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Öğe A global overview of genital tuberculosis from gynecologist's respect(Refik Saydam National Public Health Agency (RSNPHA), 2020) Görkem, Ümit; Arslan, SertaçTuberculosis (TB) is one of the most common 10 diseases that affect millions of people and result in death all over the world. Nowadays, there has been a significant decrease in mortality rates due to the improvement in TB diagnosis and effective treatment methods. However, TB is still a public health problem that remains important. TB is still among the most common non-obstetric causes of maternal mortality in the developing countries. Genital tuberculosis (GTB) is considered to be one of the important causes of infertility, pelvic pain, chronic pelvic inflammatory disease, dyspareunia and abnormal uterine bleeding. Therefore, negative consequences of GTB can be prevented or minimized by early diagnosis, appropriate and effective treatment. GTB often develops secondary to pulmonary TB or extrapulmonary TB foci in the kidneys, meninges, skeletal system and gastrointestinal system. The TB bacillus infects the genital system in 4 ways: 1-Hematogenous spread, 2-Lymphatic spread, 3-Descending direct spread, 4-Primary infection of the genitalia with sexual intercourse. In addition, the disease can be spread by the peritoneal dialysis in renal failure. The genital organs affected by GTB, in the order of frequency are; Fallopian tubes (90-100%), uterine endometrium (50-60%), cervix (5-15%), uterine myometrium (2-5%), vulva and vagina (1-2%). TB causes infertility by causing tubal damage and impaired endometrial receptivity in the genital tract. Endometrial damage resulting in intrauterine adhesions, menstrual abnormalities and impaired endometrial receptivity increases recurrent pregnancy losses and ectopic pregnancy risks. In addition, GTB should not be ignored for the differential diagnosis of pelvic masses. The most realistic treatment approach for the infertile patients with GTD is to direct the patients to the assisted reproductive techniques after evaluation of the endometrium. However, it should be kept in mind that pregnancy outcomes are not very successful with assisted reproductive techniques. Appropriate screening procedures for high-risk populations are extremely crucial for the prevention of gynecological, obstetric and reproductive adverse outcomes, and TB eradication. Recently, immigration rate has been increasing rapidly in Turkey, as all over the world. Therefore, TB, which is seen as a forgotten disease today, should be kept in mind in our gynecological and obstetric practice. © 2020 Refik Saydam National Public Health Agency (RSNPHA).Öğe Adverse effects of ingredients available in single nasal decongestant formulation at trachea and lungs on an experimental rat model(Discovery Publication, 2019) Arslan, Sertaç; Güney, Güven; Akyüz Ünsal, Ayşe İpek; Demir, Emre; Demirci, BuketBackground and Aim: There is little histologic data concerning effects of nasal decongestants on respiratory tract. We aimed to put forth the effects of mostly used ingredients of nasal decongestants on trachea and lower airways of rats. Materials and Method: Four-six months old 60 male rats were randomly categorized into 6 groups. Experimental drugs were applied to the same nostril twice daily for 8 weeks (Xylometazoline, Benzalkolyum, EDTA, Sorbitol and combined drug solution). Normal saline solution (NaCl % 0.9) applied for the controls. At the end, trachea and both lungs were dissected and kept in formaldehyde for histopathologic evaluation. Results: Inflammation and bronchial edema were most common findings. All rats in sorbitol group had increased numbers of type 2 pneumocytes. Eighty percent of BAC group had increased numbers of type 2 pneumocytes. Spillover of tracheal epithelium was seen mostly in sorbitol, EDTA and combined drug groups (60%, 87.5%, 50% respectively). Bronchial smooth muscle hypertrophy was seen mostly in BAC and EDTA group (70%, 62.5% respectively). Number of goblet cells showed significant difference between control-combined drug (p=0.025) and control-BAC (p=0.001) groups. Conclusion: Nasal decongestants might have adverse effects such as increased airway inflammation, edema, type 2 pneumocyte numbers and epithelial desquamation mostly.