Browsing by Author "Akkoçlu A."

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    Microbiological results of bronchoalveolar lavage that was performed for opportunistic pulmonary infections; [Firsatçi pulmoner infeksiyon ön tanisiyla yapilan bronkoalveoler lavajin mikrobiyolojik sonuçlari]
    (2006) Gülcü A.; Sevinç C.; Esen N.; Kilinç O.; Uç E.S.; Itil O.; Çimrin A.H.; Kömüs N.; Şener G.; Akkoçlu A.; Gülay Z.; Yücesoy M.
    Between 2001-2002; in 62 cases, 33 (53%) male, 29 (47%) female, mean age 51.4 ± 18.1 years) bronchoalveolar lavage (BAL) was performed for diagnosis of opportunistic pulmonary infection and specimens were evaluated for results of microbiological examinations. There was hematological malignancy in 18 (29%) and solid organ malignancy in 13 (21%) cases. Thirty-one (50%) cases were immuncompromised for reasons other than malignancy. By endoscopic evaluation endobronchial lesion was seen in 2 (3%) cases, indirect tumor signs were seen in 2 (3%) cases and signs of infection were seen in 11 (18%) cases. Fortyseven (76%) cases were endoscopically normal. Acid-fast bacilli (AFB) direct examination was positive in 3 (5%) cases. In 4 (6%) cases mycobacterial culture was positive, Mycobacterium tuberculosis-polymerase chain reaction (PCR) was also positive in these four cases. Examination of Gram-stained smears for bacteria was associated with infection in 14 (23%) cases. Bacteriologic cultures were positive for single potential pathogen in 10 (16%) cases, and for mixed pathogens in 7 (11%) cases for a total number of 17 (27%). Fungal cultures were positive in 3 (5%) cases all of which had hematological malignancy. As a result in 24 (39%) cases microbiological agent of infection is determined: in four mycobacteria, in 17 bacteria other than mycobacteria and in three fungi.
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    Comparison of clinical assessments with computerized tomography pulmonary angiography results in the diagnosis of pulmonary embolism; [Pulmoner emboli tanisinda klinik olasiliklarin bilgisayarli tomografi pulmoner anjiyografi bulgulari ile karşilaştirilmasi]
    (2007) Gülcü A.; Akkoçlu A.; Yilmaz E.; Öztürk B.; Osma E.; Şengün B.
    Pulmonary embolism (PE) is difficult to diagnose. We investigated the relationship between computed tomography pulmonary angiography (CTPA) with clinical assessments and thrombus localization. 56 patients with the suspicion of PE; 27 male, 29 female were included. They were evaluated by empirical and Wells clinical assessments, tested with D-Dimer. According to the combination of both CTPA was performed where necessary (if one of the clinical assessments was high or intermediate or those with low clinical probability and high D-Dimer) in the algorithm we used. CTPA was regarded as gold standard. Dyspnea, chest pain, tachypnea, crackles were the most common symptoms and signs in patients having PE. Recent surgery within the risk factors was significantly higher in the PE present group. PE was diagnosed in 31 (55.4%) patients with CTPA. According to the empirical assessment 20 (64.5%) of the patients had high, 10 (32.3%) had intermediate and 1 (3.2%) had low clinical probability within 31 PE present group, while with Wells scoring 8 (25.8%) had high, 17 (54.8%) had intermediate and 6 (19.4%) had low clinical probability. Sensitivity of the empirical assessment and Wells scoring was 97%, 80% while the specifity was 16%, 68% respectively. Positive and negative predictive values of empirical assessment were 59%, 80% and these values of Wells scoring were 76%, 73% respectively. Thrombus was localized in main pulmonary arteries in 45.8% of patients with high clinical probability according to the empirical assessment. With Wells scoring in 45.5% of the high probability patients and only in 4.3% of the low probibility patients thrombus was there. PE can be diagnosed noninvasioely. Since PE can easily be underdiagnosed, empirical assessment which is more sensitive will be appropriate. There is a significant correlation between clinical assessments and presence of PE in CTPA. As the severity of clinical assessment increases, thrombus settles more proximal.
