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Öğe An Application on Chest X-Ray Images for the Detection of Tuberculosis Disease by Employing Deep Convolutional Neural Networks(İzmir Bakırçay Üniversitesi, 2023) Koç, Hatice; Hızıroğlu, Kadir; Erbaycu, Ahmet EminTuberculosis is the second infectious disease causing death after COVID-19. Diagnosing it is an easy and cheap via chest radiographs. However, some countries lack medical personnel and equipment for tuberculosis detection on chest radiographs. Computer-aided diagnosis and computer-aided detection systems utilizing deep learning can be employed to identify tuberculosis on medical images. Although there are some studies, they are insufficient for unbiased systems because these systems require the datasets having different features. The aim of this study is to evaluate the performance of pretrained networks for a classification application on chest X-ray images by utilizing the dataset from the Hospital in Turkey and Montgomery Count Dataset. The predictive models were implemented with the pre-trained DCNNs such as ResNet-50, Xception, and GoogLeNet. An Xception model provides the best performance.Öğe The Covid-19 pandemic and Artificial Intelligence (AI) applications in health : how much are we interested in?(Dokuz Eylul Univ Inst Health Sciences, 2022) Öztop, Mehmet Burak; Pakdemirli, Ahu; Orbatu, Dilek; Erbaycu, Ahmet Emin; Özdemir, Senem Alkan; Başok, Banu; Bitim, SemihPurpose: New viruses have emerged, causing global damage and mass deaths that can spread to international borders, the latest of which is the new coronavirus (COVID-19). After the Second International Congress on Artificial Intelligence in Health, themed Artificial Intelligence in Health During COVID-19 Pandemic Process organized online by Izmir Bakircay University and Izmir Provincial Health Directorate with the contributions of the International Association of Artificial Intelligence in Health, a questionnaire was conducted to evaluate the knowledge of the participants about artificial intelligence applications.Material and Methods: This study aimed to evaluate the interest of the congress participants in this field with the questions which form the questionnaire such as the duration of the interest of the participants in the field of artificial intelligence in health, their publication status, the development of studies on artificial intelligence with the COVID-19 pandemic, demographic structures such as age and gender, and educational level. 130 participants answered the questionnaire consisting of 23 questions. Questionnaire responses were analyzed in a statistical setting.Results: We found that 130 people filled out the questionnaire and the majority of the participants were female, with participation from many organizations, but university staff showed more interest. We have seen that the 30-39 age group is more interested in artificial intelligence than the other age groups, but the majority of the participants do not have academic studies in this field. We found that the technical terms related to artificial intelligence were not well known by the participants, and that the number of participants who tended to this field, especially in the recent year, was high. Another important point was that people working in this field stated that they would definitely follow up if scientific activities continued.Conclusion: We know how important congresses, symposiums, courses and other meetings are, especially for scientist candidates, which will be held to raise awareness about the usage areas of artificial intelligence-based health technologies, to develop new communication and work networks by bringing together different disciplines, to create an agenda and to lay the groundwork for new studies, and we think that there is a need for many repetitive activities in this field and that these activities should be continued.