Browsing by Author "Sunnetcioglu, Aysel"

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Aklınızda Bulunsun: Klomifen Sitrat Kullanımına Bağlı Pulmoner Emboli
(2021) Mermi̇t, Buket; Sunnetcioglu, Aysel; Yıldız, Hanifi
Yirmi sekiz yaşındaki bayan hasta bir gündür devam eden göğüs ağrısı nedeniyle başvurdu. Ovulatuar disfonksiyonun klomifen sitrat ile tedavisi 20 gün önce başlatılmıştı. Hastanın nabız hızı 120 vuru / dakika ve kan basıncı 100/60 mmHg idi. Elektrokar- diyografide sinüs taşikardisi saptandı. Arteriyel kan gazı testi sonucunda hem hipoksi hem de hipokapni tespit edildi. D-dimer seviyesi 5.2 μg / ml olarak ölçüldü. Bilgisayarlı tomografi anjiyografisinde sağ alt lob pulmoner arter ve alt lob segment dallarında pulmoner emboli ile uyumlu dolum defektleri görül- dü. Transtorasik ekokardiyografide ejeksiyon fraksi- yonu %65 idi ve trombüs izlenmedi. Hastaya klomifen sitrat kullanımına bağlı pulmoner emboli tanısı kon- du. Bemiparin sodyum ile antikoagülan tedavi baş- landı ve hasta taburcu edildi. Klomifen sitrat kullanı- mına bağlı akut pulmoner emboli, nadir görülen ancak karşılaşıldığında yaşamı tehdit eden bir komp- likasyon olabilir. Doktorlar olası pulmoner emboli riskinin farkında olmalıdır.
Analyze of Ventilator Associated Pneumonia
(derman Medical Publ, 2015) Sunnetcioglu, Aysel; Karadas, Sevdegul; Cegin, M. Bilal; Sunnetcioglu, Mahmut; Kanter, Ahmet
Aim: Ventilator-associated pneumonia (VAP) is the infection that is an important cause of morbidity and mortality developed in patients whom the invasive mechanical ventilation (MV) were performed in intensive care units (ICU). In this study, the factors of VAP developing in patients whom the mechanical ventilation of ICU performed, antibiotic susceptibility to these factors and determining the risk factors were aimed. Material and Method: Between January 2009 and March 2013, 79 cases, followed with the mechanical ventilation for at least for 48 hours and developed VAP, were retrospectively reviewed at Anesthesiology and Intensive Care Unit of Reanimation at Faculty of Medicine at Yuzuncu Yil University, performing endotracheal intubation. The cases were evaluated in terms of microorganisms, antibiotic susceptibility and risk factors. Results: The rate of our VAP speed was calculated to be 19.68 on the day of 1000 ventilator. While a single microorganism could be isolated in 81.1% of the 74 VAP cases whose the active pathogen could be isolated, two or more than two microorganisms were isolated in 18.9% of them. While 83 of the strains (90.2%) were gram-negative bacteria, 7 of them (7.6%) were gram-positive bacteria. Acinetobacter spp. (40.2%) was most commonly isolated as a gram-negative factor, but methicillin-resistant S. aureus (4.3%) was isolated as a gram-positive factor. It was determined that the isolated factors in VAP cases were significantly resistant to the broad-spectrum antibiotics. Discussion: As a result, in patients with high-risk factors for the development of VAP, early and appropriate empirical antibiotic treatment should be started according to the results of the sensitivity of the unit and for the multi-drug-resistant microorganisms with common and high mortality.
