Publications by authors named "Serap Duru"

14 Publications

  • Page 1 of 1

Immunization status in chronic obstructive pulmonary disease: A multicenter study from Turkey.

Ann Thorac Med 2019 Jan-Mar;14(1):75-82

Chest Disease Clinic, Afyon State Hospital, Afyon, Turkey.

Objective: The purpose of this study is to detect the prevalence and the factors associated with influenza and pneumococcal vaccination and outcomes of vaccination during 2013-2014 season in patients with chronic obstructive pulmonary disease (COPD) in Turkey.

Methods: This was a multicenter retrospective cohort study performed in 53 different centers in Turkey.

Results: During the study period, 4968 patients were included. COPD was staged as GOLD 1-2-3-4 in 9.0%, 42.8%, 35.0%, and 13.2% of the patients, respectively. Influenza vaccination rate in the previous year was 37.9%; and pneumococcus vaccination rate, at least once during in a life time, was 13.3%. Patients with older age, higher level of education, more severe COPD, and comorbidities, ex-smokers, and patients residing in urban areas had higher rates of influenza vaccination. Multivariate logistic regression analysis showed that advanced age, higher education levels, presence of comorbidities, higher COPD stages, and exacerbation rates were associated with both influenza and pneumococcal vaccination. The number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was 2.73 ± 2.85 and 0.92 ± 1.58 per year, respectively. Patients with older age, lower education levels, more severe COPD, comorbid diseases, and lower body mass index and patients who are male and are residing in rural areas and vaccinated for influenza had significantly higher rates of COPD exacerbation.

Conclusions: The rates of influenza and pneumococcal vaccination in COPD patients were quite low, and the number of annual physician/outpatient visits and hospitalizations due to COPD exacerbation was high in Turkey. Advanced age, higher education levels, comorbidities, and higher COPD stages were associated with both influenza and pneumococcal vaccination.
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http://dx.doi.org/10.4103/atm.ATM_145_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341858PMC
February 2019

Prognostic importance of central thrombus in hemodynamically stable patients with pulmonary embolism.

Cardiol J 2017 1;24(5):508-514. Epub 2017 Mar 1.

Ankara Atatürk Training and Research Hospital, Department of Pulmonary Medicine, Ankara, Turkey.

Background: The association between mortality and localization of central thrombus in hemodynamically stable patients with pulmonary embolism (PE) is unclear. Sufficient data are not available to help clinicians to select between low molecular weight heparin (LMWH), unfractionated heparin (UFH) and thrombolytics for the management of central thrombus. The present study aims to investigate whether central thrombus in the pulmonary artery affects 30-day mortality rate, and to compare the outcomes of different treatment approaches in patients with central thrombus.

Methods: This multi-central, prospective, observational study included 874 hemodynamically stable patients with PE confirmed by multidetector computed tomography scan. The localization of the emboli was evaluated and categorized as central (saddle or at least one main pulmonary artery), lobar or distal. The primary study outcome was 30-day all-cause mortality.

Results: Localization of the emboli was central in 319 (36.5%) patients, lobar in 264 (30.2%) and distal in 291 (33.2%) patients. Seventy-four (8.5%) patients died during the 30-day follow-up period. All-cause mortality rate was 11.9%, 6.8% and 6.2% in patients with central, lobar, and distal emboli, respectively (p < 0.001). Multivariate analysis did not show that hemodynamically stable central thrombus was an independent predictor of mortality. Additionally, mortality rate was not significantly different between UFH, LMWH and thrombolytic therapy groups.

Conclusions: The present study showed that central thrombus was not an independent predictor of mortality in hemodynamically stable PE patients. LMWH and UFH were similarly effective in the treatment of this patient group.
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http://dx.doi.org/10.5603/CJ.a2017.0021DOI Listing
June 2018

[Epigenetic and current treatment approaches in chronic obstructive pulmonary disease].

Authors:
Serap Duru

Tuberk Toraks 2016 Mar;64(1):47-52

Clinic of Chest Diseases, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

Epigenetics mechanisms such as DNA methylation, histone acetylation and non-coding RNAs may play are a role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Researchs with regard epigenetic in COPD can shed light on pathogenes and may be relevant in the development of novel targeted therapies. The aim of this article is to review epigenetic mechanisms new treatments approaches in COPD.
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http://dx.doi.org/10.5578/tt.7882DOI Listing
March 2016

YKL-40: may be use as a new inflammatory biomarker in obstructive sleep apnea syndrome?

