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Öğe A Case of Miliary Tuberculosis Detected with Laryngeal Oedema: Complication with Septic Shock and Thrombocytopaenia(Aves, 2013) Bulcun, Emel; Ekici, Aydanur; Ekici, Mehmet; Gulhan, Pinar Yildiz; Gungor, Omur; Kazkayasi, MustafaTuberculosis, a disease with a wide clinical spectrum, can involve all tissues and organs. A 57-year-old case appeared in the form miliary tuberculosis after laryngeal oedema. Septic shock developed in the course of tuberculosis. Thrombocytopaenia then developed, while septic shock improved following antituberculosis treatment. Thrombocytopaenia improved after rifampicin was removed from the treatment regimen. We decided to present our case here as an interesting form of tuberculosis with complications.Öğe Affect status and perception of exacerbation in patients with asthma(Ocean Side Publications Inc, 2010) Ekici, Aydanur; Ekici, Mehmet; Bulcun, EmelExacerbations occur commonly in patients with asthma but factors affecting perception of dyspnea during exacerbation are not well known. This investigation was designed to determine the effects of negative mood on perception of dyspnea during exacerbation. A total of 47 patient aged 28-78 years (mean age, 52.5 years) admitted with acute asthma had recordings of blood gas pressure, negative mood score, forced expiratory volume in 1 second (FEV1), and dyspnea score at admission and at the 72nd hour. Perceived intensity of dyspnea was estimated using a modified Borg scale. The negative mood was assessed with an overall of six mood adjectives (nervous-anxious, sad-blue, and tired-drowsy). High negative mood score was defined as the score above the cutoff point (median score, >7). Borg sore of patients with a high negative mood score was higher than that of patients with a low negative mood score (6.3 +/- 2.5 versus 4.4 +/- 2.4; p +/- 0.01). The high Borg sore of asthmatic patients with high negative mood persisted even at the 72nd hour (1.6 +/- 0.9 versus 1.0 +/- 0.7; p +/- 0.01). FEV1 values of both groups at admission were similar. The negative mood score (beta = 0.68; p = 0.0001) and initial FEV1 (beta = -0.42; p = 0.01) were the important determinants of Borg score at admission in all patients with multivariate analysis but not arterial oxygen pressure, arterial carbon dioxide pressure, asthma duration, and female sex. This study indicated that emotional factors, as well as the level of airways obstruction, predicted the magnitude of dyspnea at exacerbation of asthmatic patients. Thus, the emotional factors should be taken into account in the treatment of dyspnea at exacerbation.Öğe Assessment of patients' preferences regarding the characteristics associated with the treatment of chronic obstructive pulmonary disease(Dove Medical Press Ltd, 2014) Bulcun, Emel; Ekici, Mehmet; Ekici, AydanurObjective: Patient preferences regarding characteristics associated with the treatment of chronic obstructive pulmonary disease (COPD) must be determined to increase the compatibility between the patients and the treatments, but as yet no studies have been performed regarding these characteristics. Here, we evaluate the preferred characteristics associated with the treatment of patients with COPD. Method: The expectations of patients receiving COPD therapy were assessed in six categories: time allocated by the physician to listen to patients' complaints, treatment to be applied, estimated adverse effect frequency concerning the therapy, ability of patients to visit the same physician each time, integral approach of the physician to the treatment of the patient, and therapy cost. These groups were divided into categories of therapy indicating 25 alternative treatment methods, using conjoint analysis. Patients were sorted to the 25 types of treatment with regard to their preferences. Results: The major expectation of conjoint analysis associated with the treatment of COPD patients is for the therapy to allow the patients to completely recover from their complaints. The order preferred by patients of other treatment expectations is from sufficient time to be allowed by the physician to listen to the patient, to no cost for the treatment, to minimum adverse effects resulting from the treatment, to each follow-up to be performed by the same physician, and to the physician performing an assessment of the patient's well-being, rather than examining only the areas of complaint. Conclusion: The major expectation of COPD patients regarding treatment was to completely recover with the help of the therapy. Considering the expectations of the patient may help improve the compatibility of the patient with the treatment.