Assessments of the Associations of Thrombus Localization With Accompanying Disorders, Risk Factors, D-Dimer Levels, and the Red Cell Distribution Width in Pulmonary Embolism
(Hospital Clinicas, Univ Sao Paulo, 2015) Sunnetcioglu, Aysel; Sertogullarindan, Bunyamin; Ozbay, Bulent; Asker, Selvi; Ekin, Salemi
Objective: Pulmonary embolisms occur as a wide spectrum ranging from clinically asymptomatic thrombi to massive thrombi that lead to cardiogenic shock. The purpose of this study was to determine the associations of thrombus localization with risk factors, accompanying disorders, D-dimer levels and the red blood cell distribution width in patients with pulmonary embolism. MATERIAL AND METHODS: In 148 patients diagnosed with pulmonary embolism, the presence and anatomical localization of the thrombus were assessed via computed tomographic pulmonary angiography. The accompanying disorders, risk factors, serum D-dimer levels, and red blood cell distribution width of the patients were retrospectively evaluated. ClinicalTrials. gov: NCT02388841. RESULTS: The mean age of the patients was 54 +/- 16.0 years, and 48 patients were >= 65 years of age. The most frequent accompanying disorders were chronic obstructive pulmonary disease (22%) and malignancy (10.1%), and the most frequent risk factors were recent operation (14.1%) and immobilization (18.2%). Thrombi were most frequently observed in the right pulmonary artery (37.8%). In 31% of the patients, the thrombus was localized to the main pulmonary arteries. Immobile patients exhibited a higher proportion of thrombi in the main pulmonary arteries than mobile patients. The mean D-dimer level and the mean red blood cell distribution width in the patients with thrombi in the main pulmonary arteries were higher than those in the patients with thrombi in more distal pulmonary arterial branches. CONCLUSION: Significant associations of proximally localized thrombi with immobilization, the D-dimer levels, and the red blood cell distribution width were observed.: Pulmonary embolisms occur as a wide spectrum ranging from clinically asymptomatic thrombi to massive thrombi that lead to cardiogenic shock. The purpose of this study was to determine the associations of thrombus localization with risk factors, accompanying disorders, D-dimer levels and the red blood cell distribution width in patients with pulmonary embolism. MATERIAL AND METHODS: In 148 patients diagnosed with pulmonary embolism, the presence and anatomical localization of the thrombus were assessed via computed tomographic pulmonary angiography. The accompanying disorders, risk factors, serum D-dimer levels, and red blood cell distribution width of the patients were retrospectively evaluated. ClinicalTrials. gov: NCT02388841. RESULTS: The mean age of the patients was 54 +/- 16.0 years, and 48 patients were >= 65 years of age. The most frequent accompanying disorders were chronic obstructive pulmonary disease (22%) and malignancy (10.1%), and the most frequent risk factors were recent operation (14.1%) and immobilization (18.2%). Thrombi were most frequently observed in the right pulmonary artery (37.8%). In 31% of the patients, the thrombus was localized to the main pulmonary arteries. Immobile patients exhibited a higher proportion of thrombi in the main pulmonary arteries than mobile patients. The mean D-dimer level and the mean red blood cell distribution width in the patients with thrombi in the main pulmonary arteries were higher than those in the patients with thrombi in more distal pulmonary arterial branches. CONCLUSION: Significant associations of proximally localized thrombi with immobilization, the D-dimer levels, and the red blood cell distribution width were observed.
Associations Between the Standardized Uptake Value of 18f-Fdg Pet/Ct and Demographic, Clinical, Pathological, Radiological Factors in Lung Cancer
(E-century Publishing Corp, 2015) Sunnetcioglu, Aysel; Arisoy, Ahmet; Demir, Yusuf; Ekin, Selami; Dogan, Erkan
Objectives: F-18-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is extensively used to diagnose and stage of lung cancer. The aim of the current study was to investigate the correlation of demographic, clinical, pathological and radiological factors with primer tumor FDG Uptake in patients with lung cancer. Materials and methods: This cross-sectional, clinical study was performed on a total of 57 lung cancer patients newly diagnosed that underwent FDG PET/CT. In addition to descriptive variables, histopathological diagnosis, tumor site and size, hemoglobin level, red cell distribution width, neutrophil to lymphocyte ratio were noted for each patient. The correlation of these variables to SUVmax values in FDG PET/CT was investigated. Results: A total of 57 patients (4 women, 53 men) with an average age of 60.8 +/- 9.4 (range: 33-89) participated in the study. Histopathological diagnoses were consistent with squamous cell carcinoma (28, 49.1%), adenocarcinoma (15, 26.3%) and small cell cancer (14, 24.6%). The SUVmax of primary tumor was positively correlated with tumor size (P<0.001). The tumor SUVmax of squamous cell carcinoma (SqCC) (17.49 +/- 8.37) was higher than that of adenocarcinoma (AC) (12.80 +/- 4.77) and small cell carcinoma (SCC) (12.40 +/- 5.80) (P=0.038). Conclusion: SUVmax value was significantly higher for squamous cell carcinoma and it SUVmax values in PET scans was found to be positively correlated with tumor size. This study suggests that, tumor size and histologic subtype had influences upon FDG uptake in lung cancer.
