Browsing by Author "Uzaslan, Esra Kunt"
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Item Akciğer kanserli hastaların bronkoalveolar lavaj sıvılarında solubl Fas-FasL ekspresyonunun değerlendirilmesi(Uludağ Üniversitesi) Erdoğan, Beril Bahadır; Uzaslan, Esra Kunt; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları ve Tüberküloz Anabilim Dalı.Kanser gelişiminde, artmış hücre proliferasyonu yanında azalmış hücre ölüm hızının da önemli olduğu bilinmektedir. Programlanmış hücre ölümünü (apoptozis) aktive eden fizyolojik mediatörler Fas ve Fas Ligandtır (FasL). Hücre membran yüzeyindeki Fas-FasL etkileşimi, tümör hücrelerinin sitotoksik T lenfositler ve natural killer (NK) hücreler tarafından öldürülmesinde çok önemli bir yere sahiptir. Solubl form Fas ve FasL, organizmanın serum, bronkoalveolar lavaj sıvısı (BAL) ve plevra sıvısı gibi sıvı komponentlerde bulunur. sFasL, membrana bağlı FasL'dan matrix metalloproteinaz benzeri bir enzim aracılığı ile yıkılarak oluşur. sFas ise membrana bağlı Fas'ın transmembran bölgesini kodlayan mRNA 'daki gen defekti sonucu meydana gelir. Solubl haldeki Fas ve FasL'ında tümör gelişiminde ve tümör hücresinin konak immünitesinden kaçışında rol aldıkları düşünülmektedir. Araştırmamızda, BAL sıvısında sFas ve sFasL düzeyini akciğer kanserli grupta ve akciğer kanserli olmayan hastalardan oluşan kontrol grubunda ölçtük ve akciğer kanseri gelişiminde sFas ve sFasL'ın rolünü ve sFas ve sFasL düzeyinin yaş ve sigara içimi ile ilişkisini belirlemeyi hedefledik. Malign grupta 27, kontrol grupta 25 olmak üzere toplam 52 olgunun BAL sıvılarındaki sFas ve sFasL düzeyleri ELISA yöntemi kullanılarak ölçüldü. Malign gruptaki hastaların BAL sıvısı sFas ve sFasL düzeyleri, kontrol gruptaki hastaların sFas ve sFasL düzeylerine göre yüksek saptandı. Ancak istatistiksel olarak anlamlı düzeyde değildi.Malign ve kontrol grupta BAL sFas ve sFasL düzeyleri ile sigara içimi (sigara paket yılları) arasında ilişki saptanmadı. Her iki grupta BAL sFas düzeylerinin sigaradan bağımsız olarak olguların yaşları ile ilişkisi değerlendirildiğinde korelasyon saptanmadı. Malign ve kontrol grupta BAL sFasL düzeyleri sigaradan bağımsız olarak yaş ile karşılaştırıldığında malign grupta anlamlı bir ilişki saptanmadı. Ancak kontrol grupta olguların yaşları ile BAL sFasL değerleri arasında negatif korelasyon saptandı. Sonuç olarak; malignite patogenezinde sFas ve sFasL'ın etkili olabileceğini ancak diğer akciğer patolojilerinde de artabileceğini ve malignite tanısını gösteren bir parametre olarak kullanılamayacağını düşündürmektedir. Sigaranın apoptozise etki edip etmediği bilinmiyor. Ancak bu araştırma ile sigaranın sFas ve sFasL üzerinden apoptozise etki etmediğini saptadık.Item Bronşiyal astmalı olgularda, HLA antijenleri ile atopik ve nonatopik astma arasındaki korelasyonun karşılaştırmalı çalışması(Uludağ Üniversitesi, 1995) Uzaslan, Esra Kunt; Yüksel, Eser Gürdal; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.Çalışmamızda etyolojisinde, herediter ve çevresel faktörlerin birlikte rol oynadığı bilinen astma bronşiyalenin kalıtımını immuhogenetik açıdan incelemek amacı ile, atopik ve nonatopik astmalı toplam 50 olgunun HLA - A, B ve HLA - DR, DQ doku tipi antijenlerini araştırdık. Atopik astmalı olgularda HLA - B8, B49 ( 21 ) ve HLA - DRwl7 ( 3 ) antijenlerinin görülme sıklığının istatistiksel olarak anlamlı derecede arttığım, HLA - Bw22, DQwl antijenlerinin görülme sıklığının ise anlamlı derecede azaldığını, nonatopik astmalılarda ise HLA - B35 antijeninin görülme sıklığının anlamlı derecede azaldığını saptadık. HLA - B49 ( 21 ) doku tipi antijenine sahip olan kişilerde atopik astma ortaya çıkma riskinin bu antijeni taşımayanlara göre 6 kat arttığını ve Türk toplumda HLA - B49 ( 21 ) antijeni ile atopik astma arasında pozitif bir korelasyon olabileceği