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Öğe A clue for obstructive sleep apnea hidden in tomographic images of idiopathic pulmonary fibrosis patients(2021) Şahin Duyar, Sezgi; Ertürk, Hakan; Fırat, Selma; Çelik, DenizObjectives: The most common opinion about apnea/hypopnea formation in restrictive pulmonary diseases is based on decreased lung volumes causing upper airway collapse. This study targets to reveal some evidence for this pathophysiological pathway in patients with idiopathic pulmonary fibrosis (IPF) and obstructive sleep apnea (OSA).Methods: The clinical, demographical, and polysomnographic characteristics of 19 patients with OSA and IPF who underwent all-night polysomnography (PSG) were retrospectively evaluated for investigating the correlations between lung volumes calculated on the images of high-resolution computed tomography (HRCT) and polysomnographic findings. Supine HRCT images performed at the time of diagnosis of IPF were used for the calculation of total lung volume and low attenuation areas of the lung (LAA). The results were compared with the results of the PSG and pulmonary function tests (PFT).Results: The study group comprised 19 patients (3 female, 16 male) with a median apnea-hypopnea index (AHI) of 23.5/h. AHI in this IPF cohort was not correlated with body-mass index, neck circumference, age, or PFT. However, overall AHI and non-rapid eye movement (non-REM) AHI had a trend of positive correlation with LAA. We also showed a positive correlation between the LAA and forced vital capacity (FVC) (r=0.682 and, p = 0.003).Conclusions: The severity of OSAS in IPF patients is well correlated with LAA. This result supports the gravitational and the volumetric effect of the lung in apnea-hypopnea formation.Öğe A comparison of idiopathic pulmonary fibrosis and chronic hypersensitivity pneumonia in terms of anterior mediastinal fat properties(2022) Bulut, Sertan; Çelik, Deniz; Ertürk, Hakan; Karamanlı, Harun; Şahin, Mustafa Engin; Sönmez, Özlem; Biber, ÇiğdemAim: The shape and physical properties of the anterior mediastinum can be easily affected by inflammatory lung diseases, tuberculosis, empyema, radiotherapy, chronic fibrotic lung diseases, previous surgery, and after steroid therapy. We planned to compare the properties of anterior mediastinal fat (AMF) in 3 different groups: patients with idiopathic pulmonary fibrosis (IPF), patients with chronic hypersensitivity pneumonia (cHP), and in the healthy control group. We investigate the AMF shape, dimensions, and AMF area properties on the images of high-resolution computed tomography (HRCT) and to find any difference between IPF and cHP patients in terms of AMF. Material and Method: The study comprises a total of 80 cases in the three groups. The first group comprises 26 cases diagnosed as IPF. The second group comprises 19 cases diagnosed as cHP. The third group comprises 35 control patients. The clinical, demographical, and AMF characteristics on HRCT were retrospectively evaluated. The AMF shape and area characteristics were compared between the three groups. Results: There was no statistical difference between the mean ages of cases, BMIs, and smoking status in IPF, cHP, and control groups. Gender distribution was found statistically significant between the 3 groups (p=0.001). A statistically significant difference was observed between the IPF and cHP groups in terms of FVC levels (2.67±0.59, 2.14±0.80, respectively; p=0.024). Also, a statistically significant difference was observed between the IPF and cHP groups in terms of DLCO levels (57.42±17.21; 77.31±35.21; respectively; p=0.016). In the evaluation of AMF shape properties between two groups (cHP and IPF), the concave figure was significantly more frequent in cHP group (p=0.014). The AMF area analyses revealed that the IPF group’s areas were significantly greater than the cHP and control group’s. The AP dimension of AMF analyses revealed that only the cHP group’s dimensions were significantly smaller than the control group’s (p=0.037). In the analysis of the transverse dimension of AMF, the IPF group’s dimensions were significantly greater than the cHP and control group’s (p<0.0001 and p=0.007; respectively) and also the cHP group’s dimensions were significantly greater than the control group’s (p<0.0001). Conclusion: The transverse length, total AMF area, and shape characteristics of AMF can be evaluated as a radiological marker for differential diagnosis of IPF and cHP, whose differential diagnosis may be difficult. Both the transverse length and AMF area can take greater values in the IPF group than in the cHP group.