci S, Cottin V, Musellim B. Survey of Physician’s Knowledge, Attitudes, and Practices Regarding Idiopathic Pulmonary Fibrosis in Turkey. Turk Thorac J 2020; 21:44-48. [DOI: 10.5152/turkthoracj.2019.180181] [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] [Received: 11/12/2018] [Accepted: 12/26/2018] [Indexed: 11/22/2022]
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Kilinc M, Altinisik G. Comorbidity and Clinical Relationship and Treatment Evaluation of Patients with Nonspesific İnterstitial Pneumonia Diagnosed. Turk Thorac J 2019. [DOI: 10.5152/turkthoracj.2019.161] [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: 11/22/2022]
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Kilinc M, Yilmaz A, Altinisik G, Metin M, Ugurlu E, Telli Atalay O. Evaluation of Balance, Depression, Cough Strength and Life Quality According to COPD. Turk Thorac J 2019. [DOI: 10.5152/turkthoracj.2019.116] [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: 11/22/2022]
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Yilmaz A, Kilinc M, Altinisik G, Telli Atalay O, Metin M, Ugurlu E. The Relationship Between Cough Strength and Exercise Capacity in Patients with Bronchiectasis: Pilot Study. Turk Thorac J 2019. [DOI: 10.5152/turkthoracj.2019.89] [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: 11/22/2022]
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Telli Atalay O, Yilmaz A, Altinisik G, Cengiz B, Taskin H, Yalman A, Kizmaz E. Comparison of the Effect of Aerobic Exercise with Whole Body Vibration in Patients with Bronchiectasis: Single Blind Randomized Controlled Study. Turk Thorac J 2019. [DOI: 10.5152/turkthoracj.2019.90] [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: 11/22/2022]
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Castillo D, Walsh S, Hansell DM, Vasakova M, Cottin V, Altinisik G, Palmucci S, Sterclova M, Harari S, Richeldi L, Vancheri C, Wells AU. Validation of multidisciplinary diagnosis in IPF. The Lancet Respiratory Medicine 2018; 6:88-89. [DOI: 10.1016/s2213-2600(18)30023-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 01/17/2018] [Indexed: 12/29/2022]
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Ugurlu E, Pekel G, Cengiz B, Bozkurt K, Altinisik G. Evaluation of choroidal thickness, retinal vascular caliber, and nerve fiber layer thickness in idiopathic interstitial pneumonia. Sarcoidosis Vasc Diffuse Lung Dis 2017; 34:68-73. [PMID: 32476824 PMCID: PMC7170110 DOI: 10.36141/svdld.v34i1.5392] [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] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/07/2016] [Indexed: 06/11/2023]
Abstract
Background: Idiopathic interstitial pneumonia (IIP) is a subtype of interstitial lung disease. Hypoxia and oxidative stress that take a role in IIP, are also thought to affect ocular structures. Objectives: In this study, our aim was to evaluate the retinal nerve fiber layer thickness, choroidal thickness and retinal vessel diameter using the Spectral-domain optical coherence tomography (SD-OCT) in participants with IIP. Material and method: A total of 35 subjects with IIP were evaluated. The ocular parameters of patients with IIP were compared with that of 35 age-sex matched healthy volunteers. All subjects underwent respiratory function testing and carbon monoxide diffusion test. Arterial blood gas analysis was performed to determine the hypoxic state. In addition to SD-OCT measurements, all participants underwent a standard ophthalmic examination including visual acuity assessment, biomicroscopy, air-puff tonometry and retinal examination. Results: The mean retinal arteriolar caliber (RAC) was 89.5±5.5 μm in the IIP group and 94.3±6.9 μm in the control group (p=0.002). The mean retinal venular caliber (RVC) was 131.5±11.2 μm in the IIP group and 125.2±9.2 μm in the control group (p=0.01). The mean inferior quadrant retinal nerve fiber layer (RNFL) thickness was 127.5±19.4 μm in the IIP group and 140.1±13.8 μm in the control group (p=0.003). Conclusion: The IIP may affect retinal vessels and nerve fiber layer. The diameter of the retinal venules was larger and the diameter of the retinal arterioles was smaller in the IIP patients when compared to the healthy controls. The inferior quadrant RNFL was significantly thinner in the IIPgroup. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 68-73).