sonucuna vardık.Item Cockade-like structures in alveolar macrophages in extrinsic allergic alveolitis(Karger, 2005) Guzman, Josune; Costabel, Ulrich; Uzaslan, Esra Kunt; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; 8761653500Background and Objectives: In immunocytochemical preparations of bronchoalveolar lavage (BAL) cells from patients with extrinsic allergic alveolitis (EAA), we observed the presence of alveolar macrophages with cockade-like structures in their cytoplasm ( cockade+ alveolar macrophages). These cockade+ alveolar macrophages may reflect a subpopulation of alveolar macrophages which may show a different predominance in various interstitial lung diseases. In this study we aimed to compare the frequency of cockade+ alveolar macrophages in patients with EAA ( n = 14) with the results obtained in patients with sarcoidosis ( n = 11), idiopathic interstitial pneumonia ( IIP; n = 10) and control subjects ( n = 8). We also investigated the expression of the transferrin receptor CD71 on cockade+ alveolar macrophages. Methods: In BAL fluid, the total number of cells and differential counts were determined, and immunocytologic examinations of macrophages and lymphocytes were done using monoclonal antibodies. The percentage of cockade+ alveolar macrophages was determined by counting 300 macrophages in the CD20 field of an immunocytochemical slide. Results: The percentage of cockade+ alveolar macrophages was significantly higher in the EAA group ( 36 +/- 9%) compared to patients with sarcoidosis ( 12 +/- 5%) or IIP ( 11 +/- 10%) and control subjects ( 3 +/- 1%; p < 0.001). The proportion of CD71+ alveolar macrophages was significantly lower in EAA than in the other groups ( p < 0.01), and the CD71 antigen was expressed on a significantly lower proportion of cockade+ alveolar macrophages compared to cockade - alveolar macrophages in EAA ( p < 0.001). Conclusion: We conclude that cockade+ alveolar macrophages could play a role in the pathogenesis and differential diagnosis EAA.Publication Epidemiology and distribution of interstitial lung diseases in Turkey(Wiley, 2014-01) Müsellim, Benan; Okumuş, Gülfer; Akgün, Metin; Çetinkaya, Erdoğan; Turan, Onur; Akkoçlu, Atila; Hazar, Armağan; Köktürk, Nurdan; Çalışır, Haluk Celalettin; Uzaslan, Esra Kunt; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; CDI-1977-2022; 8761653500Introduction: There is very few data on the epidemiological features of interstitial lung diseases (ILD) in the literature. These studies on this subject suffer from limited number of patients. Objective: The goal of this study was to evaluate the epidemiological features of ILD in Turkey. Methods: Fifty-four investigators, 31 centres in 19 cities from six regions of Turkey, participated in the study. Two thousand two hundred forty-five newly diagnosed patients (51.8% females), led by Turkish Thoracic Society Clinical Problems Study Group, enrolled in this prospective study. Results: The mean age was 51.8±16.7 years. The mean age among males was 50.5±18.6 years and 53.0±14.6 years among females (P<0.001). 23.8% of the cases had ILD with known causes, while 39.4% were in granulomatous group, 23.7% were idiopathic, and 4.4% were in the unclassified group. Overall, histopathologically confirmed diagnosis rate was 40.4%. Sarcoidosis was the most common disease (37%), whereas cases with idiopathic pulmonary fibrosis (IPF) constituted 19,9% of patients. 