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Öğe The approach to community-acquired pneumonia: A survey study(Turkish Respiratory Soc, 2018) Ozyurek, Berna Akinci; Erturk, Arzu; Aydemir, Yusuf; Sen, Nazan; Alizoroglu, Dursun; Ozhan, Mustafa HikmetINTRODUCTION AND AIM: Community-acquired pneumonia (CAP), which is often seen in daily practice, is a lower respiratory tract and pulmonary parenchyma infection which develops in society and daily life with community-acquired pathogens in individuals with no known immune failure. Delay in the treatment of pneumonia is known to increase morbidity and mortality. Various scoring systems are currently used in the identification of treatment groups in pneumonia. With the aim of evaluating the approach to CAP cases, the infection. MATERIALS AND METHODS: Working Group of the Turkish Respiratory Research Association (TUSAD) prepared a 22-item questionnaire. RESULTS: The survey was published on the TUSAD official website between July 2013 and June 2016. A total of 78 individuals responded to the questionnaire on the website. CONCLUSION: The responses to the questionnaire could indicate the way forward for new guidelines for physicians in respect of the approach to CAP.Öğe Clinical factors and comorbidities affecting the cost of hospital-treated COPD(Dove Medical Press Ltd, 2016) Deniz, Sami; Sengul, Aysun; Aydemir, Yusuf; Emre, Julide Celdir; Ozhan, Mustafa HikmetPurpose: We aimed to assess the effects of comorbidities on COPD costs and to investigate the relationship between comorbidities and clinical variables. Patients and methods: All patients hospitalized with a diagnosis of COPD exacerbation between January 1, 2014, and December 31, 2014, at all state hospitals of Aydin province, a city located in the western part of Turkey, were included in this study. The costs examined in the study pertained to medications, laboratory tests, hospital stays, and other treatment-related factors, such as consumption of materials, doctor visits, and consultation fees. Results: A total of 3,095 patients with 5,237 exacerbations (mean age, 71.9+/-10.5 years; 2,434 males and 661 females) were evaluated. For 880 of the patients (28.9%), or 3,852 of the exacerbations (73.1%), at least one comorbid disease was recorded. The mean cost of each exacerbation was $808.5+/-1,586, including $325.1+/-879.9 (40.7%) for hospital stays, $223.1+/-1,300.9 (27.6%) for medications, $46.3+/-49.6 (0.9%) for laboratory expenditures, and $214+/-1,068 (26.5%) for other treatment-related factors, such as consumption of materials, doctor visits, and consultation fees. The cost of each exacerbation was $1,014.9 in patients with at least one comorbidity, whereas it was $233.6 in patients without comorbidity (P<0.001). Age >65 years, female gender, hospitalization in an intensive care unit, invasive or noninvasive mechanical ventilation, and a long duration of hospitalization were all found to be significant factors in increasing total costs during the exacerbations requiring hospitalization (P<0.05 for all). Conclusion: Comorbidities have an important role in the total costs of acute exacerbations of COPD. Strategies for the prevention, diagnosis, and effective management of comorbidities would decrease the overall financial burden associated with acute exacerbations of COPD.Öğe ERCC1 Expression Does Not Predict Survival and Treatment Response in Advanced Stage Non-Small Cell Lung Cancer Cases Treated with Platinum Based Chemotherapy(Asian Pacific Organization Cancer Prevention, 2013) Ozdemir, Ozer; Ozdemir, Pelin; Veral, Ali; Uluer, Hatice; Ozhan, Mustafa HikmetBackground: ERCC1 is considered as a promising molecular marker that may predict platinum based chemotherapy response in non small cell lung cancer patients. We therefore investigated whether its expression is indeed associated with clinical outcomes in advanced stage NSCLC patients. Materials and Methods: Pretreatment tumor biopsy samples of 83 stage 3B and 4 non-small cell lung cancer patients treated with platinum based chemotherapy were retrospectively analyzed for immunohistochemical ERCC1 expression. None of the patients received curative surgery or radiotherapy. Results: By calculating H- scores regarding the extent and intensity of immunohistochemical staining of tumor biopsy samples, ERCC1 expression was found to be positive in 50 patients (60.2%). ERCC1 positive and negative groups had no statistically significant differences regarding treatment response, progression free survival and overall survival (respectively p=0.161; p=0.412; p=0.823). Conclusions: In our study we found no association between ERCC1 expression and survival or treatment response. The study has some limitations, such as small sample size and retrospective analysis method. There is need of more knowledge for use of ERCC1 guided chemotherapy regimens in advanced stage NSCLC.