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Arzu Balkan

Publications and source records attributed to Arzu Balkan.

11 recordsLinked to original sources
PubMed2006

Bronchial artery embolization: experience with 10 cases.

PURPOSE: To report our experience with 10 cases of bronchial artery embolization (BAE). MATERIALS AND METHODS: The study included 18 cases (11 men and 7 women between 21 and 81 years of age, average 52 years), whose massive hemoptyses could not be controlled with conservative and bronchoscopic methods and were sent to the digital subtraction angiography unit between August 2002 and May 2004. Of these 18 cases, BAE was performed in 10 (7 men and 3 women between 21 and 78 years of age, average 54.2 years). An aortogram with a 5F pigtail catheter and a selective bronchial angiogram with a 4F glide Cobra (C2) catheter was obtained in every case. The same C2 catheters that had been used for bronchial angiography were also used for BAE in 7 cases. Hydrophilic microcatheters were additionally needed for BAE in the other 3 cases. Particles > 250 microns (polyvinyl alcohol [PVA], Embosphere microspheres), mechanical coils, or a combination of both were used for BAE. RESULTS: The etiologies of 10 cases in which BAE was performed were tuberculosis (n=3), sarcoidosis (n=3), bronchiectasis (n=2), and malignancy (n=2). Arterial bronchial pathology was also seen in the non-selective angiographic studies of 4 of the 10 BAE cases. Hemoptysis was controlled in all BAE cases in the first session. Recurrences were observed in 2 cases that were embolized with only mechanical coils during the first month follow-up and hemoptysis was again controlled with microparticle embolization with Embosphere microspheres. All 10 cases were followed- up for 1-21 months (average, 8 months). CONCLUSION: Non-selective angiographic examination alone, is not sufficient enough to detect the vascular pathology causing a massive hemoptysis. A selective study must be performed in every case. The cost of angiography can be lowered by using the same 4F glide C2 catheter for BAE. It may not be safe to use only mechanical coils in BAE cases. There is a need for studying additional cases to have more definitive conclusions.

Adult↗
PubMed2006

The predictive value of serum procalcitonin levels in adult patients with active pulmonary tuberculosis.

The aim of our prospective study was to evaluate the predictive value of serum procalcitonin (PCT) level in comparison with C-reactive protein level and erythrocyte sedimentation rate for the diagnosis of pulmonary tuberculosis (PTB) on admission and 6 months after the administration of anti-tuberculous chemotherapy (ATCT). Seventy-five adult male patients with active PTB who were mycobacteriologically diagnosed (smear and culture positivity) were examined in this study. As a control group, 75 healthy adult males were enrolled. The measured serum PCT levels were within the normal range both in healthy individuals and in patients 6 months after ATCT. Serum PCT levels had been slightly high on admission in patients with PTB in comparison with controls (P = 0.01) and patients who had ATCT (P = 0.001), and this difference was statistically significant, but the PCT levels of most cases with PTB (58.7%) were below the usual cut-off level (0.5 ng/mL). We conclude from this study that the serum PCT level was not a reliable indicator in the diagnosis of active PTB because of its low sensitivity (41.3%), and in most cases it was not capable of overcoming the cut-off level even if statistically meaningful results were obtained. The PCT test for the presumptive diagnosis of PTB cannot be substituted for microbiological, epidemiological, clinical and radiological data.

Adult↗
PubMed2004

Effect of dose-rate and lung dose in total body irradiation on interstitial pneumonitis after bone marrow transplantation.

The aim of this study is to evaluate the incidence of interstitial pneumonitis following fractionated total body irradiation conditioning for bone marrow transplantation with varying lung doses due to shielding technique and different dose-rates. Between 1987 and 2001, a total number of 105 patients have received total body irradiation conditioning for bone marrow transplantation for hematological malignancies at Gulhane Military Medical School. Twelve Gy fractionated total body irradiation was delivered in 6 fractions over 3 consecutive days with Co-60 teletherapy machine. Conditioning therapy included only cyclophosphamide (60 mg/ kg/day for two days) and total body irradiation. The median follow-up for patients was 12 months. Interstitial pneumonitis developed in 10 patients out of 105 patients (9.52%). The median total dose to lung was 9.60 Gy (8.88-10.90). The difference between total lung dose and interstitial pneumonitis was not significant. Pneumonitis development in the high dose-rate (>0.04 Gy/min) group versus low dose-rate (< or =0.04 Gy/min) group was statistically significant. Low dose-rate fractionated total body irradiation is a reliable conditioning program in bone marrow transplantation with effective lung sparing to avoid interstitial pneumonitis.

