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  • Küçük Resim
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    Abant İzzet Baysal Üniversitesi Tıp Fakültesinde uygulanan deri prik testlerinin sonuçları
    (2008) Talay, Fahrettin; Göksügür, Nadir; Yılmaz, Fahrettin; Kurt, Emine Bahar
    Amaç: Bu çalışmada deri prik testlerinde saptanan aeroallerjenlerin dağılımı, bu allerjenlerin yaş grupları ve hastalık türü ile ilişkilerinin incelenmesi amaçlandı. Yöntem: Polikliniğimizde Ağustos 2004-Eylül 2006 tarihleri arasında deri prik testleri uygulanmış ve en az bir allerjene pozitiflik saptanan hastalar geriye dönük olarak incelendi. Bulgular: Bu çalışmadaki 168 kişinin 96’sı (%57) kadın, 72’si (%43) erkek olup yaş ortalaması 42.4 ± 16.7 (12–75) idi. Deri prik testlerinde en sık sırasıyla 119 (%71) kişide akarlara, 71 (%42) kişide mantarlara ve 61 (%36) kişide ot polenlerine karşı pozitiflik saptandı. Yaş ile ot polenlerine karşı pozitiflik arasında negatif korelasyon vardı (r= -212, p= 0.009). Astım + allerjik rinit (AR) olanlarda yalnızca AR olanlara göre hayvan epitelleri (p= 0.002) ve mantarlara (p<0.05) karşı pozitiflik oranı daha fazla idi. Astımlılarda (allerjik rinit eşlik eden ve etmeyenlerde) yalnızca allerjik riniti olanlara göre nefes darlığı, hırıltı ve göğüste tıkanıklık şikayetlerinin sıklığı belirgin olarak daha fazla idi (p<0.001). Burun tıkanıklığı, hapşırma ve gözlerde yaşarma şikayetleri ise allerjik rinitlilerde (astım eşlik eden ve etmeyenlerde) yalnızca astımlılara göre belirgin olarak daha fazla saptandı (p<0.001). Sonuç: Bolu’da deri prik testlerinde en sık saptanan aeroallerjenler sırasıyla ev tozu akarları, mantarlar ve ot polenleri idi. Allerjik yakınmaları olan ve allerjik hastalık (astım ve allerjik rinit gibi) tanısı konulan hastalarda deri prik testleri ile aeroallerjenlere karşı duyarlılığın belirlenmesi hastaların allerjenlerden korunmasına ve allerjik hastalıkların daha iyi tedavi edilmesine katkı sağlayabilir.
  • Küçük Resim
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    Adherence and effectiveness of omalizumab treatment in severe allergic asthma patients: Do the patients like injectable treatment?
    (European Respiratory Soc Journals Ltd, 2013) Özşeker, Ferhan; Bulut, İsmet; Erdenen, Füsun; Gelincik, Aslı; Erdoğdu, Derya; Talay, Fahrettin
  • Küçük Resim
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    Allerjik ve allerjik olmayan astımlı hastaların klinik özellikleri ve solunum fonksiyonlarının karşılaştırılması
    (2008) Talay, Fahrettin; Kurt, Emine Bahar; Tuğ, Tuncer
    Amaç: Allerjik ve allerjik olmayan astımlı hastaların demografik ve klinik özellikleri ve solunum fonksiyon değerlerinin karşılaştırılması. Gereç ve Yöntem: Ocak 2005-Ocak 2007 tarihleri arasında Göğüs Hastalıkları Polikliniğinde astım tanısı konulan ve prik testi yapılan hastaların retrospektif olarak incelenmesi. Bulgular: Çalışmaya 233 astımlı hasta (102 allerjik, 131 allerjik olmayan) alındı. Allerjik astımlılarda allerjik olmayanlara göre 50 yaş altındaki hasta oranı daha fazla idi (Allerjiklerde %66, allerjik olmayanlarda %50, p<0.05). Hastaların 175’i (%75) kadın idi ve allerjik olmayan astımlılarda kadın hasta oranı (%82) allerjik astımlılara (%67) göre daha fazla idi (p= 0.009). Allerjik astımlılarda ortaokul ve üzeri eğitimlilerin oranı daha yüksek idi (p<0.001). Burun tıkanıklığı, burun akıntısı ve hapşırma yakınmalarının sıklığı allerjik astımlılarda (p<0.05), nefes darlığının sıklığı allerjik olmayan astımlılarda daha fazla idi (p= 0.002). Solunum fonksiyon testlerinin karşılaştırılmasında allerjik astımlıların ortalama FVC (%) ve FEV1 (%) değerleri allerjik olmayan astımlılara göre belirgin olarak daha yüksekti (p<0.001). Prik testinde en sık akarlara (79 kişide) ve polenlere (48 kişide) karşı pozitiflik saptandı. Sonuçlar: Bu çalışmada allerjik olmayan astımın ileri yaş, kadın cinsiyet, düşük eğitim seviyesi ve düşük solunum fonksiyon değerleri ile ilişkili olduğu bulundu. Burun akıntısı, burun tıkanıklığı ve hapşırma yakınmalarının allerjik astımlılarda, nefes darlığı yakınmasının ise allerjik olmayan astımlılarda daha sık olduğu saptandı. Allerjik astımlılarda saptanan en yaygın allerjiler akarlar ve polenler idi. Astımlı hastalarda altta yatan allerji varlığının erken dönemde saptanması hastaların tedavi ve izleminde önemlidir.