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Affiliation(s)
- Erhan Ugurlu
- Pamukkale University Medicine Faculty, Department of Pulmonology, Denizli, Turkey
| | - Gokhan Pekel
- Pamukkale University Medicine Faculty, Ophthalmology Department, Denizli, Turkey
| | - Betul Cengiz
- Pamukkale University Medicine Faculty, Department of Pulmonology, Denizli, Turkey
| | - Kerem Bozkurt
- Pamukkale University Medicine Faculty, Ophthalmology Department, Denizli, Turkey
| | - Goksel Altinisik
- Pamukkale University Medicine Faculty, Department of Pulmonology, Denizli, Turkey
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Ugurlu E, Altinisik G, Aydogmus U, Bir F. Pulmonary langerhans cell histiocytosis case with diabetes insipidus and tuberculosis. Niger J Clin Pract 2017; 20:503-506. [PMID: 28406136 DOI: 10.4103/1119-3077.204379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A 19-year-old male patient was observed due to having central diabetes insipidus (DI) for five years. He had a history of smoking 5-10 cigarettes a day for two years, but stopped smoking from the last month. The computerized tomography revealed thin-walled cystic lesions in different sizes more dominantly in the upper lobes and consolidated areas in the left upper and lower lobes. The wedge resection from the right lower lobe revealed pulmonary langerhans cell histiocytosis. Follow-up acid-fast bacteria (AFB) examinations revealed (+++) and antituberculous treatment was started. On the 40th day of the anti-tuberculosis treatment, the patient applied once again due to fever and chest pain. Although infiltrations persisted in the left upper and middle zones in the postero-anterior lung rontgenogram, right-sided pneumothorax was detected. The case is considered tuberculosis and the patient continued to receive anti-TB treatment under the close supervision.
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Affiliation(s)
- E Ugurlu
- Pamukkale University, Medicine Faculty, Chest Disease Department, Denizli, Turkey
| | - G Altinisik
- Pamukkale University, Medicine Faculty, Chest Disease Department, Denizli, Turkey
| | - U Aydogmus
- Pamukkale University, Medicine Faculty, Thoracic Surgery Department, Denizli, Turkey
| | - F Bir
- Pamukkale University, Medicine Faculty, Pathology Department, Denizli, Turkey
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Musellim B, Borekci S, Uzan G, Ali Sak ZH, Ozdemir SK, Altinisik G, Altunbey SA, Sen N, Kilinc O, Yorgancioglu A. What should be the appropriate minimal duration for patient examination and evaluation in pulmonary outpatient clinics? Ann Thorac Med 2017; 12:177-182. [PMID: 28808489 PMCID: PMC5541965 DOI: 10.4103/atm.atm_396_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Patient examinations performed in a limited time period may lead to impairment in patient and physician relationship, defective and erroneous diagnosis, inappropriate prescriptions, less common use of preventive medicine practices, poor patient satisfaction, and increased violent acts against health-care staff. OBJECTIVE This study aimed to determine the appropriate minimal duration of patient examination in the pulmonary practice. METHODS A total of 49 researchers from ten different study groups of the Turkish Thoracic Society participated in the study. The researchers were asked to examine patients in an almost ideal manner, without time constraint under available conditions. RESULTS A total of 1680 patient examinations were reviewed. The mean duration of patient examination in ideal conditions was determined to be 20.4 ± 9.6 min. Among all steps of patient examination, the longest time was spent for "taking medical history." The total time spent for patient examination was statistically significantly longer in the university hospitals than in the governmental hospitals and training and research hospitals (P < 0.001). Among different patient categories, the patients with a chronic disorder presenting for the first time and were referred from primary or secondary to tertiary care for further evaluation have required the longest time for patient examination. CONCLUSION According to our study, the appropriate minimal duration for patient examination is 20 min. It has been observed that in university hospitals and in patients with chronic pulmonary diseases, this duration has been increased to above 25 min. The durations in clinical practice should be planned accordingly.