Tuberk Toraks 2015 Sep;63(3):158-64

Clinic of Chest Diseases, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

Introduction: YKL-40 [chitinase-3 like-1 (CHI3L1)] is a glycoprotein, has been implicated in inflammation, endothelial dysfunction, tissue remodelling and it is accepted as a noninvasive prognostic biomarker for inflammation. In this study, we aimed to underline usability of serum YKL-40 as an inflammatory biomarker in patients with obstructive sleep apnea syndrome (OSAS).

Patients And Methods: Two groups OSAS patients [Group I: Mild-moderate OSAS, n:43; median apnea-hypopnea index: AHI, /hour:18], Group II: Severe OSAS, n: 25; AHI:41.6] and healthy control group [n:25, AHI: 3.6] were included in the study. Serum YKL-40 level was tested in serum samples taken after polysomnography in OSAS patients and control group. In addition, the association of serum YKL-40 level with age, body mass index and polysomnografic parameters were analyzed in the OSAS patient groups.

Results: Median serum YKL-40 level was 20.30 ng/mL (range 8.01-73 ng/mL) in mild-moderate OSAS patients, and 22.58 ng/mL (9.17-99 ng/mL in severe OSAS patients, 18 ng/mL (range 7.36-88 ng/mL) in control group (p< 0.05). Serum YKL-40 level was found to be correlated with AHI in patient with mild-moderate OSAS patients (p< 0.05) and serum YKL-40 level was found to be correlated with age, total hypopnea time (minutes) in severe OSAS patients (p< 0.05). There was no relationship serum YKL-40 level with other studied variables (p> 0.05).

Conclusion: At the end of this study, we found that serum YKL-40 level increase with severity of OSAS. The findings suggest that YKL-40 may be a useful biomarker for inflammation in patients with OSAS.
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http://dx.doi.org/10.5578/tt.9753DOI Listing
September 2015

Clinical update on pulmonary embolism.

Arch Med Sci 2014 Jun 7;10(3):557-65. Epub 2013 May 7.

Dışkapı Yıldırım Beyazıt Research and Education Hospital, Ankara, Turkey.

Pulmonary embolism (PE) is a major cause of cardiovascular mortality and financial burden that affects the community. The diagnosis of PE can be difficult because of the nonspecific symptoms, which include cough, dyspnea, hemoptysis and pleuritic chest pain. Hereditary and acquired risk factors are associated with PE. Incidence of PE is increasing, associated with the development in the diagnostic methods. Evidence-based algorithms can help clinicians diagnose PE. Serum D-dimer level, computed tomography pulmonary angiogram (CTPA), ventilation-perfusion scintigraphy or echocardiography help to establish clinical probability and the severity of PE. Anticoagulation is the standard treatment for PE. However, thrombolytic treatment is a significant alternative in high risk of PE as it provides rapid clot resolution. This article reviews the risk factors, diagnostic algorithms, and methods of treatment in PE in the light of current information.
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http://dx.doi.org/10.5114/aoms.2013.34325DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107241PMC
June 2014

[Asthma, environment and epigenetic].

Tuberk Toraks 2014 ;62(2):165-9

Clinic of Chest Diseases, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

Epigenetic defines long-lasting changes in gene expression independently from DNA sequence. Current evidence revealed that epigenetic mechanisms may have role into immune response and asthma. The purpose of this article is to review basic epigenetic mechanisms in asthma.
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http://dx.doi.org/10.5578/tt.6818DOI Listing
January 2015

The relationship between serum YKL-40 levels and severity of asthma.

Iran J Allergy Asthma Immunol 2013 Jul 9;12(3):247-53. Epub 2013 Jul 9.

Dışkapı Yıldırım Beyazıt Education and Research Hospital, Chest Diseases Clinic, Ankara, Turkey.

YKL-40 (chitinase-3-like-1) has been introduced as a marker of inflammation in asthma. The aim of this study was to determine the role of YKL-40 in asthma and to evaluate the relationship between YKL-40 and asthma severity.In the study, 60 non-smoker asthma patients without additional diseases (aged between 20-60 years, female: 34) were grouped [Group I: Well controlled asthma patients (n: 30), Group II: Patients during acute exacerbation of asthma (n: 30)]. Healthy non-smoker female individuals were included in Group III (n: 30) as a control group. The level of serum YKL-40 of all groups were determined by ELISA. Also, serum YKL- 40 level was correlated with age, asthma duration in years, body mass index (BMI), forced expiratory volume in first second/ forced vital capacity (FEV1/FVC, %), FEV1 (%), and total IgE levels of asthma patients. Mean serum YKL-40 level was highest in patients during acute exacerbation of asthma (36.36±10.49 ng/ml) while mean serum YKL-40 level was the lowest (13.20±5.60 ng/ml) in the control group. There was a negative significant correlation between the serum YKL-40 levels and FEV1 (%) in patients during acute exacerbation of asthma. There were no significant correlations between the serum YKL-40 levels and other variables in group II.We found that increased serum YKL-40 levels may be used as a marker for evaluation of asthma severity and genetic polimorphism.
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July 2013

Chitinases and lung diseases.