  • Küçük Resim Yok
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    Alt solunum yolu infeksiyonu nedeniyle yatan hastalarda nonspesifik kültür antibiyogram sonuçları ve ampirik tedavi yaklaşımları
    (2014) Talay, Fahrettin; Çetinkaya, Erdoğan; Gençoğlu, Atayla; Şafak, Gülşah; Taş, İlhan; Altın, Sedat; Kar, Özlem Kurt
    Amaç: Bu çalışmada alt solunum yolu infeksiyonu (ASYİ) ile göğüs kliniğine yatan olguların nonspesifik kültür sonuçlarında üreyen etkenlere karşı antibiyotiklerin direnç profilini belirlenmesi ve bu olgulardaki ampirik tedavi yaklaşımlarını incelenmesi amaçlandı. Yöntem: Seksen dört olgudan nonspesifik kültür istendi. Üreme olan 41 olgu değerlendirmeye alındı. Bulgular : Olguların 35’i erkek, 6’sı kadın olup, yaş ortalamaları 61.4 ± 16.1 idi. Nonspesifik kültürlerin 16’sında (%39) Streptococcus pneumoniae, 8’inde (%19.5) Pseudomonas aureginosa, 13’ünde (%31.7) Klebsiella pneumonia üredi. Streptococcus pneumoniae’ye karşı %13 penisilin, %14 ampisilin -sulbaktam, %7 siprofloksasin, %58 sefuroksim, %29 klaritromisin, %7 levofloksasin direnci vardı. Seftriakson ve moksifloksasin direnci yoktu. Klebsiella pneum onia’ya karşı %33 seftriakson, %36 seftazidim, %30 sefepim, %10 imipenem, %9 amikasin direnci vardı. Siprofloksasine direnç saptanmadı. Pseudomonas aureginosa’ya karşı, %12 imipenem, %12 siprofloksasin, %37 seftazidim, %20 sefepim direnci vardı. Amikasin v e gentamisine direnç yoktu. Olguların ampirik tedavilerinde en çok tercih edilen antibiyotikler 11 kişide (%27) ampisilin -sulbaktam, 8 kişide (%20) seftriakson + klaritromisin, 7 kişide (%17) sefuroksim + klaritromisin şeklinde idi. Bulgularımız, yatan olg uların ampirik olarak alt solunum yolu enfeksiyonlarının tedavisinde kullanılan birçok antibiyotiğe önemli oranda direnç olduğunu göstermektedir. Sonuç : Bu tür olgularda her merkezin etyolojide en sık rastlanan etkenleri ve bu etkenlerin belirli direnç paternlerini bilerek ampirik tedavi başlanması tedavi başarısında anahtar rol oynayacaktır.
