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biyopsilerde immünde-pozitlerin bulunmaması ile kendini gösterir. Olgular alveoler hemoraji ile presente olabilirler. Bu yazıda, he-moptizi, gastrointestinal kanama ve cilt lezyonları ile seyreden olgu nedeniyle mikroskopik polianjiitisin... more
biyopsilerde immünde-pozitlerin bulunmaması ile kendini gösterir. Olgular alveoler hemoraji ile presente olabilirler. Bu yazıda, he-moptizi, gastrointestinal kanama ve cilt lezyonları ile seyreden olgu nedeniyle mikroskopik polianjiitisin özel-likleri gözden geçirilmiştir. Anahtar Sözcükler: Gastrointestinal kanama; hemoptizi; mikroskopik polianjiitis. Microscopic polyangiitis is a systemic, nongranulomatous, small vessel disease involving the lung, kidney and skin. The disease is characterized by the presence of ANCA, crescentic glomerulonephritis, pulmonary capil-laritis, and no immune deposits in the involved vessels. Some cases may present with alveolar hemorrhage. We reviewed the different features of microscopic polyangiitis due to our case who presented with gastrointestinal bleeding, hemoptysis and skin lesions.
Amaç: Obstrüktif uyku apne sendromu (OUAS) hastalarının hem anatomik hem de işlevsel değişiklikler nedeniyle artmış bir direnç yüküne maruz kaldıkları düşünülmektedir. Bu, muhtemel bir solunum kası fonksiyonu bozukluğuna sebep olabilir.... more
Amaç: Obstrüktif uyku apne sendromu (OUAS) hastalarının hem anatomik hem de işlevsel değişiklikler nedeniyle artmış bir direnç yüküne maruz kaldıkları düşünülmektedir. Bu, muhtemel bir solunum kası fonksiyonu bozukluğuna sebep olabilir. OUAS’da solunum kası fonksiyonlarını ortaya çıkarmak için günlük maksimum inspiratuvar ve ekspiratuvar basınçlarını ölçmeyi amaçladık. Gereç ve Yöntem: Bir yıllık dönemde uyku laboratuvarımıza başvuran hastalar prospektif olarak analiz edildiler. Tüm olgular bir gecelik polisomnografiden geçirildi. Tüm olgulara uyku çalışmasının sabahı aynı deneyimli teknisyen tarafından akciğer fonksiyon testleri uygulandı. Çalışma grubu yaş ortalaması 47 olan 51 (%37,8) kadın ve 84 (%62,2) erkek hastadan oluşuyordu. Bulgular: Apne hipopne indeksinin (AHİ) birinci saniyedeki zorlu vital kapasite (FEV1) ve zorlu vital kapasite (FVC) değerleri ile ve FVC% ile korele olduğu bulunurken FEV1/FVC, maksimum inspiratuvar (MİP) ve maksimum ekspiratuvar basınç (MEP) değerleri...
Today, when the patients with PTE are investigated, it can be observed that there is an underlying genetic factor and an environmental factor for the development of thrombus. [1] However, despite all the studies performed, no other... more
Today, when the patients with PTE are investigated, it can be observed that there is an underlying genetic factor and an environmental factor for the development of thrombus. [1] However, despite all the studies performed, no other factors have been found in some patients with PTE and DVT.[2] PTE is a hardly identifiable disease with high mortality. In PTE undiagnosed cases, mortality rates rise to 10%. Although many scoring systems have been used for prognostic evaluation, the most current Pulmonary Embolism Severity Index (PESI) is the most commonly used one. However, the Simplified Pulmonary Embolism Index (sPESI) with fewer parameters was found to have the same effectiveness as PESI.[3] Thromboembolic events such as PTE, transient ischemic attack, and acute myocardial infarction were more frequently seen during some seasons.[4,5] In a study, it was determined that deaths from PTE were more frequent in cold seasons.[5] In addition, there are also studies in which no relation coul...
