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Acinetobacter pneumonia: Is the outcome different from the pneumonias caused by other agents
(Wolters Kluwer Medknow Publications, 2010) Edis, Ebru Cakir; Hatipoglu, Osman N.; Tansel, Ozlem; Sut, Necdet
Background : The principal aim of the present study was to determine whether Acinetobacter spp. pneumonia differs from hospital-acquired pneumonias (HAPs) caused by other agents with respect to therapeutic success and survival rate. METHODS : This study includes 140 adult patients diagnosed with HAPs caused by identified etiologic agents between March 2005 and February 2006. These patients were divided into two groups according to the agent responsible for their infection (Acinetobacter spp. [n = 63] or non-Acinetobacter spp. [n = 77]). The groups were compared in terms of risk factors, therapeutic success and six-week survival rates. Results : Previous antibiotic use and the risk of aspiration were independent factors responsible for the development of Acinetobacter spp. pneumonia. Hypoalbuminemia, steroid use and the use of a mechanical ventilator were determined to be mortality-associated independent risk factors for Acinetobacter spp. pneumonia. The clinical success rate at the end of therapy was 41.6 and, at the sixth week, the survival rate was 35 among patients in whom Acinetobacter spp. was the causative agent. Conversely, in the control group, these values were 43 and 32, respectively ( P > 0.05). We found that the use of the appropriate antibiotics for the treatment of Acinetobacter spp. pneumonia was an important factor in survival ( P < 0.001). Conclusion : The outcomes of Acinetobacter spp. pneumonia do not differ from HAPs associated with non-Acinetobacter spp. in terms of therapeutic success and survival rates.
Bronchiectasis in Türkiye: Data from a Multicenter Registry (Turkish Adult Bronchiectasis Database)
(Galenos Publ House, 2024) Edis, Ebru Cakir; Cilli, Aykut; Kizilirmak, Deniz; Coskun, Ayson Sakar; Guler, Nurcan; Cicek, Sedat; Sevinc, Can
Background: Bronchiectasis is a chronic lung disease characterized by permanent bronchial wall dilatation. Although it has been known as an orphan disease, it has recently gained attention because of registry -based studies and drug research. Aims: We aimed to use a multicenter database to analyze and compare data regarding the etiology, associated comorbidities, microbiological characteristics, and preventive strategies of bronchiectasis in T & uuml;rkiye to those of other countries. Study Design: A multicenter prospective cohort study. Methods: The multicenter, prospective cohort study was conducted between March 2019 and January 2022 using the Turkish Adult Bronchiectasis Database, in which 25 centers in T & uuml;rkiye participated. Patients aged > 18 years who presented with respiratory symptoms such as cough, sputum, and dyspnea and were diagnosed with non -cystic fibrosis bronchiectasis using computed tomography were included in the study. Demographic information, etiologies, comorbidities, pulmonary functions, and microbiological, radiological, and clinical data were collected from the patients. Results: Of the 1,035 study participants, 518 (50%) were females. The mean age of the patients was 56.1 +/- 16.1 years. The underlying etiology was detected in 565 (54.6%) patients. While postinfectious origin was the most common cause of bronchiectasis (39.5%), tuberculosis was identified in 11.3% of the patients. An additional comorbidity was detected in 688 (66.5%) patients. The most common comorbidity was cardiovascular disease, and chronic obstructive pulmonary disease (COPD) and bronchiectasis was identified in 19.5% of the patients. The most commonly detected microbiological agent was Pseudomonas aeruginosa (29.4%). Inhaled corticosteroids (ICS) were used in 70.1% of the patients, and the frequency of exacerbations in the last year was significantly higher in patients using ICS than in nonusers (p < 0.0001). Age [odds ratio (OR): 1.028; 95% confidence interval (CI): 1.005-1.051], cachexia (OR: 4.774; 95% CI: 2,054-11,097), high modified medical research council dyspnea scale score (OR: 1,952; 95% CI: 1,459-2,611), presence of chronic renal failure (OR: 4,172; 95% CI: 1,249-13,938) and use of inhaled steroids (OR: 2,587; 95% CI: 1,098-6,098) were significant risk factors for mortality. Mortality rates were higher in patients with COPD than in those with no COPD (21.7-9.1%, p = 0.016). Patients with bronchiectasis and COPD exhibited more frequent exacerbations, exacerbation -related hospitalizations, and hospitalization in the intensive care unit in the previous year than patients without COPD. Conclusion: This is the first multicenter study of bronchiectasis in T & uuml;rkiye. The study results will provide important data that can guide the development of health policies in T & uuml;rkiye on issues such as infection control, vaccination, and the unnecessary use of antibiotics and steroids.