Öğe ERCC1 Expression Does Not Predict Survival and Treatment Response in Advanced Stage Non-Small Cell Lung Cancer Cases Treated with Platinum Based Chemotherapy(Asian Pacific Organization Cancer Prevention, 2013) Ozdemir, Ozer; Ozdemir, Pelin; Veral, Ali; Uluer, Hatice; Ozhan, Mustafa HikmetBackground: ERCC1 is considered as a promising molecular marker that may predict platinum based chemotherapy response in non small cell lung cancer patients. We therefore investigated whether its expression is indeed associated with clinical outcomes in advanced stage NSCLC patients. Materials and Methods: Pretreatment tumor biopsy samples of 83 stage 3B and 4 non-small cell lung cancer patients treated with platinum based chemotherapy were retrospectively analyzed for immunohistochemical ERCC1 expression. None of the patients received curative surgery or radiotherapy. Results: By calculating H- scores regarding the extent and intensity of immunohistochemical staining of tumor biopsy samples, ERCC1 expression was found to be positive in 50 patients (60.2%). ERCC1 positive and negative groups had no statistically significant differences regarding treatment response, progression free survival and overall survival (respectively p=0.161; p=0.412; p=0.823). Conclusions: In our study we found no association between ERCC1 expression and survival or treatment response. The study has some limitations, such as small sample size and retrospective analysis method. There is need of more knowledge for use of ERCC1 guided chemotherapy regimens in advanced stage NSCLC.Öğe Exudative pleural effusion due to brucellosis in a patient with chronic obstructive pulmonary disease(Royal Soc Medicine Press Ltd, 2006) Zengi, Ayhan; Elmas, Funda; Tasbakan, Meltem; Basoglu, Ozen Kacmaz; Ozhan, Mustafa HikmetPleural involvement is a rare presentation of brucellosis. We report a patient referred for the evaluation of fever, right-sided pleural effusion and hilar lymph node enlargement. The pleural fluid revealed exudative characteristics with the predominance of neutrophils. Brucella melitensis was isolated from bone marrow, pleural effusion and blood cultures. The diagnosis was also confirmed by demonstration of a high Brucella agglutinin titre. The patient was successfully treated with rifampicin and doxicycline for three months.Öğe Factors affecting TST level in patients undergoing dialysis: a multicenter study(Wiley, 2019) Deniz, Sami; Aydemir, Yusuf; Sengul, Aysun; Emre, Julide Celdir; Tanrisev, Mehmet; Ozhan, Mustafa Hikmet; Guney, IbrahimIntroduction: The risk of TB is increased in patients with chronic kidney disease (CKD) when compared with individuals with normal renal function. We aimed to determine tuberculin skin test (TST) response and the factors which might affect the response in patients with CKD undergoing dialysis in this study. Methods: The purified protein derivative solution was administered to the patients and the diameter of induration was measured. Additionally, the age, gender and smoking status of the patients were interrogated. Comorbidities were recorded both by patients' self-reports and data from the hospital files. The number of Bacille Calmette-Guerin (BCG) scars was recorded by checking both shoulders. Findings: The study was conducted with a total of 371 patients (194 men and 177 women). The mean age was 60.09 +/- 15.88, TST was 6.99 +/- 6.9, duration of dialysis was 4.44 +/- 4.5 (3.8-0.1,24). A total of 229 patients have comorbodities (61.7%, the most frequent was hypertension). Logistic regression model was performed. Gender, vitamin D treatment and high parathormone (PTH) levels remained in the final stage of the analysis and vitamin D intake and PTH levels were detected to be statistically significant (P = 0.002, 0.007, respectively). Discussion: This study is the first study which showed a correlation between TST negativity and increased PTH levels and receiving vitamin D treatment. Starting from this point, it was concluded that PTH may suppress the immune system and especially cellular immunity.Öğe The Follow-Up of Biomarkers Better Predicts the Poor Outcome in COVID-19 Patients(Assoc Clinical Scientists, 2020) Basoglu, Ozen K.; Ozhan, Mustafa Hikmet; Ekren, Pervin Korkmaz; Ak, Gunes; Tasbakan, Mehmet Sezai; Sayiner, AbdullahObjective. To investigate the course of biomarkers on admission and follow-up in order to identify early predictors for poor outcome in COVID-19 patients. Methods. in this study, 132 COVID-19 patients were classified as good outcome (n=62) and poor outcome (n=70) groups. Laboratory parameters were evaluated on admission and within 5-7 days after hospitalization. Results. Baseline levels of neutrophil-lymphocyte ratio, CRP, procalcitonin, ferritin, D-dimer and LDH were higher (p<0.01); lymphocyte count was lower in the poor outcome patients. During follow-up there was a larger decrease in lymphocyte count and more prominent increases in other biomarkers (p<0.001). in ROC analysis, the AUCs strongly indicated the poor outcome on days 5-7 of the hospitalization. Conclusions. This study suggests that the follow-up measurements of the biomarkers better predict the poor outcome in COVID-19 pneumonia.