Person: OLGUN YILDIZELİ, ŞEHNAZ
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OLGUN YILDIZELİ
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ŞEHNAZ
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Publication Open Access Extranodal pulmonary marginal zone B-cell lymphoma(ELSEVIER SCIENCE BV, 2016) CEYHAN, BERRİN; Yildizeli, Sehnaz Olgun; Eryuksel, Emel; Abul, Yasin; Golabi, Pegah; Kaygusuz, Isik; Kodalli, Nihat; Ahiskali, Rengin; Ceyhan, BerrinAim: Extranodal mucosa-associated lymphoid tissue (MALT) arises a number of epithelial tissues, including the stomach, salivary gland, lung, small bowel, and elsewhere. Here we present a male patient with an uncommon site of extranodal MALT such as a pelvic mass diagnosed after a long period of evaluation, which initially presented with an incidental pulmonary nodule. Method: We report a 60 years old man presenting with pulmonary nodules and consolidation. He refused invasive procedures and 3 years later was administered to our clinic with disseminated pulmonary nodules on chest X-ray. Subsequently a thin needle aspiration biopsy was performed and candida geotrichum was suspected in the specimen of the lung biopsy by light microscopic examination. After this time the patient was referred to our clinic, bronchoscopy, mediastinoscopy and abdominal computerized tomography (CT) scans were performed. Results: Lymphoid hyperplasia was seen in the mediastinal lymph nodes biopsy specimens and the pelvic mass (52 x 18 mm) on the superior iliac muscles not related to any organs. Thin needle biopsy revealed MALT lymphoma and pathological examination of pulmonary nodule was similar to pelvic mass (MALT lymphoma). After the diagnosis, the thin needle biopsy of lung was repeated. The specimen appeared to be similar to the pelvic mass (MALT lymphoma) in the pathologic examination. The patient survived 5 years after initial diagnosis. Conclusion: MALT has an affinity for the different tissues however has not been located in the pelvis. Our case represent an unusual presentation in a 60 years old man with lung and a pelvic mass. (C) 2016 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license.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 Procalcitonin-Guided Antibiotic Treatment in Lower Respiratory Tract Infections(GALENOS YAYINCILIK, 2018-08-06) CEYHAN, BERRİN; Balci, Merih Kalamanoglu; Balcan, Baran; Yildizeli, Sehnaz Olgun; Ceyhan, BerrinObjective: Procalcitonin (PCT), C-reactive protein (CRP), and leukocyte count are important host response biomarkers to determine the presence of infection. The aim of the present study was to evaluate the usefulness of PCT with other markers in lower respiratory tract infections. Methods: A total of 78 patients with community-acquired pneumonia (CAP), chronic obstructive pulmonary disease (COPD) exacerbations, and healthy controls were evaluated. Baseline serum levels of PCT and CRP and leukocyte counts were assessed and repeated on day 7 of antibiotic treatment. Results: Procalcitonin levels and absolute neutrophil counts (ANCs) were higher in the CAP and COPD groups than in the control group. In the CAP and COPD exacerbation groups, the leukocyte count, ANC, and CRP and PCT levels decreased on day 7 of the treatment (p<0.001). In the CAP group, the baseline PCT levels were correlated with leukocyte counts (r=0.495, p<0.005), ANCs (r=0.426, p<0.019), and CRP levels (r=0.515, p<0.004). In receiver operating characteristic curve analysis, PCT threshold >0.12 ng/mL had a sensitivity of 70.4% and specificity of 68.7%, and CRP threshold >22.9 mg/L had a sensitivity of 85.2% and specificity of 75.0%. Conclusion: Procalcitonin is a useful marker to determine the initiation of antibiotic therapy and can also be used to cease the treatment.