Öğe The effect of positive pressure ventilation on serum ischemia-modified albumin levels in obese patients with obstructive sleep apnea syndrome(Turkish Assoc Tuberculosis & Thorax, 2022) Ajun, Ebru Gamze; Uçar, Zeynep Zeren; Arslan, Burcu Oktay; Karakoyun,İnanç; Erbaycu, Ahmet Emin; Başok, Banu İşbilenIntroduction: Respiratory abnormalities in obstructive sleep apnea syndrome (OSAS) are corrected with positive pressure ventilation treatments. We inves-tigated the effect of positive airway pressure (PAP) treatment on the serum level of ischemia-modified albumin (IMA), an oxidative stress product, in OSAS patients with higher body mass index (BMI) and indication for PAP treatment.Materials and Methods: Seven consecutive female and 23 male patients with a BMI of >= 30 kg/m2 who were diagnosed as having OSAS according to ICSD-3 criteria and were planned for PAP, were included. The Epworth Sleepiness Scale and STOP-Bang Questionnaire were performed. Morning arterial blood gas, hemogram, biochemistry, insulin, and IMA were measured after polysom-nography and after three months of PAP.Results: There were no significant changes in lactate, CRP, and serum elect-rolyte levels measured before and after PAP, except for potassium. When 30 patients were compared in terms of serum IMA levels at baseline and after treatment, the mean baseline value was 0.56 absorbance units (ABSU), and the 3rd-month follow-up IMA value was 0.53 ABSU (p= 0.537). The mean serum fasting insulin level was 15.85 mu IU/mL and 11.6 (p= 0.002) and the mean HOMA index was 4.4 and 3.0 (p= 0.001), respectively.Conclusion: Serum IMA levels seem not to be an appropriate marker for the evaluation of PAP treatment in OSAS patients with higher BMI. PAP is associ-ated with a decrease in the fasting insulin level, HOMA index, and hematocrit, but not with serum electrolytes except potassium.Öğe Efficacy of pulmonary rehabilitation on patients with non-cystic bronchiectasis according to disease severity(Turkish Assoc Tuberculosis & Thorax, 2021) Deniz, Sami; Sahin, Hulya; Erbaycu, Ahmet EminIntroduction: The European Respiratory Society guidelines support pulmo-nary rehabilitation (PR) in bronchiectasis through high-quality evidence. This study aimed to evaluate the efficacy of PR on bronchiectasis patients accor-ding to disease severity assessed by the Bronchiectasis Severity Index (BSI). Materials and Methods: This prospective study included patients with stable bronchiectasis. Demographic data of all patients were questioned. All patients underwent an 8-week PR program. The patients were grouped into three according to disease severity (mild, moderate and severe) based on their BSI scores. The following parameters were evaluated at baseline (pre-PR) and after PR (post-PR): pulmonary function test results, carbon monoxide diffusion capacity, body mass index, exercise capacity (6-minute walking test), quality of life (QoL; St. George's Respiratory Questionnaire), and Hospital Anxiety and Depression scores. Results: The study included 69 patients (55 males; mean age, 62.6 +/- 9 years). After PR, the patients were observed to have significantly improved QoL and exercise capacity (p< 0.05). According to BSI, 16 (23.2%), 29 (42.0%), and 24 (34.8%) patients had mild, moderate, and severe bronchiectasis, respecti-vely. These patient groups significantly differed regarding age, exercise capa-city, and QoL (p 0.05). Comparing the change between post-PR and pre-PR values of the study parameters (increment = post-PR value -pre-PR value), no signifi-cant differences were observed regarding the exercise capacity and QoL (p 0.05) in the groups. Conclusion: PR increases exercise capacity and QoL in bronchiectasis patients, and its efficacy does not differ according to disease severity. Thus, appropriate bronchiectasis patients should be referred to PR program regardless of disease severity.Öğe Evaluation of antimicrobial susceptibilities of non-tuberculous mycobacteria against linezolid and tigecycline(Indian Association of Medical Microbiologists, 2022) Şenol, Güneş; Biçmen, Can; Gündüz, Ayrız; Dereli, Şevket; Erbaycu, Ahmet EminMycobacterial susceptibility testing is important for the management of nontuberculous mycobacteria (NTM) infections. The aim of the study is to determine the susceptibilities of tigecycline (TGC) and linezolid (LZD) against NTM. The study was carried out using stocks of NTM strains in the tuberculosis department of the microbiology laboratory. It was designed a retrospective study. LZD and TGC sensitivities of study isolates were analyzed by microdilution. Forty NTM isolates have been studied. LZD and TGC sensitivities varied according to the NTM type. It is concluded that each isolate