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Aydin S.,Yedikule Chest Diseases and Chest Surgery Training and Research Hospital | Ozaras N.,Bezmialem Foundation University | Akan O.,Okmeydani Training and Research Hospital
Neurology | Year: 2016

Objective: To investigate bone resorption and formation markers as well as bone mineral density in women with restless legs syndrome (RLS). Methods: This was a prospective cross-sectional case-control study involving drug-naive women with RLS and age- and body mass index (BMI)-matched female controls. Routine blood analyses, markers of bone formation, procollagen 1 n-terminal peptide, bone resorption, c-telopeptide of type 1 collagen (CTX), sclerostin, and bone mineral density (BMD) were compared between the 2 groups. Pregnant or breastfeeding women and individuals with comorbidities other than iron deficiency, type 2 diabetes mellitus, or hypertension were excluded. Results: A significant increase in lumbar BMD was found among 78 women with RLS as compared to 78 age- and BMI-matched controls (p 0.001). The proportion of patients with osteopenia as defined by a lumbar T score was significantly lower among patients with RLS (p 0.040). CTX and sclerostin were significantly lower in patients with RLS (p 0.006 and p 0.011, respectively), as were the levels of 25-hydroxy vitamin D 3, calcemia, and free T3 (p 0.017, p 0.017, and p 0.002, respectively). Conclusions: Despite lower 25-hydroxy vitamin D 3, patients with RLS had lower bone resorption markers, higher lumbar BMD, and lower frequency of lumbar osteopenia. As patients with RLS make movements night and day to decrease the severity of their symptoms, they unconsciously perform exercise, which may potentially explain the better bone profile among patients with RLS than in controls. © 2016 American Academy of Neurology.


Kocatas A.,Tevfik Saglam Cad. No 11 | Dural A.,Tevfik Saglam Cad. No 11 | Sever N.,Bakirkoy Dr Sadi Konuk Training And Research Hospital | Kankaya B.,Tevfik Saglam Cad. No 11 | And 6 more authors.
Journal of Minimal Access Surgery | Year: 2014

Granular cell tumour (GCT), which is a rare benign soft tissue neoplasm, is mostly found in the skin and soft tissue but may develop anywhere in the body. There are less than 10 reported cases of mediastinal GCTs in the current literature. Furthermore, colonic GCTs have recently gained attention due to the increased public awareness on the importance of colonoscopy screening. We report a case of a 52-year-old woman diagnosed incidentally with synchronous GCTs of the mediastinum and the hepatic flexure on her routine screening for post-operative follow-up for status-post right modified radical mastectomy due to a T 2 N 1 M 0 , Stage 2B breast cancer.


Akbas F.,Fatih University | Coskunpinar E.,Istanbul University | Aynaci E.,Yedikule Chest Diseases and Chest Surgery Training and Research Hospital | Musteri Oltulu Y.,Istanbul University | Yildiz P.,Yedikule Chest Diseases and Chest Surgery Training and Research Hospital
Experimental Lung Research | Year: 2012

Chronic obstructive pulmonary disease (COPD) as a complex disease with genetic and environmental compound is one of the leading causes of death in worldwide. This disease is characterized by lower airway inflammation, and increases risk of lung cancer in smokers. Micro-RNA (miRNA) molecules are key regulators in gene expression that have been widely associated with a several diseases. Differential expression of miRNAs is involved in lung tissue of COPD, but there is no information about biomarker potential of circulating miRNAs in patients. To analyze the miRNA expression profile in COPD, levels of serum miRNAs were profiled by quantitative reverse transcriptasepolymerase chain reaction (qRT-PCR) array system. The authors examined 72 miRNAs by qRT-PCR array, in 20 COPD patients and 12 control subjects. U6snRNA was used for normalization of the expression of miRNAs for each sample. According to the results, 5 miRNAs were found to be significantly dysregulated. There was down-regulation of miR-20a, miR-283p, miR-34c-5p, and miR-100, and up-regulation of miR-7, compared with the controls. This was the first study in COPD for screening of serum miRNAs for searching for biomarker. These results are preliminary screening data and should be confirmed with large patient groups. If so, these miRNAs are likely being involved in pathogenesis of COPD and may give clues for designing therapeutic strategy. © Informa Healthcare USA, Inc.