A Case of Massive Pulmonary Embolism Due to Diabetic Ketoacidosis and Hyperhomocysteinemia
(Aves, 2014) Uzmezoglu, Bilge; Ozdemir, Levent; Hatipoglu, Osman Nuri; Ozdemir, Burcu; Edis, Ebru Cakir
A 57-year-old woman with no prior history was admitted to our emergency department with complaints of chest pain, dyspnea, xerostomia, syncope, and cyanosis on her lips and feet. On her physical examination, cyanosis, tachypnea, hypotension and sinus tachycardia were revealed. On the spiral computed tomography of the thorax of the patient with diabetic ketoacidosis, thrombus was detected in the left and right main pulmonary artery and segmental branches of the right pulmonary artery. The fibrinolytic treatment was initiated in the emergency department for the patient with hemodynamic shock due to the diagnosis of acute massive pulmonary embolism. Etiological examinations revealed B12 deficiency and hyperhomocysteinemia. This case, with the presentation of massive pulmonary embolism, resulted from the synergistic effect of hyperhomocysteinemia associated with B12 deficiency; hypovolemia caused by diabetic ketoacidosis was reported owing to its rareness.
Case of Prolonged Viral Shedding: Chronic, Intermittan COVID-1 9?
(Aves, 2022) Kaya, Bilkay Serez; Yilmam, Ilker; Edis, Ebru Cakir; Karabulut, Derya; Mert, Tulin Elmaslar; Eryildiz, Canan; Demir, Muzaffer
COVID-19 is a pandemic that has been affecting the entire world and has caused the death of approximately 2.8 million people. Although the duration of viral shedding varies, an average of 7-10 days is accepted. It is still unclear whether prolonged viral shedding means prolonged contagious period and whether COVID-19 will become chronic or not. This article presents a case with hematological malignancy (lymphoma) with the longest polymerase chain reaction positivity that we could find in the literature (110 days in total).
Chronic Pulmonary Diseases and COVID-19
(Aves, 2020) Edis, Ebru Cakir
Over the past few months, coronavirus disease 2019 (COVID-19) has assumed the character of a pandemic, leading to significant global mortality mostly because of COVID-19-related pneumonia. Pneumonia is likely to progress more severely in patients with underlying chronic lung disease. The purpose of this review is to discuss the management strategies in patients with chronic lung disease such as chronic obstructive pulmonary disease, asthma, pleural diseases, and obstructive sleep apnea during the COVID-19 pandemic, with current literatures and international guidelines.
