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    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, Mecit
    Introduction 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.
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    Coexistence of three malignancies: Two different lung cancers synchronous with lymphoma
    (İstanbul Tıp Fakültesi, 2017) Ogan, Nalan; Baha, Ayşe; Akıncıoğlu, Egemen; Kaplan, Tevfik; Doğan, Handan; Gülhan, Meral
    Epithelial tumors synchronous with hematologic malignancies are very rare. The hystopathologic type and stage of synchronous tumors are very important for prognosis. A 77-year-old male patient was diagnosed with lymphoma after an excisional biopsy was taken from the retroauricular region. Positron emission tomography, performed for lymphoma staging, revealed a positive solid nodule (SUVmax: 24.3) in the posterobasal segment of the right lower lobe and a negative subsolid nodule in the anterior segment of the upper lobe. Right lower lobectomy and wedge resection for subsolide nodule in the upper lobe were performed. Histopathological examination revealed mildly differentiated squamous cell carcinoma for the solid nodule and mildly differentiated adenocarcinoma with lepidic pattern for the subsolid nodule. The patient was treated for only lymphoma according to the decision of the tumor board, and his condition is stable for 1 year without any evidence of lung cancer recurrence. This case presents the treatment approach and the fact that triple synchronic malignant cases are rare in the literature. © 2017, Turkish Society for Radiation Oncology.
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    Incidental pulmonary nodule frequency in Turkey
    (2019) Ogan, Nalan; Baha, Ayşe; Sanhal, Ebru Ozan; Alhan, Aslıhan; Gülhan, Meral
    Introduction: Pulmonary nodules are common incidental findings on computed tomography (CT). In Turkey, there is no available data about the follow-up of the frequency of incidental nodules. Our aim is to assess the frequency and size distrubition of incidental pulmonary nodule in our country. Materials and Methods: Between January 2015 and December 2016, computed tomographies, taken of all outpatient and emergency department that recorded in the screening database were examined retrospectively. Nodules and their characteristics (number, size, density, localization) and relationship between age and gender were evaluated. Results: The age range of the cases was mean 58.99 ± 16.20 years, 256 (42.5%) were women and 347 (57.5%) were men. A total of 288 (48.25%) cases had 420 nodules. Solid nodule was present in 184 cases (30.5%). The number of cases with one solid nodule was 119 (64.7%). There were 124 solid nodules (55.36%) of ? 4-< 6 mm diameter, 64 solid nodules (28.57%) of ? 6-< 8 mm diameter and 36 solid nodules (16.07%) of ? 8 mm diameter. Nodule frequency increased statistically significantly with the age (p= 0.001). Conclusion: The frequency of incidental nodule was found higher than in our country than in developed countries.
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    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]
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    The Course of Renal Functions in COPD. Two Statition: Exacerbation and Stable Period
    (2019) Baha, Ayşe; Ogan, Nalan; Akpınar, Evrim Eylem; Ateş, Can; Gülhan, Meral
    OBJECTIVE: Comorbidities in chronic obstructive pulmonary disease (COPD) are important factors that determine the prognosis of the disease. However, there are few studies about renal dysfunction. We aimed to compare the renal functions in COPD patients with stable and exacerbation periods and to determine the frequency of acute renal failure (ARF) during exacerbation. MATERIALS AND METHODS: The files of 320 patients with COPD (forced expiratory volume in 1 s/forced vital capacity <70% in pulmonary function test) who were admitted to our hospital between 2015 and 2016 were evaluated retrospectively. After exclusion criteria, 113 patients were included in the study. Data were analyzed by appropriate statistical method. RESULTS: Ninety (80.4%) of the patients were male and 23 (19.6%) were female. In the exacerbation period, blood urea nitrogen (P < 0.001), creatinine (P < 0.001), white blood cell (P < 0.001), C?reactive protein (P < 0.001), and sedimentation (P < 0.001) were higher than that in the stable period. Furthermore, hemoglobin (P = 0.021) and estimated glomerular filtration rate (eGFR) (P < 0.001) were significantly lower. The number of emergency department admission in patients with eGFR <60 ml/min during the exacerbation more than the patients with eGFR ?60 ml/min. Twenty (17.7%) patients have developed ARF during exacerbation (eGFR <60 ml/min). CONCLUSION: In COPD exacerbation period, kidney function is affected negatively in most patients (even if it does not reach the ABY border) and tends to improve in the stable period. In patients with COPD, it is thought that the causes of respiratory failure negatively affect renal function.