53% of the sarcoidosis patients were females, and the ratio reaches to 75% under 50 years of age (for this group, IPF ratio is %3). In contrast, sarcoidosis and IPF ratios were equal in males (25%). Sarcoidosis was 8% in men over 50, while IPF was %45. Conclusion: The overall incidence of ILD in Turkey was computed to be 25.8/100000.Publication Evaluation of indoleamine 2, 3 dioxygenase (IDO) gene polymorphisms in COVID-19(Wiley, 2021-08-01) Karaca, Mert; Arslan, Gözde; Ermiş, Diğdem Yöyen; Bal, Salih Haldun; Uzaslan, Esra Kunt; Özkalemkaş, Fahir; Macunluoğlu, Aslı Ceren; Budak, Ferah; Akalın, Halis; Oral, Haluk Barbaros; KARACA, MERT; Arslan, Gözde; YÖYEN ERMİŞ, DİĞDEM; BAL, SALİH HALDUN; Uzaslan, Esra Kunt; ÖZKALEMKAŞ, FAHİR; Macunluoğlu, Aslı Ceren; BUDAK, FERAH; AKALIN, EMİN HALİS; ORAL, HALUK BARBAROS; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İmmunoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biostatik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; 0000-0002-6802-5998; 0000-0001-7625-9148; 0000-0001-7530-1279; 0000-0003-0463-6818; 0000-0002-6802-5998; 0000-0001-6711-676X; IZP-9398-2023; AAU-8952-2020; K-7285-2012; F-4657-2014; JFS-2013-2023; AAG-7406-2021; GYL-2038-2022; KBR-5535-2024; AAI-1004-2021; JLE-5241-2023; GBP-6589-2022Item Extrapulmonary involvement in patients with sarcoidosis in Turkey(Wiley, 2011-04) Okumuş, Gülfer; Musellim, Benan; Çetinkaya, Erdoğan; Türker, Hatice; Uzun, Oğuz; Sağlam, Leyla; Kumbasar, Özlem Özdemir; Çelik, Gökhan; Annakkaya, Ali Nihat; Altıay, Gündeniz; Tabak, Levent; Sakar, Ayşin; Kiter, Göksel; Erturan, Serdar; Türktaş, Haluk; Yalnız, Enver; Akkoçlu, Atilla; Ogus, Candan; Doğan, Ömer Tamer; Özkan, Metin; Aktoğu, Serir; Uzel, Işıl; Öngen, Gül; Uzaslan, Esra Kunt; Uludağ Üniversitesi/Tıp Fakültesi/Akciğer Hastalıkları Anabilim Dalı.; 8761653500Background and objective: Extrapulmonary sarcoidosis is common, and is almost always associated with concomitant thoracic involvement. Extrapulmonary manifestations vary on the basis of gender, age at presentation and ethnicity. The aim of this study was to investigate extrapulmonary involvement in patients with sarcoidosis in Turkey. Methods: This study was conducted by Turkish Thoracic Society Clinical Problems Study Group. New cases of sarcoidosis between 1 June 2004 and 31 May 2006 were recorded on electronic case record forms sent to all potential investigators and information about extrapulmonary involvement was collected. Results: One hundred and nineteen of 293 patients (83 female, 36 male, mean age = 45 +/- 12 years) had extrapulmonary involvement in this study (40.6%). The median time to diagnosis was 6 months and this was longer than patients with just thoracic sarcoidosis (P = 0.001). Extrapulmonary symptoms were present in 181 (61.8%) patients, and skin lesions, arthralgia and back pain were the commonest (33.4%, 20.8% and 16.4%, respectively). Incidence of organ involvement was independent of age with the exception of ocular involvement, which was higher in those under the age of 40 years (P = 0.007). Conclusions: Skin and peripheral lymph node involvement were the most common sites of extrapulmonary involvement and ocular involvement was more common in those under the age of 40 years in patients with sarcoidosis in a Turkish population.Item Impaired left ventricular systolic and diastolic functions in patients with early grade pulmonary sarcoidosis(Oxford University Press, 2010-12) Aydın Kaderli, Aysel; Güllülü, Sümeyye; Coşkun, Funda; Yılmaz, Dilber Durmaz; Uzaslan, Esra Kunt; Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastlaıkları Anabilim Dalı.; 0000-0003-3604-8826; AAD-1271-2019; 7801322152; 57204660708; 21734137500; 36246929800; 8761653500Cardiac sarcoidosis is symptomatic in only 5% of patients, and it is an independent predictor of mortality and carries a very poor prognosis. In our study, we aimed to assess left ventricle (LV) systolic and diastolic functions with tissue Doppler imaging (TDI) in patients with early grade pulmonary sarcoidosis. The study population included 55 patients with Grade I-II sarcoidosis (41 females, 14 males, mean age: 47.9 +/- 10.1) and 22 healthy subjects. LV lateral and septal wall early