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Öğe Chlamydia pneumoniae arthritis in a patient with common variable immunodeficiency(Amer Coll Allergy Asthma Immunology, 2005) Ardeniz, O; Gulbahar, O; Mete, N; Cicek, C; Basoglu, OK; Sin, A; Kokuludag, ABackground: Arthritis is an important and sometimes life-threatening complication in patients with common variable immunodeficiency (CVID). Objective: To describe a patient with CVID and arthritis due to Chlamydia pneumoniae, which is usually regarded as a respiratory tract pathogen and has not previously been detected in the synovial fluid by cell culture technique. Methods: Routine bacteriologic, virologic, mycologic, and tuberculosis cultures were performed. The patient's synovial fluid was examined for fastidious organisms that might be causative pathogens of arthritis, such as chlamydiae, and special cell culture methods were used. Serologic tests were performed to determine viral and bacteriologic etiology. Results: The patient had a history of recurrent respiratory tract infections, and the latest exacerbation was followed by arthritis. Cytologic examination of the fluid yielded abundant lymphocytes. Chlamydia pneumoniae was detected in synovial fluid specimens by cell culture technique. Her nasopharyngeal swab and sputum culture specimens were also positive for this pathogen. She was diagnosed as having arthritis caused by C pneumoniae and was given antibiotherapy. Conclusion: Chlamydia pneumoniae should be kept in mind as a causative pathogen in patients with CVID and arthritis, especially when effusion fluid is full of lymphocytes rather than polymorphonuclear cells and no organism is grown on routine cultures.Öğe Conventional and diffusion-weighted MR imaging of intracranial tuberculomas(Blackwell Munksgaard, 2002) Basoglu, OK; Savas, R; Kitis, OIntracranial tuberculoma is a rare form of central nervous system tuberculosis. We here report on conventional and diffusion-weighted cranial MR images of a non-immunocompromised patient with multiple intracranial tuberculomas, tuberculous lymphadenitis and pulmonary tuberculosis. Conventional MR imaging revealed multiple ring-enhancing mass lesions. At follow-up MR, appearances of both edema and number and size of nodules were decreased. Diffusion-weighted MR was normal and normal ADC values were found in this case of tuberculomas.Öğe The efficacy of incentive spirometry in patients with COPD(Wiley, 2005) Basoglu, OK; Atasever, A; Bacakoglu, FObjective: Although incentive spirometry (IS) is frequently used to prevent postoperative pulmonary complications, its efficacy in patients with COPD has not been documented. The aim of this study was to evaluate the effects of IS on pulmonary function tests, arterial blood gases, dyspnoea and health-related quality of life in patients hospitalized for COPD. Methodology: A total of 27 consecutive patients (mean age, 68.4 +/- 7.9 years; 26 males) admitted for COPD exacerbations were recruited for the study. In total, 15 (IS treatment group) used IS for 2 months, together with medical treatment. The remaining 12 (medical treatment group) were given only medical treatment. Pulmonary function and blood gases were measured. Assessment of dyspnoea by visual analogue scale (VAS) and quality of life using the St. George's Respiratory Questionnaire (SGRQ) were performed at admission and after 2 months of treatment. Results: The activity, impact and total scores for the SGRQ improved (all P <= 0.0001), PaCO2 values decreased (P = 0.02), PaO2 and PAO(2) values increased (P = 0.02 and P = 0.01, respectively) in the IS treatment group. However, there were no significant differences between the measurements made pretreatment and after 2 months of medical therapy in the medical treatment group, with regards to pulmonary function, blood gases, SGRQ scores and VAS. Conclusion: The use of IS appears to improve arterial blood gases and health-related quality of life in patients with COPD exacerbations, although it does not alter pulmonary function parameters.Öğe Eosinophilic bronchitis as a cause of chronic cough(W B Saunders Co Ltd, 2003) Ayik, SO; Basoglu, OK; Erdinc, M; Bor, S; Veral, A; Bilgen, CEosinophilic bronchitis is a recently described condition inpatients with chronic cough, sputum eosinophilia, normal spirometry and no evidence of bronchial hype rreactivity. The aim of the study was to assess the causes of chronic cough and to identify the prevalence of eosinophilic bronchitis as a cause of chronic cough. Thirty-six patients [mean age 45.4 +/- 14.3 years (range 16-69 years), M/F 4/32] with an isolated chronic cough lasting for more than 4 weeks were recruited from the outpatient clinic. In all patients, after a full history and physical examination, blood eosinophil count, eosinophilic cationic protein (ECP), serum total and specific IgE levels were measured. Spirometry, methacholine provocation test, skin prick tests, ear, nose and throat examination, induction of sputum and esophageal pH testing were performed. The mean duration of cough was 31.3 +/- 52.3 months. Sputum eosinophilia greater than 3% was present in 12 (33.3%) patients and they were diagnosed as eosinophilic bronchitis. Their induced sputum had a mean eosinophil count of 8.3% and a mean ECP level of 98.5 mg. l(-1), which were higher than the others (P=0.003, both), The diagnosis of the remaining patients were postnasal drip syndrome in eight, gastroesophageal reflux disease in eight, post-infectious cough in two and cough-variant asthma in one patient. In conclusion, eosinophilic bronchitis is an important cause of chronic cough and should be considered in the assessment of patients before regarding them as having idiopathic chronic cough. (C) 2003 Elsevier Science Ltd. All rights reserved.