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    Angiotensin converting enzyme as a predictor of extrathoracic involvement of sarcoidosis
    (Mattioli 1885, 2015) Yaşar, Zehra; Özgül, Mehmet Akif; Çetinkaya, Erdoğan; Karğı, Aysel; Gül, Şule; Talay, Fahrettin
    Background: Sarcoidosis is a multisystem disease, with extrathoracic involvement occurring in 25-50% of patients. Multi-organ involvement is often associated with a more chronic and severe course. The value of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in diagnosing extrathoracic involvement in sarcoidosis has been demonstrated; however, because of the radiation dose and high cost, indications for its use must be well defined. Angiotensin-converting enzyme (ACE) is produced by active granuloma cells; thus, serum ACE (sACE) levels may reflect the total granuloma load. Objectives: In this retrospective study, we evaluated the diagnostic value of sACE in the detection of extrathoracic involvement in sarcoidosis. Methods: 43 patients with biopsy-proven sarcoidosis underwent FDG-PET/CT during the initial work up. Positive findings were classified as thoracic and/or extrathoracic. The diagnostic value of sACE was estimated using sensitivity, specificity, and area under the receiver operating characteristic curves (AUCs). Results: Of the 43 patients studied, 17 (39.7%) had extrathoracic involvement. In this group, sACE values were higher than in patients without extrathoracic involvement (331 vs. 150, p=0.002) and correlated positively with extrathoracic involvement (R:0.532 p=0.02). Receiver operator characteristic curve analysis revealed an AUC of 0.816 [95% confidence interval: 0.669-0.963, p=0.002], 70.6% sensitivity and 80% specificity at the sACE cut-off value. Conclusions: In sarcoidosis, extrathoracic involvement may be life threatening or indicative of poor outcome. sACE levels are easily determined and may predict extrathoracic involvement. In patients with sarcoidosis, sACE levels can be used to better define those who would benefit from FDG-PET/CT examination to detect extrathoracic involvement.
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    Angiotensin-converting enzyme as a predictor of extrathoracic involvement of sarcoidosis
    (Mattioli 1885 S.p.A., 2015) Yasar, Zehra; Özgül, Mehmet Akif; Cetinkaya, Erdo?an; Kargi, Aysel; Gül, Şule; Talay, Fahrettin; Tanriverdi, Elif
    Background: Sarcoidosis is a multisystem disease, with extrathoracic involvement occurring in 25- 50% of patients. Multi-organ involvement is often associated with a more chronic and severe course. The value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in diagnosing extrathoracic involvement in sarcoidosis has been demonstrated; however, because of the radiation dose and high cost, indications for its use must be well defined. Angiotensin-converting enzyme (ACE) is produced by active granuloma cells; thus, serum ACE (sACE) levels may reflect the total granuloma load. Objectives: In this retrospective study, we evaluated the diagnostic value of sACE in the detection of extrathoracic involvement in sarcoidosis. Methods: 43 patients with biopsy-proven sarcoidosis underwent FDG-PET/CT during the initial workup. Positive findings were classified as thoracic and/or extrathoracic. The diagnostic value of sACE was estimated using sensitivity, specificity, and area under the receiver operating characteristic curves (AUCs). Results: Of the 43 patients studied, 17 (39.7%) had extrathoracic involvement. In this group, sACE values were higher than in patients without extrathoracic involvement (331 vs. 150, p=0.002) and correlated positively with extrathoracic involvement (R:0.532 p=0.02). Receiver operator characteristic curve analysis revealed an AUC of 0.816 [95% confidence interval: 0.669-0.963, p=0.002], 70.6% sensitivity and 80% specificity at the sACE cut-off value. Conclusions: In sarcoidosis, extrathoracic involvement may be life threatening or indicative of poor outcome. sACE levels are easily determined and may predict extrathoracic involvement. In patients with sarcoidosis, sACE levels can be used to better define those who would benefit from FDG-PET/CT examination to detect extrathoracic involvement. © Mattioli 1885.
