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Öğe BILATERAL CHYLOTHORAX, B SYMPTOMS AND DYSPROTEINEMIA: AN ANGIOIMMUNOBLASTIC T CELL LYMPHOMA CASE(Pergamon-Elsevier Science Ltd, 2017) Öneç, Birgül; Altuntaş, Gülşah; Öneç, Kürşad; Boran, Mertay; Yalıcı, Özge; Ertop, Şehmus…Öğe Doppler ultrasound findings in kidney transplant recipients with and without of new onset diabetes mellitus beyond 5 years after transplantation(E-Century Publishing Corp, 2015) Boran, Mediha; Tola, Muharrem; Boran, Ertay; Boran, MertayObjective: Renal Doppler Ultrasound (RDU) indices: resistive index (RI) and pulsatility index (PI) are frequently applied as a noninvasive method that measured possible causes of allograft dysfunction in kidney transplant patients. We aimed to compare long-term prognosis and associated risk factors including the RDU markers in recipients with and without new-onset diabetes after transplantation (NODAT) beyond 5 years after kidney transplantation. Methods: A prospectively maintained database of 137 kidney allograft recipients, transplanted in a single center, maintained on reduced tacrolimus-based immunosuppressive regimen and angiotensin receptor blocker (ARB) was retrospectively analyzed. The assessment including incidence of NODAT and associated risk factors including RI and PI was compared between 12 recipients with and 125 recipients without NODAT median 77.5 months and 74 months, respectively, after kidney transplantation. Results: NODAT was detected in 12 (9.6%) of the 137 kidney transplant recipients, without gender predilection. In univariate regression analysis recipient age (P < 0.001), recipients weight at the time of NODAT >= 65 kg (P < 0.001), as well as proteinuria (P = 0.026), tacrolimus trough levels (P = 0.005), PI (P = 0.023) were associated with the long-term risk of NODAT and multivariate regression analysis also revealed that recipients weight at the time of NODAT = 65 kg (P = 0.004) was independent long-term risk factor for NODAT. Conclusions: Our study demonstrated that beyond 5 years after kidney transplantation the RDU indices: RI and PI are not long-term risk factors for NODAT and the correction of recipient's body weight, the treatment with ARB and maintained reduced TAC doses lowered the incidence of NODAT.Öğe ECG Evaluation in Patients with Pneumothorax Admitted to the Emergency Department: A Three years Analysis(Duzce Univ, Fac Medicine, 2021) Karakoyun, Salih; Boran, Mertay; Saritas, Ayhan; Boran, ErtayObjective: Pneumothorax is one of the life-threatening differential diagnoses of patients presenting to emergency department (ED) with shortness of breath and chest pain. The place of dynamic electrocardiography (ECG) changes in diagnosis of pneumothorax was not well defined. The aim of our study was to reveal the clinical importance of ECG in pneumothorax. Methods: Between 01.04.2014 and 01.04.2017, 147 patients who applied to our ED and take a diagnosis of pneumothorax were retrospectively examined. The patients were divided as Group 1 (with pneumothorax volume <20%), and group 2 (with pneumothorax volume >= 20%). Patient demographics, mechanism of pneumothorax formation (traumatic or spontaneous), X-ray and tomographic findings, ECG findings, hospitalization-follow-up periods, treatment methods; were derived from the hospital's data recording system and compared between groups. Results: 109 (74.1 %) of 147 patients had a traumatic pneumothorax, and 38 (25.8%) had a spontaneous pneumothorax (p <0.001). 21 (55.2%) of the spontaneous pneumothorax cases are primary spontaneous pneumothorax. 64.6% (n=95) of the patients had chest pain. The two groups were similar in terms of age, hemoglobin level, GCS, number of days followed, gender and smoking status, (p> 0.05). When the ECG data was analyzed, a difference was found between the two groups. While 52.8% of the patients in group 1 had ECG changes, all of the patients in group-2 (100%) had unusual ECG findings (p = 0.004). Conclusions: Pneumothorax is a condition that should not be overlooked at ED. Pneumothorax especially with large volume size (size >= 20%) should be remembered in cases with abnormal findings in their ECG.