Browsing by Author "Gunbatar, Hulya"

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Analysis of Endogenous Oxidative Damage Markers and Association With Pulmonary Involvement Severity in Patients With Sars-Cov Pneumonia
(Elsevier France-editions Scientifiques Medicales Elsevier, 2021) Yildiz, Hanifi; Alp, Hamit Hakan; Ekin, Selami; Arisoy, Ahmet; Gunbatar, Hulya; Asker, Selvi; Haylu, Mine
Introduction: The SARS-CoV-2 virus affects many organs, especially the lungs, with widespread inflammation. We aimed to compare the endogenous oxidative damage markers of coenzyme Q10, nicotinamide dinucleotide oxidase 4, malondialdehyde, and ischemia-modified albumin levels in patients with pneumonia caused by SARS-CoV-2 and in an healthy control group. We also aimed to compare these parameters between patients with severe and non-severe pulmonary involvement. Methods: The study included 58 adult patients with SARS-CoV-2 pneumonia and 30 healthy volunteers. CoQ10 and MDA levels were determined by high-pressure liquid chromatography. NOX4 and IMA levels were determined by ELISA assay and colorimetric method. Results: Higher levels of CoQ10, MDA, NOX4, and IMA and lower levels of COQ10H were observed inpatients with SARS-CoV-2 pneumonia than in the control group. MDA, IMA, NOX4, and CoQ10 levels were significantly higher in patients with severe pulmonary involvement than in patients with non-severe pulmonary involvement, but no significant difference was observed in CoQ10H levels. CoQ10 levels were significantly and positively correlated with both ferritin and CRP levels. Conclusion: SARS-CoV-2 pneumonia is significantly associated with increased endogenous oxidative damage. Oxidative damage seems to be associated with pulmonary involvement severity.
Assesment of Palliative Care in Lung Cancer in Turkey (Aspect Study)
(European Respiratory Soc Journals Ltd, 2015) Bulbul, Yilmaz; Ozlu, Tevfik; Arinc, Sibel; Ozyurek, Berna A.; Gunbatar, Hulya; Senturk, Aysegul; Talay, Fahrettin
Betatrophin Association With Serum Triglyceride Levels in Obstructive Sleep Apnea Patients
(Wolters Kluwer Medknow Publications, 2019) Sertogullarindan, Bunyamin; Komuroglu, Ahmet Ufuk; Ucler, Rifki; Gunbatar, Hulya; Sunnetcioglu, Aysel; Cokluk, Erdem
Background: Obstructive sleep apnea (OSA) is a common sleep problem, in which patients are at increased risk for metabolic and cardiovascular problems, including metabolic syndrome, diabetes mellitus (DM), and dyslipidemia. Betatrophin is a novel protein that regulates fatty acid and triglyceride (TG) metabolism and is related to obesity and metabolic abnormalities, including metabolic syndrome, DM, and dyslipidemia. Although OSA and betatrophin share common abnormalities, their relationship has not been investigated. AIM: The aim of this study is to investigate the relationships among betatrophin, OSA, and the serum lipid profile. METHODS: Ninety consecutive patients with suspected OSA underwent polysomnography (PSG) to confirm OSA. Plasma betatrophin, leptin, adiponectin, and the full lipid profile were analyzed. The patients were categorized as OSA or control based on the apnea-hypopnea index (AHI). RESULTS: About 61% of patients had OSA, and 39% had normal PSG. The levels of betatrophin, leptin, and adiponectin were higher in patients with OSA (256.59 +/- 29.35, 374.20 +/- 37.93, and 17.86 +/- 2.63 mu g/mL, respectively) compared to the controls (141.86 +/- 26.20, 205.53 +/- 14.75, and 7.52 +/- 1.02 mu g/mL, respectively). Betatrophin levels were correlated with the AHI, leptin (r = 0.413, P = 0.002, r = 0.782, P = 0.000). TG levels were significantly higher, and high-density lipoprotein cholesterol (HDL-C) levels were lower, in OSA patients compared to controls (244 +/- 20.33 vs. 138 +/- 14.89, and 37.21 +/- 1.26 vs. 43.78 +/- 1.62, respectively). The TG level was correlated with betatrophin (r = 0.353, P = 0.013). Multiple regression analysis showed that the AHI, leptin, and arousals were independent predictors of betatrophin level (B = 1.70 P = 0.046 95%, B = 0.56 P < 0.005, and B = 1, 2, P = 0.003, respectively). CONCLUSIONS: Our results suggest a complex relationship between OSA, betatrophin, TG, and HDL, as well as other adipokines. Our results require further investigation to assess this complex association and re-evaluate previous related studies.