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    Assesment of palliative care in lung cancer in Turkey (ASPECT study)
    (European Respiratory Soc Journals Ltd, 2015) Bülbül, Yılmaz; Özlü, Tevfik; Arınç, Sibel; Özyürek, Berna A.; Günbatar, Hülya; Yaşar, Zehra Aşuk; Talay, Fahrettin
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    Assessment of palliative care in lung cancer in Turkey
    (Karger, 2017) Bülbül, Yılmaz; Özlü, Tevfik; Arınç, Sibel; Özyürek, Berna Akıncı; Günbatar, Hülya; Yaşar, Zehra; Talay, Fahrettin
    Objective: To investigate the symptoms of lung cancer in Turkey and to evaluate approaches to alleviate these symptoms. Subjects and Methods: This study included 1,245 lung cancer patients from 26 centers in Turkey. Demographic characteristics as well as information regarding the disease and treatments were obtained from medical records and patient interviews. Symptoms were evaluated using the Edmonton Symptom Assessment Scale (ESAS) and were graded on a scale between 0 and 10 points. Data were compared using the. 2, Student t, and Mann-Whitney U tests. Potential predictors of symptoms were analyzed using logistic regression analysis. Results: The most common symptom was tiredness (n = 1,002; 82.1%), followed by dyspnea (n = 845; 69.3%), appetite loss (n = 801; 65.7%), pain (n = 798; 65.4%), drowsiness (n = 742; 60.8%), anxiety (n = 704; 57.7%), depression (n = 623; 51.1%), and nausea (n = 557; 45.5%). Of the 1,245 patients, 590 (48.4%) had difficulty in initiating or maintaining sleep. The symptoms were more severe in stages III and IV. Logistic regression analysis indicated a clear association between demographic characteristics and symptom distress, as well as between symptom distress (except nausea) and well-being. Overall, 804 (65.4%) patients used analgesics, 630 (51.5%) received treatment for dyspnea, 242 (19.8%) used enteral/parenteral nutrition, 132 (10.8%) used appetite stimulants, and 129 (10.6%) used anxiolytics/antidepressants. Of the 799 patients who received analgesics, 173 (21.7%) reported that their symptoms were under control, and also those on other various treatment modalities (dyspnea: 78/627 [12.4%], appetite stimulant: 25/132 [18.9%], and anxiolytics/antidepressants: 25/129 [19.4%]) reported that their symptoms were controlled. Conclusion: In this study, the symptoms progressed and became more severe in the advanced stages of lung cancer, and palliative treatment was insufficient in most of the patients in Turkey. (C) 2016 S. Karger AG, Basel
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    Astımlı hastalarda obezite ile demografik özellikler, hastalık şiddeti ve atopi arasındaki ilişki
    (2008) Talay, Fahrettin; Kurt, Bahar
    Amaç: Bu çalışmada astımlı hastalarda obezite ile cinsiyet, yaş, eğitim durumu, atopi ve hastalık şiddeti arasındaki ilişkiyi incelemeyi amaçladık. Gereç ve yöntem: Göğüs Hastalıkları polikliniğimizde astım tanısı konulan 261 hasta çalışmaya alındı. Hastaların vücut kitle indeksi (VKİ) (kg/m2) hesaplandı. Bulgular: Bu çalışmadaki astımlıların (195 kadın, 66 erkek) yaş ortalaması 48.4 ± 16.2 idi. Kadın hastalarda erkek hastalara göre obezite sıklığı daha fazla idi (kadınlarda %44, erkeklerde %23, p=0.003). Elli yaşın üzerinde ve ilkokul ve daha düşük eğitimli kadın astımlılarda obezite sıklığı daha fazla idi (p<0.001). Astımlılarda obezite ile atopi arasında bir ilişki bulunmadı (p>0.05). Hastalık şiddeti arttıkça obezite sıklığının arttığı saptandı (p<0.001). Astımlı hastalarda spearman korelasyon katsayısında VKİ ile astım şiddeti (r=0.326, p<0.001) ve yaş (r=0.361, p<0.001) arasında doğrusal ilişki saptandı. VKİ ile FVC de¤eri aras›nda ise negatif ilişki (r=-0.325, p<0.001) saptandı. Multivariate lojistik regresyon analizinde obezite için risk faktörleri şu şekilde bulundu. Elli yaşın üzerinde [odds ratio (OR)=2.2, 95% confidence interval (CI)=1.2-4.0], ilkokul ve daha düşük seviyede eğitimli (OR = 2.8, 95% CI=1.4–5.5), orta persistan astımlı (OR=5.1, 95% CI=1.3–19.4) ve ileri persistan astımlı olmak (OR=5.1, 95% CI=1.3–21.6). Sonuç: Bu çalışmada özellikle düşük eğitimli ve 50 yaş üzerindeki kadın astımlılarda obezite sıklığı daha fazla saptandı. Astım şiddeti arttıkça obezite sıklığı da artmaktaydı. Astım şiddeti ile obezite arasındaki nedensel ilişkinin açıklanabilmesi için daha detaylı çalışmalar yararlı olacaktır.