Batın Cerrahi Sonrası Radyolojik Bulgu Gösteren Akciğer Komplikasyonlarının Değerlendirilmesi
(2021) Ekin, Selami; Sunnetcioglu, Aysel; Mermi̇t, Buket; Yuzkat, Nureddın
GİRİŞ ve AMAÇ: Cerrahi girişimler ve uygulanan anestezi sonrasında meydana gelen patofizyolojik değişiklikler akciğer komplikasyonlarının gelişimini kolaylaştırmaktadır. Bu çalışmada batın cerahisi sonrası radyolojik bulgu gösteren akciğer komplikasyonlarının değerlendirilmesi amaçlandı. YÖNTEM ve GEREÇLER: Genel enestezi altında batın cerahisi yapılan 619 hastadan istenen göğüs hastalıkları konsültasyonları retrospektif olarak incelendi. Radyolojik bulgu saptanan hastalar çalışmaya alındı. BULGULAR: Postoperatif göğüs hastalıkları konsültasyonu istenen hastaların %20,7’sinde radyolojik bulgu tespit edildi. Hastaların yaş ortalaması 57.28±11.2 olarak saptandı. Değerlendirilen 128 hastanın, 81 (63.2%) üst batın, 47’ne (36.7%) alt batın cerahisi yapılmıştı. Üst batın cerahi yapılan hastaların 51’i (62.9%) 60 yaş üzerindeydi. En sık akciğer komplikasyonları plevral effüsion (32.8%), pnömoni (26.5%), atelektazi (17.9%) idi. Üst batın cerahisinde ateletazi(69.5%) ve plevral effüzyon(66%) daha fazla iken alt batın cerrahisinde pnömoni (76%) daha sıktı. TARTIŞMA ve SONUÇ: Plevral efüzyon, pnömoni ve atelektazi, batın cerahisi sonrası radyolojik bulgu veren en yaygın akciğer komplikasyonlarıydı. Özellikle üst batın cearahisi sonrası ateletazi ve plevral efüzyon, alt batın cerahisi sonrası ise pnömoni daha sık görülmesine rağmen bu komplikasyonların gelişiminde risk faktörleri arasında önemli bir fark yoktu.
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.
A Case of Sarcoidosis With Pleural Involvement
(Wiley, 2018) Sunnetcioglu, Aysel; Sertogullarindan, Bunyamin; Batur, Abdussamet; Bayram, Irfan
Sarcoidosis is a chronic, multisystem inflammatory disorder of unknown etiology that is characterized by noncaseating granulomas. Although lung involvement is common in sarcoidosis, pleural involvement is rare. Pleural involvement may manifest as a pleural effusion, pneumothorax, pleural thickening and nodules, hydropneumothorax, hemothorax, or chylothorax. Here, we describe a case of sarcoidosis with pleural nodular thickening.
Clinical and Laboratory Features of Adult Measles Cases Detected in Van, Turkey
(Pakistan Medical Assoc, 2015) Sunnetcioglu, Mahmut; Sunnetcioglu, Aysel; Mentes, Osman; Baran, Ali Irfan; Karadas, Sevdegul; Aypak, Adalet
Objective: To evaluate adult measles patients with respect to their clinical and laboratory findings as well as complications. Methods: The retrospective study was conducted at YuzuncuYil University, Van, Turkey, between December 2012 and June 2013, and comprised cases diagnosed with measles. The diagnosis was based on clinical findings and all were serologically confirmed with the presence of Anti-measles Immunoglobulin M antibodies. Results: Of the 50 records studied, 41(84%) related to women. Overall mean age was 25.52+/-4.07 years. The most common symptoms were fever and rash 50(100%), malaise 49(98%), cough 48(96%), headache 44(88%) and sore throat 36(72%). The presence of Koplik spots, lymphadenopathy and hepatomegaly were observed in 3(6%), 6(12%) and 2(4%) patients respectively. Thrombocytopenia and elevated liver enzymes were detected in 26(52%) and 22(44%)patients. Pneumonia was the most common complication in 9(18%) patients. Other respiratory complications were bronchitis 5(10%) and laryngotracheitis 6(12%). Of the cases, 9(18%) exhibited otitis media. Premature delivery and spontaneous abortus occurred in 2(4%) and 3(6%) patients of the 15(30%) pregnant women. Conclusion: Measles continues to be an important health problem in Turkey and needs an effective elimination programme.
