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Öğe Antimicrobial Susceptibility and Clonal Relation Between Acinetobacter baumannii Strains at a Tertiary Care Center in Turkey(Ahvaz Jundishapur Univ Med Sci, 2015) Ece, Gulfem; Erac, Bayri; Cetin, Hasan Yurday; Ece, Cem; Baysak, AysegulBackground: Acinetobacter baumannii is an opportunistic pathogen, related with nosocomial infections such as bacteremia, urinary tract infections, and ventilator-associated pneumonia. Multidrug resistant (MDR) A. baumannii strains are first line causes of infection, especially in patients hospitalized at intensive care units (ICUs). Infection with MDR A. baumannii strains has a longer duration at ICUs and hospitals. There are studies using molecular methods which can differentiate MDR A. baumannii strains at the clonal level. This helps controlling these resistant strains and prevents their epidemy. Objectives: The aim of our study was to investigate the antimicrobial susceptibility and clonal relationship between the A. baumannii strains isolated from our ICU. Materials and Methods: The identification and antimicrobial susceptibility of 33 A. baumannii strains were performed by automatized Vitek version 2.0. The clonal relationship among A. baumannii strains was analyzed using enterobacterial repetitive intergenic consensus (ERIC) polymerase chain reaction (PCR). Results: A total of 33 A. baumannii strains were included in this study. A. baumannii complex strains were classified into seven clusters based on the fingerprint results. Our results revealed that two main clusters were responsible for the prevalence of A. baumannii complex strains at the ICU. Conclusions: MDR A. baumannii strains cause an increment in morbidity and mortality, particularly in ICUs. The use of molecular epidemiological methods can help us with the detection of the pathogen and preventing from spreading of these resistant strains.Öğe Clinical Characteristics of Patients with Bronchioloalveolar Carcinoma: A Retrospective Study of 44 Cases(Asian Pacific Organization Cancer Prevention, 2013) Dirican, Nigar; Baysak, Aysegul; Cok, Gursel; Goksel, Tuncay; Aysan, TulinBackground: Bronchioloalveolar carcinoma (BAC) is considered a subtype of adenocarcinoma of the lung. Recently BAC has been variously termed adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic predominant invasive adenocarcinoma, and invasive mucinous adenocarcinoma. The aim of the study was to analyze and detect prognostic factors of patients with BAC over a 7-year period. Materials and Methods: This retrospective single-center study included 44 patients with BAC. The impact on survival of fifteen variables (gender, age, smoking status, cough, dyspnea, hemoptysis, fever, chest pain, sputum, metastasis number, Karnofsky performance status, pT, pN, TNM stage, cytotoxic chemoterapy) were assessed. Results: Median age was 55 years (38-83). Most patients were male (63.6%) and stage IV (59.1%). Twenty-one patients (47.7%) received cytotoxic chemotherapy (platinum-based regimens) for metastatic disease. Objective response rate was 33.3% (4 partial, 3 complete responses). Stable disease was observed in nine in patients (42.8%). Disease progression was noted in 5 (23.8%). The median OS for all patients was 12 months (95% CI, 2.08-22.9 months). Independent predictors for overall survival were: Karnofsky performance status (HR:3.30, p 0.009), pN (HR:3.81, p 0.018), TNM stage (HR:6.49, p 0.012) and hemoptysis (HR:2.31, p 0.046). Conclusions: Karnofsky performance status, pN, TNM stage and hemoptysis appear to have significant impact on predicting patient survival in cases of BAC.