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    Benefit of metformin in COPD: an effect on autonomic nervous system?
    (Informa Healthcare, 2015) Yaşar, Zehra; Erdem, Fatma; Talay, Fahrettin
    To the Editors: With great interest we read the recent article by Hitchings et al. on the safety of metformin in patients with type-2 diabetes mellitus and COPD (1). They found that in patients at high risk for lactate accumulation, metformin therapy was associated with a minor elevation of lactate concentration of doubtful clinical signifi cance. An additional fi nding was that metformin was associated with a longer survival, which was diffi cult to interpret because of possible unmeasured confounders. We would like to propose a mechanism of metformin by which metformin may have a benefi cial eff ect in terms of survival of COPD patients. Studies have shown that alterations in autonomic nervous system are present in COPD, with or without arterial COPD (2–6), which may contribution to the severity of disease and survival. Metformin is an anti-diabetic agent that has been shown to reduce insulin resistance and hyperglycemia, and also reduce the incidence of diabetes (7). Studies have also shown that metformin has benefi cial eff ects on autonomic control (8,9) and can improve cardiac sympathovagal balance in obese patients with type-2 diabetes (8). We think it can be hypothesized that the preceding eff ects of metformin on the autonomic nervous system might have played a role in the survival data reported by Hitchings et al.(1).
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    Bronchocentric granulomatosis in a patient with rheumatoid arthritis
    (Springer Heidelberg, 2012) Beş, Cemal; Kılıçgün, Ali; Talay, Fahrettin; Yılmaz, Fahri; Soy, Mehmet
    Bronchocentric granulomatosis is an uncommon entity which has no specific clinical, radiological and immunological features. It is usually diagnosed at morphological examination of biopsy or resected lung material. Aetiology of bronchocentric granulomatosis is unclear. A 49-year-old female patient, who was followed up with diagnosis rheumatoid arthritis in our outpatient clinic, presented with right lobe nodular lesion in chest radiography. Right thoracotomy and wedge resection was performed. Pathological examination revealed bronchocentric granulomatosis. Bronchocentric granulomatosis has been rarely reported in rheumatoid arthritis. This case might be a proof that bronchocentric granulomatosis may be one of the respiratory manifestations of rheumatoid arthritis.
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    Can non-thyroid illness sndrome predict mortality in lung cancer patients? A prospective cohort study
    (Springer, 2014) Yaşar, Zehra Aşuk; Kıraklı, Cenk; Yılmaz, Ufuk; Uçar, Zeynep Zeren; Talay, Fahrettin
    This study aims to evaluate the incidence of non-thyroid illness syndrome (NTIS) among patients diagnosed as lung cancer and its association with the stage of the disease, Eastern Cooperative Oncology Group (ECOG) performance score, nutritional parameters, and survival. We enrolled 120 patients that 71 of them with newly diagnosed and staged non-small cell lung cancer and 49 of them small-cell lung cancer. The cases were examined for thyroid function tests, ECOG performance score, and nutritional evaluation before treatment. Also, cases were evaluated for their overall survival rates. NTIS was identified in 30 (42 %) of the 71 non-small cell lung cancer patients and 22 (44 %) of the 49 small-cell lung cancer patients. NTIS was more frequent among advanced stage of cases. Serum albumin level, cholesterol level, lymphocyte level, and body mass index were detected to be significantly low and ECOG performance score was significantly high in cases with NTIS when compared to cases without NTIS. NTIS was found to be negatively correlated with body mass index, ECOG performance score, and serum albumin level, and it was positively correlated with disease stage. NTIS was detected significantly as a poor prognostic factor for lung cancer. NTIS was frequently seen in cases with non-small cell lung cancer and small-cell lung cancer. NTIS can be used as a predictor of poor prognosis for lung cancer patients.