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.Publication Open Access Determination of Factors Affecting Mortality of Patients with Sepsis in a Tertiary Intensive Care Unit(BILIMSEL TIP PUBLISHING HOUSE, 2015-07-06) BALCAN, MEHMET BARAN; Balcan, Baran; Olgun, Sehnaz; Torlak, Fatih; Sagmen, Seda Beyhan; Eryuksel, Emel; Karakurt, SaitOBJECTIVES: Sepsis is a disease with high mortality that is frequently observed in intensive care units. This study aimed to determine the risk factors affecting mortality of patients with sepsis who were followed up in the intensive care unit (ICU). We aimed to contribute to literature by evaluating the relationship between mortality and pro-brain natriuretic peptide (pro-BNP9), C-reactive protein (CRP), thrombocyte count, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, duration of hospitalization in the intensive care unit, and the presence of multidrug-resistant microorganism. MATERIAL AND METHODS: Patients hospitalized in ICU because of the diagnosis of sepsis and septic shock between December 2010 and June 2012 were included in this retrospective study. RESULTS: A total of 141 patients, including 74 male (52.5%) and 67 female (47.5%) patients, were involved in the study, and the median age was 66.8 +/- 17.9 years. Sixty-nine patients (48.9%) were discharged from the ICU; however, 72 patients (51.1%) were exitus. Multi-drug-resistant microorganism was detected in 34 patients (24.1%). The patients' median SOFA score was 9.16 +/- 3.16, median APACHE-II score was 24.9 +/- 7.83, and median duration of hospitalization in the ICU was 8.44 +/- 11.61 days. It was found that mortality rate significantly increased in patients with the APACHE-II score of 24.5 and over, SOFA score of 8.5 and over, pro BNP value of 7241 ng/L and over, and CRP value of 96.5 mg/dL and over. Mortality rate was detected to be higher in patients undergoing invasive mechanical ventilation than in patients undergoing non-invasive mechanical ventilation. When thrombocyte count and mortality were associated with each other, it was found that the median value was 86000 mg/dL in exitus patients, whereas it was 185000 mg/dL in patients discharged from the ICU. CONCLUSION: It was revealed that increased APACHE-II score, increased SOFA score, increased pro BNP score, increased CRP, the presence of multidrug-resistant microorganism, and decreased thrombocyte count elevated the rate of mortality. However, no relationship was observed between the duration of hospitalization in the ICU and mortality.Publication Open Access Tuberculosis and COVID-19: An overlapping situation during pandemic(J INFECTION DEVELOPING COUNTRIES, 2020-07-31) KARAHASAN, AYŞEGÜL; Sarinoglu, Rabia Can; Sili, Uluhan; Eryuksel, Emel; Yildizeli, Sehnaz Olgun; Cimsit, Cagatay; Yagci, Aysegul KarahasanIntroduction: The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19). First COVID-19 case was detected in March, 10, 2020 in Turkey and as of May, 18, 2020 148,067 cases have been identified and 4096 citizens have died. Tuberculosis (TB) is a worldwide public health concern, incidence of tuberculosis (per 100,000 people) in Turkey was reported at 14, 1 in 2018. During pandemic COVID-19 was the main concern in every clinic and as we discuss here overlapping respiratory diseases may result in delaying of the diagnosis and treatment. Methodology: There were 4605 respiratory samples examined between March 23 and May 18 for COVID-19 and 185 samples for Mycobacterium tuberculosis in our laboratory. The Xpert Ultra assay was performed for the diagnosis of pulmonary tuberculosis; SARS-CoV-2 RNA was determined by real-time PCR (RT-PCR) analysis in combined nasopharyngeal and deep oropharyngeal swabs of suspected cases of COVID-19. Results: Both of SARS-CoV-2 and M. tuberculosis tests were requested on the clinical and radiological grounds in 30 patients. Here we discussed 2 patients who were both COVID-19 and TB positive. One patient already diagnosed with tuberculosis become COVID-19 positive during hospitalization and another patient suspected and treated for COVID-19 received the final diagnosis of pulmonary TB and Human Immunodeficiency Virus infection. Conclusions: We want to emphasize that while considering COVID-19 primarily during these pandemic days, we should not forget one of the great imitators, tuberculosis within differential diagnoses.Publication Open Access Akut solunum sıkıntısı sendromunda ekstrakorporal membran oksijenasyonu (ECMO) kullanımı: Klinik deneyimlerimiz(2017-01-01) ERYÜKSEL, SEMİHA