Öğe Eosinophilic bronchitis as a cause of chronic cough(W B Saunders Co Ltd, 2003) Ayik, SO; Basoglu, OK; Erdinc, M; Bor, S; Veral, A; Bilgen, CEosinophilic bronchitis is a recently described condition inpatients with chronic cough, sputum eosinophilia, normal spirometry and no evidence of bronchial hype rreactivity. The aim of the study was to assess the causes of chronic cough and to identify the prevalence of eosinophilic bronchitis as a cause of chronic cough. Thirty-six patients [mean age 45.4 +/- 14.3 years (range 16-69 years), M/F 4/32] with an isolated chronic cough lasting for more than 4 weeks were recruited from the outpatient clinic. In all patients, after a full history and physical examination, blood eosinophil count, eosinophilic cationic protein (ECP), serum total and specific IgE levels were measured. Spirometry, methacholine provocation test, skin prick tests, ear, nose and throat examination, induction of sputum and esophageal pH testing were performed. The mean duration of cough was 31.3 +/- 52.3 months. Sputum eosinophilia greater than 3% was present in 12 (33.3%) patients and they were diagnosed as eosinophilic bronchitis. Their induced sputum had a mean eosinophil count of 8.3% and a mean ECP level of 98.5 mg. l(-1), which were higher than the others (P=0.003, both), The diagnosis of the remaining patients were postnasal drip syndrome in eight, gastroesophageal reflux disease in eight, post-infectious cough in two and cough-variant asthma in one patient. In conclusion, eosinophilic bronchitis is an important cause of chronic cough and should be considered in the assessment of patients before regarding them as having idiopathic chronic cough. (C) 2003 Elsevier Science Ltd. All rights reserved.Öğe Glaucoma associated with metered-dose bronchodilator therapy(W B Saunders Co Ltd, 2001) Basoglu, OK; Emre, S; Bacakoglu, F; Ates, HÖğe Pulmonary aspiration of a two-unit bridge during a deep sleep(Wiley, 2005) Basoglu, OK; Buduneli, N; Cagirici, U; Turhan, K; Aysan, TAspiration of teeth and dental restorations is a recognized, yet an infrequent happening in the literature. Main reasons of aspiration are maxillofacial trauma, dental treatment procedures or ethanol intoxication and dementia. The present case of a 2-unit bridge aspiration is however, not related with any trauma, dental procedure or systemic disease. A 37-year-old male patient had aspirated his bridge while sleeping and the bridge remained unidentified for 1 year despite the radiographic controls. He was then referred to the Chest Diseases Department of School of Medicine, Ege University and the radio-opaque object in the right intermediate bronchus was diagnosed to be an aspirated dental prosthesis. Subsequent to the failure of the rigid bronchoscopy, the patient was referred to the Thoracic Surgery Department and had to be operated for retrieval of the foreign body.Öğe Pulmonary tuberculosis in patients with diabetes mellitus(Karger, 2001) Bacakoglu, F; Basoglu, OK; Cok, G; Sayiner, A; Ates, MBackground. Diabetes mellitus has been reported to modify the presenting features of pulmonary tuberculosis, but there are varying data, particularly regarding the association with lower lung field involvement. Objectives: To determine whether diabetes mellitus alters the clinical and radiographic manifestations of tuberculosis in nonimmunocompromised hosts and to define the determinants of lower lung field involvement. Methods. A retrospective review of the records of all patients with tuberculosis and diabetes mellitus seen during a 14-year period and of an age- and sex-matched nondiabetic control group with tuberculosis was carried out. The duration of symptoms, tuberculin reaction, bacteriologic and radiographic findings of the two groups were compared. Results:The presence of diabetes mellitus was found not to have an effect on patients' symptomatology, bacteriology results, tuberculin reaction and localization of pulmonary infiltrates. On the other hand, fewer diabetic patients were smear-positive and fewer had reticulonodular opacities compared with the control patients. A higher number of insulin-dependent diabetic patients presented with cavitary disease as compared with nondiabetic controls. Lower lung field tuberculosis was significantly associated with female gender and, in patients older than 40 years, was more frequently observed in diabetics. Conclusion: These data show,that diabetes does not affect the presenting features of pulmonary tuberculosis to a large extent and is only associated with lower lung field disease in older patients. Copyright (C) 2001 S. Karger AG, Basel.Öğe Tuberculosis in renal transplant recipients on various immunosuppressive regimens(Oxford Univ Press, 2005) Atasever, A; Bacakoglu, F; Toz, H; Basoglu, OK; Duman, S; Basak, K; Guzelant, A; Sayiner, ABackground. Mycophenolate mofetil (MMF) and tacrolimus (TAC) are more potent than conventional immunosuppressive drugs, i.e. azathioprine, cyclosporin and prednisolone, and may be associated with an increase in the incidence of infections in the post-transplantation (post-tx) period. The aim of this study was to determine if the use of either or both of MMF and TAC for immunosuppression in renal transplant recipients increases the prevalence or modifies the clinical presentation of tuberculosis (TB), when compared with conventional therapy. Methods. The medical records of 443 adult patients who received a kidney transplant between 1994 and 2002 were reviewed retrospectively. Comparisons were made between patients who had conventional immunosuppressive treatments (cyclosporin, azathioprine and prednisolone) or an alternative regimen (including MMF, TAC or both). Results. We found 20 patients (4.5%) to have post-tx TB. There were 13 cases of TB (age 38.9 +/- 10.6 years) among 328 patients who received conventional immunosuppressants (group I) (4.0%) and seven cases (age 24.2 +/- 17.4 years) among 115 (6.1%) who received an alternative immunosuppressive regimen (group II) (P > 0.05). The patients in group II were younger than the patients in group I (P=0.002). A significantly higher number of patients in group II developed TB within the first 6 months post-tx (P=0.042). However, there was no significant difference between the two groups regarding clinical and radiographic presentations or outcomes. Conclusions. Immunosuppression with TAC or MMF is associated with the development of TB earlier in the post-tx period and in younger patients.