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    Clinical Features and Outcomes of Patients with Small Cell Lung Carcinoma; Retrospective Analysis
    (2015) Ünalmış, Duygu; Yaşar, Zehra; Büyükşirin, Melih; Polat, Gülru; Üçsular, Fatma Demirci; Tibet, Gültekin; Talay, Fahrettin; Özyalvaçlı, Gülzade
    Objectives: Lung cancer is the leading cause of cancer-related mortality in both men and women worldwide. Small cell lung cancer (SCLC) represents 15-20 % of all lung cancers. The aim of this study was to evaluate the clinical features of small cell lung cancer (NSCLC) cases that were diagnosed in our clinic. Methods: The patients who were diagnosed as SCLC in our clinic were comprised the study group. The files and records of the study group were retrospectively reviewed to identify patients. The study group included 64 patients (59male, 5 female). Results: The mean age was 57.5 ±8.1 years. All patients were current smokers ( 50,3 pack-year). The most frequent symptoms on admission were chest pain, cough and weight loss. The most common radiologic finding was a hilar solid mass and hilar lymphadenopathies. The diagnosis was established by histopathologic examination of biopsy specimens obtained by various means, in which bronchoscopy was the sole means of diagnosis in 92,2 % of the patients. The stages of SCLC were limited disease in 26(29,7 %) and extensive disease in 38 (59,3%) patients. Metastasis was most frequently to the liver followed by bone and brain. Five (7,8%) patient had complete response (CR). forty nine (76,5%) patients had partial response. The median survival was 309 days, 210 days and 270 days for LS, ES and overall patients, respectively. Conclusions: In conclusion, demographic and clinical features of the patients were similar with the literature. Due to the high rates of extensive disease, the median survival rates and responses were lower than the previous series.
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    Comparison of BIPAP and SIMV+PEEP modes during weaning from mechanical ventilation after coronary artery bypass; effects on pulmonary function, ventilatory parameters and gas exchange
    (2007) Karaaslan, Kazım; Talay, Fahrettin; Gülcü, Nebahat; Dağlar, Bahadır; Çolak, Cemil; Gümüş, Esra; Koçoğlu, Hasan
    We aimed to compare the effects of biphasic intermittant positive airway pressure (BIPAP) and synchorised intermittant mondatory ventilation (SIMV) + PEEP (positive end expiratory pressure) on pulmonary functions, gas exchange and ventilatory parameters during weaning procedure after coronary artery bypass surgery. Twenty four patients aged 30-70 years scheduling for elective cardiopulmonary bypass grefting (CABG) were included in the study. Patients were ventilated with the mode of either BIPAP (GI, n: 12) or SIMV (G2, n: 12) randomly. Five cmH2O PEEP were applied in SIMV+PEEP group. Ventilation support decreased to 4-6 min-1 according to the adequacy of spontaneous respiration, and all patients in both, groups were extubated after waiting 30 min. The spirometric measurements were performed 1 day before operation (t0), 6 hrs (t1) and 24 hrs (t2) after extubation. The decrease during t1 and t2 in FEV1 were 62 % and 58 % in G1, 56 % and 61 % in G2 respectively. During the same period of time, FVC decreased 48 % and 42 % in G1, 58 % and 52 % in G2. These differences were not statistically significant between groups. FEV1/FVC ratio was similar within and between groups. We conclude that the rise of BIPAP or SIMV+PEEP have not affected the extubation time, gas exchange and pulmonary functions during weaning after CABG.
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    Comparison of chest x-ray, thoracic computed tomography and 18F-FDG PET/CT for staging of sarcoidosis
    (European Respiratory Soc Journals Ltd, 2015) Yaşar, Zehra; Çetinkaya, Erdoğan; Tanrıverdi, Elif; Kargı, Aysel; Gül, Şule; Talay, Fahrettin
    Sarcoidosis is an autoimmune disease that characterized by noncaseating granulomas with unknown etiology.Despite the highly advanced method for imaging, currently staging of sarcoidosis is performed by conventional chest X-ray. In this study we aimed to determine staging of sarcoidosis with chest X Ray and compare between thoracic computerized tomography and 18F-FDG PET/CT.43 patients with biopsy-proven sarcoidosis who underwent FDG-PET/CT during the initial work-up evaluated retrospectively.All cases, the chest X-Ray, thoracic CTand PET / CT scans were available and were studied approximately simultaneously.Staging of sarcoidosis was performed according to all three imaging.The Cohen's kappa was calculated to determine the rate of agreement.According to the Chest X-ray 3 patients in Stage 0, 27 in Stage 1,11 in Stage 2, 2 in Stage 3.Based on staging by Thoracic CT 9 in Stage 1,33 in Stage 2, one in Stage 3;staging with PET/CT,respectively,1 in Stage 0,16 in Stage 1,25 in Stage 2,one patient in Stage 3.The agreement was poor for considering staging between chest X-ray and thoracic CT (κ 0.128 35%), chest X-ray and PET/CT(κ 0.135 36%) and Thoracic CT and PET/ CT(κ 0.164 38%).The importance of advanced imaging methods such as CT and PET/CT is increasing for the determination of the activation and extend of the disease in patients with sarcoidosis. The management of sarcoidosis can be modified when this imaging methods used in staging.As a result, sarcoidosis staging and usage of these methods in appropriate patients can be discussed in the light of advanced imaging techniques for adequate management.