Öğe Molecular Epidemiology of Tuberculosis (TB) Patients Attending to Ege University Faculty of Medicine(European Respiratory Soc Journals Ltd, 2018) Nesil, Imren; Ozhan, Mustafa Hikmet; Cavusoglu, CengizÖğe Molecular epidemiology of tuberculosis cases admitted to Ege University Medical Faculty Hospital(Kare Publ, 2024) Taskiran, Imren; Cavusoglu, Cengiz; Ozhan, Mustafa HikmetBACKGROUND AND AIM: Advances in molecular diagnostic tools for tuberculosis (TB) have improved the typing of TB. Leading to the identification of infection origins in populations and early detection of resistant TB strains. In this study, we used molecular techniques to identify, genotype, and determine the drug resistance of TB bacilli in samples from patients with pulmonary and extra-pulmonary TB at Ege University Hospital. Data were analyzed for correlations with biochemistry, clinical, and radiological aspects of the disease. METHODS: Molecular typing was performed using the Spacer Oligonucleotide Typing (spoligotyping) method on samples from 402 patients diagnosed with pulmonary and extra-pulmonary TB at Ege University Hospital between 2009 and 2014. We retrospectively extracted demographic data from patient files, including clinical and radiological findings, case origin, diagnosis date, gamma release test, length of hospital stay, and one-year mortality. RESULTS: The study included 402 patients (238 males/164 females, mean age: 52 +/- 18.4 years) with a microbiological diagnosis of TB. The patients predominantly originated from the Aegean province (203; 50.5%). Comorbidities were present in 146 (36.3%) patients, with 85 (21.1%) in an immunosuppressed state. The bacilli family was not identified in 52 (12.9%) patients' samples. The most frequently identified family was T1 (40%), followed by H3 (8.2%), LAM7-TUR (7%), H1 (5%), LAM3-S (complex) (4%), and U family (4%). No correlation was found between bacilli families in terms of age, radiological and clinical data, and laboratory findings. Drug resistance patterns were investigated within the families, with the Beijing family showing 55.6% resistance to Rifampicin (R), Isoniazid (H) (1 mg/mL and 0.2 mg/mL), and Streptomycin (S). Hospitalization occurred in 71.6% of patients, and one-year mortality was 17.6%. No differences in hospitalization and mortality rates were found between the families. CONCLUSIONS: This study revealed that the T1 family is dominant in our community, with a higher percentage of resistant bacilli found in the Beijing family. Further studies on the clinical aspects of these families and those from other areas are necessary to better understand the behavior of TB in our community.Öğe Pneumococcal infections and protection with vaccination in adult chronic lung diseases(Turkish Assoc Tuberculosis & Thorax, 2020) Karadeniz, Gulistan; Kilinc, Oguz; Olmez, Ayse; Ozhan, Mustafa Hikmet; Ozlu, Tevfik; Ozyurek, Berna Akinci; Sayiner, AbdullahPneumococcal infections are an important cause of mortality and morbidity in Chronic Lung Diseases. However, exacerbations, which make the treatment of diseases very difficult, and corticosteroids used during treatment carry a great risk of pneumococcal infection and adversely affect the treatment. The most rational way to reduce the negative impact of pneumococcal infections on the clinical and economic burden of Chronic Lung Diseases is vaccination of the risky population. Although, vaccination recommendations are well defined, recommended by national and international guidelines and are paid by health authorities, in Turkey, vaccination rates in adults with chronic lung disease is far below the expected. Since physicians are considered to be the most important and reliable resource that can guide their patients in vaccination, applying pneumococcal vaccination routinely in all patients with chronic lung diagnosis and making it a part of daily practice will greatly contribute to reducing the clinical and economic burden of pneumococcal infections in these patients. in this review, the effects of pneumococcal diseases on chronic lung diseases, the risk and clinical burden of pneumococcal diseases in chronic lung diseases are discussed in the light of guidelines and current literature, and the importance of protection from pneumonia in these patients is emphasized. in addition to general information and efficacy data about pneumococcal vaccines available in our country, application methods and access routes to vaccines are also described.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.