Chronic Effects of Environmental Biomass Smoke on Lung Histopathology in Turkish Non-Smoking Women: a Case Series
(inst Medical Research & Occupational Health, 2012) Gunbatar, Hulya; Sertogullarindan, Bunyamin; Ozbay, Bulent; Avcu, Serhat; Bulut, Gulay; Kosem, Mustafa
Biomass is widely used for fuel in developing countries. Particles and gases of biomass burning may cause changes in the lung. In this prospective study we investigated histopathological changes in the lungs of 42 non-smoking women [mean age (59 +/- 10) years] caused by biomass smoke. We valuated exposure to biomass smoke, case histories, and the findings of physical examination, radiology, bronchoscopy, and lung histopathology. Mean exposure to biomass smoke was (28 +/- 9) hour-year (1 hour-year equals 365 hours of exposure per year with average exposure of 1 hour a day). The radiological findings were mass (42 %), reticulonodular opacities (31 %), mediastinal lymphadenopathy (26 %), pleuro-parenchymal fibrotic banding (19 %), widening of the pulmonary artery (14 %), ground glass (11 %), mosaic perfusion (9 %), consolidation (9 %), segmental or subsegmental atelectasis (7 %), and bronchiectasis (7 %). The patients were diagnosed with lung cancer (35 %), interstitial lung disease (31 %), sarcoidosis (9 %), tuberculosis (9 %), chronic obstructive pulmonary disease (4 %), chronic bronchitis (9 %), and metastasis (4 %). Bronchoscopy showed pilies, oedema, erythema, bronchus narrowing, endobronchial tumour, mucosal irregularity, increased vascularisation, blue-black anthracotic plaques, mucosal oedema, and purulent secretion. Transbronchial biopsies revealed neutrophil and lymphocyte leucocytes in the perivascular, peribronchiolar, and interalveolar septa, slightly enlarged connective tissue, thickening of the basal membrane, thickening of interalveolar septa, intimal and medial thickening of the vascular wall and vascular lumen narrowing, anthracosis between the cells and in the bronchiole epithelium. These findings confirm that biomass smoke has important toxic effects on the lung parenchyma, interstitium, and pulmonary vessels that may result in malignancies.
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.
Could a New Measurement, a New Body Shape Index, Replace Bmi in Detecting Obesity and Predict the Presence of Obesity and Depression in Asthma Control
(2022) Ekin, Selami; Mermi̇t, Buket; Gunbatar, Hulya; Yıldız, Hanifi; Sunnetcioglu, Aysel
Obesity is common in asthma. Depression is thought to be one of the risk factors that increase obesity. It is known that depression has an effect on poor asthma control. Body Mass Index (BMI) is mostly used to define obesity. In recent years, however, the ‘A Body Shape Index’ (ABSI) based on waist circumference (WC) measurement has been developed and the higher ABSI corresponds to a more central body volume concentration. Our aim was to examine the effect of obesity and depression on asthma control in a way that questions the usability of ABSI, which is new in abdominal obesity measurement. A total of 99 asthmatic patients aged between 18-80 years who were followed up in Chest Diseases outpatient clinics were included in the study. Demographic and medical history of the patients were recorded. Waist circumference /BMI2/3 X Length(m) 2/3 was calculated for ABSI measurement. Beck Depression Scale (BDS) and Asthma Control Test (ACT) were applied. Pulmonary Function Test was applied to all patients by the same trained person. Obese and morbidly obese patients had poor asthma control. We found that the presence of depression caused poor asthma control in all BMI groups. The poorly controlled asthma group and the obese and morbidly obese patients had higher depression scores. BMI and waist circumference were higher in the poorly controlled asthma group (p=0.002, 0.033 respectively). However, there was no significant difference between the asthma groups in terms of ABSI (p=0.529). The findings of this study indicate that depressive symptoms, increased BMI and WC were significantly associated with poor asthma control. But ABSI is no superior to BMI in detecting asthma control and depressive mood. However, we should prompt our patients to treatment and exercise, especially for abdominal obesity. We should recommend that asthma patients with depression consult a psychiatrist. In this way, we can control our asthma patients more effectively by minimizing the existing risks.