should be individually evaluated due to variable susceptibilities to LZD and TGC. © 2022 Indian Association of Medical MicrobiologistsÖğe Göğüs hastalıkları onkolojik acillerin değerlendirilmesi(2020) Tatar, Dursun; Anar, Ceyda; Özdoğan, Yasemin; Yalnız, Enver; Çırak, Ali Kadri; Erbaycu, Ahmet EminAmaç: Göğüs hastalıkları hastanesi acil servisine başvuran onkoloji hastalarının genel özelliklerini ortaya koymak amaçlandı. Yöntem: Bir aylık dönemde acil servise başvuran malignite tanılı hastaların sosyodemografik verileri ile birlikte başvuru semptomları ve acil tanıları retrospektif olarak incelendi.Bulgular: Çalışmaya alınan 118 hastanın 105 (%84.7)’si erkek, 13 (%15.3)’ü kadın ve yaş ortalaması 61.2 yıl idi. En sık başvuru yapan yaş aralığı 50-59 idi. Hastalarımızda saptanan en sık semptomlar nefes darlığı (%50), ağrı (%27.9), ateş (%14.4) ve hemoptizi (%10.1) idi. Daha az sıklıkta bulantı (%9.3), öksürük-balgam çıkarma (%7.6) ve halsizlik (%5.9) izlendi. Küçük hücreli dışı akciğer karsinomlu hastaların %87.5’i ve küçük hücreli akciğer karsinomunun %23.5’i ileri evre kansere sahip idi. En sık rastlanan acil tanı 49 (%41.5) hastada solunum yetmezliği, 14 (%11.8) hastada kemik metastazı, 13 (%11) hastada beyin metastazı idi.Sonuç: Göğüs hastalıkları acil servisine başvuran hastaların en sık yakınmaları nefes darlığı ve ağrı, en sık acil tanıları solunum yetmezliği ve metastatik hastalıktır. Genel talep palyatif tedaviler içindir, ölüm oranı düşüktür.Öğe The impact of chemotherapy on the EORTC QLQ-C30 and LC-13 quality of life scales in patients with lung cancer(2021) Karakurt, Gamze; Güvençli, Müge; Kömürcüoğlu, Berna; Yalnız, Enver; Erbaycu, Ahmet EminObjective: The concept of quality of life (QoL) in lung cancer includes many physical, psychological and social components. We aimed to assess the effect of chemotherapy (CT) on QoL of lung cancer patients using QoL scales. Methods: Fifty inoperable lung cancer patients who were newly diagnosed and taken into a CT plan were included. Patients were followed in terms of responsiveness and toxicity. Turkish versions of the EORTC QLQ-C30 and LC13 scales were used before every cycles. Results: The average age was 60.1 years. There was no difference between QoL and age/income levels. The assessment of physical, social and occupational functions and overall health status of the male patients was better than female. Overall health status without comorbidity was better in the first cycle CT. Chemotherapy led to deterioration in social functions and economic status together with increase in neuropathy, constipation and hair loss. Patients with complete or partial response to treatment were observed to have better physical, occupational, emotional, cognitive and social functions, economic status and overall health; less fatigue, pain, shortness of breath, neuropathy and better appetite. Toxicities were found to affect the QLQ C30 and LC13 scales adversely. Conclusion: Presence of comorbidity, low education levels, socioeconomic status and CT induced hematologic/ gastrointestinal toxicities are the major parameters affect QOL in lung cancer. Chemotherapy leads to deterioration in social functions, increase in adverse events as well as worsening in economic status. Radiologic complete or partial response and small cell carcinoma are states in which parameters of QoL are affected positively by chemotherapy.Öğe Iterative surgical resections in non-small cell lung cancer(Termedia Publishing House Ltd, 2021) Üçvet, Ahmet; Yazgan, Serkan; Samancılar, Özgür; Gürsoy, Soner; Erbaycu, Ahmet Emin; Kömürcüoğlu, BernaIntroduction: We reviewed our surgical preferences and the prognosis for recurrent and second primary tumors in patients who underwent surgical treatment for non-small cell lung carcinoma (NSCLC). Aim: We report our experience with patients undergoing iterative pulmonary resection for lung cancer. Material and methods: Among patients who underwent anatomical resection for primary NSCLC, those who underwent a second surgical resection between 2010 and 2020 due to recurrent or second primary tumor were included in the study. Operative mortality, survival, and prognostic factors were investigated. Results: In total, 77 cases were included: 31 (40.3%) underwent the second resection for the recurrent disease and 46 (59.7%) underwent the second resection for the second primary tumor. Postoperative mortality occurred in 8 (10.4%) patients. All patients with postoperative mortality were in the group that underwent thoracotomy in both surgical procedures. The 5-year survival rate was 46.5%. The 5-year survival of those operated on for recurrent or second primary tumor was 32.8% and 51.1%, respectively (p = 0.81). The 5-year survival rate was 68.8% in patients under the age of 60 years, while it was 27.5% in patients aged 60 years and above (p = 0.004). The 5-year survival was 21.8% in patients with an interval of 36 months or less between two operations and 72.2% in those with a longer interval (p = 0.028). Conclusions: Our study shows that survival results similar to or better than primary NSCLC surgery can be obtained with lower mortality if more limited resections are performed via video-assisted thoracic surgery, especially in young patients. In addition, the prognosis is better in patients with an interval of more than 36 months between two operations.Öğe Iterative surgical resections in non-small cell lung carcinoma(European Respiratory Soc Journals Ltd, 2021) Üçvet, Ahmet; Yazgan, Serkan; Samancılar, Özgür; Gürsoy, Soner; Erbaycu, Ahmet Emin; Kömürcüoğlu, Berna[Abstract Not Available]Öğe Kronik obstrüktif akciğer hastalığında radyolojik fenotiplerin yaşam süresine etkisi(İzmir Göğüs Hastalıkları Hastanesi, 2024) Deniz, Sami; Yılmaz, Emine Sena Dikmentepe; Erbaycu, Ahmet EminSami Deniz 1, Emine Sena Dikmentepe Yılmaz 1, Ahmet Emin Erbaycu 2 1 Sağlık Bilimleri Üniversitesi, Dr Suat Seren Göğüs Hastalıkları ve Cerrahisi Eğitim ve Araştırma Hastanesi, Göğüs Hastalıkları Kliniği, 2 zmir Bakırçay Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı Giriş ve Amaç: Amfizem, kronik bronşit ve bronşektazi kronik obstrüktif akciğer hastalığı (KOAH)’da görülen baskın fenotipler olup zamanla farklı oranlarda gelişebilir. Çalışmada KOAH’lı hastalarda bu üç radyolojik fenotipin yaşam süresine etkisinin araştırılması amaçlandı. Gereç ve Yöntem: Çalışma retrospektif ve kesitsel olarak tasarlandı. 2015-2019 yılları içinde başvuran, stabil KOAH’lı olup toraks yüksek çözünürlüklü bilgisayarlı tomografi ile radyolojik olarak üç fenotipten birinin belirlendiği hastalar çalışmaya alındı. Otuzu bronşektazi, 30’u amfizem ve 30’u kronik bronşit olmak üzere toplam 90 erkek hasta dahil edildi. Hastaların yaş, vücut kitle indeksi, spirometrik ölçüm değerleri, kan testleri, tanı konulma zamanı, ölüm zamanı, komorbiditeleri ve demografik verileri kaydedildi. Bulgular: Üç grup arasında yaş, temel laboratuvar ve spirometrik değerlerde FEV1/FVC hariç istatistiksel olarak fark saptanmadı. Amfizem baskın KOAH’da FEV1/FVC oranı diğer iki fenotipe göre daha düşük bulundu (p=0,023). Üç grup arasında hipertansiyon, diyabet, kronik kalp yetmezliği gibi komorbiditeler benzer sıklıktayken, koroner arter hastalığı amfizem grubunda anlamlı şekilde yüksek bulundu (p=0,030). En kısa yaşam süresi kronik bronşit ve amfizem baskın KOAH’da, en uzun yaşam süresi bronşektazi baskın KOAH grubunda belirlendi (p=0.037). Sonuç: KOAH’lı hastalarda kronik bronşit, amfizem, bronşektazi fenotipleri arasında yaş, laboratuvar testleri, vücut kitle indeksi gibi temel değerlerde ve FEV1/FVC oranı hariç spirometrik ölçümler benzerdir düzeydedir. Bu üç fenotip başta kardiyak olmak üzere yüksek oranda komorbiditeyle birliktedir. En kısa yaşam süresi kronik bronşit ve amfizem fenotipinde, en uzun yaşam süresi bronşektazi fenotipindedir.Öğe Mahkûmlar ve genel populasyondaki akciğer tüberkülozunun karşılaştırılması(2020) Alizoroğlu, Dursun; Deniz, Sami; Canbaz, Mustafa; Erbaycu, Ahmet EminAmaç: Mahkûmlardaki akciğer tüberkülozu genel populasyona göre daha yüksektir. Zayıf sağlık bakımı, kötü beslenme, azalmış fiziksel aktivite, kolay yayılım şartları bu prevelansı artırmaktadır. Çalışmamızda, mahkûmlarda görülen akciğer tüberkülozunun genel populasyonda görülen akciğer tüberkülozu ile karşılaştırılması amaçlanmıştır.Yöntem: 2010-2014 tarihleri arasında akciğer tüberkülozu teşhisi konulan 29 mahkûm ve 29 genel populasyona ait, toplam 58 hasta çalışmaya alındı. Hastalara ait tüm bilgiler bilgisayar sisteminden elde edildi. Hastaların yaşı, rutin biyokimyasal ve hemogram değerleri, bronş aspirasyonu ve balgam asidorezistan basil