The Diagnostic Value of Oxidative Stress Products in Pulmonary Embolism
(Bilimsel Tip Publishing House, 2011) Batmaz, Emrah; Edis, Ebru Cakir; Eskiocak, Sevgi; Hatipoglu, Osman Nuri; Kaya, Sabriye
Objective: The aim of our study is to show the oxidative stress in pulmonary embolism by detecting the levels of ischemia modified albumin (IMA), advanced oxidation protein product (AOPP) and malondialdehyde (MDA) in patients with pulmonary embolism. Material and Method: 39 patients, who were dagnosed with pulmonary embolism in the Emergency Service or Thoracic Diseases Polyclinic of the Trakya University Faculty of Medicine between September 1, 2008 and March 31, 2009, and 39 healthy volunteers were included in the study. IMA, AOPP and MDA levels were studied. T-test and Mann Whitney and X-2 tests were applied in independent samples. A value of p<0.05 was accepted as statistically significant. Results: There was no significant difference between the two groups in terms of age, height, and weight. The difference in the AOPP levels of the two groups was not significant. The difference in the serum albumin levels of the two groups was found significant (p<0.001). The difference in levels of IMA after being corrected according to the albumin levels of the two groups was not significant. MDA levels of the two groups showed a significant difference (p=0.032). Conclusion: AOPP levels in patients with pulmonary embolism were not found different but, the increases of MDA levels were significant. We suggest using albumin-adjusted IMA levels to interpret IMA levels more correctly. We need more studies about using IMA levels as an indicator for diagnosis of pulmonary embolism.
Economic burden of nosocomial pneumonia in non-intensive care clinics
(Turkish Assoc Tuberculosis & Thorax, 2015) Edis, Ebru Cakir; Hatipoglu, Osman Nuri; Yilmam, Ilker; Sut, Necdet
Introduction: Almost all data on the cost of nosocomial pneumonia (NP) in the literature is associated with ventilator- associated pneumonia. This study aims to determine the economic burden of nosocomial pneumonia in clinical inpatients. Materials and Methods: Data on costs of the 154 adult patients (97 male, 57 female; mean age 64.53 +/- 14.92) who were hospitalized in non-intensive care clinics and developed NP were recorded prospectively. The control group consisted of 148 patients without pneumonia matched for age (mean age 65.66 +/- 13.86), sex (94 male), diagnosis, and hospitalization date. Data obtained from both groups of patients for the number of hospitalization days and the data obtained from the hospital automation program (Avicenna) for costs were compared using the Mann-Whitney U test. Results: While the mean duration of hospitalization was 32.8 days in patients with NP, it was 9.8 (p< 0.0001) in the control group. The cost of hospital beds was $631 for NP patients and $153 for the controls (p< 0.0001). The total cost was $ 6241 for NP patients and $1117 for the controls (p< 0.0001). Conclusion: NP is a high-cost condition that increases the duration of hospitalization 3.5-fold, hospital-bed cost 4-fold, and the total cost 5-fold.
The Effect of Acute Total Sleep Deprivation on Energy Metabolism
(Aves, 2011) Caliyurt, Okan; Edis, Ebru Cakir; Altiay, Gundeniz
Objective: The aim of the present study was to assess the effects of total sleep deprivation on daily basal energy expenditure. Methods: Twenty healthy volunteers were included in the study. Resting energy expenditure was measured with indirect calorimetry device (Vmax 29c Sensor Medics, Yorba Linda, CA, USA) at 09: 00 a. m., and food was withheld after midnight the prior evening. The measurements were carried out after eight hours of rest in awake subjects at constant ambient (environmental) temperature for at least 20 minutes. After 24 hours of total sleep deprivation, the measurements were repeated. Results: The first-measured mean resting energy expenditure was 1351.10+/-600.37 kcal/24 h and the second measurement revealed slight decrease with a mean value of 1250.60+/-454.39 kcal/24 h, but the difference did not reach the level of statistical significance. The changes in mean resting energy expenditure values before and after total sleep deprivation were evaluated in men and women separately, but no significant difference was observed between the two genders. Mean body mass index values correlated positively and significantly with both first and second resting energy measurements. Conclusion: Our results showed that total sleep deprivation did not directly affect daily basal energy expenditure. Sleep deprivation, sleep disorders and insomnia are associated with metabolic changes. Those metabolic effects are more likely related to chronic sleep restriction and changes in appetite and glucose metabolism that may cause weight gain and diabetes, rather than being direct effects on energy expenditure. (Archives of Neuropsychiatry 2011; 48: 17-21)