Öğe The effect of cold application on pain in patients with chest tubes before deep breathing and coughing exercises: A randomized controlled study(Mosby-Elsevier, 2022) Kıy, Beyza Levent; Demiray, Ayşe; Boran, MertayBackground: Pain control is very important to ensure the comfort of patients and increase their quality of life. Objectives: The purpose of this randomized controlled trial was to examine the effects of cold therapy in patients with chest tube before deep breathing and coughing exercises. Methods: The study participants were patients with chest tubes, who were treated at a training and research hospital in Turkey between May 2, 2017, and October 24, 2019. Seventy patients participated in the study in accordance with the inclusion criteria. The intervention group, patient identification form, and visual analogue scale were used to collect data. Cold therapy was applied for the intervention group before deep breathing and coughing exercises, and not for the control group. Results: The pain rates of the intervention group participants were lower (3.31) after the deep breathing and coughing exercises, than the rates (4.24) before the exercises (p<0.01). The pain rate (5.29) among the control group participants after the deep breathing and coughing exercises was significantly higher than those before (3.47) the exercises (p<0.01). Conclusions: The study revealed that cold therapy before deep breathing and coughing exercises effectively relieves pain in patients with chest tubes. (C) 2022 Elsevier Inc. All rights reserved.Öğe Elongation and aberrant articulation of cervical transverse processes mimicking osteochondroma(Elsevier Science Inc, 2015) Ünlü, Elif Nisa; Büyükkaya, Ayla; Ünlü, İlhan; Boran, Mertay; Güneş, Harun…Öğe HLA-Identical Sibling Renal Transplantation: Influence of Donor and Recipient Gender Mismatch on Long-term Outcomes(Elsevier Science Inc, 2014) Boran, Mediha; Boran, Mertay; Boran, ErtayBackground. Long-term function of living-related kidney allograft depends on multiple variables. The aim of the present study was to assess the influence of donor and recipient gender mismatch on the short and long-term outcomes in human leukocyte antigen (HLA)-identical sibling renal transplants (SRTs) receiving induction therapy and different immunosuppressive regimens. Material and Methods. Twenty-nine recipients who were grafted from their HLA-identical siblings between 1994 and 2008 were divided into 2 groups (same and mismatched) according to gender of donor and recipient. The analyzed variables were age, gender, cholesterol, triglyceride, proteinuria, estimated glomerular filtration rate, weight, body mass index, and serum creatinine at 6, 12, 24, 36, 48, and 60 months, and median follow-up. Univariate and multivariate logistic regression models (when appropriate) were used to evaluate the effects of variables on allograft survival. Results. The number of male donors (P = .001) and recipient age (P = .019) was significantly higher in the same gender group than in mismatched gender group; there were no relationships between remainder analyzed parameters. Multivariate regression analysis revealed that after median follow-up period of 84 months (range, 60-232) the most important potential factors to significantly influence long-term outcomes were male donor (P = .002), recipient age (P < .001), and donor age (P = .021). Conclusion. Our study demonstrated that male donor, and donor and recipient age affected long-term survival of HLA-identical SRTs, supported with antibody induction therapy and lifetime immunosuppression.Öğe Is There a Relationship Between Paratracheal Air Cysts and Upper Lobe Fibrosis?(Lippincott Williams & Wilkins, 2016) Ünlü, Elif Nisa; Balbay, Ege Güleç; Boran, Mertay; Sungur, Mehmet Ali; Büyükkaya, Ayla; Şafak, Alp AlperObjective The purpose of this study was to determine the characteristics of paratracheal air cysts (PACs) and their relationship with upper lobe pulmonary fibrosis. Materials and Methods The routine thoracic computed tomography scans of 3549 patients carried out between January 2014 and April 2015 were retrospectively evaluated. The presence, location, structural characteristics (uniloculated or multiloculated), number of cysts, and anterior-posterior and transverse dimensions of the PAC and its communication with the tracheal lumen were evaluated. The presence of upper lobe fibrosis, emphysema, and bronchiectasis was also evaluated. The relationship between upper lobe fibrosis, emphysema, bronchiectasis, and the presence of paratracheal cysts was evaluated in all patients. An equal number of randomized patients with no paratracheal cysts were selected as a control group. Results A total of 190 PAC cases were diagnosed, with a prevalence rate of 5.35%: 146 (76.8%) of the cases were men, 44 (23.2%) were female, and the mean (SD) age was 53.79 (16.64) years (range, 12-89 years). The control group included 105 men (57.4%) and 78 women (42.6%), and the mean (SD) age was 53.87 (16.65) years (range, 13-87 years). The groups were similar in terms of age (P = 0.876), whereas the proportion of men in the PAC group was significantly higher (P < 0.001). Most of the PACs were located on the right side (n = 188, 98.9%). The incidence of fibrosis in the paratracheal cyst group was 45.8% (n = 87) compared with 19.5% (n = 37) in the control group; this difference was statistically significant (P < 0.001). The prevalence rates of emphysema in the cyst group and the control group were 29.5% (n = 56) and 11.6% (n = 22), respectively, and the difference was statistically significant (P < 0.001). When the groups were compared regarding bronchiectasis (scar and non-scar related), the rate of bronchiectasis in the paratracheal cyst group was 17.9% (n = 34), compared with 3.7% (n = 7) in the control group; this difference was statistically significant (P < 0.001). Conclusions Paratracheal air cysts are relatively common, but the etiology is still unclear. We detected increased rates of cyst formation that may result from the traction effect on the tracheal wall in the presence of upper lobe fibrosis.