Objective: Aspergillus fumigatus and Aspergillus niger are Aspergillus species that generally invade cavitary structures of the lungs and form fungus balls of Aspergillus hyphae, fibrin, mucus, blood, and inflammatory and epithelial... more
Objective: Aspergillus fumigatus and Aspergillus niger are Aspergillus species that generally invade cavitary structures of the lungs and form fungus balls of Aspergillus hyphae, fibrin, mucus, blood, and inflammatory and epithelial cells; they are very rarely seen in extra-respiratory organs and systems. Tracheal diverticulum is a rare and mostly asymptomatic entity usually found in the paratracheal region, but its etiology and pathophysiology is not fully known. An interesting and very rare case of aspergilloma located in a tracheal diverticulum is presented in this article. ABSTRACT DOI: 10.14744/scie.2018.35744
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AIM: To investigate the diagnostic value of ultrasound (US) guided transthoracic fine needle aspiration biopsy (TTFNA) and US guided transthoracic tru-cut biopsy (TTTCB) in malignant thorax lesions. MATERIALS AND METHODS: Patients who... more
AIM: To investigate the diagnostic value of ultrasound (US) guided transthoracic fine needle aspiration biopsy (TTFNA) and US guided transthoracic tru-cut biopsy (TTTCB) in malignant thorax lesions. MATERIALS AND METHODS: Patients who underwent US guided transthoracic biopsies between April 2014 and May 2017 were retrospectively evaluated. Patients who were diagnosed as thoracic malignancy and both TTTCB and TTFNA performed for the same lesion were included in the study. The diagnostic accuracy of TTTCB, TTFNA and their combination were analyzed. The diagnostic accurracy of methods were statistically compared by McNemar Test. RESULTS: Thirty two patients were included in the study. Ultrasound guided TTFNA and/or TTTCB were diagnostic in 30 (93.8%) of them. TTFNA was diagnostic in 23 (%71.8), TTTCB were diagnostic in 26 (%81.2) of these pateints. Seven (77.7%) of 9 patients in which TTFNA was not diagnostic, TTTCB was diagnostic. The diagnostic accuracy was 71.8% and 81.2% for TTFNA ...
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OBJECTIVE This study aimed to compare the success rate of 3 different drug prescription policies: Free drugs with online system prescription, free drugs with doctor's prescription, and drugs paid for by patients with doctor's... more
OBJECTIVE This study aimed to compare the success rate of 3 different drug prescription policies: Free drugs with online system prescription, free drugs with doctor's prescription, and drugs paid for by patients with doctor's prescription. MATERIAL AND METHODS The effect of 2 different Ministry of Health (MoH) projects with free-of-charge and self-payment pharmacotherapies for smoking cessation were compared. Patients who completed 6 months of pharmacotherapy and follow-up were evaluated. The first period was free-of-charge medication, which was determined by an online system, the following period was the self-payment period, and the third period was free medication, which was prescribed by a doctor. In all the groups, smoking habits in pack years and comorbidities of the patients were recorded, and pulmonary function tests (PFTs) and expiratory carbon dioxide (CO2) measurements were performed. Patients who had an expiratory CO2 level >5 ppm at the control visits were accepted as quitters. RESULTS A total of 829 patients with 438 patients in the first free-of-charge period (group 1), 111 in the self-payment period (group 2), and 280 in the second free-of-charge period (group 3) were enrolled in the study. Smoking cessation rates were significantly higher in the self-payment medication group (25%) according to the MoH's free-of-charge project groups. There was no difference in smoking cessation rates between the 2 free-of-charge medication project groups (15% in group 1 and 11% of group 3). Among all the patients, we compared 124 patients who quit smoking with 705 patients who did not. The quitters were older, mostly male, and heavier smokers. In addition, the number of patients with chronic obstructive pulmonary disease and obstructive PFT rates were higher among the quitters. Their dependency score, PFTs, and the use of free medication was lower, and treatment duration was longer. Independent factors that increased smoking cessation success were longer treatment duration, lower dependency score, and self-payment of medication. CONCLUSION Free medications provided via 2 different modalities did not increase the smoking cessation success. Paying for the medication, lower dependency score, and longer treatment duration increased smoking cessation success independently.