Covıd-19 Hastalarında Antioksidanların ve Oksidatif Hasarın Durumu
(2023) Akmeşe, Şükrü; Binici, İrfan; Huyut, Zübeyir; Gunbatar, Hulya; Karahocagil, Mustafa Kasim; Akbay, Halil İbrahim; Gürbüz, Esra
Amaç: COVID-19, son zamanlarda bir pandemiye neden olan ve insan sağlığını önemli ölçüde etkileyen bir viral hastalıktır. Bu çalışmada COVID-19'da süperoksit dismutaz, glutatyon peroksidaz, glutatyon, toplam tiyol, doğal tiyol, disülfid, oksidatif DNA hasarı ve malondialdehit düzeyleri araştırıldı. Araçlar ve Yöntem: Bu çalışmaya revers transkriptaz-polimeraz zincir reaksiyonu ile COVID-19 tanısı konan 35 hasta ve 35 sağlıklı gönüllü dahil edildi. Enzim bağlantılı immünosorbent testi ile serum glutatyon, glutatyon peroksidaz, süperoksit dismutaz, doğal tiyol, toplam tiyol ve disülfid seviyeleri ve yüksek basınçlı-sıvı kromatografisi ile malondialdehit ve 8-hidroksi-2-deoksiguanozin/10⁶ deoksiguanozin seviyeleri ölçüldü. Bulgular: COVID-19 hasta grubunda serum süperoksit dismutaz, glutatyon peroksidaz, malondialdehit, 8-hydroxy-2-deoksiguanozin/10⁶, disülfid düzeyleri sağlıklı kontrol grubuna göre daha yüksek iken, glutathione, toplam tiyol, doğal tiyol düzeyleri daha düşüktü. Ayrıca 8-hydroxy-2-deoxyguanosine/10⁶ deoxyguanosine ile glutatyon, doğal tiyol ve toplam tiyol arasında negatif, disülfid ile pozitif korelasyon vardı. Sonuç: Bu çalışma, COVID-19 hastalarında serum süperoksit dismutaz, glutatyon peroksidaz, glutatyon, malondialdehit, 8-hydroxy-2-deoxyguanosine/10⁶ deoxyguanosine ve disülfid düzeylerinin arttığını ve glutatyon, toplam tiyol ve doğal tiyol düzeylerinin azaldığını ortaya koydu. Bu sonuçlar, COVID-19 hastalarında, antioksidan belirteç düzeylerinde azalma ve oksidatif stres belirteçlerinde artış olduğunu ortaya koydu.
Endobronchial Tumors Presenting as Asthma
(Daedalus Enterprises inc, 2014) Arisoy, Ahmet; Ekin, Selami; Gunbatar, Hulya; Sertogullarindan, Bunyamin; Akdeniz, Huseyin; Bulut, Gulay; Demirkiran, Hilmi
Evaluation of Oxidative Damage and Antioxidant Mechanisms in Copd, Lung Cancer, and Obstructive Sleep Apnea Syndrome
(Daedalus Enterprises inc, 2016) Sunnetcioglu, Aysel; Alp, Hamit H.; Sertogullarindan, Bunyamin; Balaharoglu, Ragip; Gunbatar, Hulya
BACKGROUND: Oxidative damage is a major contributing factor to carcinogenesis and obstructive disorders in lungs. Current evidence suggests that the inflammatory processes yield to oxidative mechanisms, which underlie COPD, lung cancer, and obstructive sleep apnea syndrome (OSAS). This study aimed to evaluate the oxidative damage in these diseases by evaluating the oxidative and antioxidant biomarkers. METHODS: Malondialdehyde, 8-oxo-7,8-dihydro-2'-deoxyguanosine, and coenzyme Q10 levels were evaluated in the blood samples of subjects with COPD, lung cancer, and OSAS by high-pressure liquid chromatography. RESULTS: A total of 111 participants (35 females, 76 males) with OSAS (n = 29), COPD (n = 26), and lung cancer (n = 28) and healthy controls (n = 28) were included in the study. The malondialdehyde and coenzyme Q10 levels were significantly higher in all 3 diseases when compared with controls (P < .01), whereas 8-oxo-7,8-dihydro-2'-deoxyguanosine levels were only significantly higher than in healthy controls in subjects with lung cancer (P = .005). The highest levels of malondialdehyde and coenzyme Q10 were determined in subjects with OSAS and lung cancer, respectively. The highest 8-oxo-7,8-dihydro-2'-deoxyguanosine levels were also observed in subjects with lung cancer, but the differences of this biomarker with other diagnoses were not statistically significant (P = .56). CONCLUSION: Oxidative damage was observed in all 3 diagnoses, and, as a response to oxidative stress, antioxidant mechanisms were also active in these diseases. Malondialdehyde and 8-oxo-7,8-dihydro-2'-deoxyguanosine were found to be efficiently usable in the evaluation of oxidative damage in chronic respiratory diseases.
