Publications by authors named "Neslihan Özçelik"

15 Publications

  • Page 1 of 1

Effect of coronaphobia on smoking habits.

J Addict Dis 2020 Dec 7:1-9. Epub 2020 Dec 7.

Department of Chest Diseases, Recep Tayyip Erdogan University, Rize, Turkey.

Introduction And Objective: Coronavirus disease 2019 (COVID-19) epidemic had exhibited negative effects on patients with a nicotine use disorder because of social stress situations. The objective of this study is to investigate the changes that occurred in the smoking habits of the patients who applied to our smoking cessation clinic because of the COVID-19 outbreak's effect (coronaphobia) on their mental health.

Method: In this study, we included the patients who applied to our smoking cessation clinic between January 1 and June 30, 2020. We conducted telephonic and face-to-face interviews with the patients during the outbreak, and inquired about the changes in their smoking habits.

Results: In total, 114 volunteers (mean age: 41.2 years [min-max: 18-82 years], M/F: 70/44 [61.4/38.6%]) who registered in the smoking cessation clinic of Chest Diseases Clinic were included in the study. The number of people with and without coronaphobia was 64 (56.1%) and 50 (43.9%), respectively. The analyses of the changes in smoking behaviors because of coronaphobia demonstrated that people with coronaphobia exhibited a significantly higher decrease or cessation of smoking as compared to no change in smoking behavior or increase in the number of cigarettes (: .006).

Conclusions: Success in smoking cessation can be increased with the accurate analyses of the anxiety effects caused by coronaphobia after COVID-19 outbreak on the desire of smoking cessation. This resolution depends on the solution-oriented strategies that will increase the awareness of physicians and patients, a close follow-up of patients with tools such as telemedicine, and a quick determination of their needs.
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http://dx.doi.org/10.1080/10550887.2020.1849950DOI Listing
December 2020

The value of the platelet count and platelet indices in differentiation of COVID-19 and influenza pneumonia.

J Med Virol 2021 04 10;93(4):2221-2226. Epub 2020 Nov 10.

Department of Chest Diseases, Recep Tayyip Erdogan University, Rıze, Turkey.

It is difficult to distinguish coronavirus disease-2019 (COVID-19) from other viral respiratory tract infections owing to the similarities in clinical and radiological findings. This study aims to determine the clinical importance of platelet count and platelet indices in the differentiation of COVID-19 from influenza and the value of these parameters in the differential diagnosis of COVID-19. The medical records of the patients and the electronic patient monitoring system were retrospectively analyzed. Demographic characteristics, admission symptoms, laboratory findings, radiological involvement, comorbidities, and mortality of the patients were recorded. Forty-three patients diagnosed with influenza and 54 diagnosed with COVID-19 were included in the study. The average age of the COVID-19 patients was lower than that of the influenza patients (influenza: 60.5 years, COVID-19: 52.4 years; pp = 0.024),.024), and the male gender was predominant in the COVID-19 group (influenza: 42%, COVID-19: 56%). According to laboratory findings, the mean platelet volume (MPV) and MPV/platelet ratio were statistically significantly lower, whereas the eosinophil count and platelet distribution width levels were significantly higher (p < 0.05) in the COVID-19 group. It was found that the most common symptom in both groups was dyspnea and that the symptom was more prevalent among influenza patients. In the diagnosis of COVID-19, the platelet count and platelet indices are easily accessible, inexpensive, and important parameters in terms of differential diagnosis and can help in the differentiation of COVID-19 from influenza during seasonal outbreaks of the latter.
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http://dx.doi.org/10.1002/jmv.26645DOI Listing
April 2021

Weight Loss as the First-Line Therapy in Patients with Severe Obesity and Obstructive Sleep Apnea Syndrome: the Role of Laparoscopic Sleeve Gastrectomy.

Obes Surg 2021 Mar 27;31(3):1082-1091. Epub 2020 Oct 27.

Department of Pulmonology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey.

Purpose: The objective of this study is to investigate the effects of laparoscopic sleeve gastrectomy (LSG) on the polysomnographic parameters related to OSAS.

Materials And Methods: We conducted this 3-year prospective cohort study in a tertiary care center between December 2016 and December 2019. In total, we enrolled 31 patients with severe obesity who underwent full-night polysomnography (PSG) before LSG. Later, the patients were re-evaluated by full-night PSG 12 months after the surgery.