Tuberk Toraks 2013 ;61(1):71-5

Clinic of Chest Diseases, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

Chitinase enzymes that hydrolize chitin and some articficial substrates are expressed in human despite lacking of the endogenous chitin within the body. Chitinases phatophysiological functions within human are not fully known. Recent evidence revealed that chitinases may have role into some processes of immune responses and inflammatory system. In this review, we discuss the role of chitinases in lung diseases based on the available information from the literature.
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http://dx.doi.org/10.5578/tt.3773DOI Listing
July 2013

General Characteristics and Prognostic Factors of Pneumonia Cases Developed During Pandemic (H1N1) Influenza-A Virus Infection in Turkey.

Balkan Med J 2013 Mar 1;30(1):68-73. Epub 2013 Mar 1.

Department of Chest Diseases, Faculty of Medicine, Istanbul University, İstanbul, Turkey.

Objective: Unlike seasonal influenza, seen in previous years, the strain identified in the 2009 influenza-A pandemic involved high mortality. In this study, prognostic factors and general characteristics of pneumonia cases developed in Turkey during the H1N1 pandemic between October 2009 and January 2010 were analyzed.

Study Design: Multicenter retrospective study.

Material And Methods: This multicentric retrospective study was conducted between August and October 2010 and patients' data were collected by means of standard forms.

Results: The study included 264 pneumonia cases, collected from 14 different centers. Mean age was 47.5±18.6 years. Nineteen patients (7.2%) were pregnant or had a new birth and comorbid diseases were detected in 52.3% of all patients. On admission, 35 (13.8%) cases had altered mental status. Overall, 32.6% were treated in intensive care units (ICU) and invasive/non-invasive mechanical ventilation was performed in 29.7%. The mean duration of ICU stay was 2.9±6.2 and total hospital stay was 12.0±9.4 days. Mortality rate was 16.8% (43-cases). The length of ICU treatment, total hospital stay, and mortality were significantly higher in H1N1-confirmed patients. Mortality was significantly higher in patients with dyspnea, cyanosis, and those who had altered mental status on admission. Patients who died had significantly higher rate of peripheral blood neutrophils, lower platelet counts, higher BUN, and lower SaO2 levels.

Conclusion: This study showed that pneumonia developed during H1N1 pandemic in our country had resulted in a high mortality. Mortality was especially high among patients with cyanosis, altered mental state and those with lower SaO2.
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http://dx.doi.org/10.5152/balkanmedj.2012.089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4116019PMC
March 2013

Serum S100B protein: a useful marker in obstructive sleep apnea syndrome.

Neurol Neurochir Pol 2012 Sep-Oct;46(5):450-5

Clinic of Chest Disease, DIs¸kapI YIldIrIm BeyazIt Training and Research Hospital, Ankara, Turkey.

Background And Purpose: We aimed to underline the importance of serum S100B protein as a useful biochemical marker in patients with obstructive sleep apnea syndrome (OSAS).

Material And Methods: Forty-three newly diagnosed patients with OSAS (median apnea-hypopnea index [AHI, events/ hour]: 37.5 [range 11.3-137]) and 25 subjects with AHI < 5 (median AHI: 4.4 [range 0.7-4.8]) were included in the study. Serum S100B protein level was tested in serum samples taken after polysomnography in both groups and the difference between OSAS patients and the control group regarding that level was assessed. In addition, the association of S100B protein serum level with age, body mass index, AHI, mean O2 saturation percentage during sleep, minimum O2 saturation value (%) at the end of the apneas, and the time spent at an O2 saturation less than 90% were analyzed in the OSAS patient group.

Results: Median serum S100B protein level was 133.7 pg/ mL (range 20.97-230.70 pg/mL) in patients with OSAS and 16.1 pg/mL (range 10.1-22.9 pg/mL) in the control group (p < 0.005). Serum S100B protein level did not correlate with any studied variable (p > 0.05 for each correlation coefficient).

Conclusions: Serum S100B protein level is increased in patients with OSAS and may be a useful biochemical marker in those patients.
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http://dx.doi.org/10.5114/ninp.2012.31355DOI Listing
March 2013

Hepcidin: A useful marker in chronic obstructive pulmonary disease.

Ann Thorac Med 2012 Jan;7(1):31-5

Diskapi Yildirim Beyazit Education and Research Hospital, Department of Chest Diseases, Ankara, Turkey.

Purpose: This study was designed to evaluate the levels of hepcidin in the serum of patients with chronic obstructive pulmonary disease (COPD).

