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Öğe A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection(2019) Erçelik, Merve; Akın, Gül; Önenç, Kürşad; Aytekin, Fuat; Ataoğlu, Özlem; Elverişli, Mehmet FatihPneumocystis jirovecii pneumonia (commonly called Pneumocystis pneumonia or PCP) is an opportunistic infection that occurs in immunocompromised individuals. 26 year-old male patient admitted to nephrology department for hypervolemic hyponatremia and consulted to our clinic due to the desaturation. He has been diagnosed with collapsing glomerulonephritis and he was using cyclosporine and prednisolone. Postero-anterior chest X-ray showed a blunt left cardiodiaphragmatic sinus. After ten days the patient's hypoxia deepened. Repeated chest X-ray showed bilateral perihilar heterogeneous opacity. Pneumocystis jirovecii was detected in lavage culture. We presented a case of Pneumocystis Jirovecii pneumonia secondary to cyclosporin toxicity because of a rare case.Öğe A case with diffuse granulomatous inflammation mimicking malignancy [Maligniteyi taklit eden yaygın granülomatöz inflamasyon olgusu](Duzce University Medical School, 2017) Erçelik, Merve; Balbay, Ege Güleç; Arbak, Peri; Ataoğlu, ÖzlemA 59-year-old female patient was admitted to outpatient clinic with a 3-week dry cough and a 2-month exercise dyspnea (MRC 2). Within the last 3 months there was a loss of 5 kg. She has never smoked. She was a housewife. In thoracic computed tomography of the patient’s postero-anterior chest x-ray, the right lower quadrant is the opacity of the right atrium. A large number of nodules (5 mm in size) in both upper lobes of the lungs, and a common reticulonodular dancer in the middle lobe of the right lingula. The desired positron emission tomography of the patient with malignancy pre-diagnosis; right lobe of the lungs, reticular densities in the left lung, gastroesophageal junction, stomach fundus and large curvature in the dorsal wall of the nasopharynx, bilateral cervical lymphadenopathies, bilateral cervical lymphadenopathies, bilateral lymph nodes, right lobe of the lungs, right scapula and left iliac bone intense hypermetabolic involvement was detected. The axillary lymph node dissection was diagnosed as granulomatous lymphadenitis. The patient was accepted as sarcoidosis, inhaled steroid therapy was initiated and followed. © 2017, Duzce University Medical School. All rights reserved.Öğe Clinical and polysomnographic evaluation of sleep-related breathing disorders in patients with sarcoidosis(Springer Heidelberg, 2022) Ataoğlu, Özlem; Annakkaya, Ali Nihat; Arbak, Peri Meram; Yıldız Gülhan, Pınar; Elverişli, Mehmet FatihObjective This study aimed to evaluate the frequency of obstructive sleep apnea (OSA) in patients with sarcoidosis and related clinical factors. Materials and method Consecutive patients diagnosed with sarcoidosis in our clinic were evaluated for OSA risk during sleep using the Epworth Sleepiness Scale, Stanford Sleepiness Scale, Pittsburgh Sleep Quality Index, Berlin questionnaire, STOP and STOP-BANG questionnaires, and polysomnography (PSG). Results A total of 60 sarcoidosis patients (mean age: 50 +/- 11 years, 45 (75%) women) were included in the study. Polysomnography was performed in 54 cases and revealed the diagnosis of OSA in 70% (38/54) of the patients. The mean age was higher in patients with sarcoidosis and OSA (54 +/- 11 vs. 47 +/- 13, p = 0.041) and body mass index values were significantly higher as well (31.9 +/- 4.4 vs, 29.0 +/- 4.6 kg/m(2), p = 0.034). Polysomnography revealed a higher rate of OSA in patients with sarcoidosis who had high-risk scores in Pittsburgh Sleep Quality Index, STOP questionnaire, and STOP-BANG questionnaire (p = 0.024, p < 0.001, and p < 0.001, respectively). Based on polysomnography, OSA was detected in 39% (5/13) with stage 1 sarcoidosis, 78% (28/36) with stage 2, and in all cases (5/5) with stage 3. OSA frequency and apnea-hypopnea index (AHI) were determined to increase with advanced sarcoidosis stage (p = 0.003, p = 0.043, respectively). AHI was positively correlated with sarcoidosis stage (p = 0.003, r = 0.391). The prevalence of OSA was significantly higher in patients receiving treatment compared to treatment-naive patients (88% vs. 57%, p = 0.018). Multivariate logistic regression analysis revealed the stage of the disease (p = 0.026) to be the single independent risk factor associated with increased risk of OSA in patients with sarcoidosis. Conclusion High rates of OSA were detected in sarcoidosis, increasing with the advanced disease stage. The findings suggest that patients with sarcoidosis and advanced age, obesity, steroid treatment, and involvement of lung parenchyma (stages 2 and 3) should be evaluated for OSA risk. Further investigations are needed to establish the potential causes of the high prevalence of OSA in sarcoidosis.Öğe COVID-19 Hastalarında Hastalık Şiddeti ile Viral Döngü Eşik Değeri Arasındaki İlişkinin Değerlendirilmesi(2022) Habiloğlu, Arif Doğan; Öztürk, Elif; Özel, Mehmet Ali; Demircan, Serkan; Uludoğan, Burcu; Memiş, Nagihan; Ataoğlu, ÖzlemAmaç: Literatüre göre bazı viral hastalıklarda, viral yük ile hastalık şiddeti arasında pozitif bir ilişki vardır. COVID-19’da ise SARS-CoV-2 viral yükünün hastalık şiddeti üzerine etkisini gösteren çalışmaların sonuçları çelişkili olup söz konusu bulguların, hastaların semptom süreleri ve örnekleme tekniği gibi nedenlerle tespit edilen viral yükün etkilenmesinden kaynaklaması olasıdır. Çalışmamız tespit edilen viral yük ile COVID-19 hastalarının klinik durumu arasındaki ilişkiyi değerlendirmeyi ve literatürde bulunan çelişkili sonuçları açıklamayı amaçladı. Yöntemler: COVID-19 ön tanısı ile 01 Mayıs – 31 Haziran 2020 tarihleri arasında merkezimize başvuran hastaların verileri geriye dönük olarak incelendi. Moleküler tanı için Bio-Speedy® SARS CoV-2 RT-qPCR kiti (Bioeksen AR-GE Teknolojiler, Türkiye) kullanıldı. Kombine burun ve boğaz sürüntüsünde polimeraz zincir reaksiyonu (“polymerase chain reaction – PCR”) ile SARS-CoV-2 saptanan hastalara COVID 19 tanısı koyuldu ve çalışmaya dahil edildi. Has- talar Dünya Sağlık Örgütü (DSÖ) sınıflandırmasına uygun olarak hafif-orta ve şiddetli klinik olarak iki gruba ayrıldı. Demografik verilerin yanı sıra laboratuvar, klinik ve radyolojik sonuçlar elektronik kayıtlardan alındı. Bulgular: Kohortun tamamı 285 hasta olup 254’ü hafif-orta klinik seyir gösterirken, 31’i şiddetli klinikle seyrediyor- du. İstatistiksel analizler, iki grup arasında tanı anına kadar geçen semptom süresinin ve viral yükün benzer olduğunu gösterdi (p>0.05). İki grubun tek değişkenli analizinde; yaş, hastanede kalış süresi, bilgisayarlı tomografi skorları, serum D-dimer, üre, kreatinin, ferritin, aspartat aminotransferaz (AST), laktat dehidrogenaz (LDH), gama-glutamil trans- feraz (GGT), troponin, C-reaktif protein (CRP) ve nötrofil değerleri açısından anlamlı düzeyde farklılık tespit edildi. Bununla birlikte çok değişkenli lojistik regresyon analizinde; yalnızca ferritin, CRP ve LDH’nin şiddetli klinik seyir ile pozitif korelasyon gösterdiği tespit edildi (p<0.05). Sonuç: COVID-19 hastalarında SARS-CoV-2 viral yükü ile klinik şiddet arasında pozitif bir ilişki bulunamadı. Bu nedenle, hastalık şiddetini öngörmede kullanılmasını önermiyoruz. Diğer yanda; ferritin, CRP ve LDH yüksekliğinin şiddetli klinik seyre eşlik ettiğini tespit ettik.