Effecting factors on survival in patients taking thrombolytic treatment due to massive pulmonary embolism
(Turkish Assoc Tuberculosis & Thorax, 2010) Hatipoglu, Osman Nuri; Perincek, Gokhan; Edis, Ebru Cakir; Tabakoglu, Erhan; Altiay, Gundeniz
Massive pulmonary embolism (MPE) is a life threatening disease, thrombolytic treatment could save lives. The aims of this study are to identify early and late mortality rates in patients with MPE who received thrombolytic treatment, and mortality related risk factors. All the hospital records for the MPE patients who received thrombolytic treatment between 1998 and 2006 were retrospectively investigated. Pulmonary embolism was diagnosed through computed tomografi scan and V/P scintigraphy. Due to MPE, 21 women total 41 patients who undergo tPA or streptokinase were included in the study. Kaplan-Meier for the survival analysis and cox regression analysis for determining the mortality related independent risk factors were used. Dying while staying in hospital was accepted as early or hospital mortality, after discharge from hospital as late mortality. Out of 41 patients, 12 of them died while they are hospitalized (hospital mortality; 29%) 6 of them died after they were discharged (late mortality; 21%). The average survival time among discharged patients was 2304 days (95% confidence interval: 1725-2884). Among those patients who took streptokinase or tPA, late or early mortality rates (p>0.05) and survival time did not show significant difference (p=0.8908). The presence of arrhythmia [p=0.01; odds rate (OR): 6.25] and jugular vein distention (JVD) (p=0.03; OR: 6.25) for hospital mortality and multiple ongoing health problems for the late mortality were identified as the independent risk factors. For the hospital mortality, the presence of JVD or arrhythmia, for prognostic sensitivity, specificity, positive predictive value and negative predictive value were recorded as 75%, 79%, 60% and 88% respectively. In conclusion, the presence of arrhythmia and/or JVD on a patient with MPE is a negative prognostic factor for hospital mortality. The presence of other ongoing health problems influences the survival time of the discharged patients.
Evaluation of insomnia in healthcare personnel after COVID-19 vaccination
(Kare Publ, 2023) Yilmam, Ilker; Kaya, Bilkay Serez; Temelli, Suereyya; Edis, Ebru Cakir; Yulugkural, Zerrin
BACKGROUND AND AIM: Sleep disturbances are common during Coronavirus Disease 2019 (COVID-19) infection. Coronasomnia is a concept used to identify sleep disturbances observed during the pandemic. Although coronasomnia has been described during and after coronavirus infection, no data on sleep disturbances seen after vaccinations have been found. The aim of this study was to detect the prevalence of sleep disturbances observed after COVID-19 vaccinations (specifically CoronaVac).METHODS: In April 2021, healthcare personnel who had received the CoronaVac vaccine were administered questionnaires to investigate potential adverse effects of the vaccine and any sleep disturbances. RESULTS: The study included 787 individuals, of whom 506 (64.3%) were women. The mean age was 35 +/- 9.6 (19-65) years. 303 (38.5%) healthcare workers reported adverse effects after vaccination. The most common adverse effects were exhaustion, muscle pain, and headache. At least one sleep disturbance (difficulty falling asleep, frequent awakening, difficulty maintaining sleep, excessive daytime sleepiness, and need to use sleeping pills) that did not exist before vaccination but occurred afterwards was found in 86 (10.9%) participants. Women had higher insomnia scores than men (p=0.02). An important result of the study is that the insomnia scores of healthcare workers who had COVID-19 are statistically higher than those who did not (p=0.02).CONCLUSIONS: Adequate sleep is important for both protection from infection and the immune response against infection. Although coronasomnia developing after the COVID-19 variant that was identified at the beginning of the pandemic is well-defined, we believe that effects such as sleep disorders that may develop after vaccination should be monitored in the long term and in a large population.
