Browsing by Author "Cilingir, Buket Mermit"

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Can B-Type Natriuretic Peptide (Bnp) Levels Serve as an Early Predictor of Clinical Severity in Patients With Covid-19 Pneumonia
(Clin Lab Publ, 2022) Cilingir, Buket Mermit; Askar, Selvi; Meral, Ayfer; Askar, Muntecep
Background: COVID-19 has continued to aggressively spread and kill. The incidence of complications and associated mortality rates are high. Cardiac damage, which is related to survival, is one of these. The purpose of this study is to assess the role of BNP, a cardiac biomarker, in predicting mortality in COVID-19. Materials and Methods: This single-center, prospective observational study was performed from July to September 2020 in a tertiary university hospital designated for the treatment of COVID-19 patients. Patients whose diagnoses were confirmed with real-time polymerase chain reaction (RT-PCR) tested nasopharyngeal swabs and with thoracic computed tomography (CT) findings compatible with COVID-19 pneumonia were included in the study. All clinical and laboratory data were obtained within the first 24 hours of hospital admission. To determine the risk of in-hospital death, patients were followed from admission until their discharge (1 to 15 days). The primary outcome was in-hospital death, defined as the case-fatality ratio. Results: Among all biomarkers that were included in the multivariate analysis only high BNP levels was independently associated with mortality [Mean 1.012, 95% CI (1.005 -1.02 pg/mL) (p = 0.002)]. Mortality was found to be significantly associated with older age and higher BNP, LDH, AST, HGB, PLT, ferritin, D-dimer, and CRP levels. In addition, mortality was found to be higher with longer duration of hospitalization (p = 0.041). Conclusions: Our fundamental goal for COVID-19 is to determine whether the hospitalized patients are in the mortality risk group at an early stage of disease. Adding measurement of BNP levels to routine laboratory tests for COVID-19 may be a practical approach to determine the patients with a high risk of mortality. (Clin. Lab. 2022;68:xx-xx. DOI: 10.7754/Clin.Lab.2021.210602)
Cognitive Dysfunction Among Patients in Chronic Obstructive Pulmonary Disease: Effects of Exacerbation and Long-Term Oxygen Therapy
(Wiley, 2020) Cilingir, Buket Mermit; Gunbatar, Hulya; Cilingir, Vedat
Background We investigated the association between cognitive dysfunction (CD) and chronic obstructive pulmonary disease (COPD) during exacerbation and compare with stable COPD patients and control subjects. Also, we compared the cognitive function of long-term oxygen therapy (LTOT) dependent patients and not receiving LTOT. Methods The 121 people included in the study. They were divided into three groups: exacerbation of COPD (COPD-E), stable COPD (COPD-S) and control groups. Also, COPD patients were divided into two groups, non-user LTOTD-COPD and regular-user LTOTD-COPD. The patients were asked in their native language by exact conversion of the questions of MMSE (Mini Mental State Examination). Results The mean age of patients was 67 and ratio of patients with MMSE results below 24 was 41.6%. MMSE score was 18.9 in patient with exacerbation and 25.7 in stable COPD. Age average was higher and MMSE was lower in COPD-E group. Low educational degree was predicting factor for CD in COPD-E group. Low MMSE was related with decreased FEV1%, pO(2)and sO(2)values, increased pCO(2)values, low educational level and increased comorbidity. MMSE score was 18.8 in reguler-user LTOTD COPD and 24.9 in nonuser LTOTD-COPD. Regular-user LTOTD-COPD groups exacerbation rate was higher than nonuser LTOTD-COPD group. Conclusion MMSE scores was low in COPD-E group and regular-user LTOTD-COPD group. This is important because MMSE identifies clinically significant CD. This suggests that the CD may be linked to the causes of severe exacerbations. Clinicians need to look for CD, because cognitive function needs to be taken into account in their management of the patient.