direkt bakısı, kültür sonuçları, sitolojisi, akciğer grafisindeki lokalizasyonu ve özellikleri (konsolidasyon, nodül, kavitasyon) ve verilen tedaviler kaydedildi.Bulgular: Hastaların yaş ortalaması 35,7 yıl idi. Gruplar arası karşılaştırmada genel populasyonda kan protein düzeyleri mahkûm hastalara göre daha düşük idi (p=0,007). Kreatinin düzeyleri arasındaki fark sınırda idi (p=0,05). Akciğer tüberkülozunun akciğer grafisindeki özellikleri kıyaslandığında, mahkûmlarda konsolidasyon, genel populasyonda nodüllerin varlığı ön planda idi (p=0,018). Verilen tedavi açısından değerlendirildiğinde, 22 mahkûm hasta, 21 genel populasyona ait akciğer tüberkülozlu hasta klasik 4’lü tedavi almıştı. İki mahkûm ve 3 genel populasyonda görülen akciğer tüberkülozu olan hasta ise HRZES tedavisi almıştı.Sonuç: Mahkûmlarda saptanan akciğer tüberkülozunun genel populasyonda görülen akciğer tüberkülozu arasında hastalığın özellikleri ile ilgili, belirgin fark saptanmamıştır.Öğe The effect of radiological phenotypes on survival of chronic obstructive pulmonary disease(İzmir Göğüs Hastalıkları Hastanesi, 2024) Deniz, Sami; Yılmaz, Emine Sena Dikmentepe; Erbaycu, Ahmet EminIntroduction and Aim: Emphysema, chronic bronchitis and bronchiectasis are the predominant phenotypes seen in chronic obstructive pulmonary disease (COPD) and may develop at different rates over time. The aim of the study was to investigate the effects of these three radiological phenotypes on survival in patients with COPD. Materials and Methods: The study was designed as retrospective and cross-sectional. Patients with stable COPD who applied between 2015 and 2019 and whose thorax high-resolution computed tomography were diagnosed with one of the three phenotypes radiologically were included in the study. A total of 90 male patients, 30 of whom had bronchiectasis, 30 had emphysema, and 30 had chronic bronchitis, were included. Age, body mass index, spirometry measurement values, blood tests, time of diagnosis, time of death, comorbidities and demographic data of the patients were recorded. Results: There was no statistical difference between the three groups in terms of age, baseline laboratory and spirometry values, except for FEV1/FVC. The FEV1/FVC ratio was found to be lower in emphysema-predominant COPD than in the other two phenotypes (p=0.023). While comorbidities such as hypertension, diabetes, and chronic heart failure were at a similar frequency between the three groups, coronary artery disease was found to be significantly higher in the emphysema group (p=0.030). The shortest survival was determined in chronic bronchitis and emphysema-predominant COPD, and the longest in the bronchiectasis-predominant COPD group (p=0.037). Conclusion: The phenotypes of chronic bronchitis, emphysema, and bronchiectasis in patients with COPD are similar in baseline values such as age, laboratory tests, body mass index, and spirometry measurements, excluding FEV1/FVC ratio. These three phenotypes are associated with a high rate of comorbidity, primarily cardiac. The shortest lifespan is in the chronic bronchitis and emphysema phenotype, and the longest in the bronchiectasis phenotype.Öğe The Impact of Artificial Intelligence on Healthcare Industry: Volume 1: Non-Clinical Applications(CRC Press, 2024) Berktas, Mustafa; Hiziroglu, Abdulkadir; Erbaycu, Ahmet Emin; Er, Orhan; Kahyaoglu, Sezer BozkusHealthcare and medical science are inherently dependent on technological advances and innovations for improved care. In recent times we have witnessed a new drive in implementing these advances and innovations through the use of Artificial Intelligence, in both clinical and non-clinical areas. The set of 2 volumes aims to make available the latest research and applications to all, and to present the current state of clinical and non-clinical applications in the health sector and areas open to development, as well as to provide recommendations to policymakers. This volume covers non-clinical applications. The chapters covered in this book have been written by professionals who are experts in the healthcare sector and have academic experience. © 2025 Mustafa Berktas, Abdulkadir Hiziroglu, Ahmet Emin Erbaycu, Orhan Er and Sezer Bozkus Kahyaoglu.