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Review Citation - WoS: 3Citation - Scopus: 4Akciğer Kanserinde İmmünoterapi ve Tedavide Multidisipliner Yaklaşım(Turkish Assoc Tuberculosis & Thorax, 2020) Karadurmuş, Nuri; Kaya, Akın; Göksel, Tuncay; Yılmaz, Ülkü; Tülek, NeclaAkciğer kanseri dünya genelinde kanserle ilişkili ölümlerin başlıca nedeniolmaya devam etmektedir. Son 20 yılda kanser biyolojisi ve patogenezi hakkındaki bilgiler artmış, immün kontrol noktası inhibitörleri (İKNİ) kullanımasunulmuş ve böylece solid kanserlerin tedavisinde önemli bir dönem başlamıştır. Bu derlemede; tedavide yenilikler, immünoterapi ve tedavide multidisipliner yaklaşım çerçevesinde akciğer kanseri ele alınmıştır. Küçük hücreli dışıakciğer kanseri (KHDAK) en sık görülen ve özellikleri nedeniyle İKNİ tedavisinden ideal olarak yararlanabilecek akciğer kanseri türü olması nedeniyleyazının odak noktasını oluşturmuştur. Bu derleme, akciğer kanseri tedavisindeimmünoterapi yaklaşımının göğüs hastalıkları başta olmak üzere tüm branşlarda multidisipliner farkındalığını artırmayı ve yönetimi hakkında bilgi sağlamayıamaçlayan ilk Türkçe derlemedir. Ayrıca bu derleme, KHDAK tedavisinde İKNİkullanımına ilişkin son klinik çalışmaların dikkat çekici sonuçlarını sunmasıaçısından önem teşkil etmektedir. İmmünoterapi kanser tedavisinde yeni bir dönem başlatmıştır ve İKNİ tedavisinin kendine özgü etki mekanizması yeni bazı advers olay grubunun ortaya çıkmasına nedenolmuştur, bunlar arasında pnömonitis özellikle önemlidir ve advers olaylar konusunda gerektiğinde hastaların ilgili uzmanlık dalları ilekonsülte edilmesi gerekmektedir. Akciğer kanserinde tedavi, hastanın özellikleri, histolojik özellikler, genetik durum göz önünde bulundurularak her bir hastaya özel planlanmalı ve akciğer kanserli bir hastanın tanısal değerlendirilmesi ve en uygun şekilde tedavisi içingöğüs hastalıkları, göğüs cerrahisi, tıbbi onkoloji, radyasyon onkolojisi, patoloji ve radyoloji uzmanlık dalları arasında işbirliği sağlanmalıdır. Bununla birlikte, aile hekimleri de akciğer kanserinin erken tanınmasında ve ayrıca hastalarını tütün bırakmayı teşvik ederekkanserin önlenmesinde önemli rol oynayabilirler. Ayrıca, toplumda farkındalık yaratmak ve erken tanı için akciğer kanseri yönündentarama çalışmaları yapmak hedeflenmelidirArticle Citation - WoS: 2Citation - Scopus: 2The Relationship Between Lung Function, Exercise Capacity, Oxidant and Antioxidant Response in Primary Ciliary Dyskinesia and Cystic Fibrosis(Turkish J Pediatrics, 2024) Kartal, Yasemin; Ozel, Cemile Bozdemir; Cakmak, Aslihan; Ulu, Hazal Sonbahar; Ince, Deniz Inal; Tural, Dilber Ademhan; Sabuncuoglu, Suna; Özçelik, Uğur; Inal-ınce, Deniz; Budak, Murat; Arıkan, HülyaBackground. There is a need to identify the complex interplay between various physiological mechanisms in primary ciliary dyskinesia (PCD) and cystic fibrosis (CF). The study investigated the interaction between respiratory function, exercise capacity, muscle strength, and inflammatory and oxidant/antioxidant responses in patients with PCD and CF. Methods. The study included 30 PCD patients, 30 CF patients, and 29 age and sex-matched healthy subjects. Exercise capacity was assessed using the modified shuttle walk test (MSWT). Handgrip strength (HGS) was used to evaluate general muscle strength. Oxidative stress-inflammatory parameters were also assessed. Pulmonary function test was performed by spirometry. Regarding the forced expiratory volume in 1 second (FEV1) 1 ) z-score, patients with PCD and CF were subdivided into normal, mild, and severe/moderate groups. Results. Forced vital capacity (FVC) z-scores were lower in PCD and CF patients than controls. FEV1, 1 , FEV1/ 1 / FVC, peak expiratory flow (PEF), and forced mid expiratory flow (FEF 25-75% ) z-scores were lower in PCD than in the other groups. HGS was lower in both mild PCD and normal CF patients relative to the controls. MSWT distance was lower in severe/moderate PCD patients than controls. Catalase (CAT), glutathione S-transferase (GST), glutathione peroxidase (GPx), and malondialdehyde (MDA) levels did not differ significantly among the study groups, but superoxide dismutase (SOD) level in severe/moderate PCD, and glutathione (GSH) level in normal CF were higher than in controls. Interleukin-6 (IL-6) level was higher in patients with normal PCD and CF compared to the controls. IL-1 beta level was higher in PCD compared to controls. Additionally, correlations among these parameters were also determined in some patient groups. Conclusion. Homeostasis related to respiratory function, aerobic performance, muscle strength, inflammatory response, and oxidant/antioxidant balance were affected in PCD and CF. Evaluating these mechanisms together may contribute to elucidating the pathophysiology of these rare diseases.Article Citation - WoS: 1Citation - Scopus: 2Cannabinoid Receptor Ligands Modulate Fibrosis and Inflammation in Idiopathic Pulmonary Fibrosis: a Preliminary Study(Tubitak Scientific & Technological Research Council Turkey, 2024) Kose, Sevil; Onen, Selin; Gizer, Merve; Boduroglu, Esin; Gonullu, Ugur; Korkusuz, PetekBackground/aim: No specific pharmacological treatment regimen for idiopathic pulmonary fibrosis (IPF) exists. Therefore, new antiinflammatory therapeutic strategies are needed. Cannabinoids (CBs), known for their inflammation-modulating and antifibrotic effects, may be potential medication candidates for treating IPF. We aim to evaluate the inflammation-modulating and antifibrotic effects of CB receptor (CBR) agonists and antagonists in lipopolysaccharide-stimulated normal human lung fibroblast, epithelial cells, IPF fibroblast cells, and monocytes. Materials and methods: We detected CBRs in normal human lung fibroblasts (LL24) and IPF fibroblast cells (LL29), epithelial cells (A549) and monocytes (THP-1) by flow cytometry. We determined TGF-(31, IL-8, and TNF-alpha inflammatory cytokines in the LL24, LL29, A549, and THP-1 cell culture supernatants on days 1 and 5 by ELISA. We evaluated the cell viability in LL24, LL29, and A549 cells on days 1, 3, and 5 spectrophotometrically and detected collagen Type I (ColI) production in the LL24 and LL29 cell culture supernatants on days 1, 3, and 5 by ELISA. Results: LL24, LL29, A549, and THP-1 cells exhibited CB1 (CB1R) and CB2 (CB2R) receptors. CB1R and CB2R agonists WIN55,2122 and JWH015 inhibited fibroblastic and epithelial cell proliferation on day 5. TGF-(31 and TNF-alpha release increased, while IL-8 release decreased in LL24, LL29, A549, and THP-1 cells in response to the administration of WIN55,212-2 and JWH015 at a 10-2 mM concentration. CB1R and CB2R antagonists AM251 and AM630 did not block agonistic responses, suggesting a nonclassical CBRmediated pathway. CB2R agonist JWH015 decreased ColI expression in IPF lung fibroblasts LL29 on day 3. Conclusion: These results suggest that CB signaling regulates the progression of pulmonary inflammation and fibrosis via CBR activation. This may offer a potential pharmacological tool for developing antifibrosis therapies.Article Herpes Zoster Hastalarının Demografik ve Klinik Özelliklerinin Değerlendirilmesi(Selcuk University, 2023) Demirci Saadet, E.; Hasanbeyzade, S.; Hasanbeyzade, Sabir; Saadet, Elif DemırcıBackground: Herpes zoster is a disease that is more frequently seen in people aged over 50 years and negatively affects the quality of life due to the development of post-herpetic neuralgia. This study aimed to investigate the demographic and clinical characteristics of patients diagnosed with herpes zoster. Methods: In this cross-sectional study, the data of patients who were followed up with a diagnosis of herpes zoster at the dermatology department between 2013 and 2020 were retrospectively examined. Results: Of 440 patients, 252 (57.3%) were female and 188 (42.7%) were male. The mean age was 48.9±18 (4-94) years. The most common localization was the thoracic region at a rate of 35.5% and the lumbar region at a rate of 21.4%. Disseminated and ophthalmic zoster were more common in elderly patients (p<0.001). The most common comorbidities were hypertension (HT)+coronary artery disease (CAD) (12.6%), cancer (10.3%), and diabetes+HT (5.9%). Severe