Person: KOCAKAYA, DERYA
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KOCAKAYA
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Publication Open Access Lung cavitation as a long-term imaging pattern of covid-19(2023-06-01) KOCAKAYA, DERYA; Çınar C., Kocakaya D., Olgun Yıldızeli S., Karakurt S.Background A wide variety of radiological imaging findings, especially CT findings, have been reported in patients with COVID-19 pneumonia during the pandemic surge. Generally, on control chest imaging, individuals who have been cured of the disease usually show complete remission; however, in severe cases, residual pulmonary fibrosis, other abnormalities, and, rarely, lung cavitation can be observed. In this retrospective descriptive study, we aimed to describe the clinical, radiological, and laboratory characteristics of patients who developed lung cavitation in the course of SARS-CoV-2 disease recovery. Methodology Over a period of five months from March 1, 2021, to August 1, 2021, 15 consecutive patients who developed cavitary lesions on chest CT during the course of recovery from COVID-19 were recruited as the study population. All patients had a history of a SARS-CoV-2 infection diagnosed with a positive real-time polymerase chain reaction test. Patients who already had cavitary lesions in chest CT during the start of COVID-19 symptoms were excluded. Results In this study, 14 patients were male (93.3%). The only female patient was the only severely obese patient in the study population, with a body mass index was 40.4 kg/m2 . The median (range) age of the patient population was 61 (42-79) years. Eight patients (53.3%) required intensive care unit admission during the hospitalization period. Three patients who required intensive care unit were intubated and needed invasive mechanical ventilation. Two patients died during hospitalization. Conclusions Lung cavitation remains a rare occurrence in the course of COVID-19. Bronchoscopic evaluation and scanning for pulmonary embolism should be done in appropriate patients to determine secondary reasons for cavitation. Although this descriptive study showed that cavitary lesions can develop in patients with severe disease, more comprehensive studies with a control group are needed to reach a definitive conclusion.Publication Open 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.Publication Open Access The role of procalcitonin as a biomarker for acute pulmonary exacerbation in subjects with cystic fibrosis and non-cystic fibrosis bronchiectasis(2022-01-01) KOCAKAYA, DERYA; ARIKAN, HÜSEYİN; ERYÜKSEL, SEMİHA EMEL; CEYHAN, BERRİN; Mammadov F., Olgun Yildizel S., Kocakaya D., ARIKAN H., Cinar C., Eryuksel E., CEYHAN B.Objective: Patients with cystic fibrosis (CF) and non-CF bronchiectasis are prone to exacerbations of pulmonary infections. C-reactive protein (CRP) and procalcitonin (PCT) are inflammatory markers. The aim of this study is to evaluate the role of CRP and PCT on exacerbations of CF and non-CF bronchiectasis. Patients and Methods: The medical records of 18 CF (52 hospitalizations) and 20 non-CF bronchiectasis patients (51 hospitalizations) were reviewed retrospectively. CRP, PCT levels and, white blood cell (WBC) counts on admission and follow-up were evaluated. Results: C-reactive protein levels correlated with PCT levels on admission in all patients. Baseline PCT levels were markedly higher (>0.5µg/L) in 12% of CF and 10% of non-CF bronchiectasis patients, however, baseline CRP values were markedly higher (>5mg/L) in 96% of CF and non-CF bronchiectasis patients (p=0.760 and p=0.100, respectively). Baseline CRP and PCT levels were positively correlated with hospitalization length (r=0.501, p=0.001 and r=0.289, p=0.04, respectively) in CF patients, but not in non-CF bronchiectasis. Conclusion: Our study shows the potential utility of these biomarkers to determine the severity of the exacerbation particularly predicting hospitalization length in CF patients. Both biomarkers could be able to guide antibiotic treatment of infective exacerbations in CF and non-CF bronchiectasis patients.Publication Open Access Radial arterial thrombosis in COVID-19: A case report(2022-01-01) ÇİÇEK, FURKAN CUMA; EYÜPLER, ÇAĞLA; YETGİNOĞLU, ÖZGE; AK, KORAY; KOCAKAYA, DERYA; Durmus N. S. , ÇİÇEK F. C. , EYÜPLER Ç., Omur C., YETGİNOĞLU Ö., AK K., KOCAKAYA D.Thrombosis due to hypercoagulable state is an important cause of morbidity and mortality in coronavirus disease 2019 (COVID-19). Increased D-dimer levels are an important marker of the presence and risk of thrombosis. In this report, we present that a 59-year-old male patient developed thrombosis in the distal radial arteries despite normal D-dimer level. The patient was treated with enoxaparin, iloprost infusion, and cilostazol. This case should lead us to be very careful that people diagnosed with COVID-19 with normal D-dimer levels may also have thrombosis.Publication Open Access The effectiveness of additional long-term use of bottle-positive expiratory pressure in chronic obstructive pulmonary disease: A single-blind, randomized study.