Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital

İstanbul, Turkey

Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital

İstanbul, Turkey

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PubMed | Yeditepe University, Dskap Yldrm Beyazt Training and Research Hospital, Inonu University, Bagclar Training and Research Hospital and 10 more.
Type: Journal Article | Journal: Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir | Year: 2016

The purpose of this study was to identify patient characteristics and statin discontinuation-related factors in patients with hypercholesterolemia.A total of 532 patients (age meanSD: 57.411.5 years; 52.4% women, 47.6% men) with hypercholesterolemia and statin discontinuation were included in this national cross-sectional non-interventional observational study. Data on socio-demographic characteristics of patients, cardiovascular risk factors, past treatment with and discontinuation of statin treatment were collected in one visit.MeanSD duration of hypercholesterolemia was 4.94.2 years at time of discontinuation of statin treatment. Statin treatment was initiated by cardiologists in the majority of cases (55.8%), whereas discontinuation of statin treatment was decided by patients in the majority of cases (73.7%), with patients with higher (at least secondary education, 80.4%) more likely than those with lower (only primary education, 69.7%) to decide to discontinue treatment (p=0.022). Negative information about statin treatment disseminated by TV programs-mostly regarding coverage of hepatic (38.0%), renal (33.8%), and muscular (32.9%) side effects (32.9%)-was the most common reason for treatment discontinuation.The decision to discontinue statin treatment was made at the patients discretion in 74% of cases, with higher likelihood of patients with higher educational status deciding to discontinue treatment and switch to non-drug lipid-lowering alternatives. Cardiologists were the physicians most frequently responsible for the initiation of the statin treatment; coverage of several non-life-threatening statin side effects by TV programs and patients lack of information regarding high cholesterol and related risks were the leading factors predisposing to treatment discontinuation.


PubMed | Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital and Istanbul Science University
Type: Journal Article | Journal: Turkish journal of medical sciences | Year: 2016

Tracheobronchomalacia (TBM) leads to the obstruction of expiratory airflow and interference with secretion clearance. Stabilization of the airway wall using a silicon stent or laser coagulation of the posterior wall may be treatment options.This study aimed to retrospectively analyze which interventional bronchoscopic method could be used to provide airway stabilization and gain control of symptoms and for whom this method could be used.Fifteen patients who had received treatment in our interventional pulmonology unit were analyzed. We analyzed the techniques used, stent duration, complications, and long-term treatment success retrospectively.Stents were used in 10 patients: 4 patients had silicon Y-stents and 4 patients had silicon tracheal stents. Stents were removed due to early migration in 3 patients. In 5 of the 7cases, the stent was removed due to frequent obstructions of the stent due to recurrent severe mucostasis. A suitable stent was not found for one patient who had an extremely enlarged trachea. Good clinical results were achieved in just two cases. The frequency of admissions to the emergency room and hospitalizations were diminished during the follow-up time in these two patients.Silicon stents may be a good treatment option in selected patients with TBM and dynamic collapse. However, our patients were high-risk; thus, the criteria for candidates for bronchoscopic treatment should be carefully defined.


PubMed | Afyon Kocatepe University, Konya Training and Research Hospital and Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital
Type: Journal Article | Journal: The clinical respiratory journal | Year: 2016

Some treatment modalities may cause losses in patients life comfort because of the treatment process. Our aim is to determine the effects of thoracic surgery operations on patients quality of life.This is a multicenter and prospective study. A hundred patients, who had undergone posterolateral thoracotomy (PLT) and/or lateral thoracotomy (LT), were included in the study. A quality of life questionnaire (SF-36) was used to determine the changes in life comfort. SF-36 was performed before the operation, on the first month, third month, sixth month and twelfth month after the operation.Seventy-two percent (n=72) of the patients were male. PLT was performed in 66% (n=66) of the patients, and LT was performed in 34% (n=34) of the patients. The types of resections in patients were pneumonectomy in four patients, lobectomy in 59 patients and wedge resection in 11 patients. No resection was performed in 26 patients. Thoracotomy caused deteriorations in physical function (PF), physical role (RP), bodily pain (BP), health, vitality and social function scores. The deteriorations observed in the third month improved in the sixth and twelfth months. The PF, RP, BP and MH scores of the patients with lung resection were much more worsened compared with the patients who did not undergo lung resection.Thoracic surgery operations caused substantial dissatisfaction in life comfort especially in the third month postoperatively. The worsening in physical function, physical role, pain and mental health is much more in patients with resection compared with the patients who did not undergo resection.