Results: The mean age of the patients was 44.1 ± 9.6 years. The mean body mass index (BMI) decreased significantly from a mean value of 49.8 ± 8.5 kg/m at baseline to 33.2 ± 8.2 kg/m and a percent BMI (%BMI) reduction of 33.8 ± 10.4% and a percent total weight loss (%TWL) of 35.4 ± 10.8% was achieved on the same day of the postsurgical PSG (p < 0.001). There was a remarkable improvement in the AHI (baseline: 36.1 ± 27.1, 12 months after the surgery: 10.3 ± 11.8; difference: 25.8 ± 22.8 events per hour) (p < 0.001). Importantly, there was a decrease in the percentage of non-rapid eye movement (NREM) 2 (p < 0.001), whereas NREM 3 and REM stages witnessed a significant increase (p = 0.001 and p < 0.001, respectively) after the surgery.

Conclusion: The results of this study showed that weight loss after LSG yields improvement not only in AHI but also in many polysomnographic parameters such as sleep quality and desaturation indices.
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http://dx.doi.org/10.1007/s11695-020-05080-4DOI Listing
March 2021

Can artificial intelligence distinguish between malignant and benign mediastinal lymph nodes using sonographic features on EBUS images?

Curr Med Res Opin 2020 Dec 24;36(12):2019-2024. Epub 2020 Oct 24.

Pulmonary Medicine, Karadeniz Technical University, Trabzon, Turkey.

Aims: This study aimed to develop a new intelligent diagnostic approach using an artificial neural network (ANN). Moreover, we investigated whether the learning-method-guided quantitative analysis approach adequately described mediastinal lymphadenopathies on endobronchial ultrasound (EBUS) images.

Methods: In total, 345 lymph nodes (LNs) from 345 EBUS images were used as source input datasets for the application group. The group consisted of 300 and 45 textural patterns as input and output variables, respectively. The input and output datasets were processed using MATLAB. All these datasets were utilized for the training and testing of the ANN.

Results: The best diagnostic accuracy was 82% of that obtained from the textural patterns of the LNs pattern (89% sensitivity, 72% specificity, and 78.2% area under the curve). The negative predictive values were 81% compared to the corresponding positive predictive values of 83%. Due to the application group's pattern-based evaluation, the LN pattern was statistically significant ( = .002).

Conclusions: The proposed intelligent approach could be useful in making diagnoses. Further development is required to improve the diagnostic accuracy of the visual interpretation.
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http://dx.doi.org/10.1080/03007995.2020.1837763DOI Listing
December 2020

COVID-19 Pregnant Patient Management with a Case of COVID-19 Patient with An Uncomplicated Delivery.

Turk Thorac J 2020 Sep 1;21(5):354-356. Epub 2020 Sep 1.

Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey.

Pregnancy has always been a concern in epidemics all over the world. While coronavirus (COVID-19) disease ravages the world, it is a big curiosity how pregnant women will be affected by this disease. There are a few published case series and commentary of COVID-19 occurring during pregnancy. In this study, we discussed how to manage this disease in pregnant women. A 38-week pregnant, 37-year-old woman whose father passed away from COVID-19 admitted to the hospital with dyspnea, nonproductive cough, and fever. She had positive radiological features for COVID-19, and her rapid antibody test was positive. Lopinavir-ritonavir combination and azithromycin treatments were given, and the patient's symptoms regressed with treatment. The patient was taken to cesarean by providing isolation conditions, and she had a healthy baby with an uncomplicated delivery. There are no certain data about whether COVID-19 infection is worse in pregnant patients or not. On the basis of the limited data in the literature, we cannot see intrauterine transmission from infected mother to baby. However, we know that there would be serious pulmonary complications for the infected mother. Fortunately, the severe acute respiratory syndrome coronavirus 2 infection did not progress more severely in pregnant women than in the normal population compared with the previous severe acute respiratory syndrome outbreak.
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http://dx.doi.org/10.5152/TurkThoracJ.2020.20135DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544414PMC
September 2020

Unclear Issues Regarding COVID-19.

Eurasian J Med 2020 Jun;52(2):191-196

Department of Chest Diseases, Ataturk University School of Medicine, Erzurum, Turkey.

