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Öğe Acinetobacter pneumonia: Is the outcome different from the pneumonias caused by other agents(Wolters Kluwer Medknow Publications, 2010) Edis, Ebru Cakir; Hatipoglu, Osman N.; Tansel, Ozlem; Sut, NecdetBackground : The principal aim of the present study was to determine whether Acinetobacter spp. pneumonia differs from hospital-acquired pneumonias (HAPs) caused by other agents with respect to therapeutic success and survival rate. METHODS : This study includes 140 adult patients diagnosed with HAPs caused by identified etiologic agents between March 2005 and February 2006. These patients were divided into two groups according to the agent responsible for their infection (Acinetobacter spp. [n = 63] or non-Acinetobacter spp. [n = 77]). The groups were compared in terms of risk factors, therapeutic success and six-week survival rates. Results : Previous antibiotic use and the risk of aspiration were independent factors responsible for the development of Acinetobacter spp. pneumonia. Hypoalbuminemia, steroid use and the use of a mechanical ventilator were determined to be mortality-associated independent risk factors for Acinetobacter spp. pneumonia. The clinical success rate at the end of therapy was 41.6 and, at the sixth week, the survival rate was 35 among patients in whom Acinetobacter spp. was the causative agent. Conversely, in the control group, these values were 43 and 32, respectively ( P > 0.05). We found that the use of the appropriate antibiotics for the treatment of Acinetobacter spp. pneumonia was an important factor in survival ( P < 0.001). Conclusion : The outcomes of Acinetobacter spp. pneumonia do not differ from HAPs associated with non-Acinetobacter spp. in terms of therapeutic success and survival rates.Öğe ASSESSMENT OF QUALITY OF LIFE IN PATIENTS WITH LUNGCANCER TREATED WITH CISPLATINUM-BASED CHEMOTERAPY: A PROSPECTIVE COHORT STUDY(Lippincott Williams & Wilkins, 2012) Ozdemir, Burcu; Hatipoglu, Osman N.[Abstract Not Available]Öğe A case of septic emboli secondary to osteomyelitis(Aves, 2006) Ozlen, Burcu; Cikmaz, Tuba; Ozdemir, Levent; Hatipoglu, Osman N.A 58 year-old woman was admitted to our emergency department with dyspnea, swelling and increased temperature of left leg. Since bilateral peripheral disseminated infiltrates on chest X-ray and severe hypoxemia in arterial blood gas were found, she was hospitalized with initial diagnosis of sepsis, Adult Respiratory Distress Syndrome, pulmonary embolism and vasculitis. Computed tomography revealed peripheral cavitary nodules in pulmonary paranchyme. Osteomyelitis was established in bone scan. Based on these findings the diagnosis was septic embolism secondary to osteomyelitis. Clinical and radiographic parameters were improved by empirical antibiotic therapy, noninvasive mechanical ventilation and other supportive care. Bilateral and peripheral infiltrates on chest x-ray; sub-pleural cavitary nodules on computed tomography and the presence of an extrapulmonary infection focus are significant clues that pneumonia may occur via hematogenous spread.Öğe Effectiveness of Thoracic Ultrasonography in the Evaluation of the Severity of Pulmonary Involvement in Patients With Systemic Sclerosis(Turkish League Against Rheumatism, 2016) Cakir Edis, Ebru; Hatipoglu, Osman N.; Pamuk, Omer N.; Mutlucan Eraslan, Renginar; Aktoz, Meryem; Tuncel, Sedat AlpaslanObjectives: This study aims to investigate the effectiveness of thoracic ultrasonography (USG) in a single session in the evaluation of the severity of pulmonary involvement in systemic sclerosis. Patients and methods: A total of 48 consecutive systemic sclerosis patients (2 males, 46 females; mean age 50.8 +/- 11.9 years; range 21 to 76 years) followed-up in our center were included. A thoracic USG using a linear probe was performed for each patient to evaluate the parenchymal involvement by two pulmonary disease specialists. The number of B-lines (B-lines described USG sign of interstitial lung fibrosis) was recorded. Systolic pulmonary artery pressure was measured by means of using a phase probe to evaluate pulmonary hypertension in the same sequence. The same day, pulmonary function tests were conducted. Warrick score was calculated according high resolution computed tomography (HRCT) images which were evaluated independently from each other by a radiologist and a pulmonary disease specialist. Medsger severity scale was calculated for each patient according to the results of HRCT findings, pulmonary function test, and systolic pulmonary artery pressure. Results: The