myocardial peak velocity (E-m), late myocardial peak velocity (A(m)), E-m to A(m) ratio, myocardial relaxation time (RTm), myocardial systolic wave (S-m) velocity, isovolumic acceleration (IVA), myocardial pre-contraction time (PCTm), contraction time (CTm), and the PCTm to CTm ratio were measured. No statistically significant difference was detected between the groups according to age, gender, body mass index, systolic and diastolic blood pressure, or heart rate. LV systolic parameters, LV septal, and lateral wall IVA, were significantly lower, and the PCTm to CTm ratio (P = 0.026) was higher at the septal annulus as compared with control group. E-m, a LV diastolic parameter, was significantly lower at the septal annulus. Cardiac sarcoid involvement is not rare and is treatable. It should be identified at an early stage. TDI, especially IVA, may be a suitable tool for the early detection of subclinical LV sarcoid involvement.Item Increased pleural soluble fas ligand (sfasl) levels in tuberculosis pleurisy and its relation with t-helper type 1 cytokines(Springer, 2008-10) Budak, Ferah; Uzaslan, Esra Kunt; Cangür, Şengül; Göral, Güher; Oral, Haluk Barbaros; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları ve Tüberküloz Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyostatistik Anabilim Dalı.; 0000-0003-0463-6818; F-4657-2014; AAI-1004-2021; K-7285-2012; 8604063700; 6701913697; 8761653500; 6603453166; 7004498001Tuberculosis (TB) pleurisy is accepted to be the best model for evaluating the local protective cellular immune response to Mycobacterium tuberculosis (MTB) since it can be spontaneously self-cured. Therefore, we aimed to evaluate the involvement of cytokines and the soluble apoptosis-modulating factors sFas and sFasL in local protective cellular immunity to MTB. Pleural fluid samples were collected from 35 patients with TB pleurisy, 39 patients with malignant pleurisy, and 14 patients with non-TB nonmalignant (n-TB n-M) pleurisy and were evaluated for the levels of several cytokines, soluble Fas (sFas), and sFas ligand (sFasL) by using ELISA. The levels of IFN-gamma, IL-12p40, IL-18, IL-8, and sFasL in TB pleurisy were significantly higher in comparison to those in the malignant pleurisy and n-TB n-M pleurisy groups. In addition, pleural sFasL levels were increased and positively correlated with IFN-gamma and IL-18 levels in TB patients. In conclusion, this study demonstrates that Th1-type-specific cellular immunity is responsible for protective immunity in TB and suggests that Fas-mediated apoptosis may be at least a part of protective immunity to tuberculosis and could be regulated by type 1 T-cell response. IFN-gamma and sFasL levels can be used as diagnostic markers for differing TB pleurisy from other pleurisies.Item Interleukin-10 (IL-10) gene polymorphism as a potential host susceptibility factor in tuberculosis(Academic Press Ltd-Elsevier Science Ltd, 2006) Baştürk, Bilkay; Oral, Haluk B.; Bekar, Ahmet; Budak, Ferah; Akalın, Halis; Uzaslan, Esra Kunt; Ege, Ercüment; Ener, Beyza; Göral, Güher; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Beyin Cerrahisi Anabilim Dalı.; 0000-0002-4803-8206; 0000-0003-0463-6818; F-4657-2014; AAI-1004-2021; AAG-8523-2021; K-7285-2012; AAU-8952-2020Several genes encoding for different cytokines may play crucial roles in host susceptibility to tuberculosis (TB), since the cytokine production capacity varies among individuals and depends on the cytokine gene polymorphism. The association of the cytokine gene polymorphisms with the development of TB was investigated in this study. DNA samples were obtained from a Turkish population of 81 patients with the different clinical forms of TB, and 50 healthy control subjects. All genotyping (IL-6, IL-10, IFN-gamma, TGF-beta and TNF-alpha) experiments were