Öğe The Impact of Artificial Intelligence on the Health Industry: General Framework on Non-clinical Applications(CRC Press, 2024) Berktas, Mustafa; Erbaycu, Ahmet Emin; Hiziroglu, Kadir; Er, Orhan; Kahyaoglu, Sezer BozkusThis chapter provides the general framework for a basic introduction to non-clinical applications of artificial intelligence (AI) in the healthcare industry. All activities related to patient care that are not observable in the disease treatment process can be referred to as non-clinical healthcare activities. The healthcare industry appears as a top priority in almost every subject in both advanced and emerging countries around the world. Therefore, this book is planned with the aim of closely examining and contributing to the dynamics of the healthcare sector, which has such a strategic importance and social impact. In this respect, Volume 1 covers non-clinical applications of AI and, as a next step, Volume 2 will provide information on the impact of AI on clinical implications. In this context, a wide range of topics will be described, from health big data and the characteristics of the health big data production process to key processes related to health service delivery, quality and accreditation. While the health industry is large in scale, it also has a very complex structure in terms of its operations, services and technologies. For this reason, it is one of the sectors expected to internalize and exploit technological advances most quickly. AI, which is contributing to revolutionary innovations in technological development, is spreading widely through intelligent tools with different algorithms based on machine learning and deep learning techniques. While the applications of artificial intelligence have benefits, they also pose challenges. The topics discussed in this book attempt to open the discussion on all aspects of AI with a balanced approach based on the literature. It provides value-added recommendations for public health management that should be considered in the development of health policies needed to improve service standards and quality, especially in the healthcare industry and the healthcare supply chain process. © 2025 Mustafa Berktas, Abdulkadir Hiziroglu, Ahmet Emin Erbaycu, Orhan Er and Sezer Bozkus Kahyaoglu.Öğe The Impact of the 2023 Kahramanmaraş (Türkiye) Earthquakes on Asthma Control in Adults: A Single Center Cross-Sectional Study(Turkiye Klinikleri, 2024) Güçsav, Mutlu Onur; Yüce, Hande; Erbaycu, Ahmet Emin; Ayranci, AysuObjective: On 6 February 2023, 2 earthquakes with magnitudes of 7.8 and 7.6 Mw occurred in Kahramanmaraş. Earthquakes have caused catastrophic damage in an area of approximately 350,000 km². We aimed to establish the effect of earthquakes on asthma control. Material and Methods: The data of 116 asthma patients were assessed between May 1 and December 1, 2023. The use of inhaled corticosteroids (ICS), short-acting beta-agonists (SABA), and numbers of asthma exacerbations were compared in pre-and post-earthquake periods. In addition, patients were divided into 2 groups according to asthma control status. Both groups were compared for demographic data, medication, exacerbations, anxiety, and quality of life. Results: In the post-earthquake period, ICS use decreased significantly (p<0.001), while SABAs use and exacerbation rate increased significantly (p<0.001, p<0.001). Approximately 2/3 (66.4%) of patients were un-controlled. Exacerbations were significantly higher in the uncontrolled group (p=0.011). ICS use was also lower in the uncontrolled group (un-controlled: 28.6% vs 53.8% controlled, p=0.008). However, no significant difference was found between the groups for SABAs use. There was no difference between the two groups in terms of housing status (p=0.497), quality of life (p>0.05 for all quality-of-life scales), and anxiety level (p=0.686). Conclusion: We found that the earthquake significantly impaired asthma control. The main reason for the lack of asthma control in the post-earthquake period seems to be the difficulty in accessing ICS. Therefore, disaster management plans should be developed to provide timely medical supplie and optimal health services in areas vulnerable to disasters. © 2024 by Türkiye Klinikleri.