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BOZKURTLAR, EMİNE

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BOZKURTLAR

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EMİNE

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Author: KOCAKAYA, DERYA × Start date: 2015 ×

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Now showing 1 - 7 of 7
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    PublicationOpen Access
    Outcome of solid and cavitary pulmonary nodules in rheumatoid arthritis patients— case series
    (2022-01-01) AKSOY, AYSUN; BOZKURTLAR, EMİNE; KARAKURT, SAİT; ERYÜKSEL, SEMİHA EMEL; İNANÇ, GÜZİDE NEVSUN; KOCAKAYA, DERYA; AKSOY A., KOCAKAYA D., Yalçinkaya Y., BOZKURTLAR E., KARAKURT S., Eryüksel E., İnanç N.
    © TÜBİTAK.Background/aim: Rheumatoid pulmonary nodule can be detected in up to 32% of rheumatoid arthritis (RA) patients and approximately one-third of nodules may cavitate. We aimed to evaluate characteristics of patients with RA developing cavitary pulmonary nodular (CPN) lesions under disease-modifying antirheumatic drugs (DMARDs), follow-up of both cavitary and solid nodules, and their outcome with the treatment. Materials and methods: RA patients who presented with CPN lesions during follow-up were recruited retrospectively in this case series analysis. Total numbers and mean diameters of cavitary and solid nodules in each thorax computed tomography (CT) have been determined and followed up by two experienced pulmonary physicians. Moreover, changes in treatment after the development of the CPN lesions and characteristics of cavitary nodules were collected. Results: Eleven patients with CPN lesions were reported. At the time of CPN diagnosis, more patients were taking leflunomide than methotrexate (81% vs 19%). Half of the patients were receiving biologic therapy and only 18% were taking anti-TNF drugs. After a median of 24 (3–65) months of follow-up, the regression of CPN lesions was determined in 45% (5/11) of patients. Four of these 5 (80%) patients were switched to a treatment regimen without leflunomide and three of them to nonanti-TNF biologic treatment or targeted synthetic DMARDs (tocilizumab, tofacitinib, and rituximab). Conclusion: CPN lesions seen in RA patients are often pulmonary manifestations of the underlying disease; however, one must rule out malignancies or infections. If lesions progress under DMARDs, it is advised to discontinue synthetic DMARDs (LEF/MTX) and switch to another biological DMARD with different modes of action.
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    Histopathological evaluation of post-mortem pulmonary specimens excised from ICU patients with COVID-19: Do we know what we do not know
    (2023-05-06) ERMERAK, NEZİH ONUR; BOZKURTLAR, EMİNE; KOCAKAYA, DERYA; GÜL, FETHİ; KARAKURT, SAİT; ERMERAK N. O., BOZKURTLAR E., KOCAKAYA D., GÜL F., KARAKURT S., Cinel I.
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    Endobronchial ultrasound transbronchial needle aspiration in elderly patients: safety and performance outcomes EBUS-TBNA in elderly
    (TAYLOR & FRANCIS LTD, 2020) TUFAN ÇİNÇİN, ASLI; Yildizeli, Sehnaz Olgun; Tufan, Asli; Bozkurtlar, Emine; Arikan, Huseyin; Kocakaya, Derya; Eryuksel, Emel; Ceyhan, Berrin; Karakurt, Sait
    Aim Complication rates are low and endobronchial ultrasound guided needle aspiration (EBUS-TBNA) is generally regarded as a safe procedure, but there is a very limited number of studies evaluating the efficacy and safety of the procedure in advanced ages. The aim of this study is to assess the safety and performance outcomes of EBUS-TBNA in elderly. Methods It was a retrospective observational study; patients who received EBUS-TBNA between September 2016 and January 2018 were evaluated. We analyzed patient's characteristics, doses of midazolam, and lidocaine used, regions of lymph node biopsies, and complications. Also, functionality and general physical status of patients over 65 years of age were evaluated. Results During study period 132 cases of EBUS-TBNA were evaluated. 39 (29.5%) cases were aged 70 years, and over. There were more comorbidities in older group. Performance status of older group was worse. Furthermore, when evaluated according to American College of Cardiology (ACC)/American Heart Association (AHA) and American Society of Anesthesiologists (ASA), the older group was found to be composed of the riskier patients. When patients aged between 65 and 69, and over 70 compared, older patient's Barthel, EQ 5-D, SGA, and G8 scores were found to be worse. Despite that, there was no difference in the frequency, and types of complications between both groups. Diagnostic performance was not different between age groups. Conclusions Independent from comorbidities, general health status, and functionality EBUS-TBNA procedure in 70-year-old and over patients is a safe minimally invasive procedure.