performed using sequence-specific primers PCR (PCR-SSP). Analysis of allete frequencies showed that IL-10 - 1082 G allele frequency was significantly more common in TB patients than healthy controls (37.7% vs 23.0%, p: 0.0 14). No statistically significant differences were observed betwe\en the different clinical forms of the disease. These results suggest that the polymorphisms in IL-10 gene may affect susceptibility to TB and increase risk of developing the disease. To confirm the biological significance of our results, further studies should be performed on other population groups. (c) 2006 Elsevier Ltd. All rights reserved.Publication Is serum iron responsive protein-2 level associated with pulmonary functions and frequent exacerbator phenotype in copd?(Turkish Assoc Tuberculosis & Thorax, 2020-01-01) Öztürk, Nilufer Aylin Acet; ACET ÖZTÜRK, NİLÜFER AYLİN; Dilektaşlı, Aslı Görek; GÖREK DİLEKTAŞLI, ASLI; Demirdoğen, Ezgi; DEMİRDÖĞEN, EZGİ; Coşkun, Funda; COŞKUN, NECMİYE FUNDA; Ursavas, Ahmet; URSAVAŞ, AHMET; Karadağ, Mehmet; KARADAĞ, MEHMET; Uzaslan, Esra Kunt; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; 0000-0002-6375-1472; 0000-0001-7099-9647; 0000-0002-7400-9089; 0000-0003-3604-8826; 0000-0002-9027-1132; JPK-7012-2023; Z-1424-2019; AAI-3169-2021; AAD-1271-2019; AAH-9812-2021; AAI-1004-2021; AAG-8744-2021Introduction: Chronic Obstructive Pulmonary Disease (COPD) exacerbations contribute to the overall severity in individual patients because they are associated with airway inflammation, pulmonary function loss, decreased quality of life and increased mortality. Although, identifying frequent exacerbator patients is important due to severe outcomes associated with frequent exacerbator phenotype in COPD patients there is no single biomarker which can differentiate this phenotype. Iron responding protein-2 (IRP2) is the protein product of IREB2 gene, which is a COPD susceptibility gene that regulates cellular iron homeostasis and has a key role in hypoxic conditions. Previous research indicates that IREB2 expression in lung tissue is associated with spirometric measurements and emphysema in COPD. In this study, our aim was to investigate whether serum IRP2 levels were associated with frequent exacerbator phenotype, to evaluate whether IRP2 levels in serum are associated with pulmonary functions and selected systemic inflammation biomarkers.Materials and Methods: Designed as a single tertiary care center based, cross-sectional study, included high risk (GOLD C, D) COPD patients who admitted to outpatient clinic consecutively between December 2015 and July 2016.Results: The study included 80 COPD patients. Serum IRP2 levels were negatively correlated with FEV ml (r= -0.25, p= 0.02) and body weight (r= -0.35, p= 0.002) but not with markers of systemic inflammation. COPD patients with at least one exacerbation history in the last year tended to have higher 1RP2 levels than patients without any exacerbation (12.3 (IQR 25-75: 10.417.1) vs 10.5 (1QR 25-75: 8.8-18.5), p= 0.061.Conclusion: Serum IRP2 level is significantly correlated with FEV1 mL but not with FEV1 predicted and cannot be used to differentiate frequent exacer bator patients. Although IREB2 gene expressions in lung tissue and bronchoalveolar lavage results have significant associations with emphysema and FEV1/FVC, FEV1 %predicted in COPD patients, our results suggests serum IRP2 level is not as promising.Item Mutation analysis of the FHIT gene in bronchoscopic specimens from patients with suspected lung cancer(Sage Publications, 2008) Çeçener, Gülşah; Tunca, Berrin; Egeli, Ünal; Karadaǧ, Mehmet; Vatan, Özgür; Uzaslan, Esra Kunt; Tolunay, Şahsine; Uludağ Üniversitesi/Fen-Edebiyat Fakültesi/Biyoloji Bölümü.; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Biyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0001-7904-883X; 