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.
General Characteristics and Therapeutic Options in Lung Cancer in Turkey
(European Respiratory Soc Journals Ltd, 2015) Ozlu, Tevfik; Bulbul, Yilmaz; Arinc, Sibel; Ozyurek, Berna A.; Gunbatar, Hulya; Senturk, Aysegul; Talay, Fahrettin
Increased Asymmetric Dimethylarginine and Ischemia-Modified Albumin Levels in Obstructive Sleep Apnea
(Daedalus Enterprises inc, 2016) Sunnetcioglu, Aysel; Asker, Selvi; Alp, Hamit Hakan; Gunbatar, Hulya
BACKGROUND: Asymmetric dimethylarginine and ischemia-modified albumin are new biomarkers that are used for evaluation of ischemia and oxidative stress. The present study aimed to investigate whether serum levels of asymmetric dimethylarginine and ischemia-modified albumin are altered in subjects with obstructive sleep apnea (OSA). METHODS: A cross-sectional, clinical study was implemented on data derived from 79 subjects who underwent polysomnography. Cases were allocated into 3 groups with respect to polysomnography results: Group 1 consisted of 22 subjects without apnea, whereas Group 2 comprised 29 subjects with mild to moderate OSA, and Group 3 included 28 subjects with severe OSA. These 3 groups were compared in terms of demographic datas and polysomnographic parameters, serum levels of asymmetric dimethylarginine and ischemia-modified albumin. RESULTS: Serum levels of ischemia-modified albumin were significantly higher in Groups 2 and 3 (P = .001). Mean S-pO2 of Group 3 was notably lower than that of Groups 1 and 2 (P < .001), whereas times for S-pO2 < 90% were statistically significantly different from each other in all 3 groups (P < .001). Serum levels of asymmetric dimethylarginine in Group 3 were notably higher than those in Group 1 (P = .027). Levels of ischemia-modified albumin were correlated positively with AHI and time S-pO2 < 90% values (P = .008 and P <.001, respectively). CONCLUSIONS: Ischemia-modified albumin and asymmetric dimethylarginine were significantly higher in subjects with OSA. Furthermore, ischemia-modified albumin was independently associated with severity of OSA defined by AHI and severity of oxygen desaturation.
Investigation of Frequency of Osas in Patients With Pulmonary Hypertension by Polysomnography
(European Respiratory Soc Journals Ltd, 2013) Sunnetcioglu, Aysel; Sertogullarindan, Bunyamin; Gunbatar, Hulya; Ozbay, Bulent
Is There a Relationship Between Obstructive Sleep Apnea (Osa) and Hearing Loss
(int Scientific Literature, inc, 2016) Ekin, Selami; Turan, Mahfuz; Arisoy, Ahmet; Gunbatar, Hulya; Sunnetcioglu, Aysel; Asker, Selvi; Yildiz, Hanifi
Background: Obstructive sleep apnea (OSA) is a common disorder with an estimated prevalence in the general population of 2-5%. Its main clinical features are loud snoring and breathing stoppage during sleep. Ischemia could be a consequence of noise-induced hearing loss because cochlear oxygen tension is reduced during and after noise exposure. In this study, we evaluated auditory function in patients affected by OSA and simple snoring. Material/Methods: A total of 66 participants (male to female ratio: 40: 26) were included in the study, of which 21 were in the control group, 18 were in the simple snoring group, and 27 were in the OSA patient group. Polysomnography and audiometric examination were performed in all participants. Results: The mean ages of the participants in the control, simple snoring, and OSA groups were 39.14 +/- 9.9, 37.28 +/- 8.2, and 41.56 +/- 8.99 years, respectively. There were no statistically significant differences among groups regarding age or sex; however, there were statistically significant differences among groups in body mass index, apnea-hypopnea index scores, mean saturation, and duration under 90% saturation. In addition, statistically significant differences were found between the patient group and the control and simple snoring groups concerning the mean saturation, duration under 90% saturation, and the extended high frequency of hearing. Conclusions: These data show that snoring may cause hearing loss at extended high frequencies.