Kocaturk C.I.,Yedikule Chest Diseases and Chest Surgery Training and Research Hospital | Seyhan E.C.,Yedikule Chest Diseases and Chest Surgery Training and Research Hospital | Gunluoglu M.Z.,Yedikule Chest Diseases and Chest Surgery Training and Research Hospital | Urer N.,Yedikule Chest Diseases and Chest Surgery Training and Research Hospital | And 3 more authors.
Tuberkuloz ve Toraks | Year: 2012

Introduction: Primary pulmonary non-Hodgkin's lymphoma (PPNHL) of the lung occurs very rarely. To clarify clinical features, treatment alternatives and outcomes, we evaluated our surgically diagnosed PPNHL cases. Materials and Methods: A retrospective review of PPNHL cases from January 2004 to December 2009 was performed. Demographic and clinical data are presented as means or medians. Overall survival was estimated using the Kaplan-Meier method. Survival rates were compared using the log-rank test. A p value < 0.05 was considered significant. Results: Patients were eight males and two females with a median age of 50 years (range, 29-76 years). In 40% of the patients, antigenic stimulation, immune-suppression or auto-immune disease could not been found. All patients were symptomatic at presentation. Surgical procedures were needed to obtain a diagnosis (nine wedge resections and one pneumonectomy). Eight patients had an extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), and two had diffuse large B-cell lymphomas. The patients were treated with observation (pneumonectomy case), chemotherapy (n= 7), and chemotherapy and radiotherapy (n= 1). Five-year survival was 76%. Difference in survival rates of patients with bilateral vs. unilateral disease were not statistically different. Conclusions: On contrary of the literature, PPNHL can occur with absence of antigenic stimulation, and patients generally have some symptoms. Chemotherapy or surgery can be used to treat PPNHL. Patient survival is good.


Yasar Z.,Abant Izzet Baysal University | Cetinkaya E.,Yedikule Chest Diseases and Chest Surgery Training and Research Hospital
Tuberkuloz ve Toraks | Year: 2015

Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible and eventually fatal chronic interstitial pneumonia limited to the lung and associated with the histological and/or radiological pattern of usual interstitial pneumonia.The mean age of the disease is 65 and it is more frequent in men than women. The disease washistorically considered as an inflammatory disease, but currently this has shifted towards a prominent role of impaired wound healing process. The diagnosis of disease requires exclusion of other known causes of interstitial lung disease, the presence of a usual interstitial pneumonia pattern on high -resolution computed tomography (HRCT) in patients or specific combinations of HRCT and surgical lung biopsy patterns. The patients are considered as mild, moderate and severe according to the symptoms, radiological and pulmonary function tests. It is difficult to predict the course of the disease; clinical exacerbation can be seen after a long stable period. Average median survival is approximately 3 years. Advanced age, smoking, low body mass index, widespread radiological involvement, comorbidities and complications (pulmonary hypertension, emphysema, and bronchogenic cancer) are considered as poor prognostic factors. The treatment approach is the basis on the severity of the disease and patient preference. The recent positive result of the pirfenidone and nintedanib phase II and III clinical trials based on the prevailing mechanism of İPF pathogenesis particularly targeted fibroblast activation and myofibroblast differentiation have currently been reported. Initiating therapy with pirfenidone and nintedanib is recommended for the patients with mild and moderate İPF who do not have underlying liver disease and who live in area where these drugs are available. Nausea and rashes are more common in treatment with pirfenidone while diarrhea and deterioration in liver function tests are seen more frequently in nintedanib. The information regarding participation in randomized trials should be given to all patients and also early referral for transplantation should be considered. © 2015, Ankara University. All rights reserved.