Scientists from all over the world have been intensively working to discover different aspects of Coronavirus disease 2019 (COVID-19) since the first cluster of cases was reported in China. Herein, we aimed to investigate unclear issues related to transmission and pathogenesis of disease as well as accuracy of diagnostic tests and treatment modalities. A literature search on PubMed, Ovid, and EMBASE databases was conducted, and articles pertinent to identified search terms were extracted. A snow-ball search strategy was followed in order to retrieve additional relevant articles. It was reported that viral spread may occur during the asymptomatic phase of infection, and viral load was suggested to be a useful marker to assess disease severity. In contrast to immune response against viral infections, cytotoxic T lymphocytes decline in SARS-CoV-2 infection, which can be partially explained by direct invasion of T lymphocytes or apoptosis activated by SARS-CoV-2. Dysregulation of the urokinase pathway, cleavage of the SARS-CoV-2 Spike protein by FXa and FIIa, and consumption coagulopathy were the proposed mechanisms of the coagulation dysfunction in COVID-19. False-negative rates of reverse transcriptase polymerase chain reaction varied between 3% and 41% across studies. The probability of the positive test was proposed to decrease with the number of days past from symptom onset. Safety issues related to infection spread limit the use of high flow nasal oxygen (HFNO) and continuous positive airway pressure (CPAP) in hypoxic patients. Further studies are required to elucidate the challenging issues, thus enhancing the management of COVID-19 patients.
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http://dx.doi.org/10.5152/eurasianjmed.2020.20092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311136PMC
June 2020

Prevalence of non-thyroidal illness syndrome in COPD exacerbation and effect of hypoxaemia and hypercapnia on thyroid functions.

Clin Respir J 2020 Sep 26;14(9):806-812. Epub 2020 May 26.

Department of Pulmonary Medicine, Recep Tayyip Erdogan University, Rize, Turkey.

Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease showing acute exacerbations during its course. Comorbidities often accompany. Non-thyroidal illness syndrome (NTIS) occurs because of the functional impairment in the hypothalamic-pituitary-thyroid axis in severe critical cases. The objective of the current study is to determine the prevalence of NTIS among hospitalised patients due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and to reveal the factors affecting thyroid functions.

Materials And Methods: A total of 132 patients hospitalised for AECOPD were enroled. Arterial blood gas samples at room air and venous blood samples for thyroid function tests were obtained within 24 hours following hospitalisation.

Results: The mean age was 69.3 ± 9.6 years with male predominance (M/F:130/2). The prevalence of NTIS was 55%. Subgroups of NTIS cases were analysed. Low TSH levels were the most common pathology (55%). Patients with NTIS had significantly lower PaO and SaO levels compared with those without NTIS (P = 0.045 and P = 0.022, respectively). In addition, a positive correlation was found between PaO and free thyroxine (fT4) (P < 0.001, r = 0.313). A statistically significant negative correlation between PaCO and fT4 was found (P < 0.001, r = -0.393). And a statistically significant negative correlation between PaCO and free triiodothyronine (fT3) values were found (P = 0.040, r = -0.183).

Conclusion: NTIS is a very common condition during AECOPD. We believe that hypoxemia causing functional impairment in the hypothalamic-pituitary-thyroid axis is the main mechanism in NTIS development and hypercapnia disrupts freeT3 and freeT4 production and secretion.
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http://dx.doi.org/10.1111/crj.13200DOI Listing
September 2020

Regional distribution of genetic mutation in lung cancer in Turkey (REDIGMA).

Tuberk Toraks 2019 Sep;67(3):197-204

Department of Chest Diseases, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Introduction: The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey.

Materials And Methods: Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients' biopsy materials.

Result: The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p<0.000, p<0.001). Again, the frequency of mutations in adenocarcinoma was higher in metastatic disease. There was no difference between the patient's age, area of residence, comorbidity and clinical stage and mutation frequency.

Conclusions: Our study revealed that the EGFR mutation rate in Turkey with NSCLC was similar to East European, African-American and Caucasian patients, and was lower than in East Asia.
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http://dx.doi.org/10.5578/tt.68707DOI Listing
September 2019

A rare disease; congenital pulmonary airway malformation in an adult.

Tuberk Toraks 2019 Mar;67(1):71-76

Department of Chest Diseases, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.

Congenital pulmonary airway malformation (CPAM), is a rare disease known as a developmental abnormality of the lower respiratory tract. It may occur in the neonatal period due to respiratory distress and patients usually die in the first few months of life. Rarely, it may remain asymptomatic until adulthood. In this study we describe an adult case and present a review of the literature. A 19-year-old male with no relevant medical history was admitted to our clinic with cough and wheeze. The patient had a history of frequent lower respiratory tract infection during childhood. Chest radiograph revealed a diffuse opacity and volume loss in the right hemithorax. High resolution tomography showed hypoplasia of the right hemithorax, multiple cysts in all of the lobes and segments on the right side, ground glass opacity and interlobular septal thickening of the whole right lung parenchyma. Right pneumonectomy was performed with the pre-diagnosis of congenital pulmonary airway malformation and the pathological examination was compatible with CPAM. CPAM is a rare disease in adulthood. We should consider CPAM in the differential diagnosis of patients with frequent recurrent pulmonary infection and cystic lung lesions. In order to prevent infections and to eliminate the risk of malignancy, surgical treatment should be applied for definite diagnosis and treatment.
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http://dx.doi.org/10.5578/tt.68095DOI Listing
March 2019

Sleep disturbances in patients with lung cancer in Turkey.