Öğe Clinical Characteristics of Patients with Bronchioloalveolar Carcinoma: A Retrospective Study of 44 Cases(Asian Pacific Organization Cancer Prevention, 2013) Dirican, Nigar; Baysak, Aysegul; Cok, Gursel; Goksel, Tuncay; Aysan, TulinBackground: Bronchioloalveolar carcinoma (BAC) is considered a subtype of adenocarcinoma of the lung. Recently BAC has been variously termed adenocarcinoma in situ, minimally invasive adenocarcinoma, lepidic predominant invasive adenocarcinoma, and invasive mucinous adenocarcinoma. The aim of the study was to analyze and detect prognostic factors of patients with BAC over a 7-year period. Materials and Methods: This retrospective single-center study included 44 patients with BAC. The impact on survival of fifteen variables (gender, age, smoking status, cough, dyspnea, hemoptysis, fever, chest pain, sputum, metastasis number, Karnofsky performance status, pT, pN, TNM stage, cytotoxic chemoterapy) were assessed. Results: Median age was 55 years (38-83). Most patients were male (63.6%) and stage IV (59.1%). Twenty-one patients (47.7%) received cytotoxic chemotherapy (platinum-based regimens) for metastatic disease. Objective response rate was 33.3% (4 partial, 3 complete responses). Stable disease was observed in nine in patients (42.8%). Disease progression was noted in 5 (23.8%). The median OS for all patients was 12 months (95% CI, 2.08-22.9 months). Independent predictors for overall survival were: Karnofsky performance status (HR:3.30, p 0.009), pN (HR:3.81, p 0.018), TNM stage (HR:6.49, p 0.012) and hemoptysis (HR:2.31, p 0.046). Conclusions: Karnofsky performance status, pN, TNM stage and hemoptysis appear to have significant impact on predicting patient survival in cases of BAC.Öğe Diagnostic Yield of Bronchoscopy with C-Arm Scopy in Cases without Endobronchial Lesion(Derman Medical Publ, 2016) Emre, Julide Celdir; Baysak, Aysegul; Oz, Adnan Tolga; Cok, Gursel; Goksel, TuncayAim: Fiberoptic bronchoscopy (FOB) is widely used in the diagnosis and treatment of pulmonary diseases. FOB sensitivity is generally low in tumors localized in the outer third of the lung. Diagnosis of peripheral pulmonary lesions can be difficult; however, the use of computed tomography (CT)-, fluoroscopy- or ultrasonography (USG)-guided surgery increases the diagnostic rates. In this study we aimed to compare the diagnostic values of C-arm fluoroscopy-guided bronchoscopic lavage, brushing, and biopsy samples obtained in cases where radiological masses or parenchymal lesions were detected, but endobronchial pathology was not found. Material and Method: In this prospective observational study, bronchoscopy was performed to the patients who had a mass lesion or parenchymal infiltration on chest radiogram and who had no endobronchial lesion, the diagnostic results of the bronchoscopic lavage, brush and biopsy specimens have been compared where C-arm scopy guided the procedures. Results: 60 patients (45 male) with a mean age 61.5 +/- 9.6 were enrolled into the study. The lesions were mostly located in the right upper lobe. 45 patients had peripheral mass lesion, 17 patients had noduler lesion where consolidation or infiltration were present in 18 patients. The diagnostic yield of the bronchoscopic biopsy was 36%, brushing 20% and 21% for the bronchoscopic lavage. Overall diagnostic yield with all bronchoscopic methods was 45%. In lesions with a diameter of <3 cm, bronchoscopic brushing was significantly ineffective. There was not any severe complication due to these procedures. Discussion: The C-arm scopy guided bronchoscopic biopsy was much more valuable in the diagnosis of peripheral lesions.Öğe N-acetylcysteine in patients with COPD exacerbations associated with increased sputum(Springer Wien, 2015) Aytemur, Zeynep Ayfer; Baysak, Aysegul; Ozdemir, Ozer; Kose, Timur; Sayiner, AbdullahBackground N-acetylcysteine (NAC) has been shown not to alter the clinical outcome in chronic obstructive pulmonary disease (COPD) exacerbations. However, NAC may improve symptoms through its mucolytic effect in the subgroup of patients with increased sputum production. The aims of this study were to determine whether NAC improves symptoms and pulmonary function in patients with COPD exacerbation and increased sputum production. Methods This was a placebo-controlled study, where patients with severe COPD and increased sputum production, who were hospitalized for an exacerbation, were included. They were randomized to receive either NAC 200 mg tid or placebo in addition to the usual treatment. Results