0000-0002-3820-424X; 0000-0002-9027-1132; 0000-0002-7687-3284; 0000-0002-1619-6680; AAH-1420-2021; AAP-9988-2020; AAG-8744-2021; AAI-1612-2021; O-7508-2015; ABI-6078-2020; ISV-0209-2023; 6508156530; 6602965754; 55665145000; 6601970351; 16235098100; 8761653500; 6602604390Aims and background. Lung cancer is a leading cause of cancer death worldwide. However, despite recent advances in molecular biology that have revealed various genetic changes in lung cancer, the prognostic Outcome of lung cancer patients has improved only minimally. This Situation has changed fundamentally With the identification of molecular abnormalities that are characteristic of premalignant changes, Such as changes ill tumor suppressor genes, loss of heterozygosity at crucial sites, and activation of oncogenes. Inactivation of the tumor suppressor gene Fragile Histidine Triad (FHIT) is a frequent genetic change in lung cancer. The aim of this study was to identify FHIT-gene alterations in bronchoscopy specimens of patients with suspected lung cancer and to determine the molecular relevance, if any, of FHIT alterations in the development of cancer.Patients and methods. Sixty-two patients with suspected lung tumors were screened for variations within exons 5-9 of the FHIT gene using intronic primer pairs and single-strand conformation polymorphism and sequencing analysis.Results. FHIT gene alterations were detected in 27 out of 62 bronchoscopic specimens (43.54%). All of these alterations were identified as T to A alteration at position IVS8-17. This intronic variant also was identified in approximately half of control cases (45%).Conclusions. Our findings showed that the FHIT IVS8-17 T to A alteration identified in bronchoscopy specimens from patients with clinically suspected lung cancer is a polymorphism found in the Turkish population. We think that this polymorphism does not affect gene function because it is located in the intron portion of the gene and is present in many cancer patients as well as healthy Subjects. We Suggest that the FHIT gene may be turned off in lung carcinogenesis via other genetic or epigenetic mechanisms rather than mutations.Item Prevalence and risk factors of allergies in turkey (PARFAIT): Results of a multicentre cross-sectional study in adults(European Respiratory Soc Journals, 2009-04) Kurt, Emel; Metintaş, Selma; Başyiğit, İlknur; Bulut, İsmet; Coşkun, Evşen; Dabak, Şennur; Deveci, Figen; Fidan, Fatma; Kaynar, Hasan; Onbaşı, Kevser; Özkurt, Sibel; Karakış, Gülden Paşaoğlu; Sahan, Suzan; Şahin, Ünal; Oğuzülgen, Kıvılcım; Yıldız, Füsun; Mungan, Dilşad; Yorgancıoğlu, Arzu; Gemicioğlu, Bilun; Kalyoncu, Ali Fuat; Uzaslan, Esra Kunt; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; AAI-1004-2021; 8761653500The Prevalence and Risk Factors of Allergies in Turkey (PARFAIT) study was planned to evaluate the prevalence of and risk factors for asthma and allergic diseases in Turkey. The present analysis used data from 25,843 parents of primary school children, obtained from a cross-sectional questionnaire-based study. A total of 25,843 questionnaires from 14 centres were evaluated. In rural areas, the prevalences asthma, wheezing, allergic rhinitis and eczema in males were: 8.5% (95% confidence interval (CI) 7.9-9.1%), 13.5% (95% Cl 12.8-14.2%), 17.5% (95% Cl 16.7-18.2%) and 10.8% (95% Cl 10.2-11.4%), respectively; and in females were: 11.2% (95% Cl 10.9-11.8%), 14.7% (95% Cl 14.3-15.1%), 21.2% (95% Cl 20.4-22.0%) and 13.1% (95% Cl 12.4-13.8%), respectively. In urban areas, the corresponding prevalences in males were: 6.2% (95% Cl 5.8-6.6%), 10.8% (95% Cl 10.3-11.3%), 11.7% (95% Cl 11.4-12.0%) and 6.6% (95% Cl 6.2-7.0%), respectively; and in females were: 7.5% (95% Cl 7.9-7.1%), 12.0% (95% Cl 11.7-12.3%), 17.0% (95% Cl 16.4-17.6%) and 