Öğe Bir Olgu Sunumu: Hipersensitivite Pnömonisi(2016) Bulcun, Emel; Ekici, Aydanur; Ekici, Mehmet; Çifci, Aydın; Cerit, AhuNefes darlığı, öksürük semptomları ile gelen PA akciğer grafisi doğal olan ancak detaylı anamnezle güvercin maruziyeti öyküsü tarifleyen ve hipersensitivite pnömonisi tanısı alan olguyu sunduk. 66 yaşında erkek hasta üç aydır olan nefes darlığı, öksürük şikayetleri ile polikliniğine başvurdu. Fizik muayenesinde solunum sesleri doğaldı. Çevresel, mesleksel maruziyet ve özellikli bir ilaç kullanım öyküsü yoktu. PA akciğer grafisi normaldi. Toraks yüksek çözünürlüklü bilgisayarlı tomografi (YÇBT)'de orta ve alt loblarda daha belirgin olan yaygın buzlu cam dansitesinde sentriasiner nodüller izlendi. Hastanın evin çatısındaki güvercinlere ait atık ürünlerini haftalık temizlediği öğrenilmesi üzerine güvercinlerle direk ve dolaylı maruziyetinin kesilmesi önerildi. Bir ay sonraki kontrolünde öksürük ve nefes darlığı semptomlarında gerileme olduğu öğrenildi. Kontrol toraks YÇBT'de her iki akciğerde izlenen yaygın sentriasiner nodüllerin kaybolduğu görüldü. Nefes darlığı, öksürük gibi semptomlarla başvuran hastalarda akciğer grafisi normal bile olsa hipersensitivite pnömonisinin de olabileceği göz önünde bulundurulmalı ve hastaların maruziyet öyküsü detaylı olarak sorgulanmalıdırÖğe Case of round pneumonia: pulmonary infarct and a rare situation that is similar with the lung cancer(Wiley-Blackwell, 2015) Cimen, Dilay; Bulcun, Emel; Ekici, Aydanur; Gungor, Omur; Ekici, MehmetBackground and AimsRound pneumonia (RP) is a rare radiological presentation of a subtype of lobar pneumonia that arises because of a developmental defect in connective tissues (pores of Kohn and channels of Lambert). The round appearance on chest X-ray (CXR) is thought to occur from an infectious process that spreads from small peripheral alveoli centrifugally through interalveolar channels via the pores of Kohn and the canals of Lambert. This explains the nonsegmental distribution and shape of RP. The pathogenesis of RP is unknown. An alternative theory holds that RP in children occurs because of underdeveloped pores of Kohn and the absence of canals of Lambert, limiting the spread of the organism and resulting in a focal, round mass seen on radiographs. As a result of this developmental defect, dissemination of infection remains in a limited area. While this is a well-known entity in childhood, it has been described infrequently in adults. Lesions of RP are not necessarily round; oval lesions can also be seen. It is a radiological subtype of the pneumonia subtype and presents as a solitary nodule or a mass lesion in CXR. MethodsWe presented two cases of RP. One mimicked and was mistaken for pulmonary infarction because of triangular pleural-based density and the other mimicked pulmonary malignancy because of a homogeneous triangular opacity based on the pleura on the posteroanterior radiography and computed tomography. ConclusionThese cases were presented because of RP's importance, and RP should be considered a part of differential diagnosis of pulmonary infarct and lung tumor.Öğe Chronic airway diseases in adult life and childhood infections(Karger, 2008) Ekici, Mehmet; Ekici, Aydanur; Akin, Ahmet; Altinkaya, Volkan; Bulcun, EmelBackground: Respiratory disorders in childhood may predispose to pulmonary disease in late adult life. Objectives: The aim of this study was to evaluate the relationship between their effects in adult life and the characteristics of the respiratory system in childhood. Methods: A total of 10,224 parents and grandparents of students from 14 randomly selected primary schools in the city center were asked to answer questionnaires given to their children. 