Öğe An unusual complication of Behcet disease: Spontaneous bilateral pneumothorax(W.B. Saunders, 2016) Gülyüz, Ömer Cenap; Arslan, SertaçBehcet disease is a multisystem vasculitis of unknown etiology, and pulmonary involvement is unusual. Concurrent bilateral pneumothorax is also seen rarely. To the authors' knowledge, this is the first reported case of Behcet disease with concurrent bilateral pneumothorax in the literature.Öğe Assessment of the risk of obstructive sleep apnoea syndrome among healthcare workers(2019) Güçlü, Özge Aydın; Karadağ, Mehmet; İntepe, Yavuz Selim; Acıcan, Turan; Arslan, Sertaç; Sertoğullarından, BünyaminIntroduction: Sleep deprivation is known to increase the risks for workplace accidents, neuro-behavioural symptoms and reduced quality of life. Shift work leads to sleep related problems, such as sleep deprivation, poor sleep quality and daytime sleepiness. The purpose of our study is to assess snoring prevalence and obstructive sleep apnoea risk among healthcare workers (HCWs) by using the Berlin Questionnaire. Materials and Methods: HCWs employed at different centres that agreed to take part in this study were enrolled. Employing the Berlin Questionnaire, demographic characteristics, smoking histories, comorbidities, on-call shifts, number of on-call shifts and sleep durations of the participants were surveyed. Results: 604 HCWs including specialist, nurse, junior doctor, medical student, clinical academic, health technician and hospital staff were enrolled in this study. In terms of sleep apnoea, 92 (15.1%) participants were identified as high-risk and 512 (84.8%) as low-risk according to the findings of the questionnaire. When the two groups identified as high and low risk for sleep apnoea according to the Berlin Questionnaire were compared, significant differences were found between the two groups in terms of age, sex, height, weight, BMI value and hypertension (p< 0.001 for all variables). Multivariate logistic regression analysis has shown that on-call shifts (OR= 0.199, CI= 0.053-0.747, p= 0.017) are negative associated with sleep apnoea risk. Conclusion: With extended working hours and on-call shifts increasing the risk of sleep disorders among HCWs, surveys designed for screening can be used to identify the prospective cases in this population for further examination.Öğe Clinical, radiological and prognostic features of influenza cases in the influenza epidemic during years 2016-2017(Ankara Üniversitesi, 2018) Erçen Diken, Özlem; Arslan, Sertaç; Akdoğan, Özlem; Yapar, Derya; Ünal, Özgür; Demir, Emre; Baykam, NurcanIntroduction: Influenza subtypes vary by clinical, radiological, and prognostic courses and may go along with viral pneumonia. We aimed to identify clinical, radiological, and prognostic aspects of influenza epidemic during years 2016-2017. Materials and Methods: Influenza cases reported to the Public Health Directorate in our city was assessed retrospectively. Clinical, radiological, and prognostic parameters were compared based on influenza subtypes. Results: We analyzed samples from 197 cases with suspected influenza. Mean age of the subjects was 51.17 ± 26.74. We found influenza A/H1N1, influenza A/H3N2, and influenza B in 59 (30.0%), 29 (14.7%), and 3 (1.5%) cases, respectively. Comorbidity was present in 48 (24.4%) cases. Most common radiological finding was interstitial pattern. Seventy-one