(2022-06-01) KOCAKAYA, DERYA; Keniş-Coşkun Ö., Kocakaya D., Kurt S., Fındık B., Yağcı İ., Eryüksel E.Objectives: This study aimed to investigate the long-term use of bottle-positive expiratory pressure (PEP) in addition to breathing exercises as a home-based rehabilitation aid on exercise capacity, spirometric parameters, and quality of life in chronic obstructive pulmonary disease (COPD) patients. Patients and methods: From a total of 30 patients with stable moderate-to-severe COPD, 24 (22 males, 2 females; mean age: 62.4+7.2 years; range, 40 to 75 years) were included in the final study and randomized into two groups: the group that performed breath retaining techniques and the group that was instructed to use the bottle-PEP in addition to these techniques. Patients were evaluated with modified Medical Research Council scale, COPD assessment test (CAT), spirometry, St. George’s Respiratory Questionnaire (SGRQ), and 6-min walk distance (6MWD) before, three months and six months after the initiation of the program. Results: In the bottle-PEP group, patients’ mean 6MWD increased from 380.6±67.6 to 444.1±22.0 m (p=0.002), the mean CAT score decreased from 17.8±36.8 to 12.9±6.2 (p=0.03), and the mean SGRQ total score significantly decreased from 57.1±23.1 to 47.6±21.9 (p<0.05) after three months. The improvement in 6MWD continued in six months but disappeared in SGRQ and CAT scores. In the exercise group, only the 6MWD improved, and there were no significant improvements in other parameters regardless of time. There were no significant differences between the groups in any of the parameters at any follow-up session. Conclusion: While bottle-PEP does not significantly contribute when added to breathing exercises in patients with moderate-to-severe COPD in improving function and quality of life, it can be used as a safe choice in patients’ home rehabilitation programs.Publication Open Access The impact of cystic fibrosis- and noncystic fibrosis-bronchiectasis on pulmonary artery wall thickness and right heart functions assessed by speckle-tracking echocardiography(2023-06-01) GÜREL, YUSUF EMRE; VEZİR, DUYGU; KOCAKAYA, DERYA; SÜNBÜL, MURAT; ÇİNÇİN, AHMET ALTUĞ; ÖZBEN SADIÇ, BESTE; SAYAR, NURTEN; CEYHAN, BERRİN; Gürel E., VEZİR D., Güçtekin T., Doğan Z., KOCAKAYA D., Olgun S., SÜNBÜL M., Çinçin A., Özben B., SAYAR N., et al.BACKGROUND: Right heart functions are affected in patients with bronchiectasis as a result of pulmonary hypertension induced by chronic hypoxemia. Pulmonary artery wall thickness has recently been introduced as a sign of intensive and prolonged inflammation. The aim of this study was to analyze right ventricular and right atrial functions and to mea-sure pulmonary artery wall thickness in patients with cystic fibrosis-bronch iecta sis in comparison to those with noncystic fibrosis-bronchiectasis and healthy individuals. METHODS: We studied 36 patients with cystic fibrosis-bronchiectasis, 34 patients with noncystic fibrosis-bronchiectasis, and 32 age- and sex-matched control subjects. Lung function tests were performed. All subjects underwent comprehensive echocardiographic evaluation including conventional, tissue Doppler, speckle-tracking, and pulmonary artery wall thickness measurements. RESULTS: Right ventricular global longitudinal strain and global longitudinal right atrial strain during ventricular systole decreased in cystic fibrosis-bronchiectasis group compared with noncystic fibrosis-bronchiectasis and control groups (P <.001, both). Conversely, pulmonary artery wall thickness was increased in cystic fibrosis-bronchiectasis group in comparison to other groups (P <.001). Moreover, right ventricular global longitudinal strain was lower and pulmonary artery wall thickness was higher in patients with airflow obstruction (P <.001 and P =.025, respectively) than in those without. Only right ventricular global longitudinal strain was significantly correlated with pulmonary function test parameters. The negative effect of cystic fibrosis on right ventricular and right atrial functions was independent of age, gender, and disease duration. CONCLUSION: Our study showed that right ventricular and right atrial functions were deteriorated and pulmonary artery wall was thickened in cystic fibrosis-bronchiectasis patients more than noncystic fibrosis-bronchiectasis patients. Right ventricular global