9,853 of 10,224 persons (the overall response rate was 96.3%) were eligible for analysis. In the questionnaire subjects were asked about respiratory system-related symptoms and characteristics. Results: Chronic cough [14.3 vs. 4.7%, OR 3.4 (2.6 - 4.4), p < 0.001], chronic bronchitis [35.3 vs. 11.8%, OR 4.0 (3.4 - 4.8), p ! 0.001] and asthma [34.2 vs. 5.1%, OR 9.6 (8.0 - 11.5), p < 0.001] in the childhood respiratory infection group were more common than in the control group. Childhood respiratory infections were associated with an increased risk of asthma (OR 5.6, p < 0.001), chronic bronchitis (OR 2.3, p < 0.001) and chronic cough (OR 1.5, p < 0.001), after adjusting for possible confounding factors. In addition, the presence of dampness or visible mould, wall-to-wall carpets, pets at home and parents' smoking during childhood were associated with an increased risk of frequent childhood respiratory infections. Conclusion: These results indicated that frequent respiratory infections during childhood might play an important role in the occurrence of chronic airway diseases in adult life. The removing of risk factors for frequent childhood respiratory infections may reduce the subsequent risk of chronic airway disease in late adult life. Copyright (C) 2007 S. Karger AG, Basel.Öğe Effects of Septoplasty on Pulmonary Function Tests in Patients with Nasal Septal Deviation(Bmc, 2010) Bulcun, Emel; Kazkayasi, Mustafa; Ekici, M. Aydanur; Tahran, Filiz Datli; Ekici, MehmetObjective: To investigate the effects of septoplasty on pulmonary function tests (PFTs) and bronchial hyperresponsiveness (BHR) in patients who had no previous pulmonary diseases. Design: Prospective, controlled clinical trial. Patients: Fourteen patients with nasal septal deviation (NSD) and 20 controls were enrolled in the study. Main Outcome Measures: All patients were evaluated with anterior rhinoscopy, nasal endoscopy, acoustic rhinometry (AR), visual analogue scale (VAS), PFTs, and bronchoprovocation test (BPT) on the day before surgery and 8 to 12 weeks after surgery. Results: The postoperative values of forced expiratory volume in 1 second, forced vital capacity, and peak expiratory flow percentages were higher than preoperative ones, and these results were statistically significant (p = .007, p = .04, and p = .007, respectively). Nine patients had preoperative BHR, and three of them had negative BPT postoperatively. When compared with the preoperative values, there was a borderline decrease in the rate of BHR in six patients. There were significant improvements in the symptoms of left and right nasal congestion, headache, postnasal drip, and olfactory function after surgery. We found important improvement in the values of AR at right minimal cross-sectional area 1 (p = .02), left distance 1 (p = .04), and left distance 2 (p = .04) postoperatively. Conclusion: An improvement in both nasal symptoms and PFT values was seen after surgical treatment for NSD. We concluded that septoplasty may be considered as having favourable effects on BHR.Öğe Effects of Timolol and Latanoprost on Respiratory and Cardiovascular Status in Elderly Patients With Glaucoma(Mary Ann Liebert, Inc, 2009) Ergin, Ahmet; Örnek, Kemal; Güllü, Reyhan; Bulcun, Emel; Ekici, Mehmet; Ekici, AydanurPurpose: To investigate the respiratory and cardiovascular effects of switching therapy from topical timolol 0.5% to latanoprost 0.005% in elderly patients with glaucoma. Methods: Twenty-five patients with primary open-angle glaucoma (POAG) who were treated with topical timolol 0.5% were included in the study. The beta-blocker treatment was ended due to insufficient intraocular pressure (IOP) and systemic or local side effects. The treatment then switched to latanoprost in these patients. All recruited patients underwent a full ocular, cardiovascular, and respiratory