Evaluation Serum Levels of Ykl-40, Periostin, and Some Inflammatory Cytokines Together With Il-37, a New Anti-Inflammatory Cytokine, in Patients With Stable and Exacerbated Asthma
(Mosby-elsevier, 2021) Yildiz, Hanifi; Alp, Hamit Hakan; Sunnetcioglu, Aysel; Ekin, Selami; Cilingir, Buket Mermit
Introduction: As asthma has a wide range of inflammatory pathways, the researchers were focused on the markers that may be associated with exacerbation and stability in asthma. Objective: Our aim is to investigate the serum levels of some inflammatory markers and cytokines in stable and exacerbated asthmatic patients. Methods: The study included in 59 non-smoker asthma patient (Exacerbated=25, Stable=34) and 30 healthy volunteers. The serum level of periostin, YKL-40, IL-4, IL-5, IL-37, and TNF-alpha were detected by enzyme-linked immunosorbent assay. Results: Except for IL-37, the periostin, YKL-40, IL-4, IL-5, and TNF-alpha level in asthmatic patients were significantly higher than those of healthy control. In the exacerbated group, the periostin, YKL-40, IL-5, and TNF-alpha level were significantly higher than stable asthma and healthy control groups. The serum levels of IL-4 in exacerbated and stable asthma groups were significantly higher than healthy control group. There was a significant difference between IL4 levels, in stable asthma and healthy control groups. In exacerbated asthma group, IL-37 level was significantly lower than stable and healthy control groups. The highest area under the ROC curve (AUC) was found for IL-4. While there was a significant negative correlation between these parameters and FEV1, there was a positive correlation between IL-37 and FEV1, but not significant. Conclusions: This study showed that increased serum periostin, YKL-40, IL-5, IL-4, and TNF-alpha and decreased serum IL-37 were associated with exacerbation showing uncontrolled asthma. (C) 2020 Elsevier Inc. All rights reserved.
Factors Determining the Therapeutic Level of Positive Airway Pressure in Patients With Obstructive Sleep Apnea Syndrome
(Wolters Kluwer Medknow Publications, 2023) Sunnetcioglu, Aysel; Cilingir, Buket Mermit; Gunbatar, Hulya; Yildiz, Hanifi; Dogan, Hediye Ulker
Objectives: In daily practice, we encounter with obstructive sleep apnoea syndrome (OSAS) patients who require different levels of positive airway pressure (PAP) despite having a similar apnoea-hypopnea index (AHI). We aimed to determine the parameters contributing to the determination of the therapeutic level of PAP. Methods: Data on 548 patients who underwent polysomnography and PAP titration were analysed retrospectively. Patients were divided into groups according to OSAS severity (mild, moderate, and severe) and the mean pressure in each group was determined, after which patients were further divided into those who required a PAP below the mean and those who required a PAP above the mean. Results: The mean optimal PAP level in the mild, moderate, and severe OSAS groups was 7.4 +/- 2.3, 8.6 +/- 2.4, and 9.8 +/- 2.9 cm H2O, respectively. In the moderate and severe OSAS group, the subgroup that needed high pressure had a higher supine AHI, a longer apnoea time, and a longer SaO(2) <90% time as compared with the subgroup that needed low pressure. Conclusion: A longer apnoea duration and a higher supine AHI are associated with a higher PAP level in patients with moderate and severe OSAS.
Transfusion Related Acute Lung Injury (Trali) After Convalescent Plasma Therapy in Covid-19 Patient
(Turkish Soc Medical & Surgical intensive Care Medicine, 2021) Cilingir, Buket Mermit; Askar, Selvi
The coronavirus disease 2019 (COVID-19) continues to spread all around the world. Mortality and morbidity rates are increasing-up to now. Although convalescent plasma therapy can be thought to be useful in the treatment of COVID-19, it carries potential risks, such as transfusion-related acute lung injury (TRALI). In COVID-19 infection, tachypnea, tachycardia, increased need for oxygenation, and the presence of bilateral widespread infiltrates on radiological imagings are evaluated as acute respiratory distress syndrome (ARDS). This clinical situation may develop independently from disease progression in patients receiving convalescent plasma therapy and it is called TRALI. We aimed to present our case to discuss the difficulty of this situation to differentiate from COVID-19 related ARDS.