pain was observed in 19.7% of the patients and was more common in women (p=0.016). The rate of moderate and severe pain was high in the patients with HT+CAD and cancer (p˂0.001). Post-herpetic neuralgia was observed in 15.3% of the patients aged over 50. Conclusions: Herpes zoster is especially common in adults. Since it causes acute pain and can lead to postherpetic neuralgia development, risky patient groups should be more carefully followed up and treated. © 2023, Selcuk University. All rights reserved.Article The Impact of Covid-19 Pandemic on Surveillance of Influenza and Influenza-Like Viruses: a Single Center Experience(2023) Özsoy, Metin; Tülek, NeclaAims: Influenza and the agents responsible for influenza-like illness (ILI) are a significant cause of upper and lower respiratory tract infections, with a notable pattern of seasonal incidence. The surveillance of influenza and agents causing ILI is important for the developmentof a prophylaxis approach and infection control. In the present study, we utilize the Reverse transcription-polymerase chain reaction (RT-PCR) method to identify the presence of influenza virus and other agents associated with ILI in nasopharyngeal smears obtained from patients exhibiting symptoms of influenza and ILI. The study sample included patients who were admitted to multiple clinics and intensive care units (ICU) of the Health Sciences University Ankara Training and Research Hospital in the period preceding, and in the initial months and first year following the coronavirus disease 2019 (COVID-19) outbreak. Throughthe comparisons made in the study, the intention is to gain a better understanding of the influence of the COVID-19 pandemic on other viral infectious agents transmitted via the respiratory tract. Methods: Included in the study were 257 admitted to different wards and ICUs of our hospital due to symptoms of upper or lower respiratory tract infection and ILI between 2015 and 2021 (excluding data from 2017–2018). The study was conducted prospectively within the scope of the Global Influenza Hospital Surveillance Network project. Using sterile swabs, nasopharyngeal swab samples were collected from inpatients who provided informed consent for their participation in the study, and the samples were placed in a viral transport medium. The presence of influenza viruses (Influenza A, subtypes of Influenza A and Influenza B) and agents causing ILI (i.e. respiratory syncytial virus, coronavirus) was investigated with an RT-PCR approach. Results: The most common symptoms among the 257 patients included in the study with pre-diagnoses of influenza and ILI were cough (82.2%), fever (67.7%), shortness of breath (66.1%) and myalgia (40%). The RT-PCR detected a viral agent in 60 (23.3%) of the 257 patients, whereas no agent could be detected in 197 (76.6%) patients. Furthermore, 51 (18.5%) tested positive for influenza virus, five (1.9%) for respiratory syncytial virus (RSV), and four (1.5%) for SARS-CoV-2. An analysis of the results within two distinct time frames, namely prior to the COVID-19 pandemic (2016–2017, 2019–prior to December 10, 2020) and during the COVID-19 pandemic (between December 11, 2020 and 2021), influenza viruses (influenza A H1N1 and influenza A H3N2), RSV and influenza type B were identified as the dominant viruses before the COVID-19 pandemic, while the predominant viruses were a single influenza strain and four SARS-CoV-2 variants during the COVID-19 pandemic.A significant difference was noted in the distribution of viruses between the two time frames – prior to the pandemic and during the pandemic. Of the patients, 199 (77.4%) were discharged with full recovery while 58 patients died (22.6%). Of the 58 patients that died, 25 were female (25/131 females) and 33 were male (33/126 males), 11 had tested positive for influenza virus andone for RSV, while no infectious agent could be identified in 46 patients. Conclusion: The implementation of molecular testing methods for the identification of viral infectious agents among inpatients during influenza and ILI outbreaks, administering antiviral and