Tuberk Toraks 2018 Dec;66(4):297-303

Department of Chest Diseases, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey.

Introduction: Sleep quality is known to be associated with the distressing symptoms of cancer. The purpose of this study was to analyze the impact of cancer symptoms on insomnia and the prevalence of sleep-related problems reported by the patients with lung cancer in Turkey.

Materials And Methods: Assesment of Palliative Care in Lung Cancer in Turkey (ASPECT) study, a prospective multicenter study conducted in Turkey with the participation of 26 centers and included all patients with lung cancer, was re-evaluated in terms of sleep problems, insomnia and possible association with the cancer symptoms. Demographic characteristics of patients and information about disease were recorded for each patient by physicians via face-to-face interviews, and using hospital records. Patients who have difficulty initiating or maintaining sleep (DIMS) is associated with daytime sleepiness/fatigue were diagnosed as having insomnia. Daytime sleepiness, fatigue and lung cancer symptoms were recorded and graded using the Edmonton Symptom Assessment Scale.

Result: Among 1245 cases, 48.4% reported DIMS, 60.8% reported daytime sleepiness and 82.1% reported fatigue. The prevalence of insomnia was 44.7%. Female gender, patients with stage 3-4 disease, patients with metastases, with comorbidities, and with weight loss > 5 kg had higher rates of insomnia. Also, patients with insomnia had significantly higher rates of pain, nausea, dyspnea, and anxiety. Multivariate logistic regression analysis showed that patients with moderate to severe pain and dyspnea and severe anxiety had 2-3 times higher rates of insomnia.

Conclusions: In conclusion, our results showed a clear association between sleep disturbances and cancer symptoms. Because of that, adequate symptom control is essential to maintain sleep quality in patients with lung cancer.
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http://dx.doi.org/10.5578/tt.67689DOI Listing
December 2018

[Causes of mediastinal/hilar granulomatous lymphadenitis].

Tuberk Toraks 2018 Sep;66(3):212-216

Department of Pathology, Faculty of Medicine, Karadeniz Teknik University, Trabzon, Turkey.

Introduction: Granulomatous lung disease (GLD) is caused by a wide range of conditions and it is challenge for pulmonologist. A detailed history of exposures is fundamental in GDL and has been found pivotal to reach a precise diagnosis.

Materials And Methods: Between September 2014 and December 2016, the distribution of patients diagnosed with granulomatous lymphadenitis in the mediastinal/hilar lymph nodes by endobronchial ultrasound (EBUS) or mediastinoscopy was analyzed. To be listed as 'confident', a diagnosis of sarcoidosis required compatible histological, radiological and clinical findings in conjunction with negative cultures. Infectious entities listed as 'confident' had either microorganisms in tissue section, positive culture, positive serology or positive antigen detection in a consistent clinical pathological setting.

Result: Granulomatous lymphadenitis was detected in 110 patients. The included 110 cases consisted of 70.9% women and median age of 53 (range 44-61) years. The final diagnosis of the patients was accepted to be sarcoidosis in 79 (71.8%), sarcoid like granulomas in 7 (6.4%), tuberculosis in 4 (3.6%), silicosis in 4 (3.6%), drug-associated granuloma in 2 (1.8%), hypersensitivity pneumonitis in 1 (0.9%), Chron disease in 1 (0.9%), unspecified in 12 (10.9%). Three patients were classified as tuberculosis based on culture.

Conclusions: In this study, we found that the most common cause of granulomatous lymphadenitis was sarcoidosis. Contrary to expectations, the number of patients diagnosed with tuberculosis was very low.
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http://dx.doi.org/10.5578/tt.67018DOI Listing
September 2018

Factors Affecting Influenza Vaccination Rates among Patients with Chronic Obstructive Pulmonary Disease in Rize, Turkey.

Turk Thorac J 2018 Jul 12;19(3):122-126. Epub 2018 Jun 12.

Department of Pulmonology, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey.

Objectives: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are major components of COPD-related socioeconomic burden. Upper or lower respiratory tract infections, usually caused by respiratory viruses or bacteria, are common causes of AECOPD. Vaccination aganist influenza virus and , the most prevalent agents, is recommended by COPD guidelines. The aims of this study were to determine the factors affecting vaccination among patients with COPD and to assess the effect of vaccination status on AECOPD.