Öğe Tüberkülozda doğrudan gözetimli tedavi başarısı ve etkileyen faktörler(2022) Erbaycu, Ahmet Emin; Deniz, SamiAmaç: Türkiye’de tüberkülozluların (TB) tedavi ve takibi Verem Savaş Dispanserleri (VSD) tarafından ücretsiz, doğrudan gözetimli olarak yapılmaktadır. Bu çalışmada Aydın ilindeki TB’li hastaların hastalığa özgü karakteristikleri ve doğrudan gözetimli tedavi (DGT) başarısını ortaya koymak amaçlanmıştır. Yöntem: İldeki dört VSD’nin dört yıl boyunca takip ve tedavi ettikleri TB’li hastalar incelenmiştir. Bu döneme ait kayıtlardan 6.557 hasta bilgisine ulaşılmış, kayıtları eksiksiz ve tedavi sonuçlarını içerenler çalışmaya alınmıştır. Hastaların demografik, mikrobiyolojik, tedavi sonuçları kaydedilmiştir. Bulgular: 1.023 erkek, 490 kadın, toplam 1.513 hasta çalışmaya dahil edildi. 1.126 (%74,4) hastaya akciğer, 387 (%25,5) hastaya akciğer dışı TB tanısı konulmuştu. Akciğer dışı TB’de en sık lenfadenit (%44,1), ikinci sıklıkta plevral TB (%41,6) saptandı. TB’nin kadınlarda daha genç yaşlarda, erkeklerde orta ve ileri yaşlarda görüldüğü tespit edildi (p=0,0001). En yüksek negatif mikroskopik inceleme sıklığı 18 yaş altında saptandı (p=0,0001). Akciğer dışı TB sıklığı kadınlarda anlamlı şekilde daha fazla ve tedaviyle kür oranı anlamlı şekilde daha düşüktü (p=0,0001). Akciğer ve akciğer dışı TB’liler karşılaştırıldığında; akciğer TB’de daha yüksek ilaç direnci ve kür oranı vardı (p=0,0001). İlaç direnci erkeklerde, 18-65 yaş aralığında ve akciğer TB’de daha sıktı. Sonuç: VSD takibindeki TB’li hastalarda tedavi başarısı %87,5 olarak bulunmuştur. TB kadınlarda daha genç yaşlarda, erkeklerde orta ve ileri yaşlarda görülmektedir. En yüksek negatif mikroskopik inceleme sıklığı 18 yaş altı hastalardadır. Akciğer dışı TB sıklığı kadınlarda daha fazladır ve tedaviyle kür oranı düşüktür. Akciğer ve akciğer dışı TB’de DGT ülkemizde pratik ve etkin bir tedavi yöntemidir.Öğe Video-assisted thoracoscopic lobectomy and bilobectomy versus open thoracotomy for non-small cell lung cancer: Mortality and survival(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2022) Üçvet, Ahmet; Yazgan, Serkan; Samancılar, Özgür; Türk, Yunus; Gürsoy, Soner; Erbaycu, Ahmet EminBackground: In this study, we aimed to evaluate patients who had non-small cell lung cancer and underwent resection, to investigate our tendency to prefer video-assisted thoracic surgery or open thoracotomy, and to compare 30-and 90-day mortalities and survival rates. Methods: Between January 2013 and January 2019, a total of 706 patients (577 males, 129 females; mean age: 61.9 +/- 8.6 years; range, 17 to 84 years) who underwent lobectomy or bilobectomy due to primary non-small cell lung cancer were retrospectively analyzed. The patients were divided into two groups as operated on through video-assisted thoracic surgery and through open thoracotomy. The 30-and 90-day mortality rates and survival rates were compared. Results: Of the patients, 202 (28.6%) underwent video-assisted thoracic surgery and 504 (71.4%) underwent open thoracotomy. Lobectomy was performed in 632 patients (89.5%) and bilobectomy was performed in 74 patients (10.5%). Patients who were chosen for video-assisted thoracic surgery were statistically significantly older, did not require any procedure other than lobectomy, did not receive neoadjuvant therapy, had a small tumor, and did not have lymph node metastases. The 30-and 90-day mortality rates in the video-assisted thoracic surgery and open thoracotomy groups were 1.8% vs. 2% and 2.6% vs. 2.5%, respectively. The five-year survival rates of video-assisted thoracic surgery and open thoracotomy groups were 74.1% and 65.2%, respectively (p>0.05). The 30-and 90-day mortality and five-year survival rates were 2.1%, 2.6%, and 73.5% in the video-assisted thoracic surgery group and 2.1%, 2.1%, and 68.5% in the open thoracotomy group, respectively, indicating no statistically significant difference between the two groups. Conclusion: Throughout the study period, video-assisted thoracic surgery was more preferred in patients with advanced age, in those who had a small tumor, who did not receive neoadjuvant therapy, did not have lymph node metastasis, and did not require any procedure other than lobectomy. In the video-assisted thoracic surgery and open thoracotomy groups, 30-and 90-day mortality and five-year survival rates were similar. Based on these findings, both procedures seem to be acceptable in this patient population.