Öğe Association between vitamin D levels and frequency of disease exacerbations and hospitalizations in patients with COPD(2022) Bulut, Sertan; Karamanlı, Harun; Şahin, Mustafa Engin; Çelik, Deniz; Biber, ÇiğdemIntroduction: Chronic obstructive pulmonary disease (COPD) is a debilitating disorder that restricts the physical activity of patients who are deprived of sunlight, which is a source of vitamin D. The purpose of this study was to assess the relationship between vitamin D and the frequency of exacerbation and hospitalization among patients with COPD. Material and Method: In the main analysis, 303 patients with COPD (stage GOLD A to D) were included in a retrospective cohort study in Turkey. Serum levels of vitamin D (25-hydroxyvitamin D) were measured in 303 patients with COPD and were associated with pulmonary function, AECOPD frequency and hospitalization in the previous year. Results: For COPD patients, the mean reference level of 25 hydroxyvitamin D in serum was 12.5 ng/dL. In comparison to patients with a serious 25-hydroxyvitamin D deficiency (< 10 ng/dL, n=119 [39,3%]), patients with a moderate deficiency (10-19.99 ng/dL, n=100 [33%]), inadequate levels (20-29.99 ng/dL, n=49 [16,2%]) presented a different risk of exacerbation (incidence rate ratio, 2.3 [95% CI, 1.9-2.6], 1.6 [95% CI, 1.2-2.0], and 0.8 [95% CI, 0.3-1.2] respectively). In patients with desirable levels (> 30 ng/dL, n=34 [11,2%]), the risk was lower but not significant (incidence ratio, 0.7 [95% CI, 0.2-1.2]. In COPD patients, 25-hydroxyvitamin D rates are low correlated with 1-s forced expiratory volume (FEV1) (r=0.187, p=0.0013). Conclusion: 25-hydroxyvitamin D deficiency is a frequent occurrence in COPD and is correlated with the frequency of exacerbation and hospitalization in COPD patients.Öğe Clinical and radiological characteristics of pulmonary actinomycosis mimicking lung malignancy(2022) Baykal, Hüsnü; Ülger, A. Füsun; Çelik, Deniz; Benli Tanrıkulu, Fatma; Tatçı, EbruINTRODUCTION: Pulmonary actinomycosis, clinically and radiologically, mimics abscess, tuberculosis, and lung malignancy, resulting in misdiagnosis or delay in diagnosis. In this study, we analyzed the clinicoradiological features of pulmonary actinomycosis, the presence of any differences between clinical prediagnosis and radiological diagnosis, and whether imaging modalities help distinguish pulmonary actinomycosis from lung cancer. METHODS: A total of 22 patients who had a histopathological diagnosis of actinomycosis in a tertiary health center participated in this study. Of these, 14 had positron-emission tomography/computed tomography. RESULTS: In all, 81.8% of the patients were males. The diagnostic procedures employed for the diagnosis of actinomycosis were surgery in 54.5% of patients, fiberoptic bronchoscopy in 36.4% of patients, and rigid bronchoscopy in 9.1% of patients. Radiological and clinical prediagnosis showed malignancy in 31.8 and 40.9% of patients, respectively. The mean of the maximum standardized uptake value was 6.33±3.6 on positron-emission tomography/computed tomography. Kappa compliance analysis revealed that clinical and radiological diagnoses were significantly compatible with each other and that radiological pre-diagnoses were not superior to clinical diagnoses (?=0.701 and p<0.001). CONCLUSION: Pulmonary actinomycosis shows high metabolic uptake in positron-emission tomography/computed tomography, and this may mislead clinicians for a diagnosis of malignancy. Our results suggest that positron-emission tomography/computed tomography does not help distinguish pulmonary actinomycosis from lung malignancy and does not provide a clear diagnostic benefit to the clinician, so pathological diagnosis is necessary.Öğe Clinical and radiological characteristics of pulmonary actinomycosis mimicking lung malignancy(2022) Baykal, Hüsnü; Ülger, A. Füsun; Çelik, Deniz; Tanrıkulu, Fatma Benli; Tatçı, EbruINTRODUCTION: Pulmonary actinomycosis, clinically and radiologically, mimics abscess, tuberculosis, and lung malignancy, resulting in misdiagnosis or delay in diagnosis. In this study, we analyzed the clinicoradiological features of pulmonary actinomycosis, the presence of any differences between clinical prediagnosis and radiological diagnosis, and whether imaging modalities help distinguish pulmonary actinomycosis from lung cancer. METHODS: A total of 22 patients who had a histopathological diagnosis of actinomycosis in a tertiary health center participated in this study. Of these, 14 had positron-emission tomography/computed tomography. RESULTS: In all, 81.8% of the patients were males. The diagnostic procedures employed for the diagnosis of actinomycosis were surgery in 54.5% of patients, fiberoptic bronchoscopy in 36.4% of patients, and rigid bronchoscopy in 9.1% of patients. Radiological and clinical prediagnosis showed malignancy in 31.8 and 40.9% of patients, respectively. The mean of the maximum standardized uptake value was 6.33±3.6 on positron-emission tomography/computed tomography. Kappa compliance analysis revealed that clinical and radiological diagnoses were significantly compatible with each other and that radiological pre-diagnoses were not superior to clinical diagnoses (?