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    PublicationOpen Access
    Ebus: hasta başı değerlendi̇rmeni̇n önemi̇
    (2018-03-06) BOZKURTLAR, EMİNE; OLGUN YILDIZELİ, ŞEHNAZ; KOCAKAYA, DERYA; BOSTANCI, KORKUT; AHISKALI, ASİYE RENGİN; BOZKURTLAR E., ERÇETİN Y., OLGUN YILDIZELİ Ş., KOCAKAYA D., BOSTANCI K., AHISKALI A. R.
    Amaç: Endobronşial ultrasonografi (EBUS) aracılı biyopsi tüm dünyada yaygın olarak kullanılan ve hastaların morbidite sebebi olabilecek mediastinoskopi gibi işlemlerden kaçınmasını sağlayabilen kabul görmüş bir yöntemdir. Yapılan çalışmalarla duyarlılığı ve özgüllüğü kanıtlanmış bu yöntemin yakın zamanda merkezimizdeki uygulamalarda ortaya koyduğu sonuçları ve bunların klinikopatolojik yansımasını göstermeyi amaçlıyoruz. Gereç ve Yöntem: Mayıs 2016-Temmuz 2017 tarihleri arasında Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi Patoloji Laboratuvarın’da değerlendirilen EBUS aracılı biyopsiler çalışmamıza alınmıştır. Olgulara ait klinik bilgiler retrospektif olarak merkezimiz sistemi üzerinden ve patolog eşliğinde işlem yapılan olgularda olgu patoloji formu üzerine patolog tarafından alınan notlardan elde edilmiştir. Bulgular: Toplam 61 olgunun değerlendirildiği çalışmamızda, 3 olguya 2 defa EBUS aracılı biyopsi uygulandığı görülmüştür. Bu olguların yalnız 5’inde hasta başı değerlendirme yapılmamıştır. Olgularda ortalama yaş 58, kadın/erkek oranı 20/41’dir. Olguların ön tanılarında sırasıyla malignite (%70, n=42), sarkoidoz (%30, n=18), enfeksiyon (tüberküloz dahil)(%16, n=10), lenfoma (%3, n=2) ve son olarak moleküler inceleme için yeni tümör dokusu (%2, n=1) yer almaktadır. Elli beş (%90) olguda mediastinal lenf noduna girilmiş, 4 (%7) olguda akciğerdeki kitleye, 2 (%3) mediastendeki kitleye ve 1 (%2) olguda hiler lenf noduna girilmiştir. Olgu başına yapılan ortalama girişim sayısı 4’tür. Dokuz olguda yetersiz sitolojik materyal değerlendirmesi yapılmıştır. Bu olguların 2’sinde hasta başı değerlendirme yapılamamış, 3 olguda 1’er girişim sonrası hasta uyumsuzluğu veya lezyon/lezyonların uygunsuzluğu nedeniyle işlem sonlandırılmak zorunda kalınmış, 4 olguda hasta başı değerlendirmede yetersiz ya da sınırlı sayıda hücre içeren materyal olduğu bildirilmiş kalıcı patolojik incelemede olgulara ait tüm materyal incelendiğinde tanı için yeterli materyalin olmadığı görülmüştür. Olguların kalıcı patoloji incelemesi/ hasta başı değerlendirme uyumuna bakacak olursak malignite pozitif olgularda %100 uyum (18/18) saptanırken, yetersiz olguları göz ardı edersek, malignite negatif olgularda da uyum %100 olarak saptanmaktadır. Granülom olarak raporlanan olgularda uyum %70 (10/7) olarak saptanmıştır. Malignite pozitif olgularımızdan 5’inde klinik istek üzerine hücre bloklarından moleküler inceleme yapılmış, bir olgudaki EGFR mutasyonu incelemesi açısından yetersizlik dışında, EGFR-ALK-ROS1 moleküler incelemelerinin tamamından sonuç alınabilmiştir. Sonuç EBUS aracılı biyopsi uygulamalarında klinik ön tanılarda sıkça yer alan malignite ve granülomatöz patolojiler çalışmamızda özellikle ele alınmıştır. Malignite pozitif olgularda hasta başı değerlendirme ve kalıcı patoloji incelemeleri uyumu %100 olarak saptanmıştır. Bu durum başta yeni tanı alan olgular olmak üzere klinik yönlendirmede hızlı ve doğru adımlar atılmasını sağlamaktadır. Ayrıca hasta başı değerlendirmenin “yetersiz” patoloji raporlarının sayısını azaltacağını düşündürmektedir. Aynı değerlendirme granülomatöz patolojiler açısından yapıldığında %70 olarak bulunmuştur. Bunun sebebinin büyük oranda işlem sırasındaki patoloji incelemesinde olguya ait tüm yayma lamlarının ve hücre bloğunun incelenememesinden kaynaklandığı görülmüştür.