Methods: In the study, 74 male patients (ages 45-75) in a stable period for COPD were grouped as Group I: Mild COPD (n:25), Group II: Moderate COPD (n:24), and Group III: Severe COPD (n:25). Healthy non-smoker males were included in Group IV (n:35) as a control group. The differences of hepcidin level among all the groups were examined. Also, in the patient groups with COPD, hepcidin level was compared with age, body mass index, cigarette (package/year), blood parameters (iron, total iron binding capacity, ferritin, hemoglobin, hematocrit [hct]), respiratory function tests, and arterial blood gas results.

Results: Although there was no difference between the healthy control group and the mild COPD patient group (P=0.781) in terms of hepcidin level, there was a difference between the moderate (P=0.004) and the severe COPD patient groups (P=0.002). The hepcidin level of the control group was found to be higher than the moderate and severe COPD patient groups. In the severe COPD patients, hepcidin level increased with the increase in serum iron (P=0.000), hct (P=0.009), ferritin levels (P=0.012), and arterial oxygen saturation (SaO(2), P=0.000).

Conclusion: The serum hepcidin level that is decreased in severe COPD brings into mind that it may play a role in the mechanism to prevent hypoxemia. The results suggest that serum hepcidin level may be a useful marker in COPD. Larger prospective studies are needed to confirm our findings between hepcidin and COPD.
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http://dx.doi.org/10.4103/1817-1737.91562DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3277039PMC
January 2012

[Clinical, laboratory and computed tomography pulmonary angiography results in pulmonary embolism: retrospective evaluation of 205 patients].

Anadolu Kardiyol Derg 2012 Mar 3;12(2):142-9. Epub 2012 Feb 3.

Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Kliniği, Ankara-Turkey.

Objective: With this study, we aimed at evaluating demographic data, clinical, laboratory findings in pulmonary embolism (PE) and the relationship of these findings with the embolism location region and responses of the patients to the treatment of the embolism in order to contribute to the patient management in decreasing mortality.

Methods: Clinical findings, accompanying diseases, risk factors, serum D-dimer and creatinine levels, imaging modalities and mortality rates of 205 patients (female: 98, male: 107) diagnosed with PE were examined retrospectively. The relationship between the qualifier variables was evaluated using Chi-square test.

Results: Average age of the patients was 61.55±14.44 years and 86 (42%) patients were above 65 years. Most common complaint was dyspnea (85%), most frequent coexisting disease was congestive heart failure (19%). Deep vein thrombosis (DVT) (30.7%) was the most frequently seen risk factor. Pulmonary embolism was mostly in the right lobe pulmonary artery (32.1%). It was observed that the higher ages of patients the more frequency of proximal located embolism was (p<0.005), especially lobar artery involvement was observed to be high (p=0.032). An early mortality rate was 4.9% and late mortality rate was 11.2%.

Conclusion: In the patients with complaint of dyspnea who are at elder ages and have accompanying diseases, PE should be considered. PE is generally localized in the main pulmonary arteries, which emphasizes crucial importance of early diagnosis and treatment in reduction of mortality.
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http://dx.doi.org/10.5152/akd.2012.040DOI Listing
March 2012

Acanthosis nigricans in a patient with lung cancer: a case report.

Case Rep Med 2010 9;2010. Epub 2010 Aug 9.

Dişkapi Yildirim Bayazit Education and Reserch Hospital, Chest Diseases Clinic, 06200 Ankara, Turkey.

Some skin lesions may accompany malignancies. Acanthosis nigricans, one such lesion, is a paraneoplastic dermatosis characterized by hyperpigmented and velvety verrucose plaques observed as symetric eruptions. With this report, we aim to present a rare case of concomitant lung cancer and acanthosis nigricans. Malignant acanthosis nigricans is most commonly associated with intra-abdominal malignancies. A 65-year-old patient who had hyperpigmented, hypertrophic and symmetric verrucose lesions at the flexor surfaces of the lower and upper extremities, face, palms and the axillary region. Thoracic computed tomography demonstrated a hypodense mass lesion with a dimension of 5 x 5.5 cm at the center of basal segment bronchi of the left pulmonary lobe. Fiberoptic bronchoscopy showed that the access to the lower left lobe was almost completely obstructed by the endobronchial lesion. The result of the histopathologic examination of the endobronchial tissue biopsy was reported as non-small cell (adenocarcinoma) lung cancer. Result of the histopathologic analysis of the punch biopsy of the skin lesions was reported as acanthosis nigricans .There are no pathognomonic dermatological findings for lung cancer. In conclusion, there are skin lesions that accompany lung cancer and we believe that these should be considered for differential diagnosis.
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http://dx.doi.org/10.1155/2010/412159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929622PMC
July 2011