=0.701 and p<0.001). CONCLUSION: Pulmonary actinomycosis shows high metabolic uptake in positron-emission tomography/computed tomography, and this may mislead clinicians for a diagnosis of malignancy. Our results suggest that positron-emission tomography/computed tomography does not help distinguish pulmonary actinomycosis from lung malignancy and does not provide a clear diagnostic benefit to the clinician, so pathological diagnosis is necessary.Öğe Clinical features, risk factors, and antimicrobial resistance of pseudomonas putida isolates(2022) Baykal, Hüsnü; Çelik, Deniz; Ülger, A. Füsun; Vezir, Sedat; Güngör, M. ÖmürPseudomonas putida rarely results in infection, primarily in patients undergoing invasive procedures or immunocompromised hosts. We aimed to investigate the characteristics of Pseudomonas putida infections. This is a retrospectively designed cross-sectional observational study. We retrospectively scanned the data from our hospital for the 10 years before February 15, 2022. The patients with Pseudomonas putida growth in the microbiological cultures and with antibiotic susceptibility tests were included in the study. We recorded culture isolates types, age, gender, comorbidities, immunosuppressive factors, symptoms, invasive medical procedures, length of hospital stay, and radiological findings. The mean age of the patients was 66.2?±?14.5 years, and the male patients predominated (76.3%, n?=?58/76). There was growth in bronchial lavage in 33 patients, sputum in 28, pleural effusion fluid in 12, and tracheal aspirate in 3 patients. The rate of antibiotic-resistant strains was 56.6% (n?=?43). All strains were sensitive to colistin (100%), and carbapenem, amikacin, and gentamicin sensitivity rates were high. We observed that the risk of antibiotic resistance increased 4.29 times in the patients in the intensive care unit (Cl:1.27–14.47, P?=?.01). The patients with Diabetes Mellitus had a higher risk (OR 4.33, Cl:1.11–16.77, P?=?.03), and in cancer cases, the risk was 3.31 times higher (Cl:1.06–10.32, P?=?.03). The risk of Pseudomonas putida infection should be considered, particularly in patients with comorbid disorders causing immunosuppression, including Diabetes Mellitus and Cancer.Öğe Do high PaCO2 levels during discharge from the hospital predict medium-term mortality in chronic respiratory failure patients without domiciliary non-invasive mechanical ventilator?(2022) Çelik, Deniz; Yıldız, Murat; Kurt, Gızem; Saymaz, Zeynep TilbeAim: Long-term domiciliary use of a non-invasive mechanical ventilator (NIV) is a controversial form of therapy for patients with chronic obstructive pulmonary disease (COPD) and moderate hypercapnia. The present research attempted to examine hospital admissions, hospitalizations, and medium-term (6-8 months) mortality in a group of patients with compensated but moderate hypercapnia who were discharged from our clinic without a domiciliary NIV. Material and Method: The sample of this retrospective, observation-based cohort study consisted of compensated hypercapnic cases that were hospitalized in our Pulmonology Intensive Care Unit (ICU) between 01.01.2019 and 12.31.2020. Results: A total of 245 patients discharged with high partial pressure of carbon dioxide (PaCO2) levels between 01.01.2019 and 12.31.2020 were included in the study. While 58% of the cases were males (n=142), we found the mean age of the patients to be 71.89±12.63 years. The findings yielded no significant differences between the groups by sex, use of NIV during hospitalization, number of days of NIV use during hospitalization, use of LTOT or Oxygen tube at home, and intubation history before ICU admission (p>0.05). Similarly, we could not conclude significant differences between the groups by hospitalization, discharge, and follow-up arterial blood gas (ABG) parameters. Yet, the rates of congestive heart failure, coronary artery disease, and atrial fibrillation were significantly higher in the mortality group (p=0.017, p=0.032, and p=0.002, respectively). Besides, high PaCO2 levels versus mortality rates at 1, 3, 6, 8, and 12 months and in the entire follow-up period were subjected to the ROC analysis. Accordingly, when accepting 50.25 mmHg as the cut-off value for determining the 8-month mortality for discharge PaCO2 levels, we calculated the sensitivity to be 78.6% and the specificity to be 43%. Conclusion: Overall, it is highly convenient to consider the possible positive effects of NIV therapy on mortality among patients with heart-related diseases and with moderate hypercapnia (PaCO2>50 mmHg) at discharge.