prophylactic treatments targeting influenza, RSV and SARS-CoV-2 infections, and adopting infection control measures, could significantly decrease mortality and morbidity rates while mitigating the complications associated with these infectious agents.Article A Case of Congenital Total Pericardial Agenesis Mimicking Pneumothorax Findings(2024) Ulutaş, Hakkı; Ağar, Mehmet; Erdil, Nevzat; Çelik, Muhammet RehaCongenital pericardial agenesis has been reported as usually asymptomatic cases, operated on for other reasons and found incidentally or in autopsy reports. Herein, we present a case of congenital total pericardial agenesis mimicking the findings of pneumothorax and incidentally detected in a uniportal video-assisted thoracic surgery (VATS). Total agenesis of the pericardium, which is very rare and usually asymptomatic, has a very good prognosis and does not require additional treatment unless it causes complications. It may mimic pneumothorax findings.Article The Effect of Nordic Walking Exercise Training on Physical Fitness, Physical Activity Level, Anxiety-Depression and Quality of Life in Smokers: a Randomized Controlled Trial(2022) Ozkoslu, Manolya Acar; Yarımkaya, Nur Sena; Tekindal, Mustafa AgahAim: The aim of study was to investigate effects of nordic walking exercise (NWE) on physical fitness, physical activity, anxiety-depression level and quality of life in smokers. Material and Methods: 30 smoking individuals with a mean age of 31.45±12.75 years were assigned randomly into two groups: NWE (n=15) or control group (n=15). NWE group performed NWE three times a week for 6 weeks and gradually increasing to 45 min a day. No intervention was made in control group. The health-related physical fitness level was assessed with arm curl test (upper extremity endurance), chair sit and stand test (lower extremity endurance), two minutes step test (aerobic endurance), sit and reach and back scratch test (flexibility), eight foot up and go test (balance), 6-minute walk test (MWT) (cardiopulmonary endurance). Physical activity levels with International Physical Activity Questionnaire (IPAQ) short form, anxiety-depression level with Beck Depression Questionnaire, quality of life with Nottingham Health Profile (NHP) were evaluated. The differences in measurement parameters between two groups were evaluated by the Mann Whitney U Test since the data distribution was nonparametric. The distinction between categorical variables were determined by Chi-square test. Results: 6-MWT distance (p=0.005), two minutes step (p=0.022), IPAQ walking scores (p=0.028) statistically significant improvements were observed in NWE group. In control group, 6 MWT distance (p=0.025), two minutes step (p=0.032), sit and reach (p=0.043) scores decreased statistically significantly. 6 MWT distance (p=0.006), two minutes step (p=0.021), 8 foot up and go (p=0.005), IPAQ walking (p=0.045), moderate intensity activity (p=0.038), total scores (p=0.013), NHP emotional (p=0.045), total (p=0.045) scores significantly differed in favor of NWE group. Conclusion: It is thought that NWE may be effective and alternative exercise approache in increasing physical fitness, physical activity level and quality of life in smokers and guided to rehabilitation programme.Article Citation - WoS: 1Ouas’li ve Koah’li Hastalarla Sağlıklı Kişiler Arasında Solunum Fonksiyonları, Fonksiyonel Kapasite ve Uyku Kalitesinin Karşılaştırılması(Galenos Publ House, 2020) Kütükçü, Ebru Çalık; Çalışkan, Hakan; Kılıç, Kübra; Yağlı, Naciye Vardar; Ertürk, Nurel; Sağlam, Melda; Arıkan, Hülya; Savcı, Sema; Inal-ınce, Deniz; Ardıç, Sadık; Vardar-yagli, NaciyeAmaç: Bu çalışmanın amacı Obstrüktif Uyku Apne sendromu (OUAS) ve Kronik Obstrüktif Akciğer hastalığı (KOAH) olan hastalarda solunum fonksiyonları, egzersiz performansı ve uyku kalitesini sağlıklı bireylerle karşılaştırmaktır. Gereç ve Yöntem: Bu kesitsel çalışmaya 17 OUAS’li hasta (12 erkek, 5 kadın), 24 KOAH’li hasta (20 erkek, 4 kadın) ve 20 sağlıklı birey (15 erkek, 5 kadın) katıldı. Solunum fonksiyonu ve kas kuvvet testleri yapıldı. OUAS ve KOAH’li hastalarda diz