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    Pulmoner nodül rezeksiyonu yapılan olgularda klinik radyolojik bulguların malign histopatolojik tanılar ile korelasyonu
    (2023-05-09) OLGUN YILDIZELİ, ŞEHNAZ; KOCAKAYA, DERYA; ERMERAK, NEZİH ONUR; BOZKURTLAR, EMİNE; ERYÜKSEL, SEMİHA EMEL; ÇİMŞİT, NURİ ÇAGATAY; YILDIZELİ, BEDRETTİN; KARAKURT, SAİT; OLGUN YILDIZELİ Ş., GİVİVİ S., KOCAKAYA D., ERMERAK N. O., BOZKURTLAR E., ERYÜKSEL S. E., ÇİMŞİT N. Ç., YILDIZELİ B., KARAKURT S.
    Pulmonary nodules are common (nc(dental f(nd(ng on thorac(c computed tomography (CT) and st(ll a problem (n da(ly pulmonary pract(ce. Because of the w(dely usage of CT scans an (ncreased number of pat(ents follow up w(th th(s d(agnose. Nodules may or(g(nated secondary to ben(gn d(seases but pr(mary concern (s mal(gnanc(es wh(ch (s (mportant for early d(agnos(s and curat(ve opt(ons. On the other hand (t (s not cost-effect(ve follow(ng up the ben(gn les(ons w(th an add(t(onal cumulat(ve rad(at(on dose espec(ally (n prolonged durat(on. Many pred(ct(on models were proposed to evaluate the potency of mal(gnancy us(ng cl(n(cal and rad(olog(cal f(nd(ngs Mayo cl(n(c (1), Veterans Assoc(at(on (2), Brock Un(vers(ty (3) and lastly Herder model (4) mostly used models for r(sk strat(f(cat(on. Herder r(sk model evaluates also Flour(ne– flourodeoxyglucose (FDG) uptake (n pos(tron em(ss(on tomography-computed tomography (PET-CT). Comparat(ve study of these models showed non-super(or(ty to each other, added value of PET-CT (s unden(able for larger nodules but not clear for small nodules (< 8mm) (5). Mult(d(sc(pl(nary follow up, careful observat(on and d(agnost(c test(ng are st(ll h(ghly recommended espec(ally for (ndeterm(ne nodules
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    Pulmoner arter sarkomanın cerrahi sonuçları: Histoloji sağkalımı etkiler mi
    (2023-08-01) BOZKURTLAR, EMİNE; OLGUN YILDIZELİ, ŞEHNAZ; MUTLU, BÜLENT; KOCAKAYA, DERYA; BEKİROĞLU, GÜLNAZ NURAL; YILDIZELİ, BEDRETTİN; Başar V., Olgun Yıldızeli Ş., Bozkurtlar E., Ercelep ., Mutlu B., Kocakaya D., Bekiroğlu G. N., Taş S., Sunar H., Küçükoğlu M. S., et al.
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    PublicationOpen Access
    FDG PET/CT features of polysaccharide-based hemostatic agent chronic inflammatory changes can mimic metastatic lesions
    (2022-07-01) KOCAKAYA, DERYA; ASLAN, SEZER; BOZKURTLAR, EMİNE; Bozkurtlar E., Oksuzoglu K., Bostanci K., Aslan S., Kissa T. N., Kocakaya D., Ones T.
    Purpose To prevent hemorrhagic complications, hemostatic agents (HAs) have been widely used in recent years. The use of HAs can lead to false-positive results on postoperative imaging. There exists only 1 study in the literature evaluating these applications during surgical procedures. Therefore, we aimed to evaluate the postoperative imaging features of polysaccharide-based HAs in thoracic surgery patients who have had F-18-FDG PET/CT scans. Patients and Methods Two hundred nine consecutive patients who underwent thoracic surgery were enrolled in this study. A topical polysaccharide-based HA was applied to the surgical bed for all of the patients. The patients diagnosed with cancer were followed up with subsequent thoracic CT scans, and 42 of these patients were also imaged with F-18-FDG PET/CT, which then comprised the main study group. Due to suspicion of metastasis, 19/42 patients were reoperated or rebiopsied. The latest histopathological findings were accepted as criterion standard, and previous FDG PET/CT images were retrospectively reevaluated. Results Polysaccharide-based HAs that appear as amorphous basophilic material were identified in histopathological samples of 11/19 patients. Lymphocytes, plasma cells, and histiocytes, which formed foreign body reaction and/or foreign body granuloma, indicating the presence of chronic inflammation, were seen in all of the samples. F-18-FDG PET/CT showed increased FDG uptake in all of these lesions. Conclusions Despite the inconsistency of the literature, polysaccharide-based HAs can be demonstrated in human surgical specimens as amorphous basophilic materials even after a long time from the initial surgical procedure. These agents almost always cause chronic inflammatory changes. In addition, these agents may mimic \"false-positive\" findings on postoperative FDG PET/CT scans.