EMEL; OLGUN YILDIZELİ, ŞEHNAZ; AK, KORAY; KARAKURT, SAİT; ERYÜKSEL S. E., YALÇIN A., GÜVEN P., Turan C., OLGUN YILDIZELİ Ş., İspir S., AK K., KARAKURT S.Akut Solunum Sıkıntısı Sendromu (ARDS) ani gelişen alveolokapiller membran geçirgenliğinde artışa bağlı pulmoner ödem, hipoksemi ve bilateral akciğer infiltrasyonlarıyla karakterize bir sendromdur. Yoğun bakım tedavilerindeki gelişmelere rağmen, ARDS ye bağlı mortalite hala çok yüksektir. ARDS de, altta yatan hastalığın tedavisi yanında, mekanik ventilasyon yöntemi olarak düşük tidal volümlü akciğer koruyucu ventilasyon önerilmektedir. Ancak, bu tedaviye rağmen, hedef oksijen değerine ulaşılamayan hastalarda ya da düşük tidal volum uygulanmasına rağmen yüksek plato basınçlarının geliştiği, yüksek karbondioksit seviyeleri ve düşük Ph değerini tolere edemeyen hastalarda ECMO bir tedavi seçeneği olabilir. Bu yazıda, kliniğimizde 2013-2014 yılları arasında ARDS nedeniyle izlenen ve Ekstrakorporal membran oksijenizasyonu (ECMO) kullanılan hastalar retrospektif olarak incelenmiş ve literatür eşliğinde tartışılmıştır.Publication Open 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.Publication Open Access Prolonged Methylprednisolone Therapy in the Fibro-Proliferative Phase of Acute Respiratory Distress Syndrome(CUREUS INC, 2021-11-25) CEYHAN, BERRİN; Kocakaya, Derya; Yildizeli, Sehnaz Olgun; Ataizi-Celikel, Cigdem; Ceyhan, BerrinLate-stage acute respiratory distress syndrome (ARDS), primarily associated with fibro-proliferative changes, may occur in many patients. This stage, where ARDS progresses to the point of being incurable, involves a complicated and long clinical course that may give rise to functional loss; it has therefore been a major focus of both preventive and therapeutic strategies. In the present case report, the successful use of prolonged methylprednisolone therapy in the fibre-proliferative phase of ARDS is described in a patient who developed pneumonia and secondary ARDS after terminating a pregnancy due to preeclampsia. Methylprednisolone therapy, which was initiated at a daily dosage of 1mg/kg, was tapered down based on the clinical and radiologic status of the patient and was terminated at the end of the sixth month. Follow-up imaging studies and pulmonary function tests performed at the end of the first and sixth months showed marked improvements and the patient experienced no systemic adverse effects despite long-term steroid therapy.Publication Open Access Burden, depression and fatigue in caregivers of lung transplantation candidates(2023-01-01) OLGUN YILDIZELİ, ŞEHNAZ; TUFAN ÇİNÇİN, ASLI; ARIKAN, HÜSEYİN; ERYÜKSEL, SEMİHA EMEL; OLGUN YILDIZELİ Ş., Tufan Cincin A., ARIKAN H., Eryuksel E.Objective: A great deal of social support is often provided by the caregiver of the patient. The purpose of this study is to evaluate the burden, fatigue and depression of the primary caregiver of patients with pulmonary transplantation candidates.Patients and Method: The primary caregivers of patients who were admitted to our hospital\"s pulmonary transplant outpatient clinic with end-stage pulmonary disease and no definite contraindications for transplantation, were included in the study. Zarit Burden Scale, Beck Depression Inventory and Short-Form (SF)-36 - Vitality questionnaires were applied to participants.Results: Thirty-nine patients and their caregivers were evaluated. Caregivers experienced low levels of depression. Mean score for Beck Depression Inventory was 12.7 +/- 10.1. Caregivers generally experienced medium levels of burden. Mean score for Zarit Burden Scale was 26.9 +/- 14.2. Majority of caregivers experienced clinically significant fatigue. Mean score for SF-36 - Vitality was 61 +/- 16.7. Zarit Burden Scale scores and Beck Depression Inventory scores showed a statistically significant positive correlation (r:0.962 p<0.01). Conclusion: Increased burden of caregivers of lung transplant candidates was associated with depression and fatigue. The presence of depressive symptoms is noteworthy even in the mild to moderate levels of burden. Supporting caregivers, has a great importance in terms of patient care and quality.