and 79 per cent of H1N1 and H3N2 cases were influenza pneumonia, respectively. The prevalence of overall mortality was 5.5% with a predominance in H1N1 over H3N2. Influenza vaccination had been performed in 6.8% and 3.4% of H1N1 and H3N2 cases, respectively. We detected no mortality in any vaccinated patient. We identified 6 pregnant women, 2 of which ended up with preterm birth, and another one with abortion. Conclusion: Often manifested as lower respiratory tract infection, influenza may cause epidemics with increased mortality rate. Influenza should be suspected when interstitial pattern was seen on radiological images. H1N1 cases course worse. Since the prognosis is better in vaccinated patients, seasonal influenza vaccination among the community needs to be elevated. In addition, protective measures like vaccination should be taken in pregnancy to avoid preterm delivery or abortion. © 2018, Ankara University. All rights reserved.Öğe Çorum'da göğüs hastalıkları ve dermatoloji kliniklerinde solunum alerjenlerine yönelik deri prick testi sonuçları: 2 yıllık retrospektif çalışma(Hitit Üniversitesi, 2019) Arslan, Sertaç; Şenel, Engin; Öztekin, Aynure; Gülhan, Meral; Koşar, Nezahat; Taylan Özkan, Hikmet AyşegülAmaç: Bölgemizde en sık karşılaşılan alerjenleri belirlemek, erken tanıya ve koruyucu tedbirlere katkıda bulunmak. Gereç ve Yöntem: Hitit Üniversitesi Tıp Fakültesi Eğitim Araştırma Hastanesi, erişkin Göğüs Hastalıkları ve Cildiye Polikliniklerine 1 Ocak 2016 ile 30 Nisan 2018 tarihleri arasında alerjik yakınmalarla başvuran ve alerji deri testi (prick) yapılan 179 hasta retrospektif olarak değerlendirildi. Bulgular: Hastaların yaş ortalaması 31,4 ± 17,6 idi. Hastaların 70 (%39,1)'inde alerjik kontakt dermatit, 29 (%16,2)'sinde astım, 24 (%13,4)'ünde alerjik rinit mevcuttu. Erkek ve kadın hastalar arasında solunum alerjen duyarlılığı açısından fark saptanmadı. Solunum alerjeni pozitif bulunan hastaların 54 (%30,2)'sinde ev tozu akarı alerjisi, 28 hastada (%15,6) köpek tüyüne karşı alerji, 24 hastada (%13,4) hamam böceği alerjisi saptandı. Sonuç: Alerjik şikayetlerle cildiye ve göğüs hastalıkları kliniklerine başvuran hastalarda en çok ev tozu akarlarına karşı alerjik duyarlılık saptandı. Akar duyarlılığı çayır polenleri, hamamböceği ve köpek tüyü duyarlılığı ile birlikte anlamlı olarak yüksek oranlarda saptandı.Öğe Göğüs Hastalıkları Hastanesinde sağlık bakımı ilişkili pnömoni hastalarının değerlendirilmesi(Bozok Üniversitesi Tıp Fakültesi, 2017) Arslan, Sertaç; Demir, Emre; Tümtürk, Ayhanım; Erçen Diken, ÖzlemAmaç: Sağlık Bakımı ile İlişkili Pnömoniler (SBİP), sağlık hizmetlerinin yaygınlaşması ile önemi gittikçe artan, yüksek mortalite ve morbiditeye sahip hasta grubudur. Çalışmamızın amacı, göğüs hastanesinde SBİP tanısı ile tedavi edilmiş ve solunum örneklerinde etken üretilebilmiş hastaların yaş, cinsiyet, etken spektrumu, yatış süresi, yoğun bakım gereksinimi, tedaviye yanıt ve ölüm oranları yönünden SBIP kriterlerleri de gözönüne alınarak değerlendirilmesidir.Gereç ve Yöntemler: Ocak 2013-Temmuz 2014 tarihleri arasında Çorum Göğüs Hastalıkları Hastanesi'nde yatarak tedavi edilen Sağlık Bakımı İlişkili Pnömoni hastalarından, balgam/solunum yolu örneklerinde etken üretilebilmiş olan 52 olgu; yaş, cinsiyet, eşlik eden kronik hastalıklar, etken spektrumu, yatış süreleri, yoğun bakım ihtiyacı, başlangıç tedavisin yanıt ve ölüm oranı açısından retrospektif olarak incelendi.Bulgular: Toplam 52 olgu; 35 erkek (%67), 17 kadın (%33) hastadan oluşuyordu. Yaş ortalaması 71.87 bulundu. En sık görülen ek hastalık 42 (%81) olgu ile KOAH'tı. Yirmialtı hastada (%50) yoğun bakım gereksinimi ortaya çıktı. Nörolojik komorbidite YBÜ ihtiyacı (%88) ve mortalite (%77) için anlamlı risk faktörü olarak saptandı. Toplam 22 hasta (%42) kaybedildi. Başlangıç ampirik antibiyotik tedavisine göre takipte antibiyotik değişikliği gereksiniminde ve mortalitede anlamlı farklılık saptanmadı. Etkenlere göre mortalite oranında 13 hasta ile (%65) A. Baumanii ilk sırada yer aldı.Sonuç: Sağlık bakımı ilişkili pnömoni hastalarında tedavi başlangıcında seçilen antibiyotik rejiminin daha geniş spektrumlu tercih edilmesi ile mortalite ve yoğun bakım gereksiniminde azalma saptanmamıştır.