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Öğe A Case of Massive Pulmonary Embolism Due to Diabetic Ketoacidosis and Hyperhomocysteinemia(Aves, 2014) Uzmezoglu, Bilge; Ozdemir, Levent; Hatipoglu, Osman Nuri; Ozdemir, Burcu; Edis, Ebru CakirA 57-year-old woman with no prior history was admitted to our emergency department with complaints of chest pain, dyspnea, xerostomia, syncope, and cyanosis on her lips and feet. On her physical examination, cyanosis, tachypnea, hypotension and sinus tachycardia were revealed. On the spiral computed tomography of the thorax of the patient with diabetic ketoacidosis, thrombus was detected in the left and right main pulmonary artery and segmental branches of the right pulmonary artery. The fibrinolytic treatment was initiated in the emergency department for the patient with hemodynamic shock due to the diagnosis of acute massive pulmonary embolism. Etiological examinations revealed B12 deficiency and hyperhomocysteinemia. This case, with the presentation of massive pulmonary embolism, resulted from the synergistic effect of hyperhomocysteinemia associated with B12 deficiency; hypovolemia caused by diabetic ketoacidosis was reported owing to its rareness.Öğe The Efficacy of Flutter® and Active Cycle of Breathing Techniques in Patients with Bronchiectasis: A Prospective, Randomized, Comparative Study(Bilimsel Tip Publishing House, 2018) Uzmezoglu, Bilge; Altiay, Gundeniz; Ozdemir, Levent; Tuna, Hakan; Sut, NecdetOBJECTIVES: The objective of the study was to compare the efficacy of an oscillating positive expiratory device and the active cycle of breathing techniques (ACBT) in patients with bronchiectasis. MATERIALS AND METHODS: A home-based study that lasted for 4 weeks was designed to compare the oscillating physiotherapy device Flutter (R) and the ACBT in 40 patients, who were randomly assigned into two groups containing 20 patients each. The effect of the two methods of physiotherapy on sputum production, pulmonary functions, and the quality of life was compared. RESULTS: The results of the present study indicate that both the methods were associated with a reduced number of patients complaining of cough and fatigue and increased sputum production (p=0.000, p=0.004, and p=0.002, respectively). In addition, statistically significant reductions were determined by the Medical Research Council and Borg Dyspnea scores (p=0.001 and 0.002, respectively). The Flutter (R) device caused a more significant effect on the perception of dyspnea. Overall, there was an improvement in the physical sub-scale of the Short Form (SF)-36 Quality of Life Questionnaire scores of 36 patients who completed the study (p=0.001). During the physiotherapy period, no changes in pulmonary functions were observed. Exacerbations were recorded in 3 patients in the ACBT group and in 1 patient in the Flutter (R) group. CONCLUSION: The Flutter (R) device and ACBT represent effective home-based physiotherapeutic methods. The Flutter (R) device appears to be more effective with regard to sputum production.Öğe Evaluating flutter device and the active cycle of breathing technique in non-cystic bronchiectasis: The prospective randomised study(European Respiratory Soc Journals Ltd, 2012) Altiay, Gundeniz; Uzmezoglu, Bilge; Sut, Necdet; Tuna, Hakan; Hatipoglu, Osman Nuri[Abstract Not Available]Öğe Successfull High PEEP Application in a Pregnant Woman with ARDS Diagnosed with H1N1 Virus Infection(Aves, 2010) Edis, Ebru Cakir; Hatipoglu, Osman Nuri; Celebi, Derya; Celik, Aygul Dogan; Uzmezoglu, Bilge; Altiay, GundenizA seven-month pregnant woman who admitted to the hospital with high fever, cough and fatigue and developed respiratory failure within one day, was admitted to the intensive care unit with the diagnosis of acute respiratory distress syndrome (ARDS) and suspected H1N1 infection. The patient, who had bilateral infi ltration on her chest X-ray, did not respond to the ventilator adjustments appropriate to ARDS, empirical Oseltamivir treatment. In spite of this treatment, her oxygenation became worse and she was treated by caesarean section. When the patient's saturation fell to 35%, 18 cmH2O pressure PEEP was implemented, then it was observed that her oxygenation began to show improvement. The patient's initial H1N1 diagnosis was confirmed. The patient's overall health returned to normal, while no serious health problem was observed in the baby. Since pregnant patients with H1N1 may develop serious respiratory failure within a very short time, we found this report significant because lung expansion may increase with section and this condition assists the treatment of using high PEEP pressures.