Hospital-Acquired Pneumonia Developed in Non-Intensive Care Units
(Karger, 2009) Edis, Ebru Cakir; Hatipoglu, Osman N.; Yilmam, Ilker; Eker, Alper; Tansel, Ozlem; Sut, Necdet
Background: There are few studies about hospital-acquired pneumonia (HAP) developing in non-intensive care units (non-ICUs). Objectives: The aim of this study was to determine the incidence rate of non-ICU HAP, the risk factors associated with mortality and the survival rates of HAP patients at 6 weeks and 1 year. Patients and Methods: Between March 2005 and February 2006, 154 adult patients (97 males) with HAP were prospectively evaluated. Immunocompromised patients who were developing pneumonia were excluded from the study. The HAP incidence was calculated and survival was noted at 6 weeks and 1 year later. Kaplan-Meier methods were used for survival analysis; Cox regression was used to identify the risk factors associated with HAP-induced mortality. Results: During the study, and not counting those in the ICU, 45,679 adult patients were hospitalized. Of these, 154 patients developed HAP (incidence 3.3 cases/1,000 patients). The mean age of those developing HAP was 64.53 +/- 14.92 years (range 15-98). Survival rates at the 3rd, 7th, 14th, 42nd and 365th day were 91, 89, 69, 49 and 29%, respectively. Independent risk factors associated with 6-week mortality were: age [relative risk (RR) 1.026; 95% confidence interval (CI) 1.008-1.045], chronic renal failure RR 1.8; 95% CI 1.087-3.086), aspiration risk (RR 2.86; 95% CI 1.249-6.564), steroid use (RR 2.35; 95% CI 1.306-4.257), and multilobar infiltration (RR 2.1; 95% CI 1.102-4.113). Conclusion: HAP - even if it develops in non-ICU environments-is hard to treat and has a higher mortality rate. Copyright (C) 2009 S. Karger AG, Basel
Hospital-acquired pneumonia in patients receiving immunosuppressive therapy
(Galenos Publ House, 2010) Edis, Ebru Cakir; Hatipoglu, Osman Nuri; Yilmam, Ilker; Eker, Alper; Tansel, Ozlem; Sut, Necdet; Tekgunduz, Emre
Objective: The aims of this study were to determine the clinical success rates, effect of neutropenia on treatment success rates, risk factors related to mortality, and survival in patients who developed hospital-acquired pneumonia (HAP) while receiving immunosuppressive therapy. Materials and Methods: Forty-three adult patients receiving immunosuppressive therapy who developed HAP were included in this prospective study. Transplantation patients and human immunodeficiency virus (HIV)-positive patients were not included. Antibiotic treatment was managed by a multidisciplinary team. The Kaplan Meier method was used for the survival analysis and Cox regression was used for the identification of mortality-related independent risk factors. The relationship between neutropenia and the clinical success rate was determined using the chi-square test. Results: Although anti-pseudomonal antibiotics were started empirically in 40 of the 43 patients (93%) at the beginning of the treatment, the most frequently isolated pathogens were Acinetobacter spp. and Escherichia coli. The success rate at the end of the treatment was 65.1%. The survival rates for the 3(rd), 14(th), 42(nd), and 365(th) days were 97%, 86%, 58%, and 19%, respectively. Elevated levels of urea [Hazard Ratio=1.01 (95% Cl: 1.00-1.02)] and blood glucose [HR=1.01 (95% Cl: 1.00-1.02)] were found to be independent risk factors affecting survival. The treatment success rate was higher in patients without neutropenia (n=23) than in those with neutropenia (n=20) (p=0.05). Conclusion: The treatment success rate was low in patients who developed HAP while receiving immunosuppressive therapy. (Turk J Hematol 2010; 27: 20-4)
The Importance of Pathogen Identification in the Success of Treatment of Hospital Acquired Pneumonias
(Aves, 2010) Edis, Ebru Cakir; Hatipoglu, Osman Nuri; Yilmam, Ilker; Eker, Alper; Tansel, Ozlem; Sut, Necdet
Objective: The aim of this study was to determine the effects of identification of the pathogens and specific and appropriate treatments, and the success of these treatments for subjects who acquired HAP non-ICU. Material and Method: The analyzed data was obtained from the records of 154 consecutive HAP patients who acquired pneumonia non-ICU. We investigated whether the factor was identified, whether patients received a specific therapy according to the results of a culture antibiogram, and whether the patients received appropriate antibiotics therapy initially. Results: When the groups treated specifically (n=78) and empirically (n=76) were compared, there were no significant differences between