Öğe Hemodialysis catheter-related septic pulmonary embolism(Nuh Zafer Cantürk, 2016) Arslan, Sertaç; Doğan, İbrahimSebasöz lenfadenomalar, preoperatif tanıda diğer parotisbezi tümörleriyle sıklıkla karışan, oldukça nadir görülenbenign tümörlerdir. Bu çalışmada, sağ parotis bezikuyruğunda lokalize, iki yıldır mevcut, 20x15 mmebatında, ağrısız kitle şikayetiyle kliniğimizde teşhis vetedavisi yapılan 60 yaşında kadın hastada saptanansebasöz lenfedenomun klinik, görüntüleme bulguları vehistopatolojik özellikleri literatür eşliğinde tartışıldı.Sebase lenfadenomaların tedavisi cerrahi olup, parsiyelparotidektomi yeterlidir. Preoperatif tanı için, ince iğneaspirasyon biyopsisi (İİAB), ultrasonografi (USG) vemagnetik rezonans görüntüleme (MRG) teknikleriayırıcı tanıda kullanılabilirÖğe Nadir Görülen Benign Akciğer Kitlesi: Endobronşial Lipom(2021) Arslan, Sertaç; Arı Yılmaz, Yasemin; Onaran Boyacı, Hilal; Güney, Güven; Gülhan, MeralAkciğerin benign tümörleri nadir görülmektedir. Endobronşiyal Lipom akciğerin çok nadir görülen benign bir tümörüdür. Yavaş büyüme gösteren bu tümör bronş obstrüksiyonuna neden olarak postobstüktif pnömoni, kalıcı parankim hasarı gibi patolojilere yol açabilmektedir. Bununla birlikte bu olgular astım, kronik bronşit gibi yanlış tanılarla uzun süre izlenebilmektedir. Kronik öksürük nedeniyle başvuran ve bronkoskopik biyopsi ile tanı konulan akciğerin nadir görülen benign tümörü olan Endobronşiyal Lipom olgusu literatür eşliğinde sunuldu.Öğe Predicting Malignant Mesothelioma by Analyzing Serum N-ERC/Mesothelin, C-ERC/Mesothelin, Hyaluronan, Osteopontin, and Syndecan-1 Levels(Aves, 2017) Arslan, Sertaç; Mundt, Filip; Metintaş, Selma; Ak, Güntülü; Dobra, Katalin; Hjerpe, Anders; Metintaş, MuzafferObjective: Tumor biomarkers are promising study areas for the early or differential diagnosis of malignant pleural mesothelioma (MPM). This study aimed to determine the effectiveness of analyzing serum N-ERC/mesothelin, C-ERC/mesothelin, hyaluronan, osteopontin, and syndecan-1 levels for distinguishing patients with MPM from those with metastatic malignant pleural diseases (MMPDs), benign pleural diseases (BPDs), and benign asbestos pleurisy (BAP). Methods: Tumor biomarker levels of serum samples of 230 cases were analyzed by enzyme-linked immunosorbent assays. Results: All investigated biomarkers did not reveal sufficient diagnostic information to distinguish MPM from MMPD. N-ERC/mesothelin showed moderate ability to distinguish MPM from BPDs and particularly BAP (sensitivities of 67% and 73%, respectively, and specificities of 84% and 86%, respectively). C-ERC/mesothelin had a lower efficacy than N-ERC/mesothelin, whereas osteopontin had a high specificity for distinguishing MPM from other pleural diseases (80%) but with a poor sensitivity (32%). Hyaluronan and syndecan-1 had only limited effects as individual biomarkers. However, logistic regression analysis indicated that all the studied biomarkers could contribute, and a logistic model improved their performance, with the receiver operating characteristic curve plot showing an area under the curve of 0.75. Thus, the investigated biomarkers were unable to provide sufficient sensitivity and specificity levels; however, they all may contribute as a basis for an expanded logistic multiparameter model. Conclusion: Patients with high N-ERC/mesothelin and C-ERC/mesothelin levels have a high risk for MPM; appropriate invasive procedures should be performed. The patients who have high tumor biomarker levels and undefinite histopathological investigation results at the first-line procedure, should be managed using further invasive procedures.