examination including spirometry, pulse rate, and blood pressure. All measurements were made 1 day before the beta-blocker treatment was ended and 30 days after the latanoprost treatment was started. Results: Timolol treatment was associated with numerically but not statistically significant lowered pulse rates, systemic blood pressure, diastolic blood pressure, and reductions in the spirometry measurements. The change to latanoprost treatment was associated with numerical improvement in mean values of spirometric test results. There were no significant differences in changes in mean values of spirometry, pulse rate, or blood pressure. Histamine challenge test was determined to be positive in 16 of 25 patients for timolol, of whom 10 were positive for latanoprost. This was statistically significant (P < 0.05). Conclusions: Although all the results presented were statistically insignificant, switching to latanoprost treatment may offer some advantages in respiratory and cardiovascular function for elderly people with glaucoma over beta-blocker drugs. Spirometry and the measurement of pulse rate and blood pressure are advised in all patients receiving topical beta-blocker therapy.Öğe Factors Influencing Cognitive Function in Subjects With COPD(Daedalus Enterprises Inc, 2016) Dag, Ersel; Bulcun, Emel; Turkel, Yakup; Ekici, Aydanur; Ekici, MehmetBACKGROUND: The aim of this study was to assess the association between cognitive function and age, pulmonary function, comorbidity index, and the 6-min walk distance in subjects with COPD as well as to compare the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in terms of their ability to identify cognitive dysfunction in subjects with COPD. METHODS: A total of 52 individuals with stable COPD were included in this study. Cognitive function was assessed using MMSE and MoCA. Age, body mass index, the Modified Cumulative Illness Rating Scale, 6-min walk distance, arterial blood gases, and pulmonary function tests were assessed and recorded. RESULTS: The range and SD of scores in subjects with COPD were larger with MoCA than with MMSE. MMSE and MoCA scores are associated with 6-min walk distance and comorbidity index in subjects with COPD. General cognitive function measured by MoCA was negatively correlated with the comorbidity index but was positively associated with 6-min walk distance in subjects with COPD after controlling for possible confounding factors in the multivariate model. However, general cognitive function measured by MMSE was not correlated with the comorbidity index and 6-min walk distance in subjects with COPD, after controlling for possible confounding factors in the multivariate model. CONCLUSIONS: MoCA may be a more reliable screening test than MMSE in detecting cognitive impairment in subjects with COPD. The addition of cognitive tests on assessment of subjects with COPD can provide further benefit.Öğe Female sexual and hormonal status in patients with bronchial asthma: Relationship with respiratory function tests and psychological and somatic status(Elsevier Science Inc, 2007) Başar, M. Murad; Ekici, Aydanur; Bulcun, Emel; Tuğlu, Devrim; Ekici, Mehmet S.; Batislam, ErtanOBJECTIVES To assess the relationship among the sexual, hormonal, physical, and psychological status of women with bronchial asthma (BA) compared with that of healthy volunteers. METHODS Thirty-eight women with BA were enrolled in the study. The patients were asked to complete the Female Sexual Function Index, General Health Questionnaire, and Medical Outcomes Study Short Form 36-item Health Survey (SF-36). Using the answers on the SF-36, the mental and physical component summary scores were calculated. A total of 20 healthy women were enrolled in the study as the control group. The same questionnaires were given to this group as well. Statistical analysis was performed using the Mann-Whitney U test and Pearson correlation tests. RESULTS At the end of the study, statistically significant differences were observed for all questionnaire scores (P <0.05). The most common female sexual dysfunction was diminished arousal (n = 30, 78.9%) in women with BA. In the correlation analysis, the total Female Sexual Function Index score had a statistically significant and positive correlation with the mental component summary score (r = 0.503, P = 0.001) and a negative correlation with the General Health Questionnaire score (r = -0.380, P = 0.020). CONCLUSIONS The results of our study have shown that BA, as a chronic medical condition, can be a cause of female sexual dysfunction with mental and psychiatric mechanisms.