the clinical success rates. The difference was not significant between the group given an appropriate antibiotherapy initially (n=42) and the group whose initial therapy was changed according to the culture antibiogram after the factor was found (n=36). When the group given appropriate initial antibiotherapy (n=42) was compared with all the other patients (n=112), the difference between the clinical success rates was not significant. The most remarkable result of the study was the success rate being significantly higher in the group in which the pathogen could not be identified (n=66) compared with the group in (n=88) which the pathogen was identified (p=0.022). Conclusion: The clinical success rate was low in microorganism-caused HAPs with a potential for drug resistance and having the characteristic of developing rapid resistance, such as Acinetobacter spp. and Pseudomonas spp, even though specific treatment was administered. These results indicate that the prevention of infections that occur with such microorganisms is more important than the treatment.
The Influence of the Turkish Anti-Tobacco Law on Primary School Children in Edirne
(Galenos Publ House, 2011) Tabakoglu, Erhan; Caglar, Tuncay; Hatipoglu, Osman N.; Altiay, Gundeniz; Edis, Ebru Cakir; Sut, Necdet
Objective: The Turkish anti-tobacco law was accepted and effectuated in 1996. All forms of cigarette advertising, the sale of tobacco products to persons under the age of 18 and smoking in public institutions were all restricted. In this paper, we aimed to evaluate the influence of the Turkish anti-tobacco law on children for the periods before the law, after three years and after 10 years. Material and Methods: A self-completed questionnaire was distributed among primary school children. This included questions about the children's smoking habits, their opinions of parents' and teachers' smoking habits, tobacco use in public places and the recognition rate of 16 food, drink, cigarette and toothpaste logos and brand names, The first, second and third applications of the questionnaire were performed with students who attended the same classes in the same primary schools, accounting for 772 children in June 1996, 1,157 children in February 1999 and 719 children in June 2006. Results: When these three periods were evaluated, it could be seen that the prevalence of having smoked significantly decreased (13.9%, 4%, 2.2%, p<0.001), as did the rate of purchasing cigarettes within the past week (36.6%, 29.1%, 15.8%, p<0.001). The disagreement with parents' and teachers' smoking habits and tobacco usage in public places increased significantly (p<0.001), while the recognition rates of some cigarette brand names and logos significantly decreased, specifically with regards to Marlboro, Camel and Samsun (p<0.001). Conclusion: The Turkish anti-tobacco law has had a positive effect on primary school children in Edirne, and therefore could be a model for other countries.
Lung cancer histopathology in the Thrace region of Turkey and comparison with national data
(Turkish Assoc Tuberculosis & Thorax, 2005) Karlikaya, Celal; Edis, Ebru Cakir
Following the trends in lung cancer (LC) morbidity and mortality rates can show past trends of cigarette smoking and can give clues on some geographical factors. The demographics of LC patients and the histopathologic distribution of their disease in the Thrace region of Turkey have yet to be defined. A retrospective chart review of primary LC patients admitted to the pulmonology department of Trakya University Hospital between 1992 and 2001 was performed. Charts were available for review in 521 of 567 patients. The mean age was 61 +/- 10 years (30-86 years) and 497 (95.4%) patients were ma-le (male/female ratio= 20.7). When compared with national and international data, male/female ratio for the LC patients from Thrace region was higher than the ratio found from Turkey in general and also from other countries. Adenocarcinoma (ADC) was present in seven of the 24 (29.2%) of the females and prevalence of ADC was more than 2.5 times in females than males (p< 0.05). Squamous cell types were more common in males. Histopathological type did not vary with age in females, but small cell carcinoma was more prevalent in males under the age of 45 (44.7% if = 45 years old vs. 29.1% if > 45 years old, p< 0.05). These data may support that the LC associated with smoking is in the earlier phase of the epidemic in Thrace region. Monitoring the LC trend in our region can give clues on evolving cigarette design and smoking attitudes and geographic factors.
