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Öğe A Case of Pulmonary and Central Nervous System Invasive Aspergillosis with Characteristic Radiological Findings(Soc Turkish Intensivists - Sti, 2024) Akbas, Turkay; Karahan, Fatih; Ogul, Hayri; Onec, Birgul; Onmez, Attila; Unlu, Nisa; Balbay, Ege GulecCentral nervous system invasive aspergillosis is a rare fatal infection responsible for the majority of brain lesions in immunocompromised patients. A 56-year-old man with diabetes mellitus and non-Hodgkin's lymphoma was admitted to the emergency department with a diagnosis of pneumonia-related sepsis. At presentation, cranial computed tomography (CT) and magnetic resonance imaging were normal, but thoracic CT revealed right lung pneumonia, and antibiotic therapy was initiated. Control CT scans performed on the 13th day of admission because the patient had subsequently become hypotensive and somnolent revealed halo signs in the lungs and multiple hypodense lesions within the cerebrum, consistent with invasive aspergillosis. A post-contrast cranial CT scan also revealed vascular enhancement within the hypodense lesions, known as the central vascular sign. In conclusion, central nervous system aspergillosis can be diagnosed by means of tubular enhanced focuses in hypodense lesions on contrast-enhanced CT scans.Öğe A Case of Pulmonary and Central Nervous System Invasive Aspergillosis With Characteristic Radiological Findings(Soc Turkish Intensivists - Sti, 2024) Akbas, Turkay; Karahan, Fatih; Ogul, Hayri; Onec, Birgul; Onmez, Attila; Unlu, Nisa; Balbay, Ege GulecCentral nervous system invasive aspergillosis is a rare and fatal infection that accounts for the majority of brain lesions in immunocompromised patients. A 56-year-old man with diabetes mellitus and non-Hodgkin's lymphoma was admitted to the emergency department with a diagnosis of pneumonia-related sepsis. At presentation, cranial computed tomography (CT) and magnetic resonance imaging were normal. However, thoracic CT revealed right lung pneumonia, and antibiotic therapy was initiated. Control CT scans performed on the 13(th) day of admission-because the patient had subsequently become hypotensive and somnolent- revealed halo signs in the lungs and multiple hypodense lesions within the cerebrum, consistent with invasive aspergillosis. A post-contrast cranial CT scan also revealed vascular enhancement within these hypodense lesions, known as the central vascular sign. In conclusion, central nervous system aspergillosis can be diagnosed by means of tubular enhanced foci in hypodense lesions on contrast-enhanced CT scans.Öğe Chest Diseases Clinic, Pandemic Experiences(Duzce Univ, 2020) Annakkaya, Ali Nihat; Gulhan, Pinar Yildiz; Balbay, Ege Gulec; Balbay, Oner Abidin; Arbak, Peri MeramAs the chest diseases clinic of Duzce Medical School, we were one of the departments that took an active role in the COVID-19 pandemic. Chest diseases department; It was one of the main branches in the differential diagnosis, treatment and follow-up of COVID-19 cases. In this process, our assistants, who were our hands and arms, were our fighters who were at the forefront of the pandemic process. During the pandemic process, we worked every day with an order consisting of a faculty member and two assistants. We continued our scientific meeting and assistant trainings online so that our training activities are not interrupted. On the one hand, we continued our scientific activities by participating in the studies, planning new research, and writing projects. As a result, when we look back, we have completed this difficult process by further enhancing our sense of solidarity that exists as a department in the pandemic process we experienced for the first time in our lives.Öğe Do the levels of particulate matters less than 10 mu m and seasons affect sleep?