Loeffler's Syndrome: an Interesting Case Report
(Wiley, 2016) Ekin, Selami; Sertogullarindan, Bunyamin; Gunbatar, Hulya; Arisoy, Ahmet; Yildiz, Hanifi
Loeffler's syndrome is an acute pneumonia with an unclear cause. One fourth of Loeffler's syndrome patients are idiopathic, although the most common etiologic causes include parasites. Asymptomatic form is usually a reversible, self-limited disease, which does not require a specific treatment regimen. We presented a 17-year-old young man with diagnosis of Loeffler syndrome.
Multiple Lung Metastases From Parotid Adenoid Cystic Carcinoma With Respiratory Failure
(derman Medical Publ, 2013) Gunbatar, Hulya; Ekin, Selami; Sertogullarindan, Bunyamin; Yavuz, Alpaslan; Bulut, Gulay
Adenoid cystic carcinoma (ACC) is one of the most common malig-nancy in secretory glands. It accounts for about 15% -25% of all malignant salivary gland carcinomas. Typically, ACC is slow growing tumors and develops distant metastasis via haematogenous. We report a case who presented with respiratory failure and multiple metastases. A 52-year-old male, underwent a radical craniofacial resection for a right parotid gland, followed by postoperative radiotherapy. He was followed-up with head CT scans for 5 years with no signs of locoregional recurrence. Physical examination was normal. Blood gases analyses showed moderate hypoxemia. pH; 7,49 pCO2; 31,8 Po2; 38,9 HCO3; 24,1 sat O2; 79,1. Thorax CT showed multiple lesions ranging in size from 5 mm to 4 cm distributed diffusely in both lungs. CT-guided fine-needle aspiration of the lung lesion was performed. Pathological analysis reported adenoid cystic carcinoma. Multiple pulmonary metastases may cause respiratory failure and requires constant vigilance by medical practitioners.
A Novel Echocardiographic Method for Assessing Arterial Stiffness in Obstructive Sleep Apnea Syndrome
(Korean Soc Cardiology, 2015) Akdag, Serkan; Akyol, Aytac; Cakmak, Huseyin Altug; Gunbatar, Hulya; Asker, Muntecep; Babat, Naci; Gumrukcuoglu, Hasan Ali
Background and Objectives: Obstructive sleep apnea syndrome (OSAS) is associated with increased arterial stiffness and cardiovascular complications. The objective of this study was to assess whether the color M-mode-derived propagation velocity of the descending thoracic aorta (aortic velocity propagation, AVP) was an echocardiographic marker for arterial stiffness in OSAS. Subjects and Methods: : The study population included 116 patients with OSAS and 90 age and gender-matched control subjects. The patients with OSAS were categorized according to their apnea hypopnea index (AHI) as follows: mild to moderate degree (AHI 5-30) and severe degree (AHI >= 30). Aortofemoral pulse wave velocity (PWV), carotid intima-media thickness (CIMT), brachial artery flow-mediated dilatation (FMD), and AVP were measured to assess arterial stiffness. Results: AVP and FMD were significantly decreased in patients with OSAS compared to controls (p<0.001). PWV and CIMT were increased in the OSAS group compared to controls (p<0.001). Moreover, AVP and FMD were significantly decreased in the severe OSAS group compared to the mild to moderate OSAS group (p<0.001). PWV and CIMT were significantly increased in the severe group compared to the mild to moderate group (p<0.001). AVP was significantly positively correlated with FMD (r=0.564, p<0.001). However, it was found to be significantly inversely related to PWV (r=-0.580, p<0.001) and CIMT (r=-0.251, p<0.001). Conclusion: The measurement of AVP is a novel and practical echocardiographic method, which may be used to identify arterial stiffness in OSAS.
