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Öğe Carotid intima-media thickness in chronic obstructive pulmonary disease and survival: A multicenter prospective study(Wiley, 2019) Gulbas, Gazi; Turan, Onur; Sarioglu, Nurhan; Diken, Ozlem Ercen; Ogan, Nalan; Kadioglu, Esra Ekbic; Suerdem, MecitIntroduction Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovascular morbidity and mortality. Carotid intima-media thickness (CIMT) is a noninvasive method assessing atherosclerosis. Objective It was aimed to determine relationship and survival between COPD and CIMT. Methods CIMT was measured using Doppler ultrasound (USG) in 668 stable COPD patients at 24 centers. Patients were followed-up for 2 years. Results There were 610 patients who completed the study. There were 200 patients CIMT with <0.78 mm (group 1), and 410 with CIMT >= 0.78 mm (group 2). There was a significant difference at the parameters of age, gender, smoking load, biomass exposure, GOLD groups and degree of airway obstruction (FEV1) between groups 1 and 2. Our results revealed positive correlations between mean CIMT and age, smoking load (pack-years), biomass exposure (years), exacerbation rate (last year), duration of hypertension (years) and cholesterol level; negative correlations between CIMT and FEV1 (P < 0.05). According to logistic regression model, compared with group A, risk of CIMT increase was 2.2-fold in group B, 9.7-fold in group C and 4.4-fold in group D (P < 0.05). Risk of CIMT increase was also related with cholesterol level (P < 0.05). Compared with infrequent exacerbation, it was 2.8-fold in the patients with frequent exacerbation (P < 0.05). The mean survival time was slightly higher in group 1, but not significant (23.9 vs 21.8 months) (P > 0.05). Conclusion This study is the first regarding CIMT with combined GOLD assessment groups. It has revealed important findings supporting the increase in atherosclerosis risk in COPD patients. We recommend Doppler USG of the carotid artery in COPD patients at severe stages.Öğe Desquamative interstitial pneumonia: Risk factors, laboratory and bronchoalveolar lavage findings, radiological and histopathological examination, clinical features, treatment and prognosis(Spandidos Publ Ltd, 2019) Diken, Ozlem Ercen; Sengul, Aysun; Beyan, Ayse Coskun; Ayten, Omer; Mutlu, Levent Cem; Okutan, OguzhanDesquamative interstitial pneumonia is a type of smoking-associated major idiopathic interstitial pneumonia, which is characterized by accumulation of alveolar macrophages in alveolar lumens and septa and develops secondary to mainly active or passive exposure to cigarette smoke. Desquamative interstitial pneumonia mostly occurs in male smokers in association with non-specific symptoms responsive to steroid therapy and has a better prognosis than usual interstitial pneumonia. To date, no large-scale clinical studies have been performed on desquamative interstitial pneumonia patients. Factors responsible for the scarcity of data on the clinical course of this condition include the retrospective nature of the available information as well as its rare occurrence. Despite this, a general consensus exists as to the nature of its symptoms, association with smoking, age and gender distribution, findings of respiratory function tests, steroid responsivity and mortality. The objective of the present review article was to report on desquamative interstitial pneumonia and to describe its etiology, risk factors and clinical features, as well as the laboratory, bronchoalveolar lavage, radiological and histopathological findings, and the treatment and prognosis of affected patients.Öğe Evaluation of Alone or Combined Colistin Therapy Success in Patients with Carbapenem-Resistant Acinetobacter Pneumonias(Derman Medical Publ, 2015) Diken, Ozlem Ercen; Tumturk, Ayhanim; Arslan, SertacAim Carbapenem-resistant gram negative bacteria represent an increasing problem worldwide for intensive care units. We aimed to detect the outcome of different treatment regimens and mortality rates of Acinetobacter infection in our clinic. Is combined colistin therapy superior or not? Material and Method: 23 cases diagnosed and treated in our unit with documented Acinetobacter infections between January 2013 and June 2014 were retrospectively evaluated in terms of treatments administered and mortality rates. Results: 19 of 23 patients were treated in ICU and 4 of 23 patients were treated in normal patient ward. Among 19 ICU patients, 2 patients in cefoperazone + sulbactam - susceptible groups and 3 patients with cefaperazone + sulbactam - resistant groups died with colistin monotherapy. Among patients receiving combined treatment, two patients were given amikacin + colistin combination and they both died. A single patient receiving colistin + rifampicin combination responded well. Of the 4 patients treated in the normal patient ward, 3 had carbapenem resistance, and of these, only 1 was susceptible to colistin. This patient received colistin + tigecycline combination and had good response. Discussion: The combined colistin treatment seems plausible in terms of reducing mortality in Acinetobacter infections of lung. We believe that in patients with carbapenem-resistant Acinetobacter infections, a consideration should be given to rifampicin or tigecycline combination with colistin.Öğe Pulmonary physician consultancy in emergency services in Turkey (PUPCEST) - a prospective multicenter study(European Respiratory Soc Journals Ltd, 2018) Diken, Ozlem Ercen; Ekici, Aydanur; Bektas, Hayriye; Yildiz, Hanifi; Tabaru, Ali; Ogan, Nalan; Ozlu, Tevfik[Abstract Not Available]