longitudinal strain detected subclinical right ventricular dysfunction and was associated with the severity of pulmonary disease.Publication Open Access Anxiety and depression in patients with chronic obstructive pulmonary disease and their relation to serum vitamin D levels(MARMARA UNIV, FAC MEDICINE, 2018-02-26) CEYHAN, BERRİN; Kocakaya, Derya; Olgun Yildizeli, Sehnaz; Kocakaya, Ozan; Arikan, Huseyin; Eryuksel, Emel; Ceyhan, BerrinObjectives: To determine whether serum vitamin D levels were related to the risk of anxiety and depression among patients with chronic obstructive pulmonary disease (COPD), as well as their spirometry parameters, disease severity, and other clinical findings. Materials and Methods: Ninety-two stable patients with COPD aged over 18 years with no exacerbations in the previous month were included. Symptom severity was assessed using the modified Medical Research Council (mMRC) dyspnea scale and COPD Assessment Test (CAT) scores. Spirometry tests were performed and previous hospitalization histories were recorded to determine ABCD groups of the patients according to their combined COPD assessments. Their Body mass index, airflow Obstruction, Dyspnea and Exercise capacity (BODE) indices were calculated and the Hospital Anxiety and Depression Scale (HADS) was administered. Serum vitamin D levels were determined using immune electrochemiluminescence. Results: According to the HADS scores, 16 patients (17.4%) had the risk of anxiety and 29 (31.5%) had the risk of depression. The risk of anxiety differed significantly (P=0.016 Fischer's exact test) between the ABCD groups. Anxiety scores were positively correlated with both mMRC (r=0.315; P=0.002) and CAT (r=0.445; P=0.000) scores. Similarly, depression scores correlated positively with mMRC (r= 0.249; P=0.017) and CAT (r=0.373; P=0.000) scores. Neither anxiety nor depression scores were significantly correlated with % of predicted FEV1. Serum vitamin D levels were inversely correlated with anxiety (r=-0.215; P=0.039) and depression (r=-0.244; P=0.019) scores. Anxiety scores were positively correlated with BODE although not statistically significantly (r=0.199; P=0.058). Conclusion: A negative correlation was revealed between serum vitamin D levels and HADS scores, and symptom scores were positively correlated to HADS scores, independent of % of predicted FEV1.Publication Open Access Potentially inappropriate medications based on TIME criteria and risk of in-hospital mortality in COVID-19 patients(2022-11-28) KOCAKAYA, DERYA; Durmuş N. Ş., Tufan A., Can B., Olgun Ş., Kocakaya D., İlhan B., Bahat G.OBJECTIVE: This study aimed to evaluate the relationship between hospital admission potentially inappropriate medications use (PIM) and in-hospital mortality of COVID-19, considering other possible factors related to mortality. METHODS: The Turkish inappropriate medication use in the elderly (TIME) criteria were used to define PIM. The primary outcome of this study was in-hospital mortality. RESULTS: We included 201 older adults (mean age 73.1±9.4, 48.9% females). The in-hospital mortality rate and prevalence of PIM were 18.9% (n=38) and 96% (n=193), respectively. The most common PIM according to TIME to START was insufficient vitamin D and/or calcium intake per day. Protonpump inhibitor use for multiple drug indications was the most prevalent PIM based on TIME to STOP findings. Mortality was related to PIM in univariate analysis (p=0.005) but not in multivariate analysis (p=0.599). Older age (hazards ratio (HR): 1.08; 95% confidence interval (CI): 1.02–1.13; p=0.005) and higher Nutritional Risk Screening 2002 (NRS-2002) scores were correlated with in-hospital mortality (HR: 1.29; 95%CI 1.00–1.65; p=0.042). CONCLUSION: Mortality was not associated with PIM. Older age and malnutrition were related to in-hospital mortality in COVID-19Publication Open Access Anxiety, depression, and sleep disorders after COVID-19 infection(2023-07-29) KOCAKAYA, DERYA; Olgun Yıldızeli S., Kocakaya D., Saylan Y. H., Tastekin G., Yıldız S., Akbal Ş., Özkan S., Arıkan H., Karakurt S.Introduction As of December 2019, the COVID-19 infection had spread rapidly across the globe, causing a pandemic. Although the virus primarily affects the respiratory and circulatory systems, neuropsychiatric disorders have been reported in a significant number of infected individuals. The aim of this study is to identify anxiety, depression, and sleep disturbances in the early post-COVID period, as well as potential risk factors. Method Symptomatic cases whose COVID-19 diagnosis was confirmed by polymerase chain reaction (PCR) positivity within the previous three months were evaluated in the COVID-19 follow-up clinic, where they were observed for at least