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    The incidence of polyneuropthy and its relation with disease parameters in chronic obstructive pulmonary disease
    (2019) Ogan, Nalan; Sayın, Refah; Baha, Ayşe; Akpinar, Evrim Eylem; Gülhan, Meral
    Objective: Chronic Obstructive Pulmonary Disease (COPD) is accompanied by several concomitant conditions due to its systemic effects. Hypoxia and oxidative stress associated with COPD are also believed to contribute to the disease course through the effects of several inflammatory mediators. Major causative agents causing of peripheral neuropathy are age, hypoxia, duration and severity of COPD, hypercapnia and smoking. The present study aimed to investigate the incidence of polyneuropathy and its relation with disease parameters in COPD patients. Methods: Of a total number of 45 patients who had been followed up between January 1, 2015 and December 31, 2016 with a diagnosis of COPD at Ufuk University School of Medicine were enrolled retrospectively. All patients underwent electroneuromyography, arterial blood gas measurements and pulmonary function tests. Patients were divided as those with or without neuropathy, and factors contributing to the development of neuropathy were investigated based on clinical and laboratory findings. Results: Eleven (24.4%) patients were women and 34 (74.6%) were men, and the mean age was 73.2 years. Mean PaO2 was 58.2 mmHg, pCO2 was 41.2 mmHg, and FEV1 was 45.3%. Neuropathy was diagnosed in twenty (44.4%) patients. Significant differences were found in pO2, pCO2, SO2, mMRC, smoking status and number of exacerbations per year (p < 0.05). Conclusions: Patients who experience frequent exacerbations and those with hypoxemia or hypercapnia as demonstrated should be taken into more careful clinical assessments with respect to polyneuropathy.
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    The value of preoperative pulmonary assessment in predicting postoperative pulmonary complications
    (2019) Diken, Özlem Erçen; Fazlıoğlu, Nevin; Sarıoğlu, Nurhan; Ogan, Nalan; Yılmaz, Nafiye; Tanrıverdi, Hakan; Mirici, Nihal Arzu
    OBJECTIVE: We aimed to determine the preoperative parameters that may predict postoperative pulmonary complications (POPCs) and the value of some current practical indexes in predicting POPCs. MATERIALS and METHODS: Our study is a retrospective cohort study carried out in 9 different centers. Patients admitted to the chest diseases outpatient clinic for preoperative evaluation were followed up during the 6?month study period. Patients with or without postoperative complications were evaluated retrospectively, and the effect of some parameters and indexes recorded during the preoperative evaluation of chest diseases on POPC development was investigated statistically. RESULTS: A total of 307 patients were included in the study. POPCs were observed in 100 patients (32.6%). About 13% of these complications were respiratory tract infections, 59% were respiratory failure, 45% were pleural effusion, and 42% were atelectasis, which were the most common pulmonary complications. The probability of experiencing POPCs by patients with chronic obstructive pulmonary disease (COPD) is 2.5 (1.18–5.67) times more than those without COPD. We determined that patients with the history of upper respiratory tract infection during the preoperative period are 5.3 times more likely to have POPCs; similarly, the number was 4.7 for patients undergoing cardiac operation and 3.3 for patients with interstitial infiltration. CONCLUSION: The risk of pulmonary complications was higher for those with the history of upper respiratory tract infection during the preoperative period, those undergoing cardiac surgery, those with the shortness of breath, those with the history of COPD, and those with the reticular/interstitial infiltrations in the chest X?ray. These parameters should be examined carefully in the preoperative period and should be careful in terms of pulmonary complications that may develop during the postoperative period.