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OBJECTIVE: We aimed to investigate radiological and bronchoscopic aspects of endobronchial metastases (EBMs) from extrapulmonary cancers and the correlation of EBM with findings of integrated positron emission tomography-computed... more
OBJECTIVE: We aimed to investigate radiological and bronchoscopic aspects of endobronchial metastases (EBMs) from extrapulmonary cancers and the correlation of EBM with findings of integrated positron emission tomography-computed tomography (PET-CT) findings. MATERIALS AND METHODS: Patients who underwent bronchoscopic evaluation between January 2013 and December were analyzed retrospectively. Patients with endobronchial lesions in the airways and histopathologically diagnosed with extrapulmonary cancer metastasis were included in the study. RESULTS: A total of 16 patients with EBM who underwent bronchoscopic biopsies were evaluated. The patients consisted of 10 (62.5%) females and 6 (37.5%) males and the mean age was 61.8 ± 9.1. The common primary cancer related to EBM was breast 9 (%56.4). The mean interval from diagnosis of primary cancer to EBM was 55.1 ± 48.5 (1–180) months. A total of 13 (81.2%) cases were assessed with the PET-CT report. The mean SUVmaxvalue of the lung lesions was calculated as 9.8 ± 4.3. According to PET-CT, 92.4% of the cases had extrapulmonary metastasis. The mean survival duration from diagnosis of EBM was 8.5 ± 6.7 (1–21) months in 9 deceased patients. CONCLUSION: The most frequent extrapulmonary primary tumors with endobronchial metastasis were breast and the mean survival time was usually short. It was reported that most cases were multimetastatic. It was concluded that PET-CT can play a role in identifying the EBM and other organ metastasis and was important tool in planning the treatment.
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Medicine and Tuberculosis
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Gynecology and Solunum
Background Obstructive sleep apnea is a condition characterized by the complete or partial obstruction of the upper airway during sleep. This study aimed to compare the clinical and polysomnographic characteristics of our obstructive... more
Background Obstructive sleep apnea is a condition characterized by the complete or partial obstruction of the upper airway during sleep. This study aimed to compare the clinical and polysomnographic characteristics of our obstructive sleep apnea patients according to their positional and non-positional features. Results Two hundred eighty patients were included in the study. One hundred two patients (36.43%) were female, while 178 patients (63.57%) were male. While 88 (31.43%) of these patients were defined as positional patients, 192 (68.57%) were defined as non-positional patients. The mean age of the positional patients (46.78 ± 9.66) was lower than the mean age of the non-positional patients (50.90 ± 10.96) (p 0.001). Similarly, the mean body mass index of the positional patients (29.39 ± 3.80) was lower than the mean body mass index of the non-positional patients (33.30 ± 6.45) (p < 0.001). Neck circumference values of the positional patients (40.36 ± 2.65) were lower compar...
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In this study, we present a case of bilateral optic neuropathy and macular ischemia in the right eye associated with neurosarcoidosis. A 26-year-old woman presented to our clinic with complaints of bilateral blurred vision. Bilateral... more
In this study, we present a case of bilateral optic neuropathy and macular ischemia in the right eye associated with neurosarcoidosis. A 26-year-old woman presented to our clinic with complaints of bilateral blurred vision. Bilateral granulomatous anterior uveitis, vitritis, optic neuropathy, and macular ischemia were detected in the right eye in slit-lamp examination. She also reported complaints of fever, weakness, sweating, arthralgia, and headache for 2 months. She was referred to the pulmonary diseases unit of our hospital due to hilar lymphadenopathy seen in her chest x-ray, and biopsies were taken for diagnostic purposes. Histological analysis of the mediastinal lymph node biopsies revealed chronic, non-caseating, granulomatous inflammation. Furthermore, the patient was referred to a neurologist due to concomitant complaint of intense headaches. She was diagnosed with neurosarcoidosis supported by findings on cranial magnetic resonance imaging and lumbar puncture. She receive...