Öğe The Evaluation of Eating Attitudes in Patients with Sarcoidosis(2020) Gülhan, Pınar Yıldız; Ataoğlu, Özlem; Balbay, Ege Güleç; Yaşlı, Nevra Ezgi; Annakkaya, Ali NihatObjective: The aim of this present study was to investigate the eating attitudes ofsarcoidosis patients.Methods: 50 patients with sarcoidosis and 45 healthy individuals without chronicdisease were included to study. All participants evaluated for metabolic syndrome(MetS) according to National Cholesterol Education Program's Adult Treatment PanelIII (NCEP-ATP III) criteria. Eating Attitude Test (EAT) and Beck DepressionInventory (BDI) were applied to all participants. All participants evaluated formetabolic syndrome (MetS). The cut-off scores of the tests were 30 for BDI and 17for BDI.Results: When sarcoidosis cases and control group were evaluated according to EATand BDI cut-off scores; it was found that the prevalence of deterioration in eatingbehavior was higher in patients with sarcoidosis than healthy controls but theprevalence of depression was not higher (p=0.018, p=0.874 respectively).We foundthat total EAT scores were significantly higher in sarcoidosis patients who has MetS.MetS(-); EAT: 15±7, MetS(+); EAT: 27±10 p<0.001.Conclusions: This study is important to show connection between the sarcoidosis anddisordered eating attitudes. It is not adequate to establish the presence ofcomorbidities alone. Defining risk factors leading to comorbidities is also important inpatients with sarcoidosis. If causative factors are detected, controlling them by amultidisciplinary approach will prevent the onset of comorbidities and also providesatisfactory management of sarcoidosis.Öğe Evaluation of the Relationship Between Disease Severity and Viral Cycle Threshold Value in COVID-19 Patients(DOC Design and Informatics Co. Ltd., 2022) Habiloğlu, Arif Doğan; Öztürk, Cihadiye Elif; Özel, Mehmet Ali; Demircan, Serkan; Uludoğan, Burcu Ceren; Memiş, Nagihan; Ataoğlu, ÖzlemObjective: There is a positive and significant relationship between severity and viral load in some viral diseases. Studies on the relationship between SARS-CoV-2 viral load at diagnosis and severity of coronavirus disease-2019 (COVID-19) have yielded conflicting results. Therefore, we aimed to evaluate the relationship between viral load and the clinical status of patients with COVID-19. Methods: Data of the patients diagnosed with COVID-19 and admitted to our center between May 01 and June 31, 2020, were retrospectively reviewed. The patients were divided into two groups according to their clinical characteristics as mild-moderate and severe. The demographic, laboratory, clinical, and radiological data were retrieved from electronic folders. Results: The entire cohort included 285 patients; 254 had a mild-moderate clinical course, and 31 had a severe course. Statistical analyses revealed that SARS-CoV-2 viral load was not associated with symptom duration and clinical status (p>0.05). According to multivariate logistic regression analysis, only ferritin, C-reactive protein, and lactate dehydro-genase elevations were positively correlated with severe clinical course. (p<0.05). Conclusion: We do not recommend using viral load to predict disease severity in COVID-19. We also found that only ferritin, C-reactive protein, and lactate dehydrogenase accompanied severe clinical course. © 2022, DOC Design and Informatics Co. Ltd.. All rights reserved.Öğe Sarkoidoz hastalarında uykuda solunum bozukluklarının klinik ve polisomnografik değerlendirilmesi(Düzce Üniversitesi, 2020) Ataoğlu, Özlem; Annakkaya, Ali NihatAmaç: Çalışmada sarkoidoz hastalarında obstrüktif uyku apne sendromu (OSAS) sıklığının ve buna etkili olan klinik faktörlerin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Kliniğimizde tanı almış ardışık 60 sarkoidoz hastasına uykuda OSAS riskini değerlendirilmek için Epworth Uykululuk Ölçeği, Stanford Uykululuk Ölçeği, Pitsburg Uyku Kalitesi Ölçeği, Berlin Anketi, STOP ve STOPBANG anketleri uygulandı ve polisomnografi (PSG) testi yapıldı. Bulgular: Yaş ortalaması 50±11 olan 45 (%75) kadın, 15 (%25) erkek toplam 60 sarkoidoz hastası çalışmaya dahil oldu. Olguların 54'üne polisomnografi yapıldı. Polisomnografi yapılan olguların %70,4'üne (38/54) OSAS tanısı kondu. OSAS tespit edilen sarkoidoz olgularında ortalama yaş daha yüksek bulundu (47±13'e karşı 54±11, p=0,041). OSAS'lı sarkoidoz olguları daha şişmandı (VKİ 29,0±4,6 ya karşı 31,9±4,4 p=0,034). Pitsburg uyku kalitesi ölçeği, STOP