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    Pulmonary physician consultancy in emergency services in Turkey (PUPCEST) - a prospective multicenter study
    (European Respiratory Soc Journals Ltd, 2018) Diken, Özlem Erçen; Ekici, Aydanur; Bektaş, Hayriye; Yıldız, Hanifi; Tabaru, Ali; Ogan, Nalan; Özlü, Tevfik
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    Pulmonary Physician Consultancy in Emergency Services in Turkiye (PuPCEST) - a cross-sectional multicenter study
    (Lippincott Williams & Wilkins, 2024) Diken, Ozlem Ercen; Kaya, Serife; Aksoy, Hayriye Bektas; Ekici, Aydanur; Capraz, Aylin; Tabaru, Ali; Dikis, Ozlem Sengoren
    Pulmonology is one of the branches that frequently receive consultation requests from the emergency department. Pulmonology consultation (PC) is requested from almost all clinical branches due to the diagnosis and treatment of any respiratory condition, preoperative evaluation, or postoperative pulmonary problems. The aim of our study was to describe the profile of the pulmonology consultations received from emergency departments in Turkiye. A total of 32 centers from Turkiye (the PuPCEST Study Group) were included to the study. The demographic, clinical, laboratory and radiological data of the consulted cases were examined. The final result of the consultation and the justification of the consultation by the consulting pulmonologist were recorded. We identified 1712 patients, 64% of which applied to the emergency department by themselves and 41.4% were women. Eighty-five percent of the patients had a previously diagnosed disease. Dyspnea was the reason for consultation in 34.7% of the cases. The leading radiological finding was consolidation (13%). Exacerbation of preexisting lung disease was present in 39% of patients. The most commonly established diagnoses by pulmonologists were chronic obstructive pulmonary disease (19%) and pneumonia (12%). While 35% of the patients were discharged, 35% were interned into the chest diseases ward. The majority of patients were hospitalized and treated conservatively. It may be suggested that most of the applications would be evaluated in the pulmonology outpatient clinic which may result in a decrease in emergency department visits/consultations. Thus, improvements in the reorganization of the pulmonology outpatient clinics and follow-up visits may positively contribute emergency admission rates.
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    Therapeutic Treatment with Abdominal Adipose Mesenchymal Cells Does Not Prevent Elastase-Induced Emphysema in Rats
    (2020) Gülhan, Pınar Yıldız; Ekici, Mehmet Savaş; Ekici, Aydanur; Niyaz, Mehmet; Gülhan, Muhammet; Ercin, Mustafa Emre; Aksoy, Nurkan
    OBJECTIVES: Emphysema and chronic bronchitis have different pathophysiologies but both are significant components of chronic obstructive lung disease (COPD). The levels of Matrix metalloproteinase (MMP)-9 in the bronchoalveloar lavage fluid (BALF) and in serumindicate the presence of emphysema. Intratracheal administration of elastase has been used to create a rat model of emphysema. Adiposetissue-derived mesenchymal stem cells (MSC) have been postulated to prevent or reverse emphysema, however, this has not been examined in the rat model of elastase-induced emphysema.MATERIALS AND METHODS: In this study, 31 Wistar albino rats aged 6–8 weeks and weighing 250–300 g were assessed. On day 1, theanimals were treated intratracheally with 0.5 mL saline (control group, n=10), i.e., 0.5 mL saline solution containing 0.1 IU porcine pancreatic elastase (PPE) (Elastase group, n=12) or PPE plus MSC (Elastase-MSC group, n=9) was adminstered per animal. MSCs suspendedin serum were injected via the caudal vein on day 21. At least 106 cells were injected. All animals were sacrificed on day 42 and theemphysema index (EI) was calculated, along with measuring the BALF and serum MMP-9 concentrations.RESULTS: Porcine pancreatic elastase induced a significant degree of emphysema in the PPE groups as compared to the control group,which was determined by the EI index (p=0.008). This was not reversed by MSC treatment. The EI remained significantly low in comprison with the controls (p=0.001) and measured no different from the Elastase-treated animals. There was no statistically significantdifference between the BALF and serum MMP-9 levels between the control and treatment groups.CONCLUSION: Our findings suggest that therapeutic treatment with adipose tissue-derived MSC in rats has no effect on emphysema oron MMP9 expression, which is a known marker of emphysema.