Comparative Analysis of Pulmonary and Extrapulmonary Tuberculosis of 411 Cases
(Biomed Central Ltd, 2015) Sunnetcioglu, Aysel; Sunnetcioglu, Mahmut; Binici, Irfan; Baran, Ali Irfan; Karahocagil, Mustafa Kasim; Saydan, Muhammed Ridvan
Background: Tuberculosis is a disease that can involve every organ system. While pulmonary tuberculosis is the most common presentation, extrapulmonary tuberculosis (EPT) is also an important clinical problem. The current study aimed to outline and compare the demographic and clinical features of pulmonary and extrapulmonary tuberculosis cases in adults. Methods: Medical records of 411 patients (190 women, 221 men) treated between January 2010 and July 2014 in provincial tuberculosis control dispensary was retrospectively reviewed. Demographic and clinical characteristics were compared for pulmonary and extrapulmonary tuberculosis cases. Results: Of these 411 cases, 208 (50.6%) had pulmonary tuberculosis (PTB) and 203 were diagnosed with extrapulmonary tuberculosis (EPTB) (49.4%). The average ages for PTB and EPTB groups were 33.00-27.00 and 31.00-29.75, respectively (p = 0.513). Men were more frequently affected by PTB (59.6%), while EPTB was more commonly detected in women (52.2%) (p = 0.016). Main diagnostic modalities for PTB were sputum/smear analyses (72.7%), clinical-radiological data (21.7%) and biopsy (6.1%); while biopsy (71.5%), sputum/fluid analysis (18.8%) and clinical-radiological data (4.9%) were used for confirming EPTB (p < 0.0019). The most common sites of EPTB involvement were lymph nodes (39.4%), followed by pleura (23.6%), peritoneum (9.9%) and bone (7.4%). Conclusions: Extrapulmonary involvement of tuberculosis is common and females are more likely to be affected. Increased clinical awareness is important since atypical presentations of the disease may constitute diagnostic and therapeutic challenges.
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.
Could Soluble Urokinase Plasminogen Receptor (Supar) Be Used as a Diagnostic Biomarker for Ventilator-Associated Pneumonia
(Wiley, 2017) Sunnetcioglu, Aysel; Sunnetcioglu, Mahmut; Adiyaman, Firat; Binici, Irfan; Soyoral, Lokman
BackgroundSoluble urokinase plasminogen activator receptor (suPAR) is a biomarker that is increasingly used for evaluation of systemic inflammation. This study was performed to investigate whether suPAR may possess a diagnostic value in patients with ventilator-associated pneumonia (VAP). MethodsThis clinical study was performed in the anesthesia intensive care units (ICUs) of our university. In addition to descriptive data, WBC, serum levels of C-reactive protein (CRP) and suPAR prior to and after development of VAP were noted and compared in 31 patients (22 men, 9 women) diagnosed with VAP (Study Group) and 19 patients without VAP (Control Group) in ICU (14 men, 5 women). ResultsThe suPAR (P=0.023), CRP (P=0.037), WBCs (P=0.024) in patients with VAP were significantly higher than patients without VAP. There was no remarkable difference in terms of WBCs (P=0.052) and suPAR levels (P=0.616) between groups on the first day of connection to mechanical ventilator. The suPAR and CRP levels in patients with VAP were significantly higher than prior to development of VAP (P=0.001 for both). Area under curve value after diagnosis of pneumonia was found 0.248 (P=0.002). ConclusionTo conclude, our results suggest that suPAR can be a useful diagnostic biomarker in patients with VAP. However, clinical trials on larger series are warranted to explore the clinical significance more accurately.
Cytomegalovirus Pneumonia and Pulmonary Haemorrhage in a Patient With Polyarteritis Nodosa
(Pakistan Medical Assoc, 2016) Sunnetcioglu, Aysel; Sunnetcioglu, Mahmut; Emre, Habib; Soyoral, Lokman; Goktas, Ugur
Cytomegaloviruses are opportunistic pathogens that cause lung infection in immunocompromised individuals. A 24-year-old male was admitted to the hospital with complaints of cough, fever and dyspnoea. He was receiving immunosuppressive therapy for polyarteritis nodosa. A chest X-ray showed heterogeneous right-sided opacity in the middle and lower lung zones. The diagnosis of cytomegalovirus pneumonia was confirmed by positive test for serum cytomegalovirus IgM antibodies. One day after admission, haemoptysis developed and patient with hemoptysis who had shortness of breath was intubated. Computed tomography (CT) showed bilateral alveolar opacity.