(Taylor & Francis Ltd, 2020) Gulhan, Pinar Yildiz; Balbay, Ege Gulec; Elverisli, Mehmet Fatih; Ercelik, Merve; Arbak, PeriBackground: There are few studies showing that the increase in particulate matters less than 10 mu m (PM10) values increases the apnea-hypopnea index (AHI). We aimed to investigate relationship between air quality parameters and the seasons with the AHI. Methods: This was a retrospective study that included 500 adults. Polysomnography (PSG) was performed on all patients. Oxygen saturation, air temperature, relative humidity, and PM10 values were recorded in Duzce for every year. The parameters of the national air quality network and sleep parameters of 500 individuals hospitalized between 2015 and 2017 were checked. Results: A total of 500 patients were included in the study, of whom 316 (63.2%) were male and 184 (36.8%) were female. While the AHI value of patients who presented during 2016 was 27.5, it had significantly declined to 20.2 in 2017 (p = .024). A significant decline was observed in AHI values of OSA patients from 2016 to 2017 (p = .043). A significant positive correlation was observed between REM-related AHI and relative humidity (r = 0.183, p = .002). Conclusions: This study showed a clear relationship between AHI and PM10 during winter when air pollution parameters are high in the region. PM10 emerged as a parameter that substantially increases the relative risk for OSA.Öğe Earthquake and the Lung(Duzce Univ, Fac Medicine, 2023) Balbay, Ege GulecDuzce Natural disasters cause extensive damage to nature and impact on large numbers of people throughout the world. Recently, earthquakes have caused a large number of death, injured, missing, and displaced people. More than a million earthquakes occur worldwide every year, which equates to roughly two earthquakes per minute. Lung problems in earthquakes are one of the main causes of morbidity and mortality. Many pulmonary complications that occur after earthquakes are a direct result of the disaster itself. Pulmonary complications such as inhalation of dust and particulates from collapsed buildings in earthquakes, aspiration of water and pathogens due to tsunami after earthquakes, pulmonary thromboembolism, psychological effects caused by respiratory symptoms, infectious respiratory diseases and chest traumas such as pneumothorax, rib fracture, hemothorax, hemopneumothorax, diaphragmatic tear can develop after earthquakes. People in the earthquake area, search and rescue teams, and those involved in demolition and debris removal activities are at risk for asbestos exposure. The most effective solution against the lung effects of earthquakes is to take preventive and protective measures. It is very important for disaster preparedness and response teams to be aware of these problems. Respiratory problems that may arise in earthquakes were discussed in this review.Öğe The effects of non-invasive mechanic ventilator modes on intraocular pressure in COPD patients with hypercapnic respiratory failure(Wiley, 2020) Aytekin, Fuat; Gulhan, Pinar Yildiz; Teberik, Kuddusi; Balbay, Ege Gulec; Iritas, Ilter; Ercelik, Merve; Balbay, Oner AbidinBackground Chronic obstructive pulmonary disease (COPD) is not fully reversible disease that is characterized by progressive restricting airflow. Non-invasive mechanical ventilation (NIMV) treatment can be used in COPD patients who had type 2 respiratory failure. This study aimed to determine the effect of BPAP S/T and AVAPS modes on intraocular pressure (IOP), central corneal thickness (CCT) in 40 type 2 respiratory failure patients with COPD. Methods Forty patients with type 2 respiratory failure who were hospitalized between June and December 2018 with the diagnosis of COPD exacerbations were included to the study. Patients followed up without NIMV for 12 hours after the end of exacerbations treatments end. After IOP, visual acuity and CCT were measured in all patients at the same time (11.00 am), same NIMV treatment was applied to the patients for 4 hours (AVAPS-BPAP S/T). Then the measurements were repeated. The effects of these NIMV modes on IOP were evaluated. Results After NIMV treatment, it was observed that the mean IOP increased statistically significantly (13.3 vs 12.3 mm Hg; P = 0.001). After treatment with NIMV, there was a decrease for CCT close to statistical significance (P = 0.057) Conclusion As a result; increased IOP and thinning of CCT after NIMV treatment has been shown. The type of NIMV and the level of inspiratory pressure needed in hypercapnic respiratory failure seem to affect IOP and it should be cautiously used to increase IOP.