Adolescent↗
PubMed2004

[The role of high resolution computerized tomography (HRCT) in the diagnosis and treatment of pulmonary tuberculosis].

In this study we have tried to put forth the role of thorax high resolution computerized tomography (HRCT) in the pursue of the diagnosis and treatment of pulmonary tuberculosis. It was detected that of the 67 patients with active tuberculosis, 66 (98.5%) had centrilobular nodule or branching linear structures, 65 (97%) had acinary nodule, 55 (82%) had consolidation, 55 (82%) had cavities, 54 (80.5%) had tree in bud appearance and 52 (77.6%) were bilateral. Of 30 patients suffering from inactive tuberculosis, 26 (86.6%) were detected to have fibrotic changes, 20 (66.6%) bronchiectasis, 18 (60%) bronchovascular distortion and 14 (46.6%) pericicatrial emphysema. The sensitivity, specificity, positive predictive value, negative predictive values of thorax HRCT in determining the activity of the illness were found as 97%, 86.7%, 94.2% and 92.9% respectively. In conclusion we can say that thorax HRCT is a powerful and reliable diagnostic method for pulmonary tuberculosis. Thorax HRCT can be used as noninvasive diagnostic method especially in the patients suffering from smear and culture negative active tuberculosis.

Adult↗
PubMed2003

[Recurrent aspiration pneumonia and Barrett's esophagus: a case report].

Gastroesophageal reflux is a condition that causes lung complications by gastric content aspiration in both adults and children. The most common complications are asthma, chronic bronchitis or chronic cough, recurrent pneumonia, pulmonary fibrosis and in children apnea as a result of regurgitation of large amount of gastric content suddenly. The reason of recurrent aspiration pneumonia is the aspiration of gastric content or microorganisms in upper gastrointestinal system. Barrett's esophagus characterized by the conversion of the epithelium of esophagus from squamous to columnar is a histological consequence of gastroesophageal reflux. We are presenting a case of Barrett's esophagus and recurrent pneumonia who had respiratory symptoms and difficulty in swallowing but no symptoms of gastroesophageal reflux. As it has been shown in our case it is difficult to cure the respiratory disease caused by nontreated asymptomatic gastroesophageal reflux.

Adult↗
PubMed2003

[The value of fiberoptic bronchoscopy in diagnosis of smear negative pulmonary tuberculosis].

Although mycobacterial culture positivity is the gold standard for the diagnosis, the initial approach to the diagnosis of pulmonary tuberculosis (PTbc) is the detection of acid-fast bacilli (AFB) in respiratory specimens as recommended by the World Health Organization. But the physicians have to make a decision for the patients whose sputum smears are negative or who can not produce sputum. Waiting for culture results with radiological follow up or empirical antituberculous therapy are the standard options. In our study we aimed to assess the diagnostic yield of fiberoptic bronchoscopy in patients, suspected to have tuberculosis, whose sputum smears were negative or who could not produce sputum. Fifty six patients who suspected to have PTbc with sputum smear negative were enrolled in the study (fiberoptic bronchoscopy and selective bronchial washings were done to all patients. Bronchial washings were obtained from the affected parts). Mucosal biopsies were done in patients in where endobronchial abnormalities were noted. Transbronchial biopsies were done in selected patients from the radiological localizations. Ziehl-Nielsen staining and culture in Löwenstein-Jensen medium were the microbiological studies. Typical granulomas were expected to detect on histopathologic examination. Bronchoscopic lavage smears were positive for Mycobacterium tuberculosis in 13 (23%) patients. Twenty eight (50%) patients had positive culture. Histopathological results confirmed tuberculosis in eight of 20 patients who had undergone mucosal biopsies, four of seven of transbronchial biopsies, two of three of needle aspiration biopsies. By bronchoscopic procedures early diagnosis was performed in 27 (48.21%) patients. We concluded that fiberoptic bronchoscopy has an important role in the diagnosis of patients suspected to have tuberculosis, whose sputum smears were negative or who could not produce sputum. It is useful and necessary in selected cases.