Öğe Five annual observations of respiratory findings in gun factory workers exposed to solvents(2007) Saygun, Meral; Çakmak, Aytul; Ekici, Aydanur; Pinar, Tevfik; Bulcun, Emel; Ulu, Nuriye; Ekici, MehmetOBJECTIVE: We investigated whether long-term, low-level exposures to solvents had adverse longitudinal effects on pulmonary functions. METHODS: The study was performed on 1091 workers 5 years ago and then on 697 workers 5 years later. Chronic respiratory symptoms were recorded using a questionnaire on respiratory symptoms. RESULTS: The annual decrease in forced expiratory volume in 1 second in the workers exposed to solvents was not significantly different from that of the unexposed workers (69.7 ± 89.9 vs 75.8 ± 87.6 mL/yr, P = 0.5, respectively). In 453 workers who were exposed to solvents 5 years ago, the prevalence rate of asthma was 1.1%. Five years later, it was 3.6% in 193 workers from the same group. The difference was statistically significant (P = 0.03). CONCLUSIONS: Longitudinally, the chronic exposure to low doses of solvents does not adversely affect the pulmonary functions, whereas it increases the asthma prevalence. ©2007The American College of Occupational and Environmental Medicine.Öğe The inflammation and insulin resistance in obstructive sleep apnea(European Respiratory Soc Journals Ltd, 2012) Bulcun, Emel; Ekici, Mehmet; Kısa, Üçler; Ekici, Aydanur…Öğe The Inflammation In Obstructive Sleep Apnea Syndrome(2015) Bulcun, Emel; Ekici, Mehmet Savaş; Kısa, Üçler; Ekici, AydanurAmaç: Obstruktif uyku apne sendromu (OUAS) ve inflamasyon arasındaki ilişki tartışmalıdır. Uyku apne ve obesite farklı mekanizmalarla inflamasyonu arttırabilir. Bu çalışma uyku apnesi ve obesite ile proinflamatuar durumun ilişkisini inceledi. Metod: Toplam 133 olguya polisomnografi yapıldı. Polisomnografileri yapılarak, apne hipopne indeksi (AHI)5 olan 112 OUAS tanılı hasta ve AHI5 olan 21 kontrol grubu birey çalışmaya dahil edildi. Kontrol grubu bireyler grup A olarak kabul edildi. Bununla birlikte OUAS tanılı hastalar VKİ'lerine göre non-obese grup (B grup) (VKİ30) ve obese grup (C grup) (VKİ30) olarak iki gruba ayrıldı. Bulgular: Tüm inflamatuar sitokinler (CRP, hs CRP, TNF-?, IL-6) obez uyku apneli hastalarda kontrol grubu bireylerden anlamlı olarak daha yüksekti. İnsülin rezistansı obez uyku apneli hastalarda obez olmayan hastalardan ve kontrol grubundan daha yüksekti fakat insülin rezistansı kontrol grubu ve obez olmayan uyku apneli hastalar arasında farklı değildi. Tüm inflamatuar sitokinler pearson korelasyon analizinde VKİ ile anlamlı ilişki gösterdi. Ancak multiple varians analizinde CRP, hs CRP VKİ ile anlamlı ilişkiliyken, TNF-?, IL-6'nın VKİ ile anlamlı ilişkisi yoktu. Tüm inflamatuar sitokinler yine bu analize göre desaturasyon indeksi ile anlamlı ilişkiliydi. Sonuç: Adipöz dokunun proinflamatuar durumun gelişiminde anahtar rol oynadığı için bu hastalarda obesite hem uyku apnesinin şiddetini arttırır hem de inflamasyonun artışını tetikler. OSAS'ın ve metabolik bozuklukların erken tespiti kardiovasküler morbidite ve mortalitenin azalmasına yardımcı olur.