Materials And Methods: Patients with COPD were recruited from the outpatient clinic of a tertiary hospital between December 2014 and January 2015. Demographic data, vaccination status, and COPD-related hospital admissions triggered by tracheobronchial infections were evaluated.

Results: In total, 108 patients were enrolled; 102 (94%) subjects were male, and 6 (6%) subjects were female; the mean age was 65.6 years. The number of patients who had received pneumococcal and influenza vaccinations were 8 (0.07%) and 36 (33.3%), respectively. There was no significant correlation between the level of education and vaccination status. No significant difference was found between two groups in terms of exacerbation frequency, hospitalization rates, mMRC scores, and COPD stages.

Conclusion: More efforts by both physicians and patients are needed to reach the ideal rates of vaccination for COPD.
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http://dx.doi.org/10.5152/TurkThoracJ.2018.17075DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077003PMC
July 2018

[Bilateral total lung lavage in a patient with pulmonary alveolar proteinosis].

Tuberk Toraks 2017 Sep;65(3):249-254

Department of Pathology, Faculty of Medicine, Karadeniz Tecnical University, Trabzon, Turkey.

Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disease characterised by alveolar accumulation of surfactant composed of proteins and lipids. Three main categories of PAP have been defined depending on the aetiology: primer/idiopathic, neonatal/congenital, secondary and exogenous/environmental exposure. Radiologically diffuse ground glass opacities, interlobular and intralobular septal thickening is seen. Although open lung biopsy is accepted as the gold standard in diagnosis, it can be diagnosed by showing bronchoalveolar lavage (BAL) fluid with a milky appearance and periodic acid-schiff (PAS) positive globules in biopsy with clinical and radiological findings. Theraphy for PAP are supportive care (oxygen), total lung lavage, inhale/subcutaneous granulocyte macrophage colony stimulating factor (GM-CSF), rituximab, plasmapheresis, lung transplantation. We report a case of PAP presented with cough and shortness of breath, diagnosed with BAL and transbronchial lung biopsy, treated by total lung lavage by reviewing literature.
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http://dx.doi.org/10.5578/tt.50708DOI Listing
September 2017

[A newly-defined entity: combined pulmonary fibrosis and emphysema syndrome].

Tuberk Toraks 2015 ;63(1):48-52

Department of Chest Diseases, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.

Combined pulmonary fibrosis and emphysema (CPFE) syndrome is a rare disease characterized with shortness of breath, upper lobe emphysema, lower lobe fibrosis and impairment of gas exchange. This syndrome is a disease usually seen in male smokers. Pulmonary hypertension is associated with mortality. Another important feature, spirometric volumes relatively protected and a reduction in carbon monoxide diffusion test. CPFE syndrome in the literature so far have been identified in only 70 patients. In this review CPFE syndrome is presented with literature.
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http://dx.doi.org/10.5578/tt.7747DOI Listing
October 2015

Prognostic value of red cell distribution width in patients with sarcoidosis.

Clin Respir J 2015 Jan 17;9(1):34-8. Epub 2014 Feb 17.

Department of Pulmonary Medicine, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.

Background: Sarcoidosis is a multisystem granulomatous disorder of unknown etiology. There are no data on the indications for specific tests or optimal frequency for monitoring of the disease activity in sarcoidosis.

Methods: Complete blood counts, demographics and pulmonary function data from sarcoidosis patients evaluated between 2006 and 2012 were collated retrospectively. During follow-up, the latest red cell distribution width (RDW) values of the patients were recorded. The prognosis and diagnosis of sarcoidosis was based on according to the guideline. Sarcoidosis progression was classified as follows: remission, stable disease and progreesive disease.

Results: The diagnosis was based on histopathological findings in 93 out of 138 (67.4%) patients. In our cohort, the baseline mean RDW levels were 14.1% ± 1.2. The RDW distribution by stage was as follows: stage I: 14.0% (± 1.6), II: 14.2% (± 1.5), III: 13.8% (± 0.9) and IV: 15.8% (± 2.0). In patients with stage IV, baseline and follow-up values of RDW were found to be significantly higher than the other stages. While the mean baseline RDW was 14.8 (± 1.4) in the progressive disease, upon follow-up, the mean RDW had increased to 16.5% (± 1.4) (P = 0.021), No difference was found between the baseline and follow-up levels of RDW in the regressive and stable groups.

Conclusions: Serial RDW levels may be beneficial marker to predict progression of sarcoidosis.
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http://dx.doi.org/10.1111/crj.12101DOI Listing
January 2015