number of B-lines detected on thoracic USG was correlated with the Warrick score (r=0.89; p=0.0001) and Medsger disease scale (r=0.55; p=0.0001) and negatively correlated with diffusing capacity of carbon monoxide (r=-0.56; p=0.0001) and forced vital capacity (r=-0.46; p=0.001). When HRCT was accepted as the gold standard; the sensitivity, specificity, positive predicted value, and negative predicted value for thoracic USG were 100%, 84.2%, 90.6%, and 100%, respectively. If thoracic USG was used instead of HRCT for the evaluation of Medsger scale, the results changed in only one of the 48 patients. Conclusion: Thoracic USG showed good correlation with HRCT findings for the evaluation of pulmonary parenchymal involvement in systemic sclerosis. Therefore, USG might be a noninvasive and useful tool for the long-term follow-up of systemic sclerosis patients after initial examination with USG and HRCT.Öğe Hospital-Acquired Pneumonia Developed in Non-Intensive Care Units(Karger, 2009) Edis, Ebru Cakir; Hatipoglu, Osman N.; Yilmam, Ilker; Eker, Alper; Tansel, Ozlem; Sut, NecdetBackground: There are few studies about hospital-acquired pneumonia (HAP) developing in non-intensive care units (non-ICUs). Objectives: The aim of this study was to determine the incidence rate of non-ICU HAP, the risk factors associated with mortality and the survival rates of HAP patients at 6 weeks and 1 year. Patients and Methods: Between March 2005 and February 2006, 154 adult patients (97 males) with HAP were prospectively evaluated. Immunocompromised patients who were developing pneumonia were excluded from the study. The HAP incidence was calculated and survival was noted at 6 weeks and 1 year later. Kaplan-Meier methods were used for survival analysis; Cox regression was used to identify the risk factors associated with HAP-induced mortality. Results: During the study, and not counting those in the ICU, 45,679 adult patients were hospitalized. Of these, 154 patients developed HAP (incidence 3.3 cases/1,000 patients). The mean age of those developing HAP was 64.53 +/- 14.92 years (range 15-98). Survival rates at the 3rd, 7th, 14th, 42nd and 365th day were 91, 89, 69, 49 and 29%, respectively. Independent risk factors associated with 6-week mortality were: age [relative risk (RR) 1.026; 95% confidence interval (CI) 1.008-1.045], chronic renal failure RR 1.8; 95% CI 1.087-3.086), aspiration risk (RR 2.86; 95% CI 1.249-6.564), steroid use (RR 2.35; 95% CI 1.306-4.257), and multilobar infiltration (RR 2.1; 95% CI 1.102-4.113). Conclusion: HAP - even if it develops in non-ICU environments-is hard to treat and has a higher mortality rate. Copyright (C) 2009 S. Karger AG, BaselÖğe The Influence of the Turkish Anti-Tobacco Law on Primary School Children in Edirne(Galenos Publ House, 2011) Tabakoglu, Erhan; Caglar, Tuncay; Hatipoglu, Osman N.; Altiay, Gundeniz; Edis, Ebru Cakir; Sut, NecdetObjective: The Turkish anti-tobacco law was accepted and effectuated in 1996. All forms of cigarette advertising, the sale of tobacco products to persons under the age of 18 and smoking in public institutions were all restricted. In this paper, we aimed to evaluate the influence of the Turkish anti-tobacco law on children for the periods before the law, after three years and after 10 years. Material and Methods: A self-completed questionnaire was distributed among primary school children. This included questions about the children's smoking habits, their opinions of parents' and teachers' smoking habits, tobacco use in public places and the recognition rate of 16 food, drink, cigarette and toothpaste logos and brand names, The first, second and third applications of the questionnaire were performed with students who attended the same classes in the same primary schools, accounting for 772 children in June 1996, 1,157 children in February 1999 and 719 children in June 2006. Results: When these three periods were evaluated, it could be seen that the prevalence of having smoked significantly decreased (13.9%, 4%, 2.2%, p<0.001), as did the rate of purchasing cigarettes within the past week (36.6%, 29.1%, 15.8%, p<0.001). The disagreement with parents' and teachers' smoking habits and tobacco usage in public places increased significantly (p<0.001), while the recognition rates of some cigarette brand names and logos significantly decreased, specifically with regards to Marlboro, Camel and Samsun (p<0.001). Conclusion: The Turkish anti-tobacco law has had a positive effect on primary school children in Edirne, and therefore could be a model for other countries.