To evaluate the role of ultrasonography (USG) in the diagnosis of bleomycin-induced pulmonary toxicity (BT). The study included patients with suspected BT during treatment with bleomycin due to various oncologic diseases between June 2015... more
To evaluate the role of ultrasonography (USG) in the diagnosis of bleomycin-induced pulmonary toxicity (BT). The study included patients with suspected BT during treatment with bleomycin due to various oncologic diseases between June 2015 and May 2017. The patients initially underwent clinical and high-resolution computed tomography (HRCT) examinations and pulmonary function tests (PFT)-diffusing capacity of the lung for carbon monoxide (DLCO), followed by registration of USG findings-number of comet tail artifact (CTA) images by a different pulmonologist. We compared the findings from USG, HRCT, and PFT-DLCO tests between BT and non-BT groups. With the diagnosis based on clinical-radiologic and PFT-DLCO assessments taken as the gold standard, we determined the sensitivity and specificity of the USG outcomes for diagnosis of BT. The study included a total of 30 patients. Nine patients were diagnosed as having BT according to their clinical and radiologic findings and PFT-DLCO measur...
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Adolescent, Humans, Female, Male, Young Adult, and 15 moreClinical Sciences, Aged, Middle Aged, Adult, Fever, Bronchoscopy, Retrospective Studies, Abscess, Equipment Design, Bronchoscopes, Respiratory Care, Postoperative Complications, pericarditis, Cardiovascular medicine and haematology, and lung neoplasms
The purpose of this study was to investigate the sensitivity and diagnostic value of convex probe endobronchial sonographically guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of granulomatous mediastinal... more
The purpose of this study was to investigate the sensitivity and diagnostic value of convex probe endobronchial sonographically guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of granulomatous mediastinal lymphadenitis. Patients clinically and radiologically suspected to have granulomatous mediastinal disease and followed in our clinic between October 2008 and July 2010 were included. Convex probe EBUS with local anesthesia and under conscious sedation and EBUS-TBNA from hilar and mediastinal lymph nodes were performed after physical examination, chest radiography, computed tomography of the thorax, and routine biochemical analysis. Detection of noncaseating/caseating granulomas was accepted as sufficient for diagnosis of sarcoidosis/tuberculosis in the presence of clinical and radiologic findings. For patients whose EBUS-TBNA results were nondiagnostic, a definitive diagnosis was reached by invasive procedures. The sensitivity of EBUS-TBNA in the diagnosis of g...
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We aimed to introduce inhalation injury, pulmonary complications and mortality-related factors on the basis of clinical, radiological and bronchoscopic findings in patients with inhalation burns. Between January 2009 and January 2010,... more
We aimed to introduce inhalation injury, pulmonary complications and mortality-related factors on the basis of clinical, radiological and bronchoscopic findings in patients with inhalation burns. Between January 2009 and January 2010, patients hospitalized in the intensive care unit (ICU) of a burn center who were diagnosed as inhalation burn and underwent bronchoscopy were included in the study. Demographic findings, burn type, burn percentage, clinical-laboratory features, chest Xray findings on the first and fifth days, and bronchoscopic lesions were obtained from patient files. Bronchoscopic findings were classified, and bronchoscopic score for each patient was calculated. Clinical, laboratory and radiological findings, length of stay in the ICU, and bronchoscopic scores of patients who were discharged versus of those who died were compared, and mortality-related factors were investigated. Twenty-nine patients (25 male, 4 female; mean age 40.1 +/- 3.4 years) were included. Radio...