Polysomnography findings and risk factors for sleep-disordered breathing in patients with systemic sclerosis
(Turkish League Against Rheumatism, 2021) Edis, Ebru Cakir; Eraslan, Renginar Mutlucan; Hatipoglu, Osman
Objectives: This study aims to evaluate polysomnography findings and risk factors for sleep- disordered breathing in patients with systemic sclerosis (SSc). Patients and methods: Thirty-nine patients (2 males, 37 females; mean age: 51.1 +/- 12.5 years; range, 21 to 76 years) who attended to the Rheumatology Clinic of Trakya University Medical Faculty between March 2014 and May 2014 were included in the study. Thoracic computed tomography, pulmonary function tests, carbon monoxide diffusion tests, echocardiography, and all-night polysomnography in a sleep laboratory were performed in all patients. Demographic and clinical characteristics of the patients were recorded. The Apnea-Hypopnea Index (AHI) scores were calculated. Disease activity was examined using the Medsger Disease Severity Scale (MDSS). Possible risk factors for sleep-disordered breathing were evaluated. Results: Using the AHI of >= 5 for obstructive sleep apnea (OSA), 21 (53.8%) of the patients were classified as having OSA. There were no significant differences between the groups with and without OSA in terms of steroid use (p=0.4), CT involvement (p=0.3), and Warrick (p=0.6) and MDSS scores (p= 0.5). Age, body mass index (BMI), and mean oxygen desaturation index were found to be significant in the univariate analysis (p<0.1); however, the multivariate analysis revealed only BMI as significant risk factor of OSA (p=0.028). In the multivariate analysis, the mean saturation was found to be significant risk factor for high pulmonary artery pressure (p<0.001). Conclusion: Although OSA is common in SSc, only increased BMI is a significant risk factor of OSA, but not lung involvement, Warrick scores, or MDSS scores.
The Psychometric Properties and Clinical Use of the Turkish Version of the Functional Assessment of Cancer Therapy-Lung (FACT-L) Scale
(Aves Press Ltd, 2019) Aydogan, Burcu Basarik; Goksel, Tuncay; Erbaycu, Ahmet Emin; Oz, Aysen; Celik, Pinar; Gursul, Kader Kiyar; Edis, Ebru Cakir
Objectives:psychometric properties of the Turkish version of the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale and the sensitivity to changes in clinical indicators. Patients and Methods:This study was conducted within the framework of a national multicentre project. Patients with either stage IIIB or IV primary lung cancer diagnosed after April 2010were included in thisstudy. A classical confirmatory approach was used for both the reliability and validity analyses. Internal consistency was tested using Cronbach's alpha value, and the validity analysis was performed using construct validity and clinical validity. Results:276 (92.3%) patients were male and the average age was 60.8 +/- 9.4 years. The most frequently observed histological type was squamous cell carcinoma (36.8%), and 61.5% of these stage IV tumours. Cronbachs alpha values for the subscales ranged from 0.60 to 0.84. The majority of the FACT-L subscales revealed inter-scale correlation coefficients greater than 0.35. All sub-dimensions, except that of the social/family well-being scale, are able to significantly discriminate between stages IIIB and IV. Significantly lower scale scores were detected in patients with stage IV than stage IIIB. The comparative fit index was 0.917, and the root mean square error of approximation was 0.091. Dyspnoea, haemoptysis, chest pain, weight loss, anorexia, localised pain, and fever symptoms had a significant correlation with the FACT-L, trial outcome index, and lung cancer subscale. Conclusion:Turkish version of the psychometric properties of the original FACT-L scale is regarded as a valid and reliable tool and can be used safely in a clinical context when managing patients with lung cancer in Turkey.