7.3% (95% Cl 6.9-7.7%), respectively. Having an atopic first-degree relative or any other atopic diseases had significant effects on the prevalence of allergic diseases. Housing conditions, such as living in a shanty-type house, visible moulds at home and use of wood or biomass as heating or cooking material were associated with one or more allergic diseases. Although genetic susceptibility is strongly associated, country- and population-based environmental factors may contribute to increased prevalence rates of allergic diseases.Item Relationship between disease severity and D-dimer levels measured with two different methods in pulmonary embolism patients(Pagerpress Publication, 2010-06) Coşkun, Funda; Yılmaz, Dilber Durmaz; Ursavaş, Ahmet; Uzaslan, Esra Kunt; Ege, Ercüment; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; 0000-0003-3604-8826; AAD-1271-2019; AAI-3169-2021; AAI-1004-2021; 21734137500; 36246929800; 8329319900; 8761653500; 6701341320Pulmonary embolism (PE) is diagnosed with increasing frequency nowadays due to advances in the diagnostic methods and the increased awareness of the disease. There is a tendency to use non invasive diagnostic methods for all diseases. D-dimer is a fibrin degradation product. We aimed to detect the relationship between disease severity and the D-dimer levels measured with two different methods. We compared D-dimer levels in cases of massive vs. non-massive PE. A total of 89 patients who were diagnosed between 2006 and 2008 were included in the study. Group 1 included patients whose D-dimer levels were measured with the immunoturbidimetric polyclonal antibody method (D-dimerPLUS (R)), while Group 2 patients made use of the immunoturbidimetric monoclonal antibody method (InnovanceD-DIMER (R)). In each group, the D-dimer levels of those with massive and non-massive PE were compared, using the Mann Whitney U test. The mean age of Group 1 (25F/26M) was 56.0 +/- 17.9 years, and that of Group 2 (22F/16M) was 52.9 +/- 17.9 years. There was no statistical difference in gender and mean age between the two groups (p > 0.05). In Group 1, the mean D-dimer level of massive cases (n = 7) was 1444.9 +/- 657.9 mu g/L and that of non-massive PE (n = 34) was 1304.7 +/- 350.5 mu g/L (p > 0.05). In Group 2, the mean D-dimer level of massive cases (n = 6) was 9.7 +/- 2.2 mg/L and that of non-massive PE (n = 32) was 5.9 +/- 1.3 mg/L (p < 0.05). The mean D-dimer levels of massive cases as measured with the immunoturbidimetric monoclonal antibody method were significantly higher. Pulmonary embolism patients whose D-dimer levels are higher (especially higher than 6.6 mg/L) should be considered as possibly having massive embolism. Diagnostic procedures and management can be planned according to this finding.Item A renal transplant recipient with pulmonary tuberculosis and visceral leishmaniasis: Review of superimposed infections and therapy approaches(Dustri-Verlag, 2003-10) Ersoy, Alparslan; Güllülü, Mustafa; Usta, Mehmet; Özçelik, Tülay; Yılmaz, E.; Uzaslan, Esra Kunt; Vuruşkan, Hakan; Yavuz, Mahmut; Oktay, Bülent; Dilek, Kamil; Yurtkuran, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Üroloji Anabilim Dalı.; 0000-0002-0710-0923; AAH-5054-2021; AAI-1004-2021; 35612977100; 6602684544; 7005030712; 7005424333; 57224424133; 8761653500; 6507328150; 7006244754; 6602172127; 56005080200; 7003389525Visceral leishmaniasis (VL) is an acute or subacute disease that is almost invariably fatal if untreated. It is a rare disease in renal transplant recipients and frequently reported together with other infectious agents. A 39-year-old renal transplant patient was admitted to hospital for elective coronary surgery. In the post-operative period, he developed spiking fever and non-productive cough and his general condition deteriorated. While he was