Obstructive Sleep Apnea Related To Rapid Eye Movement or Non-Rapid Eye Movement Sleep: Comparison of Demographic, Anthropometric and Polysomnographic Features
(Soc Brasileira Pneumologia Tisiologia, 2016) Sunnetcioglu, Aysel; Sertogullarindan, Bunyamin; Ozbay, Bulent; Gunbatar, Hulya; Ekin, Selami
Obstrüktif Uyku Apne Sendromlu Hastalarda Optimal Sürekli Pozitif Havayolu Basınç Düzeyini Etkileyen Faktörler
(2020) Kaplan, Havva Sayhan; Gunbatar, Hulya
Amaç Bu çalışmada obstrüktif uyku apne sendromu (OUAS) olan hastalarda optimal CPAP düzeylerini etkileyen faktörlerin (VKİ, boyun çevresi, AHİ vb.) araştırılılması amaçlandı. Gereç ve Yöntemler Bu çalışmaya CPAP tedavisi için başarılı oto titrasyon uygulanan 120 OUAS hastası dahil edildi. Optimal CPAP seviyesi ile başlangıç verileri arasındaki korelasyonlar analiz edildi. Bulgular 120 OUAS hastasında ortalama optimal basınç seviyesi 9.11 ± 2.81 cm H2O idi. Hafif, orta ve şiddetli OUAS gruplarında ortalama optimal basınç seviyeleri sırasıyla 8.01 ± 2.60, 8.32 ± 2.22 ve 9.71 ± 3.01 cm H2O idi. Apne / hipopne indeksi (AHI) (r = 0.297, p <0.001) ve minimal SaO2 (r = -0.264, p <0.004) optimal basınç seviyesi ile anlamlı korelasyon gösterdi. Titrasyon yetmezliği grubundaki 22 hastada genel olarak ağır AHI vardı; 6 hastada REM ilişkili, 2 hastada pozisyona bağlı OUAS mevcuttu. Titrasyon yetmezliği grubunda, belirli bir tanısı (hızlı göz hareketi (REM) veya pozisyon OUAS) bulunmayan hastalarda çok ciddi AHI düzeyleri vardı (ortalama AHI 67.90 idi). Sonuç Korelasyon testlerine göre optimal CPAP seviyesinin en önemli iki belirleyicisi AHI ve en düşük saturasyon olarak bulundu.
Pulmonary Embolism Associated With Pandemic H1n1 Influenza a Virus Infection: a Case Report
(Galenos Publ House, 2011) Dulger, Ahmet Cumhur; Avcu, Serhat; Arslan, Harun; Ozbay, Bulent; Gunbatar, Hulya; Kucukoglu, Mehmet Emin; Bartin, Mehmet Kadir
On May 15, 2009, the Turkish Ministry of Health reported the first case of 2009 pandemic influenza A (H1N1) virus infection in the Republic of Turkey. Pandemic H1N1virus is a new and mutant influenza virus and has many epidemiologic and clinic features. These cases have been reported in multiple geographic regions of the world. School children are more affected than adults. In the elderly, it has a higher mortality rate. The clinical aspects of infection with H1N1 influenza A virus remains to be understood. A few cases of pulmonary embolism associated with H1N1 influenza A virus infection were reported. We herein report a pulmonary embolism in a patient with pandemic influenza A (H1N1) virus infection. A 42-year-old Turkish woman was admitted to our emergency department with dyspnea and pleuritic chest pain. She complained of fever, myalgia, sore throat and cough of four days duration on admission to our hospital. She was tested for pandemic influenza A (H1N1) virus by a polymerase chain reaction (PCR) test which revealed a positive result. Chest tomography showed pulmonary embolism. She was successfully treated with intravenous heparin and oseltamivir. This case report demonstrates the importance of considering pulmvonary embolism as a diagnosis in 2009 pandemic influenza A (H1N1) virus infected persons who present with sudden onset of dyspnea, fever and chest pain.