Öğe Kronik hava yolu hastalıklarında karbonmonoksit difüzyon değerleri(2009) Bulcun, Emel; Ekici, Aydanur; Şentürk, Erol; Arslan, Mesut; Akın, Ahmet; Ekici, MehmetKarbonmonoksit difüz yon (DLCO) ölçümü pulmoner gaz değişimi hakkında bilgi veren önemli ve kullanışlı noninvaziv bir testtir. Biz kronik hava yolu hastalıklarından astım, kronik obstrüktif akciğer hastalığı (KOAH) ve bronşektazi tanılı hastalarda difüzyon değerleri ile hastalık derecesi arasındaki ilişkiyi ve difüzyon değerlerini belirleyen faktörleri araştırdık. Çalışmaya astım tanılı 64, KOAH tanılı 78 ve bronşektazi tanılı 41 olmak üzere toplam 183 hasta ile sigara içmeyen 43 sağlıklı birey alındı. Atak döneminde olan 10 astımlı hasta hariç tüm hastalar stabil dönemde idi. Tüm olgulara solunum fonksiyon testi ve DLCO testi yapıldı. KOAH grubunda DLCO% ve DLCO/VA% değerleri astım, bronşektazi ve kontrol grubundan düşük bulundu (p0.001). Astımlı hastalarda atak döneminde DLCO% değeri; kontrol grubu, stabil dönemdeki orta ve ağır persistan astımlılardan yüksek bulundu (p0.05). Ağır persistan astımlılarda DLCO% değeri ise hafif persistan astımlılardan düşük bulundu (p0.05). Tüm hasta ve kontrol grubu birlikte değerlendirildiğinde, DLCO% ile FEV1% (r 0.49; p 0.0001), FEV1/FVC (r 0.36; p 0.0001) arasında ve DLCO/VA% ile FEV1% (r 0.16; p 0.01), FEV1/FVC (r 0.26; p 0.0001) arasında pozitif ilişki bulundu. Kronik hava yolu hastalıklarında DLCO kapasitesi obstrüksiyona paralel olarak azalmaktadır. DLCO değerleri kronik hava yolu hastalıklarının değerlendirilmesinde ve hastalık şiddetinin belirlenmesinde kullanılabilir.Öğe Kronik obstrüktif akciğer hastalığı olan olgularda tiroid fonksiyonları(2006) Ekici, Aydanur; Keleş, Hatice; Ekici, Mehmet; Kalpaklıoğlu, A. Füsun; Bulcun, Emel; Karlıdağ, Ali; Altınkaya, VolkanAmaç: Tiroid hormon regülasyonu, tiroid dışı sistemik hastalıklarda sıklıkla bozulur. Kronik obstrüktif akciğer hastalığı (KOAH) olanlarda kronik hipoksinin hipotalamik-hipofizer fonksiyon anormalliklerine yol açtığı bildirilmiştir. Biz de bu çalışmada, stabil KOAH'lı hastalarda tiroid fonksiyonları ve solunum fonksiyonları ile arter kan gazı (AKG) değerleri arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya "The Global Initiative for Obstructive Lung Disease (GOLD)" kriterlerine göre KOAH tanısı konulan, stabil dönemde ve farklı evrelerde olan 45 (43 erkek, 2 kadın) hasta ile 17 (14 erkek, 3 kadın) sigara içmeyen sağlıklı birey kontrol grubu olarak dahil edildi. Tüm bireylerin solunum fonksiyon testleri (SFT), AKG incelemeleri yapıldı. Serum serbest tiroksin (sTsub4/sub), serbest triiyodotironin (sTsub3/sub), tiroid stimülan hormon (TSH) düzeyleri ölçüldü. Sonuçlar: Hasta grubunun yaş ortalaması 59.86 11.11 (40-80) yıl, kontrol grubunun yaş ortalaması ise 56.88 9.93 (42-75) yıl idi ve iki grup arasında yaş ve cinsiyet dağılımı bakımından fark yoktu (sırasıyla p 0.33, p 0.09). İki grup arasında SFT ve AKG değerleri bakımından anlamlı fark mevcutken (p 0.05), sTsub3/sub, sTsub4/sub ve TSH değerleri açısından fark yoktu (p 0.05). KOAH gruplarının birbirleriyle karşılaştırılmasında ise sadece sTsub3/sub düzeyleri evre IV KOAH'lılarda evre II KOAH'lılara göre anlamlı olarak düşük bulundu (p 0.013). KOAH'lı hastalarda sTsub3/sub düzeyleri FEVsub1/sub L, FEVsub1/sub%, FVC L, pH, PaOsub2/sub ve oksijen satürasyonu (SaOsub2/sub) ile pozitif korelasyon (sırayla r 0.346, p 0.020; r 0.351, p 0.018; r 0.310, p 0.038; r 0.317, p 0.034; r 0.308, p 0.040 ve r 0.390, p 0.008) gösterirken yaş, sigara paket/yıl, PaCOsub2/sub ve hastalık süresi ile negatif korelasyon (sırasıyla r -0.355, p 0.017; r -0.332, p 0.026; r -0.330, p 0.027 ve r -0.432, p 0.003) gösterdi. TSH ve sTsub4/sub düzeyleri ile SFT ve AKG parametreleri arasında ise korelasyon saptanmadı. Yorum: Bizim çalışmamızda, stabil KOAH'lı hastalarda sadece sTsub3/sub düzeyleri SFT ve AKG değerlerinin gösterdiği hastalık ciddiyeti ile korele bulunmuştur. Bunun organizmanın hastalık ciddiyetine karşı bir cevabı olup olmadığı bilinmemektedir. Daha geniş longitüdinal çalışmalarla altta yatan mekanizmalar açıklanmalıdır.