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Affiliation(s)
- Benan Musellim
- Istanbul University, Cerrahpasa Medical Faculty, Department of Chest Diseases, Istanbul, Turkey
| | - Sermin Borekci
- Istanbul University, Cerrahpasa Medical Faculty, Department of Chest Diseases, Istanbul, Turkey
| | - Gulfidan Uzan
- Haseki Training and Research Hospital, Istanbul, Turkey
| | - Zafer Hasan Ali Sak
- Harran University Medical Faculty, Department of Chest Diseases, Sanli Urfa, Turkey
| | - Secil Kepil Ozdemir
- Ankara Dıskapı Yıldırım Beyazıt Training and Research Hospital, Allergy and Immunology Clinic, Ankara, Turkey
| | - Goksel Altinisik
- Pamukkale University Medical Faculty, Department of Chest Diseases, Denizli, Turkey
| | - Sinem Agca Altunbey
- Health Sciences University, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Nazan Sen
- Baskent University, Adana Dr. Turgut Noyan, Teaching and Medical Research Center, Adana, Turkey
| | - Oguz Kilinc
- Dokuz Eylul University Medical Faculty, Department of Chest Diseases, Izmir, Turkey
| | - Arzu Yorgancioglu
- Celal Bayar University Medical Faculty, Department of Chest Diseases, Manisa, Turkey
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Ugurlu E, Kilic-Toprak E, Altinisik G, Kilic-Erkek O, Cengiz B, Kucukatay V, Senol H, Akbudak IH, Ekbic Y, Bor-Kucukatay M. Increased erythrocyte aggregation and oxidative stress in patients with idiopathic interstitial pneumonia. Sarcoidosis Vasc Diffuse Lung Dis 2016; 33:308-316. [PMID: 28079842] [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] [Received: 12/10/2015] [Accepted: 03/14/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Hemorheological properties are important determinants of tissue oxygenation. Although hemorheological alterations in various lung diseases have been well-defined, no information is available about the effects of idiopathic interstitial pneumonia (IIP) on hemorheological parameters. OBJECTIVES The aim of this study was to investigate hemorheological parameters (erythrocyte deformability, aggregation, and plasma viscosity -PV) and associated oxidative stress indices in patients with IIP. METHODS The study enrolled 31 patients (9 Idiopathic pulmonary fibrosis (IPF), 10 non-specific Interstitial Pneumonia (NSIP), 12 Cryptogenic Organising Pneumonia (COP) and 33 healthy controls. Erythrocyte deformability and aggregation were measured by an ektacytometer. PV was determined by a cone-plate rotational viscometer and oxidative stress via a commercial kit. RESULTS Erythrocyte aggregation, total oxidant status (TOS) and oxidative stress index (OSI) of IIP patients were higher than controls whereas erythrocyte deformability, PV and total antioxidant status (TAS) were unaltered. CONCLUSIONS Increment of oxidative stress in IIP seems to depend on enhancement of oxidants, rather than alteration of antioxidants. The issue that, elevated erythrocyte aggregation may further impair tissue oxygenation by disturbing microcirculation in IIP, may be considered in the follow up and development of new treatment protocols for this disease.
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Ugurlu E, Pekel G, Altinisik G, Bozkurt K, Can I, Evyapan F. New aspect for systemic effects of COPD: eye findings. Clin Respir J 2016; 12:247-252. [PMID: 27401776 DOI: 10.1111/crj.12523] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 06/21/2016] [Accepted: 07/10/2016] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) has multisystemic implications and comorbidities. Hypoxia and systemic inflammation are thought to involve oculary structures. In this study, our aim is to evaluate retinal nerve fiber and choroidal thickness and retinal vessel diameter using the spectral-domain optical coherence tomography (SD-OCT) in COPD subjects. METHODS Forty-three subjects diagnosed with COPD according to the Global Initiative for Chronic Obstructive Lung Disease criteria at the Pulmonology Department of Pamukkale University were enrolled in the study. All subjects underwent respiratory function testing and a carbon monoxide diffusion test. To determine hypoxic state, arterial blood gas analysis was performed. The control group consisted of 31 subjects with comparable age and gender distribution. All participants underwent a standard ophthalmic examination including visual acuity assessment, biomicroscopy, air-puff tonometry, indirect retinoscopy, and SD-OCT measurements. RESULTS The mean subfoveal choroidal thickness (SFCT), foveal thickness, and retinal arteriolar caliber were found to be similar in both groups, while the mean retinal venular caliber value was markedly higher in the COPD group. The mean peripapillary retinal nerve fiber layer (RNFL) thickness was 100.2±11.8 µm in the COPD group and 105.6 ± 8.1 µm in the control group (P = .03). The inferior quadrant RNFL was significantly thinner in the COPD group. CONCLUSIONS The results of this study showed increasing diameter of the retinal veins, thinning of the RNFL, and SFCT may be associated to chronic inflammation and hypoxia in subjects with COPD. Future guidelines may include ocular findings to the present systemic manifestations of COPD.
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Affiliation(s)
- Erhan Ugurlu
- Department of Chest Diseases, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Gokhan Pekel
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| | - Goksel Altinisik
- Department of Chest Diseases, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Kerem Bozkurt
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| | - Ilknur Can
- Department of Chest Diseases, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Fatma Evyapan
- Department of Chest Diseases, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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