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    Could plasma D-dimer levels be a predictive marker for prognosis in lung cancer?
    (2013) Kurt, Bahar; Kar Kurt, Özlem; Kalaycı, Defne; Tuğ, Tuncer; Talay, Fahrettin
    Introduction: Plasma concentrations of circulatory markers of hemostatic activation which may be associated with tumor growth and dissemination have been shown to predict prognosis in malignancy. The present study was designed to investigate the prognostic value of plasma D-dimer level in lung cancer. Materials and Methods: Plasma levels of the D-dimer in 138 lung cancer patients [98 non-small cell lung cancer (NSCLC), 40 small cell lung cancer (SCLC)] were measured before the initiation of any therapy and each chemotherapy. Results: There were 124 (89.9%) men and 14 (10.1%) women with a mean age of 62.8 years (range 38-84). There were no statistically significant differences among the histopathologic types for NSCLC patients. Stage IIIA NSCLC group had statistically significant higher D-dimer level than stages I-II and IV. D-dimer levels were increased significantly after 4 cycles of chemotherapy in progressive disease. The median survival times in NSCLC patients were 26.6 months (95% CI, 17.6-35.6) and 15.9 months (95% CI, 4.2-27.7; p= 0.037) respectively, for patients with a low D-dimer level (? 1.2 ng/L) and a high D-dimer level (> 1.2 ng/L).With the cox-regression analysis, the plasma level of D-dimer and tumour stage were identified as independent predictive factors of the survival. Conclusion: These results suggest that plasmalevel of D-dimer can act as a predictive factor of decreased survival and a poor response to the treatment in lung cancer.
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    Does the prevalence of nasal polyps increase in patients using statins?
    (Springer, 2007) Yılmaz, Fahrettin; Gündüz, Hüseyin; Arınç, Hüseyin; Talay, Fahrettin; Özyıldırım, Serhan; Akyürek, Fatma; Uyan, Cihangir
    Several statins inhibit T-helper I development and induce T-helper 2 polarization and production of T-helper 2 cytokines that promote the activation and chemotaxis of eosinophils. Whether statins promote the development of nasal polyps has so far been uncertain. No studies have evaluated the frequency of the development of nasal polyps in patients using statins. To better define the relationship of statin use to the presence of nasal polyps, the investigators explored the frequency of the development of nasal polyps in patients who were using statins. A total of 200 patients who were using statins and 200 who were not using statins (400 cases) were investigated. All patients were examined for nasal polyps by anterior rhinoscopy or investigation with a fiber-optic endoscope. In addition, immunoglobulin E levels were measured, a skin prick test was performed, and the results from the 2 groups were compared. Nasal polyps were detected in 4 subjects who were using statins, whereas 5 nasal polyps were found in the control group; differences between the 2 groups were statistically insignificant (P >.05). When the atopy status of the 2 groups was compared, prick test positivity and serum immunoglobulin E levels were found to be 15% and 44 +/- 31 IU/mL in the statin group and 19% and 68 +/- 23 IU/mL in the control group (P >.05). These results show that nasal polyposis is a multifactorial disease with several different causes; however, the frequency of the development of nasal polyps does not increase in patients who use statins.