Yasar Z.,Abant Izzet Baysal University | Cetinkaya E.,Yedikule Chest Diseases and Chest Surgery Training and Research Hospital
Tuberkuloz ve Toraks | Year: 2014

Bronchial thermoplasty is a non-drug treatment modality for moderate-to-severe asthma that involves the delivery of radio frequency energy to the airway wall in a precisely controlled manner to reduce excessive airway smooth muscle. Bronchial thermoplasty is performed under conscious sedation and completed in three bronchoscopy sessions, each lasting less than one hour, and each spaced apart by about three weeks. Bronchial thermoplasty has been demonstrated to reduce severe exacerbations, emergency rooms visits for respiratory symptoms, and time lost from work, school and other daily activities and improve asthma control and quality of life in patients with moderate-to-severe asthma. Adequate patient management is important for patient comfort and safety. In this review, we aim to discuss clinical studies, the evidence for the efficacy of bronchial thermoplasty, the importance of careful patient selection, patient preparation, patient management, procedure. © 2014 Ankara University. All rights reserved.


PubMed | Yedikule Chest Diseases and Chest Surgery Training and Research Hospital
Type: Journal Article | Journal: Tuberkuloz ve toraks | Year: 2016

The aim of the present study was to evaluate and compare the diagnostic accuracy of pleura levels of adenosine deaminase (ADA) and neopterin for the differential diagnosis of pleural tuberculosis (TP).The study included 50 patients with TB, 27 patients with malignancies, and 24 patients with pleural effusion of non-tuberculous and non-malignant origin as controls. ADA and neopterin levels in pleural fluid were measured by spectrofotometric and ELISA method, respectively.Pleural neopterin levels were significantly higher in patients with pleural TB than patients with malignancy (p< 0.001). Pleural ADA levels were significantly higher in patients with pleural TB than patients with malignancy (p< 0.001) and patients with benign non-tuberculosis effusions (p< 0.001). The mean levels of ADA and neopterin in pleural effusion were evaluated according to their underlying diseases for the diagnostic accuracy. As for pleural TB receiving operating characteristic curves identified the following results; The best cut-off value for pleural neopterin was 4.7 U/L and yielded a sensitivity and specificity of 86% and 72.55%, respectively. Taking a cut-off value of 42 U/L for pleural ADA, the sensitivity and the specificity were found to be 88% and 68.63%, respectively.In the diagnosis of pleural TB pleural neopterin level has a comparable sensitivity to pleural ADA activity. Both markers may find a place as a routine investigation in the coming days for early detection of TB. However, these tests should not be considered an alternative to biopsy and culture.


PubMed | Yedikule Chest Diseases and Chest Surgery Training and Research Hospital
Type: Evaluation Studies | Journal: Tuberkuloz ve toraks | Year: 2016

The Fagerstrm Test for Nicotine Dependence (FTND), modified from Fagerstrm Tolerance Questionnairre (FTQ), is used to determine whether a smoker trying to quit will need nicotine replacement therapy to treat with drawal symptoms. The FTND has been translated into many languages and has been referred to in the smoking literature worldwide. However, only a few studies have examined the psychometric propertiesof the non-English FTND versions. This study aimed to assess the psychometric properties of the Turkish version of the FTND.Confirmatory factor analysis (CFA) was used to test the factor structure of the Turkish version of the questionnaire using a large sample from two smoking cessation clinics in Istanbul, Turkey. Our study comprised 502 smokers who entered one of these smoking cessation clinics between October 1 and December 31, 2011. All subjects gave informed consent to the study. We assessed the validity of the FTND using CFA, and we calculated Cronbachs alpha coefficients to determine reliability.One-factor CFA included all of the items on the FTND. All items loaded on this factor with a score of 0.40 or higher. The goodness of fit statistics were adequate, with a Comparative Fit Index (CFI) of 0.922, a Tucker-Lewis Index (TLI) of 0.902, and a root-mean-square error of approximation (RMSEA) of 0.081. Two-factor CFA comprised the three morning smoking items, and the three smoking pattern items. The factor loadings and the goodness-of-fit statistics confirmed that the FTND has a two-factor structure.Analyses confirmed that the Turkish version of the FTND has a two-factor structure with moderate reliability. This study found that using a total score as an estimate of nicotine dependence may limit the assessment of specific smoking dependency and tailoring intervention approaches. We suggest that a two-factor FTND in clinical practice would more accurately determine the nicotine dependence of patients.