four weeks after the diagnosis. Cases with no suspicious symptoms and no documented PCR positivity were selected as the control group. All participants completed the Hospital Anxiety Depression Scale (HADS) questionnaire and the Pittsburgh sleep quality questionnaire. The laboratory parameters of hospitalized patients with infection were recorded. Results A total of 283 patients were included in the study. While the median age of 144 patients with COVID-19 infection was 44 years, and 104 of them (72.2%) were female, the median age of the controls without COVID-19 infection was 52 years, and 65 of them (46.8%) were female. About 89 (61.8%) of the 144 patients with COVID-19 infections were hospitalized. When the results of the applied HADS questionnaire were analyzed, the median total value of all study participants was 10 points, whereas it was 13 in cases with COVID-19 and nine in those who did not have it (p<0.001). Taking into account the subgroups of the anxiety and depression questionnaires, both results are statistically significantly higher (p<0.001 and p=0.022, respectively) in post-COVID patients. When the hospitalization status of COVID-19 patients was compared, there was no difference in the development of anxiety (p=0.23), but depression (p<0.024) and poor sleep quality (p<0.001) were prevalent in hospitalized patients. The median PSQI score of the entire study population was five points, while it was seven points in cases with COVID-19 infection and four points in cases who did not have it (p<0.001). Sleep latency (p<0.003), sleep disturbances (p<0.001), and daytime dysfunction (p<0.001) were statistically significantly worse in COVID-19-infected patients. Female gender (p<0.01) and the presence of past anxiety-depression symptoms (p<0.013) were found to be as risk factors in patients with infection. The correlation between the total HADS score, the PSQI, and the results of the complete blood count and biochemical analysis at the time of diagnosis in hospitalized patients was also investigated. CRP (CI 0.26-0.58) p<0.001 vs (CI 0.09-0.45) p=0.004 and ferritin (CI 0.05-0.43) p=0.017 vs (CI 0.01-0.40) p=0.047 exhibited a positive correlation. Similarly, lymphocyte count (CI −0.65 to −0.37) p<0.001 vs (CI −0.39 to −0.01) p<0.001 and lymphocyte percentage (−0.57 to −0.24) p=0.001 vs (−0.65 to −0.37) p=0.039 were negatively correlated. Conclusion Early post-infection anxiety, depression, and sleep disturbances increased significantly in COVID-19 patients. Female gender and previous symptoms of anxiety and depression are risk factors, and inpatient treatment increases depression and poor sleep quality. High HADS and poor sleep quality scores are positively correlated with inflammatory parameters and should be evaluated in post-infection in particular.Publication Open Access The angiogenic gene profile of pulmonary endarterectomy specimens: Initial study(2023-01-01) ERMERAK, NEZİH ONUR; YILMAZ, BETÜL; BATIREL, SAİME; OLGUN YILDIZELİ, ŞEHNAZ; KOCAKAYA, DERYA; MUTLU, BÜLENT; YILDIZELİ, BEDRETTİN; ERMERAK N. O., YILMAZ B., BATIREL S., OLGUN YILDIZELİ Ş., KOCAKAYA D., MUTLU B., Tas S., YILDIZELİ B.© 2023 The Author(s)Objectives: The underlying mechanisms for the development of chronic thromboembolic pulmonary hypertension and prognostic biomarkers are not clear yet. Thus, our aim is to assess and identify new biomarkers for the expression of 84 key genes linked to angiogenesis. Methods: Patients who had levels more than 1000 dynes·sec·cm−5 were included in the test group, and the other patients were included in the control group. Twelve specimens were taken from the patients. RT2 Profiler PCR Array (Qiagen) was used to quantify the expression of the 84 key genes. Results: Eight patients (6 male, 2 female, median age 54.4 ± 13.1 years) who underwent pulmonary endarterectomy were included. Pulmonary vascular resistance improved significantly from 811 ± 390 dyn/s/cm−5 to 413.3 ± 144.9 dyn/s/cm−5 (P .005) after surgery. Median length of hospital stay was 11.62 ± 2.97 days. The test group had a distinct pattern of impaired angiogenic and antiangiogenic genes. The expression levels of TGFA, TGFB1, THBS2, THBS1, TGFBR1, SERPINE1, SERPINF1, TGFB2, TIMP2, VEGFC, IFNA1, TNF, CXCL10, NOS3, IGF1, and MMP14 were downregulated in the specimens from the patients who had higher pulmonary vascular resistance values, whereas some genes, including PDGFA, showed upregulation that was statistically nonsignificant in the same group. Conclusions: These results can lead to the development of new markers that could predict adverse outcomes of patients with CTEPH. Identification of new markers that are related to worse outcomes would enable screening patients for early diagnosis and treatment.