ve STOP-BANG anketlerinde klinik açıdan yüksek riskli bulunan sarkoidoz hastalarında polisomnografiyle OSAS sıklığı anlamlı olarak daha yüksek bulundu (sırasıyla p=0,024, p<0,001ve p<0,001). Polisomnografi yapılan sarkoidoz olgularında evre 1'de %38,5 (5/13), evre 2'de %77,8 (28/36), evre 3'de ise tüm olgularda (5/5) OSAS tespit edildi. Sarkoidoz evresi arttıkça OSAS sıklığının arttığı tespit edildi (p=0,003). Sarkoidoz evresi arttıkça apne hipopne indeksi (AHİ) ortalaması da istatistiksel açıdan anlamlı olarak artmaktaydı (p=0,043). Sarkoidoz evresiyle AHİ'nin pozitif korelasyon gösterdiği tespit edildi (p=0,003, r=0,391). Tedavi gören sarkoidoz olgularında OSAS oranları hiç tedavi görmemiş olanlara göre istatistiksel açıdan anlamlı olarak daha yüksek bulundu. (%87,5 e karşı %56,7, p=0,018) . Yapılan multivaryant lojistik regresyon analizinde sarkoidoz olgularında OSAS riskini artıran tek bağımsız risk faktörünün hastalığın evresi olduğu tespit edildi (p=0.026). Sonuç: Sarkoidozda hastalığın evresiyle artan yüksek oranlarda OSAS tespit edildi. Özellikle ileri yaştaki, obez, steroid tedavisi alan ve akciğer parankim tutulumu olan (evre 2 ve 3) sarkoidoz olgularının OSAS riski açısından klinik ve polisomnografik olarak değerlendirilmesi gerektiği kanaatindeyiz. Sarkoidozda yüksek OSAS prevalansının olası nedenlerini ortaya koymak için daha büyük ve kapsamlı çalışmalara ihtiyaç vardır.Öğe Secondary Brain Abscess in a Patient Followed Up with Lung Abscess(2022) Elverişli, Mehmet Fatih; Gülhan, Pınar Yıldız; Ataoğlu, Özlem; Balbay, Ege GüleçRespiratory tract infections are common in Down syndrome. A 24-year-old male patient with Down syndrome with concurrent diabetes mellitus underwent antibiotic treatment with a diagnosis of lung abscess in an external center with complaints of fever and vomiting, but was referred to us after his symptoms did not regress. Despite the improvement in the lung abscess noted in a radiological examination, the patient was identified with a brain abscess upon an examination due to the continuation of fever, vomiting and the onset of headache. Particular attention should be paid to additional abscess foci such as brain abscess in cases with lung abscess with an underlying comorbidity.Öğe Serum clara cell protein-16 level in non-smoker obstructive sleep apnea syndrome patients(European Respiratory Soc Journals Ltd, 2019) Balbay, Ege Güleç; Ataoğlu, Özlem; Erçelik, Merve; Şahin, İbrahim Ethem; Admış, Özlem; Arbak, Peri Meram…Öğe Serum Clara cell secretory protein (CC-16) in non-smoking patients with obstructive sleep apnea(Springer, 2020) Balbay, Ege Güleç; Ataoğlu, Özlem; Erçelik, Merve; Şahin, İbrahim Ethem; Admış, Özlem; Arbak, Peri MeramObjective: This study aimed to determine the association between the severity of obstructive sleep apnea (OSA) and serum Clara cell protein (CC16) levels in non-smoking patients with OSA. Methods: This prospective study included non-smoking patients who presented with sleep-related disturbances and underwent polysomnography (PSG). The serum CC16 level was measured and its relationship to PSG parameters was investigated. Results: The study included 128 patients (83 men) with a mean age of 48.4 ± 11.9. OSA was detected in 66 men (70%) and 29 women (30%) (p = 0.051). The severity of OSA was mild in 32 (25%), moderate in 28 (22%), and severe in 35 (27%) of the patients. There was no significant difference in CC16 levels between the OSA group (1746 ± 1006) and the OSA negative group (1721 ± 1201, p = 0.91) levels. There was no significant difference between the CC16 levels of the each four groups. Mean serum CC16 levels were significantly lower in OSA negative men than OSA positive men (777 vs 1462, p = 0.005). No significant difference was observed in CC16 values according to OSA severity in women. Conclusion: The serum CC16 level does not differ between non-smoking OSA patients and OSA negative patients. © 2020, Springer Nature Switzerland AG.