Adolescent↗
PubMed2003

[Pulmonary function and nutrition].

Respiratory system disease itself can cause malnutrition, while nutritional status can be the cause of or enhance respiratory failure. Malnutrition which exists 27-71 percent in chronic obstructive pulmonary disease, is a factor that determines functional capacity and mortality.

Humans↗
PubMed2003

[Diagnostic value of postbronchoscopic sputum, bronchoscopic lavage, and transbronchial biopsy in peripheral lung cancer].

The aim of this prospective study was to review the value of bronchoscopic lavage, transbronchial biopsy and postbronchoscopic sputum cytology in peripheral lung cancer. Two groups of patients were involved in the study who were treated in our clinic between the years 1999 and 2001: Group I (22 patients; average age 64 +/- 9 years; 18 males and four females) whose lesions were peripherally localised on chest radiographs and Group II (28 patients; average age 61 +/- 8; 26 males and two females) whose lesions were centrally localised and were visible only by diagnostic bronchoscopic procedures. The following procedures and analysis were done in all patients: Cytologic analysis of prebroncoscopic sputum, bronchoscopic lavage, bronchial biopsy, and patients were asked to give sputum in 30 minutes after bronchoscopy. The final diagnosis of all patients was primary lung cancer. In the first group none of the patients had visible endobronchial lesion on fiberoptic bronchoscopy. Sputum cytology of the patients were negative before bronchoscopy. Bronchoscopic lavage cytology was positive in five of 22 patients (22.7%). Transbronchial biopsy provided better diagnostic yield (50%) than postbronchoscopic sputum (31.8%). In the second group of patients, cytologic analysis was positive 25%, 96.4% and 42.9% in bronchoscopic lavage, bronchial biopsy and postbronchoscopic sputum respectively. Our findings suggest that postbronchoscopic sputum cytology may be an important diagnostic procedure in endoscopically nonvisible pulmonary cancer. Since its application is easy and noninvasive, cytologic analysis of postbronchoscopic sputum may be preferable to bronchoscopic biopsy although a favorable diagnostic yield is not expected.

Aged↗
PubMedDate not supplied

The effect of oral prednisolone with chronic obstructive pulmonary disease undergoing coronary artery bypass surgery.

BACKGROUND: Chronic obstructive pulmonary disease is still one of the most important problems in patients undergoing cardiopulmonary bypass. The purpose of this prospective study was to assess the beneficial effects of oral prednisolone on pulmonary functions in patients undergoing cardiopulmonary bypass. METHODS: Forty patients with chronic obstructive pulmonary disease were divided into two groups randomly and were given 20 mg oral prednisolone once daily perioperatively (Group I, n = 20) or identical placebo (Group II, n = 20). FEV(1) values, dates of intensive care unit and hospital stays of the two groups were compared. RESULTS: FEV1 values during the admission to our hospital were similar in each group mean predicted FEV1: 56.7 +/- 5.35% in Group I and 57.2 +/- 4.88% in Group II (p = 0.759). After 10 days of oral prednisolone treatment in Group I, predicted FEV1 values were significantly different between two groups (63.2%+/- 4.24 and 57.9%+/- 4.38) (p = 0.0001). While predicted FEV1 values revealed difference between two groups at the date of discharge (p = 0.0001) the values became similar at the third month (55.6%+/- 4.09 in Group I and 55.45%+/- 3.87 in Group II) (p = 0.897). CONCLUSION: Various types of complications may occur after cardiopulmonary bypass. Oral prednisolone not only decreases the rates of complications (reintubation, intubation times, and rhythm disturbances) but also decreases the cost of cardiac operations according to shorter hospital stays.

Administration, Oral↗