Öğe Late-Onset BK Viruria in Renal Transplant Recipients(Elsevier Science Inc, 2015) Boran, Mediha; Yıldırım, Tuğçe; Boran, Ertay; Boran, Mertay; Kılıç, H.Background. Most cases of BK virus (BKV) infections emerge within the 1st years of kidney transplantation. We aimed to determine the prevalence of late-onset BKV infection and whether there are any differences between risk factors in early and late BKV infections. Methods. In this single-center retrospective study, we reviewed 300 kidney transplant recipients that were under regular follow-up and selected recipients with BKV infection and recorded associated risk factors, connection with immunosuppression, and responses to modification of treatment. Results. BKV was detected within the 1st 5 years after transplantation in 20 patients (6.6%, group 1) and after 5 years in 15 patients (5.0%, group 2). There were no significant differences between the 2 groups regarding age, sex, sex mismatches, donor type, BKV elimination time, serum creatinine, and estimated glomerular filtration rate at the times of BKV detection and last follow-up visit. In group 1, 2 recipients had biopsy-proven BKV-associated nephropathy (BKVAN), 3 recipients had BK viruria and viremia without BKVAN (biopsy proven), and 15 recipients (75%) had only BK viruria. In group 2, all of the patients had only BK viruria. In this group, on detection of BK viruria and immediate modification of immunosuppressive regimens prevented BK viremia. Conclusions. Routine screening of renal transplant recipients for BKV was indicated not only during the 1st 5 years, but also for the full follow-up period after transplantation.Öğe Late-onset BK viruria in renal transplant recipients [conferenceObject](Lippincott Williams & Wilkins, 2016) Boran, Mediha; Yıldırım, Tolga; Boran, Ertay; Boran, Mertay…Öğe Noninvasive Ventilation in Esophagectomy Postoperative Surgery(Nova Science Publishers, Inc., 2022) Boran, MertayAlthough significant advances in anesthesia, pain control, surgical techniques, and postoperative intensive care follow-up and preoperative risk assessment have reduced mortality rates after esophageal resections, post-surgical morbidity and mortality rates are still high. Pulmonary complications after esophagectomy are common, and can be a cause of hospital mortality. Early intervention of aggressive pain control, decreased fluid administration and prophylactic effective chest physiotherapy, is considered as a key factor in preventing respiratory complications. Ventilation management in the patients after esophagectomy is more challenging because of the difficulty in maintaining a balance between avoiding further damage to the anastomosis and adequate ventilation. While noninvasive positive pressure ventilation is associated with fewer complications than endotracheal intubation, it is relatively contraindicated after esophagectomy due to potential injury to the anastomosis. Understanding the impact of esophageal surgery on clinical symptoms is important for successful treatment management and effective NIV administration in esophagectomy patients with acute respiratory failure. © 2022 by Nova Science Publishers, Inc.Öğe Noninvasive Ventilation in Renal Transplant. Perioperative and Postoperative(Nova Science Publishers, Inc., 2022) Boran, Ertay; Boran, MertayLife expectancy after kidney transplantation has improved over the past decade. Elderly patients with comorbid diseases not previously considered for kidney transplant are now seen as potential recipients. Besides, kidney transplantation is now performed with kidneys donated by living, unrelated donors. This potentially requires stronger immunosuppression and leads to a higher risk of complications. Respiratory failure (RF) in the postoperative period has a high risk of mortality and morbidity. It extends the length of stay in the hospital and in the intensive care unit (ICU). Early application of NIV in renal transplant recipients with RF was well tolerated and associated with a rapid and sustained improvement. © 2022 by Nova Science Publishers, Inc.Öğe Pons Bleeding: Physical Treatment Time and Amantadin Sulfate in Intensive Care: Miracle?