Pulmonary involvement in brucellosis
(Aves Yayincilik, Ibrahim Kara, 2007) Batmaz, Emrah; Edis, Ebru Cakir; Ciftci, Abdullah; Akkoyun, Sevin; Hatipoglu, Osman N.; Genchallac, Hakan
Brucellosis is a zoonotic disease caused by a Gramnegative bacillus of the Brucella gender. Involvement is multisystemic primarily affecting the reticuloendothelial system, joints,heart, and kidneys. Although the disease can be spread by inhalation, pulmonary involvement is rare. A 72-year-old female patient presented with complaints of chest pain and shortness of breath. She was admitted with a preliminary diagnosis of pneumonia. She did not respond to antibiotic therapy. Computed tomography performed for the differential diagnosis of pulmonary embolism showed no evidence for thrombus, but ground glass opacities in the lingular segment of the left lung, the right middle lobe, and bilateral lower lobes. Specific antibiotic therapy Was started upon detection of Brucella spp. by hemoculture. The patient's pain disappeared and no sign of venous thromboembolism was observed.
Skin prick test results in patients from Thrace region presenting with pulmonary symptoms
(Aves Yayincilik, Ibrahim Kara, 2007) Edis, Ebru Cakir; Tabakoglu, Erhan; Caglar, Tuncay; Hatipoglu, Osman N.; Altiay, Guendeniz
Objectives: The aim of the study was to determine the profile of allergen sensitization in patients presenting with pulmonary symptoms. Patients and Methods: Skin test results of 196 patients (136 females, 60 males; mean age 34.7 +/- 11.7 years) presenting with pulmonary complaints between October 1999 and April 2005; total IgE results and allergy information forms were analyzed retrospectively. Results: Median value of IgE was (%25-75) 202 U/ml (118-530) in the patients enrolled. The most frequent symptom was shortness of breath (65.3%), and the second was cough (63.8%). These symptoms aggravated while patients were dusting. Sensitivity to at least one allergen was observed in 59.7% of the patients. Sensitivity to a single allergen was present in 18.9% and to multiple allergens in 40.8% of all patients. The most frequent allergy was determined to house dust mite (39.8%) and was followed by allergy to tree pollens (26%). Sensitivity rate to D. Farinea was 33.7% and 32.7% to D. Pteronyssinus. Conclusion: House dust mite were the primary causes of sensitization in patients presenting with allergic symptoms in the Thrace region. The fact that the symptoms aggravated in 46.9% of the patients while they were dusting at home, seemed to support this finding.
Successfull High PEEP Application in a Pregnant Woman with ARDS Diagnosed with H1N1 Virus Infection
(Aves, 2010) Edis, Ebru Cakir; Hatipoglu, Osman Nuri; Celebi, Derya; Celik, Aygul Dogan; Uzmezoglu, Bilge; Altiay, Gundeniz
A seven-month pregnant woman who admitted to the hospital with high fever, cough and fatigue and developed respiratory failure within one day, was admitted to the intensive care unit with the diagnosis of acute respiratory distress syndrome (ARDS) and suspected H1N1 infection. The patient, who had bilateral infi ltration on her chest X-ray, did not respond to the ventilator adjustments appropriate to ARDS, empirical Oseltamivir treatment. In spite of this treatment, her oxygenation became worse and she was treated by caesarean section. When the patient's saturation fell to 35%, 18 cmH2O pressure PEEP was implemented, then it was observed that her oxygenation began to show improvement. The patient's initial H1N1 diagnosis was confirmed. The patient's overall health returned to normal, while no serious health problem was observed in the baby. Since pregnant patients with H1N1 may develop serious respiratory failure within a very short time, we found this report significant because lung expansion may increase with section and this condition assists the treatment of using high PEEP pressures.

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