Öğe DOES LOW MEAN CORPUSCULAR HEMOGLOBIN CONCENTRATION REALLY PREDICT MORTALITY IN ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE?(2023) Kurt, Gızem; Çelik, Deniz; Yıldız, Murat; Özdağ, ÖzlemObjective: Several studies have shown low mean corpuscular hemoglobin concentration (MCHC) associations with mortality and poor clinical course in conditions associated with chronic inflammation, such as cardiac failure and COPD. Thus, this study aimed to determine the link between MCHC and readmission mortality in a large patient population with a minimum of 1 year of follow-up. Methods: We recorded clinical data at admission, laboratory data, the number of admissions to the emergency room due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) following the discharge of the last patient recruited, the number of admissions to the pulmonology unit, and the number of intensive care unit admissions between 2018 and 2019. The follow-up duration ranged between 12 and 36 months. Results: A total of 339 patients were included. Based on a ROC analysis, the cut-off value for MCHC was 32.35 g/dl. Comparison of clinical data according to this cut-off value showed an increase in the incidence of pneumonia during admission, hypercapnic respiratory failure, need for noninvasive mechanical ventilation (NIV), and the number of intensive care unit admissions within one year, as well as reduced survival in nonanemic subjects with MCHC ? 32.35 g/dL. In multivariate cox-regression analysis, MCHC was not an independent predictor of mortality risk. Conclusion: We recommend careful monitoring and assessing comorbidities in acute exacerbation of COPD patients with low MCHC but without anemia. MCHC was not found to be an independent predictor of mortality, but there was a significant correlation between MCHC and survival in patients without anemia.Öğe Effectiveness Of Clinical Parameters And Laboratory Values In Predicting The Clinical Course of Sarcoidosis(2022) Çelik, Deniz; Bulut, SertanAim: The natural course of sarcoidosis is heterogeneous. There is no clear marker that can predict the course of this disease and its characteristics over months/ years. We aimed to analyze our patients' data to identify a prediction parameter at admission. Methods: The patients with sarcoidosis and followed-up between 2015-01-01 and 2020-12-31 comprised the study group. The patients were staged by a Scadding staging system. Improvement or deterioration in at least two of the clinical-laboratoryradiological parameters indicates regression, stable disease, progression, or relapse of sarcoidosis. Results: The study group comprised four cases (6.9%) defined as stage 0; fifteen cases (25.86%) as stage 1; 39 cases (67.24%) were defined as stage 2. The mean age at diagnosis was 40.84±13.56 in stage 0 + stage 1 group, while it was 48.05±13.36 in the stage 2 group (p=0.06). 74.1% of the cases were women. The female/male ratio was found at 2.86. 57 out of 58 cases had a pathological diagnosis (EBUS TBNA). While PFTs values and DLCO were significantly lower at advanced stages but the same statistical significance was not identified between these values and the clinical course of the disease. As a result of the multivariate analysis, it was observed that only the presence of chest pain at admission affected the progression of the disease in the follow-up period. Conclusion: Sarcoidosis is a multi-systemic disease and there is no clear finding for predicting the poor prognosis of the disease. We conclude that chest pain symptom at admission is valuable predictive finding and can be used as a clue for the progression at follow-upÖğe Evaluation of Acromegaly patients with sleep disturbance related symptoms(2021) Çelik, Deniz; Duyar, Sezgi Şahin; Aksu, Funda; Fırat, Selma; Çiftçi, BülentBackground and Objectives: It is known that the prevalence of obstructive sleep apnea (OSA) is increased in acromegaly. Craniofacial anomalies, macroglossia, and thickening of the laryngeal wall caused by the increase in soft tissue in these patients lead to OSA. Also, the increase in growth hormone can trigger central apnea by causing a decrease in respiratory drive. Determining the polysomnographic characteristics of acromegaly patients is important to reveal the effect of these mechanisms. Methods: The demographic and polysomnographic characteristics of 33 acromegaly patients who underwent polysomnography (PSG) with suspicion of sleep disorders between 2011 and 2018 in the sleep laboratory of our hospital