Objective: The aim of this study is to investigate which risk factors are more determinative in anaesthesia risks of patients who have been requested Chest diseases consultations. Method: The notes taken during the preoperative anaesthesia visits of 60 patients who were previously diagnosed with pulmonaiy disease and for whom chest diseases consultations are requested due to productive cough and phlegm compliant and detected pathology in their PA chest X-rays were reviewed retrospectively, and were examined in terms of the most influencing risk factors. Results: No statistically significant effect of age, gender, duration of surgery, smoking history, wheezing, breath shortness, biomass exposure and associated disease history was seen on the risk of anesthesia (p>0.05). Parameters statistically increasing the probability of high risk such as cough, phlegm, pathology in PA chest X-ray and physical examination, platelet level, FEV1 level being less than 70%, FEV1IFVC being less than 65% and peripheral oxygen saturation measurements were added to the regression model as risk factors. It was observed that according to the forward looking stepwise elimination method, the most determinative risk factor in the estimation of the preoperative pulmonary risk was observed to be FEV1 level being lower than 70%; which was followed by the complaints of cough as the second most determinative risk factor. Conclusion: It is concluded that spirometric tests have been prioritised over other risk factors in determining the preoperative pulmonaiy risks.


Sahin F.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital | Yildiz P.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital
Clinical and Investigative Medicine | Year: 2012

Purpose: CA-125 is a high molecular weight mucin-like glycoprotein and an ovarian cancer antigen. Elevated CA-125 levels are also seen with various other benign and malignant conditions. In this study, the ability of CA-125 to predict pulmonary tuberculosis activity was investigated. Methods: This analytical study included 42 cases with active tuberculosis (Group 1), 35 cases with inactive tuberculosis (Group 2) and 20 healthy subjects (Group 3). CA-125 measurements were taken in all three groups. Measurements in Group 1 were repeated after completing a two month antituberculosis treatment in 38 of the 42 patients. Results: Mean serum CA-125 level for Group 1 was 76.48±24.71 U/mL, which was significantly higher than levels in Group 2 (20.01±7.89 U/mL) and Group 3 (18.32±2.87 U/mL) (p<0.001).. Of the 38 patients in Group 1 who were studied both pre- and posttreatment, CA-125 levels decreased significantly: from 78.88±24.72 U/mL before treatment to 22.78±8.02 U/mL after treatment (p< 0.001). There was no statistically significant difference between the post-treatment values of Group 1 and either Group 2 and Group 3 values (p>0.05). Group 2 and Group 3 levels were not significantly different (p>0.05). The cut-off level for accurate determination of activity was 36.35 U/mL. The sensitivity at this level was 97.6% and specificity was 100%. Conclusion: Our findings suggest that CA-125 can be a beneficial parameter in determination of pulmonary tuberculosis activity and the evaluation of response to treatment. © 2012 CIM.


Sahin F.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital | Yazar E.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital | Yildiz P.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital
Multidisciplinary Respiratory Medicine | Year: 2012

Background: We aimed to investigate the relation of platelet count (PLT) and plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) with other acute phase reactants and radiological extent in pulmonary tuberculosis (PTB). Methods: One hundred patients with PTB (Group 1), 50 patients with community-acquired pneumonia (Group 2) and 28 healthy control individuals (Group 3) were included in this analytic study. Results: WBC (White Blood Cell), ESR (Eritrocyte Sedimentation Rate), CRP (C-Reactive Protein), PLT and PCT values were both in Group 1 and Group 2 than in Group 3. PDW values were significantly higher in Group 1 than Group 3. WBC, ESR and CRP values were lower, while PLT and PCT values were higher in the Group 1 compared to Group 2 (p < 0.001). PLT was positively correlated with CRP and ESR values in the tuberculosis group (p < 0.001), while it was not correlated with CRP and ESR in the pneumonia group (p > 0.05). ESR, CRP, PLT and PCT values were found higher in radiological advanced stage (Stage 3) patients with PTB, while hemoglobin (Hb) was found lower (p < 0.05). Higher WBC, ESR, CRP and PCT values as well as radiological advanced stage were more common in PTB patients with thrombocytosis compared to the patients with normal platelet count, whereas Hb was found lower in these patients. Conclusions: This study indicates that reactive thrombocytosis and higher PCT and PDW develop frequently in PTB and there is a relation between thrombocytosis and acute phase reactants, that is the inflammatory response. In addition, tuberculosis with radiological advanced stage is seen more frequently in the patients with thrombocytosis and higher PCT, drawing attention to the possible role of platelets in the cell-based immune process of tuberculosis. © 2012 Şahin et al. licensee BioMed Central Ltd.