taking medication for nonspecific pneumonia, a cavitary lesion occurred in his lung, and he had the diagnosis of pulmonary tuberculosis and antituberculous treatment was started. Despite treatment, his fever continued. As the patient developed pancytopenia and splenomegaly, a bone marrow aspiration was done. Evaluation of bone marrow aspirate indicated Leishmania parasites. He was successfully treated with a more intensive liposomal amphotericin (L-AmB). Complete cure was achieved during follow-up period of 10 months without clinical relapse. In the existence of fever and long-standing pancytopenia, VL should be suspected although the patient had another proved infection and did not live or visit an endemic area. L-AmB usage can be safely preferred for treatment of selected renal transplant recipients with VL as first-line therapy.Item Yüksek riskli KOAH hastalarında IREB2 düzeyi ve hastaların klinik özellikleri arasındaki ilişki(Uludağ Üniversitesi, 2016) Öztürk, Nilüfer Aylin Acet; Uzaslan, Esra Kunt; Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı.Kronik obstrüktif akciğer hastalığı (KOAH) kronik morbidite ve mortalitenin başlıca nedenlerinden biri olan önlenebilir, tedavi edilebilir bir hastalıktır. KOAH'ın doğal seyri, tekrarlayıcı semptomlar ve alevlenmeler ile karakterizedir. Her bir alevlenme KOAH hastasında artan solunum fonksiyonları kaybı ve mortalite ile ilişkilidir. Alevlenmeyi öngörebilecek veya alevlenme fenotipi hastalarını diğer KOAH hastalarından ayırabilecek bir biyobelirteç henüz gösterilememiştir. Çalışmamızda alevlenme öyküsü ile serum iron responsive element binding protein 2 (İREB2) düzeyi arasında bir ilişkinin varlığının gösterilmesi amaçlanmıştır. Bu çalışmada, stabil dönemde başvuran, yüksek alevlenme riski taşıyan, GOLD birleşik değerlendirme sisteminde grup C veya D popülasyonunda olan KOAH hastaları dahil edildi. Hastaların solunum fonksiyonları, yaşam kalitesi indeksleri, enflamasyon belirteçleri ve İREB2 düzeyleri değerlendirildi. Böylece, alevlenme sayıları nedeniyle yüksek riskli gruba dahil edilen hastalar ve geçmiş yıldaki alevlenme sayıları ile kriterleri karşılamadığı halde solunum fonksiyonları nedeniyle yüksek riskli gruba giren hastalar arasında ayırım yapılmasında ve alevlenmelerin ön görülmesinde İREB2 düzeyinin bir biyobelirteç olabilirliği sınandı. Ayrıca, yüksek riskli bu KOAH populasyonunun kendi içinde akciğer fonksiyonları, yaşam kalitesi ölçümleri ve enflamasyon belirteçleri açısından farklılıkları da değerlendirildi. Çalışmamızda, olguların alevlenme sayısı ile serum İREB2 düzeyi arasında ilişki saptamadık. Bu nedenle İREB2'nin sık alevlenen KOAH fenotipini önceden tahmin etmeyi sağlayacak bir biyobelirteç olmadığını gösterdik. Ancak çalışma popülasyonumuzda İREB2 düzeyi ile FEV1 mL ve % FEV1'e göre GOLD grubu arasında istatistiksel anlamlı bir ilişki belirledik. Olguların akciğer fonksiyonları ne kadar kötü ve FEV1 mL düzeyleri ne kadar düşük ise serum İREB2 düzeyi o kadar yüksekti. Yüksek alevlenme riskli KOAH hastaları alevlenme öyküsü ve FEV1 % değerlerine göre 2 gruba ayrıldı. Hastaların klinik ve laboratuar özellikleri karşılaştırıldığında ise alevlenme öyküleri nedeniyle risk grubuna giren hastalarda FEV1 mL, FEV1 %, FVC mL ve FVC % değerlerinde, FEV1 % değerleri nedeniyle risk grubuna giren hastalara göre istatistiksel anlamlılık düzeyinde düşüklük saptadık. Yine alevlenme öyküleri nedeniyle yüksek risk grubuna giren bu populasyonda dispnenin değerlendirildiği bütün ölçeklerde ve St George solunum anketi skorlarında istatistik anlamlı yükseklik saptandı. Araştırmamız sonucunda, serum İREB2 düzeyinin bir önceki yılda geçirilen alevlenme sayısı ile korelasyon göstermediğini ancak KOAH hastalarında prognozu öngörmede önemli bir fonksiyonel belirteç olan FEV1 mL değerleri ile korelasyonu olduğu gösterdik.