were retrospectively analyzed. One of the patients was excluded from the analysis because PSG was performed in the postoperative period. The remaining 32 patients with active acromegaly were grouped according to their gender and the presence of OSA and compared with statistical methods in terms of polysomnographic and clinical features. Results: OSA (AHI>5) was detected in 78.1% of 32 active acromegaly patients (18 females, 14 males) who underwent PSG with suspicion of sleep-disordered breathing. Moderate-severe OSA (62.5%) was found in most patients, and there was no difference between the sexes in terms of OSA detection rate and OSA severity. Respiratory events appear to be predominantly obstructive hypopneas. Also, the polysomnographic features of female and male acromegaly patients with OSA were found to be similar. It is seen that the OSA group is similar to the group with simple snoring in terms of body mass index (BMI), but is statistically significantly older (p=0,007). A positive correlation was found between age and AHI in pairwise correlation analysis (r:0,426 p:0,015, respectively). Conclusion: Considering that the prevalence of OSA in the population is approximately 5%, our results show that the risk of OSA in acromegaly increases, and obstructive pathways are effective in this increase. The probability of OSA occurrence and polysomnographic features between the genders are similar. Although the median BMI of the patients with and without OSA was similar, the median age was higher in the group with OSA, middle-aged acromegaly patients should be evaluated in terms of OSA even if there is no obvious obesity.Öğe Factors Affecting the Length of Hospital Stay in Hypercapnic Respiratory Failure(Multidisciplinary Digital Publishing Institute (MDPI), 2025) Ari, Maside; Özdemir, Tarkan; Yildiz, Murat; Çelik, Deniz; Usul, Eren; Ari, Emrah; Tuten, Omer FarukBackground/Objectives: Hypercapnic respiratory failure (HRF) is a primary cause of admittance to the intensive care unit (ICU). This study aimed to investigate the factors that affect the length of hospital stay in HRF patients. Methods: This study was designed as a retrospective, cross-sectional analysis of patients who were admitted to the ICU because of HRF between 2022 and 2024. The demographic and clinical characteristics of the patients and laboratory results were recorded. The Charlson Comorbidity Index (CCI) was calculated. The relationship between these parameters and the length of hospital stay was assessed. Results: A total of 138 patients were included in the study. The average length of hospital stay was 11.45 days, and 37% of the patients were included in the long-term hospitalization group. The degree of hypercapnia was not associated with the length of hospital stay. It was determined that the patients’ albumin levels and CCI were significant determinants of the length of hospital stay. The combined assessment of these two parameters was found to be superior compared to their separate evaluations. Conclusions: In our study, hypoalbuminemia and a higher CCI were identified as predictors of a prolonged ICU stay in HRF patients. Albumin levels of <3.25 g/dL and CCI scores of ?5 were linked to longer stays, with this combined evaluation offering greater predictive value. These factors can guide patient management. © 2024 by the authors.Öğe Göğüs hastalıkları kliniklerinde çalışan hemşirelerin noninvaziv mekanik ventilasyon bilgi düzeyi(2022) Yıldız, Murat; Akoğlan, Figen; Karakaya, İsa; Çelik, Deniz; Çevik, Fatma Büşra: Amaç: Noninvaziv mekanik ventilasyon (NIMV), hastaya invaziv bir yöntem kullanmadan maske aracılığı ile pozitif basınçlı solunum desteği vermeyi sağlayan bir uygulamadır. Bir göğüs hastalıkları hastanesinde çalışan hemşirelerin NIMV hakkındaki bilgi düzeylerini belirlenmesi amaçlandı. Yöntem: Hemşirelerin bilgi düzeyini ölçmek için Tarhan ve arkadaşları tarafından 2015 yılında geliştirilen anket, hastanemiz göğüs hastalıkları yoğun bakım ünitesi, göğüs hastalıkları klinikleri ve acil servis de çalışıp katılımcı olmayı kabul eden 128 hemşireye uygulandı. Hemşirelerin demografik özelikleri ve NIMV bilgi düzeyleri ölçüldü. Bulgular: NIMV alınan toplam puan ortalaması 36,51 ± 4,56 idi. Katılımcıların %82,8’sı kadın, %54,7’si 30 yaş altındaydı. Ankete katılan hemşirelerin çalışılan klinik dağılımına göre bakıldığında, %63,3’ü göğüs hastalıkları servislerinde, %20,3’ü göğüs hastalıkları yoğun bakım kliniğinde, %16,4’ü acil servisde çalışmaktaydı. NIMV sorularından alınan puan ortalaması sadece çalışılan kliniğe göre istatistiksel olarak anlamlı farklı bulundu (p<.05). Göğüs hastalıkları yoğun bakım çalışanlarının hem acil hem de göğüs servislerinde çalışanlara göre puan ortalaması daha istatistiksel olarak anlamlı düzeyde yüksek bulundu. Ayrıca NIMV eğitimini hekimlerden alan katılımcıların puan ortalaması hekimlerden almayanlara göre istatistiksel olarak anlamlı derecede yüksek bulundu. Sonuç: Eğitimli, bilgili ve deneyimli bir hemşire ekibine sahip olmanın tedavinin başarısını doğrudan etkileyebileceği kanaatindeyiz. Ayrıca seçilen klinik, NIV uygulamaları için yeterli teknik ve fiziksel imkanlara sahip olmalıdır.