Forty-two patients were included and were equally distributed to NAC and placebo groups. The symptoms, namely, ease of sputum production and dyspnea at rest and on exertion significantly improved in both groups; but there was no difference in improvement between NAC and placebo groups (p = 0.96, 0.62, 0.31, respectively). Similarly, forced expiratory volume-one second (FEV1) and PaO2 levels improved significantly in NAC (964 +/- 599-1239 +/- 543 ml, p < 0.001, and 57.5 +/- 14.5-70.5 +/- 16.0 mmHg, p < 0.001, respectively) and placebo groups (981 +/- 514-1180 +/- 535 ml, p < 0.001 and 57.9 +/- 14.3-68.7 +/- 19.0 mmHg, p < 0.001, respectively), without any difference between the two groups (p = 0.52 and 0.57). There was no difference in the number of exacerbations during the 6-month follow-up period. Conclusion NAC does not have any beneficial effect on clinical outcomes in patients with severe COPD exacerbation associated with increased and/or viscous mucus production.Öğe N-acetylcysteine in patients with COPD exacerbations associated with increased sputum(Springer Wien, 2015) Aytemur, Zeynep Ayfer; Baysak, Aysegul; Ozdemir, Ozer; Kose, Timur; Sayiner, AbdullahBackground N-acetylcysteine (NAC) has been shown not to alter the clinical outcome in chronic obstructive pulmonary disease (COPD) exacerbations. However, NAC may improve symptoms through its mucolytic effect in the subgroup of patients with increased sputum production. The aims of this study were to determine whether NAC improves symptoms and pulmonary function in patients with COPD exacerbation and increased sputum production. Methods This was a placebo-controlled study, where patients with severe COPD and increased sputum production, who were hospitalized for an exacerbation, were included. They were randomized to receive either NAC 200 mg tid or placebo in addition to the usual treatment. Results Forty-two patients were included and were equally distributed to NAC and placebo groups. The symptoms, namely, ease of sputum production and dyspnea at rest and on exertion significantly improved in both groups; but there was no difference in improvement between NAC and placebo groups (p = 0.96, 0.62, 0.31, respectively). Similarly, forced expiratory volume-one second (FEV1) and PaO2 levels improved significantly in NAC (964 +/- 599-1239 +/- 543 ml, p < 0.001, and 57.5 +/- 14.5-70.5 +/- 16.0 mmHg, p < 0.001, respectively) and placebo groups (981 +/- 514-1180 +/- 535 ml, p < 0.001 and 57.9 +/- 14.3-68.7 +/- 19.0 mmHg, p < 0.001, respectively), without any difference between the two groups (p = 0.52 and 0.57). There was no difference in the number of exacerbations during the 6-month follow-up period. Conclusion NAC does not have any beneficial effect on clinical outcomes in patients with severe COPD exacerbation associated with increased and/or viscous mucus production.Öğe N-acetylcysteine in patients with COPD exacerbations associated with increased sputum(Springer Wien, 2015) Aytemur, Zeynep Ayfer; Baysak, Aysegul; Ozdemir, Ozer; Kose, Timur; Sayiner, AbdullahBackground N-acetylcysteine (NAC) has been shown not to alter the clinical outcome in chronic obstructive pulmonary disease (COPD) exacerbations. However, NAC may improve symptoms through its mucolytic effect in the subgroup of patients with increased sputum production. The aims of this study were to determine whether NAC improves symptoms and pulmonary function in patients with COPD exacerbation and increased sputum production. Methods This was a placebo-controlled study, where patients with severe COPD and increased sputum production, who were hospitalized for an exacerbation, were included. They were randomized to receive either NAC 200 mg tid or placebo in addition to the usual treatment. Results Forty-two patients were included and were equally distributed to NAC and placebo groups. The symptoms, namely, ease of sputum production and dyspnea at rest and on exertion significantly improved in both groups; but there was no difference in improvement between NAC and placebo groups (p = 0.96, 0.62, 0.31, respectively). Similarly, forced