PubMed | Yedikule Chest Diseases and Chest Surgery Training and Research Hospital
Type: Journal Article | Journal: Sleep & breathing = Schlaf & Atmung | Year: 2016

Willis-Ekbom disease (RLS/WED) is common in chronic obstructive pulmonary disease (COPD). Patients with RLS/WED have poorer quality of sleep and more fatigue and depressive symptoms. The prevalence of RLS/WED in patients with COPD has been reported to vary between 29.1 and 36.8%. However, during exacerbation, the prevalence can increase up to 54%. These rates are higher than those seen in general population. We have not enough knowledge regarding the association between RLS and COPD. In this study, we aimed to determine the frequency of RLS in patients with stable COPD without comorbid conditions. In addition, we also aimed to determine possible related causative factors.We included 80 COPD patients without comorbid conditions who presented to our outpatient clinic between April 2013 and September 2013 for RLS/WED evaluation. Three cases that have polyneuropathy and one case that refused undergoing electromyography (EMG) examination were excluded from the study. Demographic data, P-A chest X-rays, pulmonary function tests (PFT), biochemical parameters (including hemogram), and dyspnea scales were evaluated for each patient. In addition, the RLS/WED rating scale and Epworth Sleep Scale (ESS) were applied. Further, each patient diagnosed with RLS/WED underwent a detailed neurological examination (performed by a neurologist) and an EMG examination to rule out polyneuropathy.Out of 76 COPD cases included in our study, 26.3% (n=20) were diagnosed with RLS/WED (mean age 60.47.5years, 20 males). The cases with RLS/WED had significantly lower body mass index (BMI) than cases without RLS/WED (p=0.009). There were no significant differences between cases with and without RLS/WED with respect to PFT, dyspnea scales, and arterial blood gas values. However, ESS was significantly different (p=0.016). There were no significant differences in RLS/WED scores and mean hs-CRP levels between COPD stages (p=0.424; p=0.518, respectively), while ESS was significantly different (p=0.016). ESS was significantly higher in stage B COPD than in stages A and D (p=0.005, p=0.008, respectively). Based on our model, we found that exacerbations and iron binding capacity (UIBC) were predictive factors for RLS/WED (p<0.100) CONCLUSION: RLS/WED is a common disease in cases with stable COPD. Despite our hypothesis suggesting that the prevalence of RLS/WED in COPD is related with systemic inflammation, we did not find a significant association between hs-CRP and COPD cases with RLS/WED. However, we did find that UIBC is a predictive factor for the development of RLS/WED. Nonetheless, further studies are needed to understand the relationships between UIBC, low BMI, and the development of RLS/WED in COPD.


PubMed | Bakirkoy Dr Sadi Konuk Training And Research Hospital, Istanbul University and Yedikule Chest Diseases and Chest Surgery Training and Research Hospital
Type: Journal Article | Journal: Journal of minimal access surgery | Year: 2014

Granular cell tumour (GCT), which is a rare benign soft tissue neoplasm, is mostly found in the skin and soft tissue but may develop anywhere in the body. There are less than 10 reported cases of mediastinal GCTs in the current literature. Furthermore, colonic GCTs have recently gained attention due to the increased public awareness on the importance of colonoscopy screening. We report a case of a 52-year-old woman diagnosed incidentally with synchronous GCTs of the mediastinum and the hepatic flexure on her routine screening for post-operative follow-up for status-post right modified radical mastectomy due to a T2N1M0, Stage 2B breast cancer.

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