Öğe Evaluation of Patients with COVID-19 Followed Up in Intensive Care Units in the Second Year of the Pandemic: A Multicenter Point Prevalence Study (vol 25, pg 11, 2024)(Aves, 2024) Balbay, Ege Gulec; Kayalar, Ozgecan; Balbay, Oner; Dikensoy, Oner; Arbak, Peri; Bayram, Hasan[No abstract available]Öğe Factors affecting compliance with positive airway pressure therapy in obstructive sleep apnea(Springer Heidelberg, 2021) Ercelik, Merve; Balbay, Ege Gulec; Gulhan, Pinar Yildiz; Cangur, Sengul; Arbak, Peri Meram; Aytekin, Fuat; Elverisli, Mehmet FatihObjective To investigate the factors affecting compliance with positive airway pressure (PAP) therapy and establish the relationship between compliance and pulmonary function tests (PFT) in patients with OSA. Material and methods In this prospective study, patients with OSA using PAP devices were questioned about the complaints related to the device. Depression and anxiety scales along with PFT parameters were also assessed. Results Of 98 participants, 63% were men. The mean age was 52.0 +/- 9.6 years. Sixty-seven percent of the patients were compliant with their devices. A significant difference was observed between the proportion of the participants compliant or non-compliant with the device, based on OSA severity (p < 0.05). Beck depression inventory (BDI) and Beck anxiety inventory (BAI) scores of the compliant patients were significantly lower than those of the non-compliant patients (p < 0.001, p = 0.044, respectively). No statistically significant difference was detected between the groups regarding individual pulmonary function tests (p > 0.05). The rates of nasal mask use, not having difficulty in tolerating CPAP, falling asleep, absence of abdominal distension, no facial sores, no air leakage, patients benefiting from the device, reduction in daytime sleepiness, and the belief that they are receiving appropriate therapy in participants compliant with the device were higher than those in non-compliant participants (p < 0.05). The rates of claustrophobia and discomfort due to pressure were significantly lower in patients compliant with the device than in the non-compliant patients (p < 0.05). Conclusion While no relationship was detected between PFT parameters and PAP therapy compliance, significant factors affecting the device compliance were detected.Öğe Impact of Earthquakes on Lung Health(Aves, 2024) Balbay, Ege Gulec; Kayalar, Ozgecan; Balbay, Oner; Dikensoy, Oner; Arbak, Peri; Bayram, HasanEarthquakes are catastrophic natural disasters that cause extensive damage to infrastructure and disrupt the lives of millions worldwide. Beyond the immediate physical and psychological damage caused by earthquakes, these events can significantly impact respiratory health. The inhalation of dust, smoke, particulates, toxic gases, and asbestos exposure can lead to various respiratory health pathologies. These include respiratory infections, exacerbations of pre-existing respiratory diseases, chest traumas, and pulmonary and venous thromboembolism. Longitudinal studies are necessary to assess the long-term respiratory health effects in affected populations. By addressing these knowledge gaps, future mitigation strategies and preparedness measures can be developed to minimize the respiratory health impacts of earthquakes and improve the well-being of affected communities. Robust building infrastructure and comprehensive earthquake preparedness are emerging as the most important determinants for not only mitigating building collapse but also significantly reducing the potential health impacts that follow. This comprehensive review aims to provide a systematic overview of the lung health impacts of earthquakes. It highlights the need for further research to identify specific pollutants, air contaminants, and environmental factors contributing to respiratory health issues following earthquakes.Öğe An Investigation of Latex Sensitivity and Respiratory Complaints in Workers in a Rubber-Based Material Manufacturing Industry(Lippincott Williams & Wilkins, 2023) Elverisli, Mehmet Fatih; Gulhan, Pinar Yildiz; Mungan, Dilsad; Ercelik, Merve; Sahin, Ibrahim Ethem; Balbay, Ege Gulec; Coban, SeyitObjectiveTo present study aimed to investigate the prevalence of latex sensitivity in a workplace that produced rubber-based vehicle seals.MethodThe serum latex-specific IgE levels, respiratory complaints, PFT, serum interleukin (IL)-4, IL-5, IL-8, IL-10, IL-13 levels of all male workers (n = 108) exposed to latex in the workplace, which produced rubber seals, were compared with the control group (n = 52).ResultsThe rates of latex-specific IgE >0.10 kU/L in the workers and control group were 12.3% and 4.1%, respectively (P = 0.147). There was no difference in IL-4, IL-5, IL-10, and IL-13 levels between latex-specific IgE-positive, and -negative participants.ConclusionLatex sensitivity was higher in workers who used rubber as a raw material than in the control group but it was not statistically significant.