Öğe Hidden face of chronic obstructive pulmonary disease: effects of patients’ psychiatric symptoms on caregivers’ burden and quality of life(2023) Karagün, Zeynep; Çelik, Deniz; Aydın, Mehmet Sinan; Gündoğmuş, İbrahim; Şipit, Yusuf TuğrulObjectives: Chronic Obstructive Pulmonary Disease (COPD) faces functional and physical limitations and often needs the help of others at certain times in their lives. Patients and caregivers can affect each other psychologically, physically, and socially. This study aims to examine the relationship between the demographic and clinical characteristics of COPD patients and the quality of life and burden of care of caregivers. Methods: The study was carried out with 250 COPD patients who applied to the chest diseases hospital and their caregivers. Hospital Anxiety-Depression Scale (HADS), The Zarit Burden Interview (ZBI), and World Health Organization Quality of Life Scale Short Form (WHOQOL-BREF) scales were applied to the patients. Results: The patients’ gender, age, regular drug use, non-invasive mechanical ventilator use, emergency room admissions, number of hospitalizations, number of intensive care admissions, presence of comorbidities were found to be associated with HADS anxiety and depression scores, ZBI, and WHOQOL-BREF. According to the results of multiple linear regression analysis; it is seen that the patient's gender, NIV use, regular device use, presence of comorbidity, HADS anxiety score, and HADS depression score is an independent predictor of the caregiver's burden (ZBI score); and the patient's NIV use, regular device use, HADS anxiety score and HADS depression score is an independent predictor of the caregiver's WHOQOL-BREF score. Conclusions: It is important to evaluate patients and caregivers in a holistic approach and to realize the factors that may negatively affect them in the early period to take the necessary therapeutic measures.Öğe Kritik hastalarda cihaza bağlı bası yarası gelişiminde rol oynayabilecek risk faktörlerinin değerlendirilmesi(MediHealth Academy Yayıncılık, 2025) Menteş, Oral; Yıldız, Murat; Arı, Maşide; Ensarioğlu, Kerem; Çelik, Deniz; Kurtuluş, Ezgi; Şirikçi, Hatice NurTıbbi cihazlara bağlı bası yaraları, özellikle yoğun bakım ünitesinde takip edilen hastalarda yaygın olarak görülen komplikasyonlardan biridir. Bu yaralar, hem hasta konforunu olumsuz etkiler hem de tedavi maliyetlerini artırır. Tıbbi cihaz kullanımına bağlı gelişen bu yaraların önlenmesi ve yönetimi için risk faktörlerinin iyi anlaşılması gerekmektedir. Bu çalışma, kritik hastalarda tıbbi cihazlara bağlı bası yaralarının prevalansını belirlemeyi ve bu yaraların oluşumunda etkili olabilecek risk faktörlerini değerlendirmeyi amaçlamaktadır. Çalışma, 1 Ocak 2021 ile 1 Aralık 2021 tarihleri arasında göğüs hastalıkları yoğun bakım ünitesinde Non-invaziv Mekanik Ventilatör (NİMV) kullanılarak takip edilen 91 hastayı kapsamaktadır. Hastaların demografik özellikleri, beslenme durumları, vücut kitle indeksleri (VKİ), biyokimyasal parametreleri ve Braden Bası Yarası Risk Değerlendirme Ölçeği skorları retrospektif olarak analiz edilmiştir. Elde edilen bulgular, tıbbi cihaz kullanım süresi ile bası yarası gelişimi arasında doğrudan bir ilişki olmadığını göstermiştir. Ancak maske kullanım gün sayısındaki artışın, özellikle bası yaralarının evre ilerlemesi ile anlamlı bir şekilde ilişkili olduğu tespit edilmiştir. Çalışma, Braden skorlama sisteminin oronazal maskelere bağlı bası yaralarını öngörmede yetersiz olduğunu ortaya koyarken Kan üre azotu (BUN) yüksek olan hastalarda yaraların erken evrede kalıp ilerlemediğini ortaya koymuştur. Ayrıca beslenme durumu, albümin seviyeleri, VKİ ve kortikosteroid kullanımı ile bası yarası oluşumu arasında anlamlı bir ilişki bulunmamıştır. Bununla birlikte, yoğun bakımda yatış süresinin artışı, bası yaralarının daha ileri evrelere ilerlemesi ile ilişkilendirilmiştir. Bu sonuçlar, tıbbi cihaz kullanımına bağlı bası yaralarının önlenmesi için cihaz kullanım sürelerinin optimize edilmesi, uygun cihaz seçiminin yapılmasının önemini vurgulamaktadır.Öğe Loss of smell in COVID-19 patients: is it related to clinical-radiological disease severity?