Öğe Larengeal Ödem ile Tanı Konulan Milyer Tüberküloz Olgusu: Septik Şok ve Trombositopeni Komplikasyonu ile Birlikte(2013) Bulcun, Emel; Ekici, Aydanur; Ekici, Mehmet; Gülhan, Pınar Yıldız; Güngör, Ömür; Kazkayası, MustafaTüberküloz, her doku ve organı tutabilen çok geniş klinik spektruma sahip bir hastalıktır. Elli yedi yaşında olgumuz larenks ödemi sonrasında milyer tüberküloz şeklinde karşımıza çıktı. Tüberkülozun seyrinde septik şok gelişti. Antitüberküloz tedavisi ile septik şok düzelirken trombositopeni gelişti. Tedaviden rifampisin çıkartıldığında trombositopenisi düzeldi. Olgumuzu tüberkülozun hem karşımıza geliş şekillerini hem de komplikasyonlarını irdelemek için burada sunmayı uygun buldukÖğe Low Cognitive Ability in Subjects With Bronchiectasis(Daedalus Enterprises Inc, 2015) Gülhan, Pınar Yıldız; Bulcun, Emel; Gülhan, Mustafa; Çimen, Dilay; Ekici, Aydanur; Ekici, MehmetBACKGROUND: Bronchiectasis may change cognitive function. The mechanism responsible for cognitive dysfunction in COPD may be neuronal damage caused by hypoxia. Cognitive function in patients with bronchiectasis is also likely to be affected by similar mechanisms. The goal of this study was to determine the frequency and determinants of low cognitive ability in subjects with stable bronchiectasis. METHODS: Thirty subjects with stable bronchiectasis and 25 healthy volunteers underwent a cognitive ability assessment using the Wechsler Adult Intelligence Scale. Bronchiectasis was diagnosed by high-resolution computed tomography of the chest. Age, body mass index, the Hospital Anxiety and Depression Scale, and pulmonary function were assessed. Perceived intensity of dyspnea after exercise (after climbing 3 flights of stairs) was estimated using a modified Borg scale. RESULTS: Mean scores on the verbal and performance tests and full-scale IQ scores were significantly lower in subjects with bronchiectasis than in healthy volunteers. Low cognitive ability in subjects with bronchiectasis was associated with higher depression scores, lower oxygen saturation, and poor lung function after adjusting for potential confounders in multivariate analysis. Borg scores after exercise in subjects with bronchiectasis and low cognitive ability were higher than those in subjects with bronchiectasis and high cognitive ability, despite similar P-aO2 and FEV1 in both groups. CONCLUSIONS: Low cognitive ability in subjects with bronchiectasis may be associated with reduced lung function, more serious hypoxemia, and higher depressive symptoms. Subjects with bronchiectasis and low cognitive ability feel more intense dyspnea than do those with high cognitive ability.Öğe Metabolic syndrome and chronic diseases in COPD(European Respiratory Soc Journals Ltd, 2012) Bulcun, Emel; Ekici, Aydanur; Ekici, Mehmet…Öğe Metabolic Syndrome And Chronic Diseases In Patients With Chronic Obstructıve Pulmonary Disease(2015) Bulcun, Emel; Ekici, Aydanur; Ekici, Mehmet SavaşAmaç: Kronik obstrüktif akciğer hastalığı (KOAH), metabolik sendrom (MS) ve komorbidite arasındaki ilişki üzerine yapılan önceki çalışmalarda bulunan sonuçlar tartışmalıdır. Bu nedenle biz bu çalışmada, KOAHlı hastalarda eşlik eden metabolik sendrom ve komorbiditeleri ayrı ayrı olacak şekilde inceledik. Yöntem: Bu çalışma periyodu sırasında, 66 KOAH ve kontrol grubu olarak da 40 kişi dahil edildi. Solunum fonksiyon testleri (SFT) flow sensitif spirometri ile ATS kriterlerine göre yapıldı. BODE indeksleri hesaplandı. Kronik hastalıklar şiddet indeksi Modifiye kümülatif hastalıklar değerlendirme ölçeği (MKHDÖ) kullanılarak değerlendirildi. MS, National Cholesterol Education Program (NCEP)a göre tanımlandı. Total metabolik bozukluk skoru da ayrıca hesaplandı. Bulgular: MKHDÖ skoru KOAHlı hastalarda kontrol grubundan anlamlı olarak yüksekti fakat total metabolik skor KOAH ve kontrol grubu arasında farklı değildi. MS KOAHlı hastalarda 18 kişide (%27.3), kontrol grubunda 8 kişide (%20) görüldü. MS görülme oranı evre II KOAHlı hastalarda evre IV KOAHlı hastalardan daha yüksekti (p:0.04). Lineer regresyon analizinde, MKHDÖ skoru BODE indeksi ile pozitif ilişki gösterirken, FEV1%, FVC%, FEV1/FVC% ile anlamlı negatif ilişki gösterdi. Ancak, MKHDÖ PO2 ile anlamlı ilişki göstermedi. Sonuç: Komorbiditeler ve MS KOAHın farklı evrelerinde görülür. Bu nedenle eşlik eden bu hastalıklar birbirinden ayrı ayrı olarak incelenmelidir.Öğe Metabolic syndrome in interstitial lung diseases(European Respiratory Soc Journals Ltd, 2015) Ekici, Aydanur; Bulcun, Emel; Ekici, Mehmet; Yildiz, Pinar; Karakoc, Tulay; Cimen, Dilay…