Sokucu S.N.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital | Karasulu L.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital | Dalar L.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital | Seyhan E.C.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital | Altin S.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital
Journal of Clinical Sleep Medicine | Year: 2012

Study Objectives: Red blood cell distribution width (RDW) is a newly recognized risk marker for various diseases. We evaluated the value of RDW in predicting the severity of obstructive sleep apnea syndrome (OSAS). Methods: From retrospective analyses of 526 patients admitted to our sleep laboratory for polysomnography between January 2010 and July 2011, 108 patients with complete medical records and hemogram analyses were evaluated. Results: The study population consisted of 108 patients (age: 49.16 ± 11.1 [range 16-76] years; 72 [66.7%] males). In the overall population, the mean RDW was 14.04 (± 2.37), and 31 patients (28.7%) had RDW > 15. RDW increased signifi cantly with increased severity of OSAS (p = 0.046) and was positively correlated with the apnea-hypopnea index (p = 0.002, r = 0.300), even in the non-anemic group (p = 0.013, r = 0.291). The apnea-hypopnea index was signifi cantly higher in the group with high RDW (> 15; p = 0.046). RDW was negatively correlated with sleep time (p = 0.028, r = 0.217), average oxygen saturation of hemoglobin (p = 0.003, r = -0.239), and minimum desaturation value (p = 0.016, r = -0.235). Conclusions: In patients referred with a clinical diagnosis of OSAS, RDW may be a marker for the severity of the condition. As RDW is usually included in a complete blood count, it could provide an inexpensive tool for triaging OSAS patients for polysomnography evaluation.


Sahin F.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital | Yildiz P.,Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital
Archives of Medical Science | Year: 2013

Introduction: We aimed to investigate the relationship between radiological extent and serum biochemical changes and body mass index (BMI) in patients with pulmonary tuberculosis (PTB) and pneumonia and to determine the usefulness of C-reactive protein (CRP) in clinical discriminative diagnosis. Material and methods: One hundred fifteen patients with tuberculosis (group 1), 70 patients with pneumonia (group 2) and 30 healthy controls (group 3) were included in this case-control study. Results: Total cholesterol (TC, p < 0.001 in group 1; p = 0.011 in group 2), highdensity lipoprotein (HDL, p < 0.001), albumin (ALB, p < 0.001) and BMI (p < 0.001) values were significantly lower group 1 and group 2 than group 3. Erythrocyte sedimentation rate (ESR), leucocyte (LEU) and CRP were higher in group 2 than group 1 and group 3 (p < 0.001). As important point; triglyceride (TG) and BMI were significantly lower in group 1 than group 2 (p < 0.001). In group 1; BMI, HDL, TG, total protein (TP) and albumin were found to decrease, while CRP and ESR increased as the radiological stage increased (p < 0.05). But no significant difference was found in levels of TC and LDL (p > 0.05). In group 2; BMI, TC, HDL, LDL, TP and ALB were observed to decrease, while LEU, CRP and ESR increased as the radiological stage increased (p < 0.05). But no significant difference was found in levels of TG (p > 0.05). The best serum CRP cut-off value in differential diagnosis of tuberculosis and pneumonia was defined as 9.4. Conclusions: The acute phase response occurring in tuberculosis and pneumonia determines the severity of the disease, leads to a decrease of serum levels of lipoproteins and BMI, and is correlated with the radiological extent. The CRP and ESR were found to be useful in differential diagnosis of tuberculosis and pneumonia. Copyright © 2013 Termedia & Banach.


PubMed | Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital
Type: | Journal: International journal of chronic obstructive pulmonary disease | Year: 2016

To compare the bronchodilator efficacy of 18 g once-daily tiotropium inhalation administered via DiscairFifty-eight patients with moderate-to-severe COPD were enrolled in this randomized, active-controlled, parallel-group, open-label, Phase IV non-inferiority trial. Patients were randomly assigned to a test group (n=29, inhalation with Discair) or a reference group (n=29, inhalation with HandiHaler). The primary efficacy parameter was the average maximum change in forced expiratory volume in 1 second (FEVThe test inhaler was non-inferior to the reference inhaler in terms of maximum change in FEVOur findings show that the Discair was non-inferior to the HandiHaler. More specifically, these devices had similar clinical efficacy in terms of time-dependent response over 24 h for patients with moderate-to-severe COPD.


PubMed | Istanbul University, Koç University and Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital
Type: | Journal: The clinical respiratory journal | Year: 2017

Recent articles revealed that an increased main pulmonary artery to ascending aorta ratio (PA/A) in thorax computed tomography (CT) correlated with pulmonary hypertension, and might be linked to a high probability of chronic obstructive pulmonary disease (COPD) exacerbations.In this study, our aim was to evaluate the clinical importance of PA/A in patients with exacerbations of COPD and investigate its relationship with the number of exacerbations in one year or short/long-term mortality after hospital discharge.One hundred fifty-six patients hospitalized for COPD exacerbations who fulfilled our inclusion criteria were enrolled in the study. We recorded the number of exacerbations in one year from hospital records, checked mortality status, and calculated the PA/A ratio from thorax CT images.PA/A ratio positively correlated with the number of hospitalizations for COPD exacerbations and the total number of exacerbations (hospitalized or not) in one year, and baseline PaCOOur study showed that PA/A was related with the number of hospitalizations and the total number of exacerbations due to COPD in one year. However, there was no relationship between PA/A and mortality. This article is protected by copyright. All rights reserved.

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