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    Effect of inhaled budesonide on oropharyngeal, Gram-negative bacilli colonization in asthma patients
    (Asian Pacific Society of Respirology, 2007) Talay, Fahrettin; Karabay, Oğuz; Yılmaz, Fahrettin; Koçoğlu, Esra
    Background and Objective: The effect of inhaled budesonide on oropharyngeal Gram-negative bacilli colonization (OGNBC) in asthmatic patients was investigated. Methods: Oropharyngeal cultures were obtained from asthmatic patients attending the hospital respiratory outpatient clinic, at baseline and 1 month after treatment with 800 mu g/day of inhaled budesonide. Cultures were evaluated for OGNBC and compared with those of healthy controls. Results: A total of 148 cultures (74 from asthma patients, 74 from healthy controls) were evaluated. Six cultures (8.1%) from healthy controls, eight cultures (10.8%) from asthma patients obtained before treatment and 20 cultures (27.0%) obtained after treatment were positive for OGNBC (P < 0.05). Gender, age, presence of atopy and the degree of illness were not found to be related to the presence of OGNBC in and healthy control cultures. In the cultures obtained from the patients after treatment, OGNBC was higher in patients > 50 years and in those with FEV1 < 70% (P < 0.05). Nine (18.8%) of 48 patients < 50 years compare with 11 (42.3%) of the 26 patients > 50 revealed OGNBC (P < 0.05). OGNBC were observed in 18.9% of the patients with FEV1 = 70% and in 47.6% of those with FEV1 < 70% (P < 0.05). Conclusions: The increased rate of OGNBC in asthma patients treated with inhaled budesonide was found to be related to increased age and lower level of FEV1. Further studies with larger numbers of patients are required for the interpretation of this colonization in the course of lower respiratory infections in these patients.
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    Effect of Inhaler Budesonide on Nasal and Oropharyngeal Carriage of Staphylococcus aureus in Asthma Patients
    (Bilimsel Tip Publishing House, 2007) Talay, Fahrettin; Karabay, Oguz; Yilmaz, Fahrettin; Kocoglu, Esra
    We aimed to investigate the effect of inhaler budesonide spray that was used for one month to treat asthma on nasal and oropharyngeal carriage of Staphylococcus aureus. Fourty two asthma patients (32 female, 10 male) and 42 healthy control groups (33 female, 9 male) were accepted for this study. Oropharyngeal cultures were obtained from asthmatics admitted to the outpatient clinic of chest disease, before and after one- month 800 g/day inhaler budesonide therapy, evaluated for nasal and oropharyngeal carriage for S. aureus and compared with one single culture that was obtained from healthy controls. Three nasal and four oropharyngeal cultures were found to be positive for S. aureus in pretreatment cultures, and 4 nasal and 4 oropharyngeal cultures were positive after treatment. Five nasal and two oropharyngeal cultures were positive for S. aureus in control group. There was no difference in nasal and oropharyngeal S. aureus colonization in asthmatics before treatment compared to controls, and after treatment compared to pretreatment values (p > 0.05). There was no relationship between nasal and oropharyngeal colonization of S. aureus and gender, age, smoking, presence of atopy, and the degree of the illness in three groups (p > 0.05). We thought that the orally used inhaler steroid, budesonide which was administered to treat asthmatic do not affect the colonization of S. aureus in the nose and oropharynx.
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    The effect of triamcinolone acetonide aqueous nasal spray on the nasal carriage of Staphylococcus aureus
    (Ocean Side Publications Inc, 2006) Yılmaz, Fahrettin; Karabay, Oğuz; Talay, Fahrettin; Köybaşı, Serap; Koçoğlu, Esra
    Background: In this study we aimed to investigate the effect of triamcinolone acetonide aqueous (TAA) intranasal spray that was used for 2 months to treat allergic rhinitis (AR) on the nasal carriage of Staphylococcus aureus (NCSA). Methods: A total of 125 adult AR patients (study group) and 133 healthy individuals (control group) were enrolled for the study. The 14 subjects were diagnosed with AR after a detailed history, physical examination, and prick testing. The AR subjects were administered TAA in a daily dosage of a 220-mu g intranasal route. Nasal cultures were obtained on the 1st (baseline), 55th, and 60th days, and the subjects in the last two cultures of whom S. aureus was detected were accepted as NCSA. Results: After all exclusion criteria were used, 110 AR and 114 control group subjects were enrolled in the study. Based on the culture results that were obtained on the 55th and 60th days, 10 (%9.1) patients from the study group and 18 (%15.7) individuals from the control group were defined to be NCSA (p>0.05). Conclusion: We conclude that the use of TAA treatment for AR does not increase the prevalence of NCSA. However, additional studies with a larger series are required to explain the effects of steroids on nasal colonization of S. aureus.