(Lippincott Williams & Wilkins, 2021) Boran, Ertay; Boran, Mertay[Bastract Not Available]Öğe Rare Complications of COVID-19 Pneumonia: Pneumomediastinum and Atrial Fibrillation(Duzce Univ, Fac Medicine, 2021) Tunc, Seyma; Yildiz, Pinar; Boran, MertayObjective: Coronavirus disease 2019 (COVID-19) is considered as systemic disease involving many vital organs in addition to the lungs, including the heart, liver, and kidneys. Pneumomediastinum associated with COVID-19 pneumonia is a rare condition usually seen in patients with underlying lung pathology, infections, or mechanical intubation. We presented a case of late diagnosis of pneumomediastinum and atrial fibrillation in COVID-19 patient undergoing Noninvasive mechanical ventilation (NIMV). Case: A 66-years-old male patient with a history of COVID-19 pneumonia and 19 days hospital follow up and a NIMV treatment was admitted to our emergency department with palpitations and dyspnea. Thoracic CT and electrocardiography revealed, scattered ground glass areas, pneumomediastinum and high-velocity atrial fibrillation, respectively. Conclusion: We recommend regular checks with imaging methods and ECG during follow-up in patients with COVID-19. Clinicians should remember that ventilator-related lung damage may be seen in COVID-19 patients undergoing NIMV.Öğe Renal Resistance Indices After Kidney Transplantation(Wiley-Blackwell, 2014) Boran, Mediha; Tola, Muharrem; Boran, Mertay; Boran, Ertay…Öğe Renal Resistance Indices After Kidney Transplantation.(Lippincott Williams & Wilkins, 2014) Boran, Mediha; Tola, Muharrem; Boran, Mertay; Boran, Ertay…Öğe Shear Wave Ultrasound Elastography and Diffusion-Weighted Magnetic Resonance Imaging Findings of Pleural Based Masses with Histopathologic Correlation(Duzce Univ, Fac Medicine, 2021) Unlu, Elif Nisa; Altinsoy, Hasan Baki; Balaby, Ege Gulec; Sungur, Mehmet Ali; Boran, Mertay; Onal, BinnurObjective: The study aims to evaluate the usefulness of non-invasive diagnostic methods, shear wave elastography (SWE), and diffusion-weighted magnetic resonance imaging (DWI) to differentiate benign and malignant lesions in the thoracic pleural based masses by comparing them with histopathological findings. Methods: Sixty-three patients having a pleural-based peripheral mass on computed tomography (CT), admitted to the interventional radiology department for transthoracic biopsy, were included in the study. All patients underwent DWI, and ADC values of the groups were measured. Transthoracic biopsy was performed with the guidance of US from the area where the highest shear wave velocity (SWV) value was calculated. ADC and SWV values of histopathologically proven benign and malignant lesions were statistically compared. Results: Fifty-six patients were male, and seven were female. The mean age was 64.68 +/- 10.13 years (41-85 years). Fourty-four patients were malignant, and 19 were benign. The maximum SWV was found to be 4.13 +/- 0.59 m/s in malignant cases and 3.55 +/- 0.71 m/s in benign cases, and the difference was significant (p = 0.001). Mean ADC value was measured as 1.04 +/- 0.30 x 10-3 mm2/s in malignant cases and 1.32 +/- 0.33 x 10-3 mm2/s in benign cases on DWI and the difference was significant (p = 0.002). In malignant cases, the minimum ADC was 0.73 +/- 0.29 x 10-3 mm2/s, and 0.99 +/- 0.44 x 10-3 mm2/s in benign cases, the difference was significant (p = 0.024). ROC analysis revealed a cut-off value of >= 4.08 m/s for SWVmax, <= 1.01x10-3 mm2/s for mean ADC, and <0.8x10-3 mm2/s for minimum ADC showed a significant performance in distinguishing malignant and benign lesions. Conclusions: Transthoracic US elastography and DWI are useful in differentiating malignant and benign lesions in appropriate cases. Both SWE and DWI are useful in routine use because they are non-invasive and do not contain radiation. In particular, SWE is suitable for biopsy guidance and may prevent the possibility of insufficient material.Öğe An unusual cause of recurrent spontaneous pneumothorax: the Mounier-Kuhn syndrome(W B Saunders Co-Elsevier Inc, 2016) Ünlü, Elif Nisa; Annakkaya, Ali Nihat; Balbay, Ege Güleç; Aydın, Leyla Yılmaz; Safçı, Sinem; Boran, Mertay; Güçlü, DeryaWe present a case of 63-year-old man who was referred to the emergency department with a right-sided pneumothorax. He had a history of spontaneous pneumothorax for 2 times. The chest computed tomographic scan showed tracheobronchomegaly with an increase in the diameter of the trachea and right and left main bronchus. Fiberoptic bronchoscopy revealed enlarged trachea and both main bronchus with diverticulas. These findings are consistent with a diagnosis of Mounier-Kuhn syndrome. Mounier-Kuhn syndrome is a rare clinical and radiologic condition. It is characterized by a tracheal and bronchial dilation. Diagnosis is made by computed tomography and bronchoscopy. Mounier-Kuhn syndrome should be kept in mind in the differential diagnosis of recurrent spontaneous pneumothorax.