Öğe Pulmonary Function, Aerobic Capacity and Related Variables in Patients With Ankylosing Spondylitis(2019) Çağlıyan Türk, Ayla; Arslan, Sertaç; Karavelioğlu, Yusuf; Kalçık, Macit; Özel, Sumru; Musmul, Ahmet; Şahin, FüsunObjectives: This study aims to evaluate the cardiopulmonary functions and exercise performance of patients with ankylosing spondylitis (AS) and to investigate the relationship between these parameters and disease activity, spine mobility and quality of life (QoL). Patients and methods: Forty-five patients with AS (group 1; 33 males, 12 females; mean age 43.1±12.1 years; range 22 to 70 years) and 30 control subjects (group 2; 23 males, 7 females; mean age 42.8±10.0; range 23 to 70 years) were included in the study. Disease activity was assessed with the Bath Ankylosing Spondylitis Disease Activity Index and spinal mobility measures with the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Ankylosing Spondylitis Quality of Life (ASQoL) Questionnaire and the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) were used. The pulmonary function test (PFT) and cardiopulmonary exercise testing (CPET) were performed. Results: There was no significant difference between groups 1 and 2 in terms of mean age. The peak expiratory flow value in PFT was significantly lower in group 1 (p<0.05). In group 1, the duration of CPET was significantly shorter, and maximum work load and metabolic equivalent were significantly lower than in group 2 (p<0.001). Maximum oxygen uptake (VO2max) in peak responses, work and heart rate were significantly lower in group 1. The duration of CPET and maximum work were negatively correlated with age and BASMI (p<0.001). VO2max was negatively correlated with age, MASES and ASQoL (p<0.05). Conclusion: There was no significant difference in PFT parameters between the groups. On the other hand, CPET parameters were significantly lower in the AS group. While CPET parameters are affected by spinal mobility, declining aerobic capacity affects QoL.Öğe The Oxidative Stress At Lungs After Menopause And The Antioxidant Effects Of Vitamin D, Fish Oil And Exercise in An Experimental Rat Model(Parlar Scientific Publications (P S P), 2020) Arslan, Sertaç; Arslan, Emine; Güney, Güven; Özcan, Oğuzhan; Demir, Emre; Uyar Hazar, Hale; Demirci, BuketMenopause is the permanent cessation of ovarian follicular activity and the menstrual cycle. There is little physiologic and histologic data concerning the possible effects of menopause on respiratory tract and possible beneficial agents for respiratory tract against the effects of menopause. The rat lungs and trachea have been obtainedfrom young and old rats which were treated with either vitamin D (VitD; 1000IU/kg/week),Fish oil (FO; 0.8 mL/kg/week) or exercise (running 45 minutes/3 times/week) for 12 weeks after one week overiectomy (OVX) followup. Oxidative stress markers found increased at OVX and OVX+E groups. However, oxidative stress marker levels were lower at OVX+E group than OVX group. Vitamin D and fish oil also caused decreased oxidative stress at lung tissue compared to OVX group. OVX group had histological changes such as epithelial desquamation, peribronchial smooth muscle hypertrophy, peribronchial lymphoid follicles, Type 2 pneumocyte hyperplasia; however, none of them was found at exercise group. Ovariectomy caused respiratory system effects in rats. Menopause cause oxidative stress; however, exercise, vitamin D and fish oil have protective effects against oxidative stress at lungs at different quantities. Ovariectomy group has the greatest damage compared to other groups. Exercise is the best protective modality against the effects of menopause at respiratory system.