(MediHealth Academy Yayıncılık, 2022) Baykal, Hüsnü; Çelik, Deniz; Bulut, Sertan; Kurt, Hasret Gizem; Ülger, Ayşe FüsunObjective: Olfactory dysfunction (OD) is one of the most prominent predictive symptoms in the early detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19), it may be the first symptom or accompany other symptoms. The predictive value of OD is unknown in terms of the overall prognosis of COVID-19. We aimed to investigate the relationship between OD and the clinical-radiological severity of the disease. Material and Method: Data of 208 COVID-19 patients (105 inpatients and 103 outpatients) who had positive Real-Time Polymerase Chain Reaction (PCR) tests between December 1, 2020, and January 15, 2021, were collected retrospectively. Presence of OD, symptoms on admission other than OD, days of hospital stay, peripheral blood analysis values, COVID-19 disease severity [World Health Organization (WHO) 2020 “Clinical management of COVID-19”] and radiologic classifications [Radiological Society of North America Expert Consensus Statement on Reporting (RSNA) Chest CT Findings Related to COVID-19] were retrospectively collected. Results: Analysis of 208 patients revealed that there were 105 (50.48%) inpatients and 103 (49.52%) outpatients. Among 102 patients who had OD, 68 were outpatients and 34 were inpatients. It was determined that the patients with OD were mostly followed up on an outpatient basis, and they did not need hospitalization (pÖğe NIV: Noninvasive Ventilation via Different Face Masks/Helmets(Springer International Publishing, 2023) Çelik, DenizVarious interfaces for noninvasive mechanical ventilation (NIV) are available because of clinical needs. Leakages and exhalation valves of NIV masks (nasal, oronasal, and face masks) are sources of aerosol droplets. The helmet interface has the lowest risk of aerosol droplet dissemination if the helmet has an inflatable neck cushion and viral filters. The helmet interface will reduce the work of breathing and improves hypoxemia. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2014, 2023. All rights reserved.Öğe Oronasal Face Masks Designs and Clinical Implications(Nova Science Publishers, Inc., 2022) Çelik, Deniz; Sahin Duyar, SezgiOronasal masks (or full-face masks) have some advantages over the other types of interfaces, owing to their simple feature of covering both the nose and the mouth. Despite high patient comfort, the nasal mask has a high risk of leakage from the mouth. The mouth respiration may reduce the efficacy of ventilation with a nasal mask and may falsify the monitoring of tidal volume. Therefore, nasal interfaces may cause failure during noninvasive ventilation for acute respiratory failure (ARF). On the other hand, the oronasal interface allows pressured air to bypass the nasal resistance and provides higher ventilation pressures with a lower leakage than the nasal mask. Besides, the oronasal interface requires less patient cooperation in case of mouth opening, coughing, or talking. Although it is recommended as the first choice interface for ARF, the oronasal mask is less comfortable than the other interfaces due to the limited communication and nutrition. The oronasal masks can lead to pressure necrosis of the skin over the nasal bridge. Interventions can reduce skin lesions and increase compliance. Appropriate attachment of the mask, suitable NIV usage time with adequate timeouts, and protecting the bridge of the nose with bandaging (foam or hydrocolloids) may increase patient comfort, NIV compliance, and reduce pressure sores and nasal bridge lesions. © 2022 by Nova Science Publishers, Inc. All rights reserved.Öğe Pandemi sürecinde göğüs hastalıkları yoğun bakımında COVID-19 dışı hastalarda tanı konulan toplum kaynaklı veya hastanede gelişen tüm enfeksiyonlar azaldı mı?(2022) Çelik, Deniz; Yıldız, MuratGiriş: COVID-19 pandemisi nedeniyle sağlık personelinde el hijyeni, alkol bazlı dezenfektan kullanımı, eldiven, maske ve diğer bariyer önlemlerin kullanımında farkındalık artışı gözlenmektedir. Çalışmamızın amacı, 2019 ve 2020 yıllarının ilk 6 aylarında COVID-19 tanısı dışlanmış, yoğun bakım izlemi gereken hastalarda oluşan enfeksiyonların oranlarında bir farklılık olup olmadığını karşılaştırmaktır. Gereç ve Yöntemler: 01/01/2019-30/06/2019 arasındaki 6 ay süreyle (kontrol grubu) ve 01/01/2020-30/06/2020 arasındaki 6 ay süreyle (vaka grubu) ikinci basamak Göğüs Hastalıkları Yoğun Bakım Ünitesine (GYBÜ) kabul edilen tüm hastalar çalışmaya dahil edildi. Çalışmamızda hariç bırakma kriteri yoktu. COVID-19 PCR pozitifliği tespit edilen veya COVID-19 PCR testi negatif olsa da klinik ve radyolojik kuşkuyla COVID-19 hastalığı düşünülen, ve/veya spesifik tedavi başlanmış/devam eden hiçbir hasta bu dönemde bu yoğun bakımımıza alınmadığı için çalışmamıza da dahil edilmediler. Bulgular: Çalışmanın kontrol grubu (n=327) ve vaka grubu (n=260) demografik bulgular ve genel özellikleri bakımından benzerdi. Gruplar arasında yaş, cinsiyet, hastanın GYBÜ’ne nakil geldiği yer, hastanın taburcu edildiği yer, GYBÜ öncesi üçüncü basamak yoğun bakımda entübasyon öyküsü, evde USOT ve/veya NIMV cihazlarının bulunması, eve raporlanan cihaz tipleri ve taburculuk sonrası takipte mortalite durumları, GYBÜ’de NIMV ihtiyacının olması ve NIMV gün sayısı, üçüncü basamak YBÜ’de yatış gün sayısı ve NIMV uygulama gün sayısı açısından gruplar arasında istatistiksel olarak anlamlı ilişki bulunmadı. Kontrol grubu ile vaka grubu arasında hastalardan alınan tüm kültürlerin üreme durumu ve kültürlerde üreyen mikroorganizmalar açısından istatistiksel olarak anlamlı farklılık izlenmedi (sırasıyla; p=0.775 ve p=0.137). Sonuç: Çalışmamızda GYBÜ’de çalışan sağlık personelinin el hijyeni ve bariyer önlemler hakkında farkındalığında artış olmasına rağmen gerek yüksek riskli dirençli bakteriyel üremelerde dönemler arasında farklılık izlenmemesi gerekse de tanı konulan enfeksiyonlarda dönemler arasında farklılık olmaması enfeksiyon kontrol önlemlerinin içselleştirildiğini ve uygulandığını göstermektedir.Öğe Predicting early mortality after CPR in the ICU: a multimodal analytical approach(MediHealth Academy Yayıncılık, 2025) Menteş, Oral; Çelik, Deniz; Doğanay, Güler Eraslan; Pehlivan, Merve Sarıyıldız; Cırık, Mustafa Özgür; Arı, Emrah; Arı, MaşideAims: Mortality rates remain high among patients admitted to the intensive care unit (ICU) following successful return of spontaneous circulation (ROSC) after cardiopulmonary resuscitation (CPR). Identifying risk factors specific to this patient group may directly inform clinical decision-making processes. This study aimed to identify the clinical and laboratory parameters associated with mortality in post-CPR ICU patients and to compare machine learning models developed using these parameterswith traditional statistical analyses. Methods: This retrospective study included a total of 82 patients treated in a tertiary-level ICU between 2020 and 2023. The post-CPR group (n=41) consisted of patients admitted to the ICU following effective CPR and ROSC, while the control group (n=41) included randomly selected patients with similar clinical characteristics who had not undergone CPR. Demographic data, clinical scores (APACHE II, SOFA, NUTRIC), laboratory values, and survival outcomes were recorded. Mortality prediction models were developed using the Random Forest algorithm applied to class-balanced datasets generated with the ADASYN method. Results: The post-CPR group had significantly higher scores and biomarker levels, including APACHE II, SOFA, and CRP, whereas albumin and GFR levels were notably lower. Both ICU and hospital mortality rates were significantly elevated in this group (75.6% and 80.5%, respectively; pÖğe Prediction of pulmonary intensive care unit readmissions with Stability and Workload Index for Transfer score(2023) Özdağ, Özlem; Çelik, Deniz; Yıldız, Murat; Kurt, GızemBACKGROUND AND AIM: Readmission of patients discharged from the intensive care unit (ICU) to the ICU is common and increases mortality. The Stability and Workload Index for Transfer (SWIFT) score is a scoring system developed and validated to predict the risk of readmission to the ICU. We evaluated the usability of this scoring system in patients with respiratory failure in a pulmonary intensive care unit (PICU). METHODS: This study was a retrospective cross-sectional study that included patients hospitalized in the PICU between January 1, 2020, and December 31, 2020. Patients who were discharged to the clinic or home and readmitted in the first 7–30 days were included in the study. Patients referred to an upper-level ICU or another hospital and those who died in the hospital were excluded from the study. RESULTS: A total of 442 patients received inpatient treatment during the study period, and 421 patients were included. Eight (1.9%) patients were readmitted within the first 7 days, and 25 (5.9%) patients were readmitted within 7–30 days. There was no significant difference between the SWIFT score, Acute Physiology and Chronic Health Evaluation II (APACHE II), and modified Charlson Comorbidity Index (mCCI) scores of the readmitted patients and those who were not. We calculated the area under the curve value for the SWIFT score as 0.548 (95% CI: 0.440–0.656). CONCLUSIONS: For patients discharged from the PICU, neither the SWIFT score nor APACHE II and mCCI were not sufficient to predict readmission. This study showed that existing scoring systems is insufficient to predict the readmission of patients with respiratory failure, and there is still a need for scoring systems to predict the readmission of these patients.