Delftia Acidovorans Pneumonia With Lung Cavities Formation
(Corporacion Editora Medica Valle, 2019) Yildiz, Hanifi; Sunnetcioglu, Aysel; Ekin, Selami; Baran, Irfan; Ozgokce, Mesut; Asker, Selvi; Akyuz, Sumeyye
Case Description: A 52-year-old female patient was admitted to our clinic with complaints of cough, sputum, fever and fatigue. The patient has been receiving immunosuppressive therapy for thrombocytopenic purpura for 5 years. Clinical Finding: Inspiratory crackles were heard on both hemithorax. Oxygen saturation measured with the pulse oximeter was 97%. Chest X-ray showed diffuse reticular opacities that were more prominent in the upper zones of both lungs. WBC counts were 17,600 mm(3) and Platelet counts were 29,000 mm3. Thorax CT showed that there were many thin-walled cavities and millimetric nodules accompanied by ground-glass infiltrates in the upper and middle lobes. Gram staining of bronchial fluid, taken by bronchoscopy, revealed Gram-negative bacilli and intense polymorphonuclear leukocytes. The bacteria were defined as Delftia acidovorans by BD Phoenix automated system. Treatment and outcomes: The patient was hospitalized with suspicion of opportunistic pulmonary infections and cavitary lung disease. After the empirical treatment of intravenous piperacillintazobactam and oral clarithromycin, her clinical and radiological findings significantly regressed, and she was discharged with outpatient follow-up. Clinical Relevance: This is the first example of cavitary pneumonia due to Delftia acidovorans in an immunocompromised patient. We would like to emphasize that Delftia pneumonia should be considered in the differential diagnosis of pulmonary cavitary involvement in such patients.
Endobronchial Aspergilloma: a Case Report
(Elsevier Science Bv, 2016) Sunnetcioglu, Aysel; Ekin, Selami; Erten, Remzi; Parlak, Mehmet; Esen, Ramazan
A 28-year-old male with B-cell acute lymphoblastic leukemia presented to our pulmonary clinic with progressive dyspnea, cough, hemoptysis, and fever. Diagnostic bronchoscopy revealed white masses at the entrance of the right middle lobe bronchus and distal to the right main bronchus. Histopathological examination of the biopsy specimen showed those masses to be hyphae of Aspergillus. (C) 2016 The Authors. Published by Elsevier Ltd.
Endobronchial Plasmacytoma in Patient With Multiple Myeloma
(Wiley, 2017) Sunnetcioglu, Aysel; Ekin, Selami; Bayram, Irfan; Ekinci, Omer; Bugday, Inci Bahadir
Endobronchial plasmacytoma is a rare manifestation of extramedullary plasmacytoma. A 49-year-old woman with a history of multiple myeloma consulted to our pulmonary service with progressive dyspnoea and cough and abnormal chest X-ray. A lesion measuring 6 x 5 cm in size existed in anterior baseline of the right lung's lower lobe in thoracic computed tomography in addition to right bronchial narrowing and atelectasis distal in lesions. Diagnostic bronchoscopy was performed previously for the obstruction and biopsy was taken from the lesion in the right middle lobe bronchus. Endobronchial biopsies showed extensive tumour infiltration with plasmocytoid cells. Immunohistochemistry was positive CD138 and Lamda. Microscopic and immunohistochemical findings supported the diagnosis of extramedullary endobronchial plasmacytoma.
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.
Evaluation of Risk Factors in Patients With Ventilator-Associated Pneumonia Caused by Acinetobacter Baumannii
(Univ Udayana, 2020) Baran, Ali Irfan; Celik, Mehmet; Arslan, Yusuf; Demirkiran, Hilmi; Sunnetcioglu, Mahmut; Sunnetcioglu, Aysel
Purpose: Ventilator-associated pneumonia is a significant disease with high mortality rates. Acinetobacter baumannii is one of the most critical pathogens leading to ventilator-associated pneumonia. This study aims to evaluate the underlying risk factors in patients diagnosed with ventilator-associated pneumonia caused by Acinetobacter baumannii, who were followed in intensive care units of our hospital. Patients and Methods: The data of 112 patients diagnosed with ventilator-associated pneumonia caused by Acinetobacter baumannii, who were followed in Intensive Care Units other than Pediatric Intensive Care Unit of our hospital from 2013 to 2017, were evaluated retrospectively. Results: Of the cases included in our study, 70.5% were male, and 29.5% were female patients. Of the cases, 875% were followed in Anaesthesiology and Reanimation Intensive Care Unit. The most common modifiable risk factors are mechanical ventilation, antacid use, and the most common non-modifiable risk factors were the presence of trauma and a history of cardiovascular disease. Conclusion: Ventilator-associated pneumonia is a clinical condition with high mortality and morbidity in intensive care units. Incidence and mortality of ventilator-associated pneumonia can be reduced through the implementation of some necessary policies for the prevention of ventilator-associated pneumonia and the practices for the reduction or elimination of modifiable risk factors.
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.
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.