expiratory volume-one second (FEV1) and PaO2 levels improved significantly in NAC (964 +/- 599-1239 +/- 543 ml, p < 0.001, and 57.5 +/- 14.5-70.5 +/- 16.0 mmHg, p < 0.001, respectively) and placebo groups (981 +/- 514-1180 +/- 535 ml, p < 0.001 and 57.9 +/- 14.3-68.7 +/- 19.0 mmHg, p < 0.001, respectively), without any difference between the two groups (p = 0.52 and 0.57). There was no difference in the number of exacerbations during the 6-month follow-up period. Conclusion NAC does not have any beneficial effect on clinical outcomes in patients with severe COPD exacerbation associated with increased and/or viscous mucus production.Öğe A rare tumor of the lung: Pulmonary sclerosing hemangioma (pneumocytoma)(W B Saunders Co Ltd, 2013) Baysak, Aysegul; Oz, Adnan Tolga; Mogulkoc, Nesrin; Bishop, Paul William; Ceylan, Kenan CanA 67-year-old woman was referred to our department for further evaluation of her abnormal, chest radiogram. Thorax computed tomography revealed a well-circumscribed, round mass in the middle lobe of the right lung. A thoracotomy was performed and pulmonary sclerosing hemangioma was diagnosed. We herein present a rare tumor of the lung. (C) 2012 Elsevier Ltd. All rights reserved.Öğe A rare tumor of the lung: Pulmonary sclerosing hemangioma (pneumocytoma)(W B Saunders Co Ltd, 2013) Baysak, Aysegul; Oz, Adnan Tolga; Mogulkoc, Nesrin; Bishop, Paul William; Ceylan, Kenan CanA 67-year-old woman was referred to our department for further evaluation of her abnormal, chest radiogram. Thorax computed tomography revealed a well-circumscribed, round mass in the middle lobe of the right lung. A thoracotomy was performed and pulmonary sclerosing hemangioma was diagnosed. We herein present a rare tumor of the lung. (C) 2012 Elsevier Ltd. All rights reserved.Öğe The role of toll like receptors on tuberculosis infection(European Respiratory Soc Journals Ltd, 2013) Biyikli, Oguz Oben; Baysak, Aysegul; Ece, Gulfem Terek; Oz, Adnan Tolga; Ozhan, Mustafa Hikmet; Berdeli, AfigÖğe Role of Toll-Like Receptors in Tuberculosis Infection(Ahvaz Jundishapur Univ Med Sci, 2016) Biyikli, Oguz Oben; Baysak, Aysegul; Ece, Gulfem; Oz, Adnan Tolga; Ozhan, Mustafa Hikmet; Berdeli, AfigBackground: One-third of the world's population is infected with Mycobacterium tuberculosis. Investigation of Toll-like receptors (TLRs) has revealed new information regarding the immunopathogenesis of this disease. Toll-like receptors can recognize various ligands with a lipoprotein structure in the bacilli. Toll-like receptor 2 and TLR-4 have been identified in association with tuberculosis infection. Objectives: The aim of our study was to investigate the relationship between TLR polymorphism and infection progress. Methods: Twenty-nine patients with a radiologically, microbiologically, and clinically proven active tuberculosis diagnosis were included in this 25-month study. Toll-like receptor 2 and TLR-4 polymorphisms and allele distributions were compared between these 29 patients and 100 healthy control subjects. Peripheral blood samples were taken from all patients. Genotyping of TLR-2, TLR-4, and macrophage migration inhibitory factor was performed. The extraction step was completed with a Qiagen mini blood purification system kit (Qiagen, Ontario, Canada) using a peripheral blood sample. The genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism. Results: In total, 19 of the 29 patients with tuberculosis infection had a TLR-2 polymorphism, and 20 of the 100 healthy subjects had a TLR-2 polymorphism (P < 0.001). The TLR-4 polymorphism and interferon-gamma allele distributions were not statistically correlated. Conclusions: Toll-like receptor 2 polymorphism is a risk factor for tuberculosis infection. The limiting factor in this study was the lack of investigation of the interferon-gamma and tumor necrosis factor-ff levels, which are important in the development of infection. Detection of lower levels of these cytokines in bronchoalveolar lavage specimens, especially among patients with TLR-2 defects, will provide new data that may support the results of this study.