ekstansörleri, omuz abduktörleri ve el kavrama kuvveti dijital el dinamometresi kullanılarak ölçüldü. Egzersiz performansı 6 dakika yürüme testi (6DYT) kullanılarak, uyku kalitesi Pittsburgh Uyku Kalitesi indeksi (PUKİ) ile değerlendirildi. Bulgular: KOAH’li hastaların 6DYT mesafesi, 6DYT mesafesi (%), omuz abduktörleri kas kuvveti ölçülen ve yüzde değerleri OUAS grubuna göre anlamlı olarak düşüktü (p<0,05). PUKİ kayıtlarına göre OUAS hastalarının %58,8’inin, KOAH hastalarının %58,3’ünün ve sağlıklı bireylerin %15,0’inin uyku kalitesi zayıftı (p=0,006). OUAS ve KOAH grubunda PUKİ-uyku bozukluğu, gündüz fonksiyon bozukluğu, alışılmış uyku etkinliği alt boyutları ve toplam PUKİ skorları sağlıklı bireylerden daha yüksekti (p<0,05). Sonuç: Bu çalışma, hem OUAS hem de KOAH hastalarında uyku kalitesinin olumsuz etkilendiğini ve sağlıklı bireylere göre OUAS ve KOAH hastalarında uyku bozukluğu ve gündüz fonksiyon bozukluğunun arttığını ve alışılmış uyku etkinliğinin azaldığını göstermiştir.Article Citation - WoS: 1Citation - Scopus: 1Noninvaziv Mekanik Ventilasyon Desteği Olan ve Olmayan Akut Solunum Yetmezliğinde Fonksiyonel Bağımsızlık ve Kas Kuvveti(Turkey Assoc Physiotherapists, 2020) Çakartaş, Şahveren; İnce, Deniz İnal; Savcı, Sema; Topeli, Arzu; Yağlı, Naciye Vardar; Sağlam, Melda; Kütükçü, Ebru Çalık; Calik Kutukcu, Ebru; Inal-ınce, Deniz; Vardar-yagli, Naciye; Güçlü, Meral Boşnak; Inal Ince, Deniz; Vardar Yagli, NaciyeAmaç: Akut solunum yetmezliği (ASY) sürecinde kas zayıflığı gelişimi sıktır. Bu çalışmanda yoğun bakımda ASY nedeni ile tek başına standart medikal tedavi (SMT) ve SMT’ye ek olarak noninvaziv mekanik ventilasyon (NIV) uygulanan olgularda kas kuvveti ve fonksiyonel bağımsızlığı karşılaştırılmak amaçlandı. Yöntem: Çalışmaya ASY ile izlenen 32 olgu (19 NIV ve 13 SMT) dahil edildi. Olguların özellikleri kaydedildi. Periferal kas kuvveti için Medical Research Council Skalası (MRC) kullanıldı ve el kavrama kuvveti ölçüldü. Fonksiyonel bağımsızlık düzeyi Barthel İndeksi (Bİ) ile değerlendirildi. Sonuçlar: NIV grubunda proksimal kas kuvveti (omuz abduktorleri) distal ekstremite kas kuvvetinden (el bileği ekstansorleri) anlamlı olarak daha düşüktü (p=0,030). Her iki grupta, proksimal alt ekstremite kas kuvveti (kalça fleksiyonu), distal ekstremite kas kuvveti (ayak bileği)’nden anlamlı olarak daha azdı (p=0,002). NIV grubunun Bİ toplam puanı SMT grubundan anlamlı olarak daha düşüktü (p=0,016). Bİ puanı, MRC toplam puanı (r=0,633) ve el kavrama kuvveti (r=0,629) ile ilişkiliydi (p<0,05). Tartışma: ASY nedeni ile NIV uygulanan hastalarda fonksiyonel bağımsızlık ve distal kas kuvveti ile karşılaştırıldığında proksimal kas kuvveti olumsuz yönde etkilenmektedir. Yoğun bakımda rehabilitasyon uygulamalarında zayıflık veya fonksiyonel kısıtlılığın hastaların uygun fonksiyon görmesini engelleyebileceği göz önünde bulundurulmalıdır.Review Yutma ve Kognitif Fonksiyonların İlişkisi(2024) Begen, Sena Nur; Arslan, Selen SerelKognitif fonksiyonlar; bilgi edinme, saklama ve kullanmayı sağlayan önemli beyin işlevlerindendir. Tüm vücut fonksiyonları gibi yutma fonksiyonunun düzenlenmesi ve ayarlanmasında kognitif fonksiyonlar önemli rol almaktadır. Bu sayede birey, besin ve çevreye ait özellikler algılanıp yordanmakta ve değişen koşullara uyum sağlanarak yutma güvenli şekilde gerçekleştirilmektedir. Özellikle görsel algılama, oryantasyon, dikkat, hafıza ve yürütücü işlevleri içeren temel kognitif fonksiyonlar etkin ve güvenli yutma için gereklidir. Yutma fonksiyonu yutma öncesi faz, oral hazırlık, farengeal ve özofageal faz olarak incelenmektedir. Yutma öncesi faz ve oral hazırlık fazında kognitif fonksiyonlara daha fazla ihtiyaç duyulmakla birlikte tüm yutma sürecinde farklı düzeylerde kognitif fonksiyona ihtiyaç olmaktadır. Kognitif bozuklukların yutma bozukluğu ile ilişkisi kognitif fonksiyonların etkilendiği; Alzheimer, demans ve inme gibi durumlarda açıkça görülmektedir. Kognitif fonksiyonlar ile yutma fonksiyonu ilişkisini inceleyen daha fazla çalışmaya ve bu çalışmalar doğrultusunda yutma bozukluğu rehabilitasyonunda yeni yaklaşımlara ihtiyaç bulunmaktadır.