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    Clinical presentations and diagnostic work-up in sarcoidosis: A series of Turkish cases (clinics and diagnosis of sarcoidosis); [Sarkoidozlu olgularda klinik görünüm ve tanısal yaklaşım: Türk olgu serisi (sarkoidoz kliniǧi ve tanı yaklaşımları)]
    (Ankara University, 2011) Kiter G.; Müsellim B.; Çetinkaya E.; Türker H.; Kunt Uzaslan A.E.; Yentürk E.; Uzun O.; Saǧlam L.; Özdemir Kumbasar O.; Çelik G.; Okumuş G.; Arbak P.M.; Altiay G.; Tabak L.; Şakar Coşkun A.; Erturan S.; Türktaş H.; Yalniz E.; Akkoçlu A.; Öǧüş C.; Doǧan O.T.; Özkan M.; Özkan S.; Uzel F.I.; Öngen G.
    Sarcoidosis is an idiopathic granulomatous disease. It usually affects the lung. The diagnosis may be problematic since the known causes of granulomatous inflammation must be excluded. This multicenter study aimed to evaluate the clinical presentations and diagnostic approaches of sarcoidosis. The study protocol was sent via internet, and the participants were asked to send the information (clinical, radiological and diagnostic) on newly diagnosed sarcoidosis cases. 293 patients were enrolled within two years. Pulmonary symptoms were found in 73.3% of the patients, and cough was the most common one (53.2%), followed by dyspnea (40.3%). Constitutional symptoms were occured in half of the patients. The most common one was fatigue (38.6%). The most common physical sign was eritema nodosum (17.1%). The most common chest radiograhical sign was bilateral hilar lymphadenomegaly (78.8%). Staging according to chest X-ray has revealed that most of the patients were in Stage I and Stage II (51.9% and 31.7%, respectively). Sarcoidosis was confirmed histopathologically in 265 (90.4%) patients. Although one-third of the bronchoscopy was revealed normal, mucosal hyperemi (19.8%) and external compression of the bronchial wall (16.8%) were common abnormal findings. The 100% success rate was obtained in mediastinoscopy among the frequently used sampling methods. Transbronchial biopsy was the most frequently used method with 48.8% success rate. Considering sarcoidosis with its most common and also rare findings in the differential diagnosis, organizing the related procedures according to the possibly effected areas, and the expertise of the team would favor multimodality diagnosis.
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    Patient and physician delay in the diagnosis and treatment of non-small cell lung cancer in Turkey
    (Elsevier Ltd, 2015) Yurdakul A.S.; Kocatürk C.; Bayiz H.; Gürsoy S.; Bircan A.; Özcan A.; Akkoçlu A.; Uluorman F.; Çelik P.; Köksal D.; Ulubaş B.; Sercan E.; Özbudak T.; Göksel T.; Önalan T.; Yamansavci E.; Türk F.; Yuncu G.; Çopuraslan T.; Mardal T.; Tuncay E.; Karamustafaoğlu A.; Yildiz P.; Seçik F.; Kaplan M.; Çağlar E.; Ortaköylü M.; Önal M.; Turna A.; Hekimoğlu E.; Dalar L.; Altin S.; Gülhan M.; Akpinar E.; Savas T.; Firat N.; Çamsari G.; Özkan G.; Çetinkaya E.; Kamiloğlu E.; Çelik B.; havlucu Y.
    Aim: The early diagnosis and treatment of lung cancer are important for the prognosis of patients with lung cancer. This study was undertaken to investigate patient and doctor delays in the diagnosis and treatment of NSCLC and the factors affecting these delays. Materials and methods: A total of 1016 patients, including 926 (91.1%) males and 90 (8.9%) females with a mean age of 61.5. ±. 10.1 years, were enrolled prospectively in this study between May 2010 and May 2011 from 17 sites in various Turkish provinces. Results: The patient delay was found to be 49.9. ±. 96.9 days, doctor delay was found to be 87.7. ±. 99.6 days, and total delay was found to be 131.3. ±. 135.2 days. The referral delay was found to be 61.6. ±. 127.2 days, diagnostic delay was found to be 20.4. ±. 44.5 days, and treatment delay was found to be 24.4. ±. 54.9 days. When the major factors responsible for these delays were examined, patient delay was found to be more frequent in workers, while referral delay was found to be more frequent in patients living in villages (. p<. 0.05). We determined that referral delay, doctor delay, and total delay increased as the number of doctors who were consulted by patients increased (. p<. 0.05). Additionally, we determined that diagnostic and treatment delays were more frequent at the early tumour stages in NSCLC patients (. p<. 0.05). Discussion: The extended length of patient delay underscores the necessity of educating people about lung cancer. To decrease doctor delay, education is a crucial first step. Additionally, to further reduce the diagnostic and treatment delays of chest specialists, multidisciplinary management and algorithms must be used regularly. © 2015 Elsevier Ltd.