Öğe A new clinical model in pulmonary embolism and its correlation with V/P scan results(Sage Publications Inc, 2006) Hatipoglu, Osman N.; Hanci, Emel; Tabakoglu, Erhan; Altiay, Gundeniz; Cermik, Tevfik Fikret; Caglar, TuncayThe study was prospectively designed to assess the correlation between a new clinical model empirically developed for acute pulmonary embolism (PE) and ventilation/perfusion (V/P) scan results. One hundred sixty consecutive patients with suspected acute PE underwent clinical evaluation before V/P scintigraphy. The clinical probability of PE was categorized according to a structured clinical model empirically developed as low, intermediate, or high, and the results were compared with those of V/P scintigraphy. Forty, 61, and 59 patients were classified as low, intermediate, and high clinical probability, respectively. Seventy-five percent (30/40) of the patients with low clinical probability were also of low scintigraphic probability or had a normal result (r(s): 0.39, p=0.000); 28% (17/61) of the patients with intermediate clinical probability demonstrated intermediate scintigraphic probability (r(s): 0.20, p=0.012); and 68% (40/59) of the patients with high clinical probability were also of high scintigraphic probability (r(s): 0.43, p=0.000). Overall, the correlation of two scoring systems was statistically significant (r(s): 0.39, p=0.000). Unilateral leg swelling (p=0.027), syncope or near syncope (p=0.002), amputation of a hilar artery (p=0.007), and electrocardiographic signs of right ventricular overload (p=0.000) prevailed in patients with high scintigraphic probability. Syncope-near syncope or hemodynamic collapse PLUS electrocardiographic signs of right ventricular overload or hypoxemia combination had the most significant correlation with a high scintigraphic probability (r(s): 0.31; p=0.000). In conclusion, the new clinical model empirically developed was significantly successful to provide comparable results with V/P scan. This consistency was particularly prominent in patients with low or high clinical probability for PE.Öğe Pulmonary involvement in brucellosis(Aves Yayincilik, Ibrahim Kara, 2007) Batmaz, Emrah; Edis, Ebru Cakir; Ciftci, Abdullah; Akkoyun, Sevin; Hatipoglu, Osman N.; Genchallac, HakanBrucellosis is a zoonotic disease caused by a Gramnegative bacillus of the Brucella gender. Involvement is multisystemic primarily affecting the reticuloendothelial system, joints,heart, and kidneys. Although the disease can be spread by inhalation, pulmonary involvement is rare. A 72-year-old female patient presented with complaints of chest pain and shortness of breath. She was admitted with a preliminary diagnosis of pneumonia. She did not respond to antibiotic therapy. Computed tomography performed for the differential diagnosis of pulmonary embolism showed no evidence for thrombus, but ground glass opacities in the lingular segment of the left lung, the right middle lobe, and bilateral lower lobes. Specific antibiotic therapy Was started upon detection of Brucella spp. by hemoculture. The patient's pain disappeared and no sign of venous thromboembolism was observed.Öğe Skin prick test results in patients from Thrace region presenting with pulmonary symptoms(Aves Yayincilik, Ibrahim Kara, 2007) Edis, Ebru Cakir; Tabakoglu, Erhan; Caglar, Tuncay; Hatipoglu, Osman N.; Altiay, GuendenizObjectives: The aim of the study was to determine the profile of allergen sensitization in patients presenting with pulmonary symptoms. Patients and Methods: Skin test results of 196 patients (136 females, 60 males; mean age 34.7 +/- 11.7 years) presenting with pulmonary complaints between October 1999 and April 2005; total IgE results and allergy information forms were analyzed retrospectively. Results: Median value of IgE was (%25-75) 202 U/ml (118-530) in the patients enrolled. The most frequent symptom was shortness of breath (65.3%), and the second was cough (63.8%). These symptoms aggravated while patients were dusting. Sensitivity to at least one allergen was observed in 59.7% of the patients. Sensitivity to a single allergen was present in 18.9% and to multiple allergens in 40.8% of all patients. The most frequent allergy was determined to house dust mite (39.8%) and was followed by allergy to tree pollens (26%). Sensitivity rate to D. Farinea was 33.7% and 32.7% to D. Pteronyssinus. Conclusion: House dust mite were the primary causes of sensitization in patients presenting with allergic symptoms in the Thrace region. The fact that the symptoms aggravated in 46.9% of the patients while they were dusting at home, seemed to support this finding.