Öğe Is sarcoidosis related to metabolic syndrome and insulin resistance?(Taylor & Francis Ltd, 2020) Gulhan, Pinar Yildiz; Balbay, Ege Gulec; Ercelik, Merve; Yildiz, Seyma; Yilmaz, Mehmet AlperAim: To investigate the relationship between sarcoidosis and metabolic syndrome (MetS) and insulin resistance (IR). Method: In our study, 47 patients with sarcoidosis who applied to our outpatient clinic and 45 healthy individuals without chronic disease were included. All patients were evaluated for MetS according to the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) criteria. The presence of three of the five factors defined by ATP III for MetS was accepted as a diagnosis of MetS. IR is calculated using the HOMA-IR index. Results: The mean age of the 47 patients with sarcoidosis was 50.7 +/- 12.2 years and the mean age of the 45 control groups was 42.9 +/- 14.4 years. Almost 80% of the patients were diagnosed as stage 2 sarcoidosis. Distribution of the patients according to the use of steroid is; almost half of the patients (47%) received steroid previously or recently. Patients with sarcoidosis have a 7.66 relative risk for MetS, whereas they also have a 5.48 relative risk of insulin resistance development. Conclusion: This study shows that MetS is associated with increased sarcoidosis risk. MetS and IR diagnosis was higher in patients with sarcoidosis.Öğe The Prevalence of Obstructive Sleep Apnea in Bariatric Surgery Patients(Duzce Univ, Fac Medicine, 2023) Annakkaya, Ali Nihat; Balbay, Ege Gulec; Pehlivan, Mevlut; Balbay, Oner AbidinObjective: Obesity is one of the most important risk factors and also consequences of obstructive sleep apnea (OSA). Weight loss and positive airway pressure therapy are the main approaches in the treatment of OSA. In this study, it was aimed to evaluate the prevalence of OSA in obesity patients scheduled for bariatric surgery.Methods: In the University Hospital Obesity Center, 141 consecutive patients who were candidates for bariatric surgery in 2015 were clinically evaluated preoperatively for sleep-related respiratory disorders. Preoperative polysomnographic examination was recommended to all cases.Results: Of 141 bariatric surgery candidates with a mean age of 37 +/- 10 years, and 103 (73%) were female. The mean body mass index of the cases was 46.9 +/- 6.4 kg/m2. Among the major symptoms of OSA, snoring was present in 119 (84.4%), daytime sleepiness in 63 (44.7%) and witnessed apnea in 49 (34.8%) patients. OSA was detected because AHI>5/hour was found in 75.7% (84/111) of the patients who accepted the polysomnographic evaluation. 24.3% (27/111) of the cases who underwent polysomnography had non OSA, 29.7% (33/111) mild OSA, 17.1% (19/111) moderate OSA, and 28.8% (32 /111), severe OSA was detected. AHI was positively correlated with age (p=0.003), neck and waist diameter (p<0.001), and negatively correlated with percent of the forced vital capacity (p<0.001). In polysomnographic controls performed an average of 9 months after bariatric surgery, an average of 41.2% improvement in AHI was observed, compared to an average of 22.8% decrease in BMI.Conclusions: OSA prevalence was found to be very high in bariatric surgery candidates. It was thought that polysomnographic examination should be performed before bariatric surgery not only in symptomatic cases but also in all cases. Bariatric surgery can help improve OSA.Öğe The Relationship Between Respiratory Complaints and Urine Aluminum Levels in Aluminum Factory Workers(Lippincott Williams & Wilkins, 2023) BilgiN, Cahit; Arbak, Peri; Balbay, Ege Gulec; Balbay, Oner; Annakkaya, Ali NihatObjectiveThis prospective case-control study aimed to investigate the forms and conditions of respiratory effects in workers working in an Aluminum Profile Factory.MethodsAll male (42 person, mean age: 32.2 +/- 6.9) workers working in an Aluminum Profile Factory were compared with 33 controls.ResultsThe urinary aluminum levels of the workers were significantly higher than the control group. Complaints of cough, sputum, shortness of breath and wheezing were statistically significantly higher than the control group. In aluminum workers, those with dyspnea had a significantly higher urinary Al level than those without dyspnea.ConclusionsIt is thought that primary and secondary prevention are both important in the workplaces with aluminum exposure. Urinary aluminum level monitoring could be key to protecting the respiratory health of the workers.
