Faruk Çiftçi

The Significance of Elevated Brain Natriuretic Peptide Levels in Chronic Obstructive Pulmonary Disease

We investigated the clinical significance of brain natriuretic peptide (BNP), a cardiac hormone, in chronic obstructive pulmonary disease (COPD). Subjects were 38 patients with stable COPD, of whom 20 had cor pulmonale (CP), and 22 were healthy individuals. Plasma BNP levels were measured and pulmonary arterial pressure (PAP) was estimated by echocardiography. Arterial blood gas analysis, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were also recorded. BNP levels of patients with COPD were higher than those of controls (48.2 ± 37.5 and 9.3 ± 3.0 pg/ml). Patients with CP had a higher mean BNP level with respect to those without CP (73.9 ± 35.8 and 21.0 ± 10.2 pg/ml, respectively). BNP levels correlated with PAP (r = 0.68), partial arterial oxygen pressure (r = −0.70), FEV1 (r = −0.65) and FVC (r = −0.52). We have concluded that BNP determination has a role in the diagnosis of CP in patients with COPD.

High resolution computed tomography findings in smear-negative pulmonary tuberculosis patients according to their culture status.

OBJECTIVE The aim of this study was to assess the clinical features and high resolution computed tomography (HRCT) findings in smear-negative pulmonary tuberculosis (PTB) and to evaluate the correlation between these parameters and the culture results. METHODS We retrospectively studied 78 active smear-negative PTB patients. They were divided into two groups according to their culture results. The HRCT findings and clinical features at the beginning of the antituberculosis treatment were reviewed. RESULTS The mean age was 22.48±3.18 years. Micronodules (87%), large nodules (63%) and centrilobular nodules (62%) were the most common HRCT findings. HRCT findings were observed in the right upper (72%), left upper (56%), right lower (32%), and left lower lobes (29%). Cough (37%) and chest pain (32%) were the most frequent symptoms at presentation. CONCLUSIONS There were no significant differences in the HRCT findings and clinical features between the two groups. Thus, in cases of smear-negative and culture-negative PTB, the patient with compatible clinical and radiological features should be considered for tuberculosis treatment.

Th1-Th2 interaction: is more complex than a see-saw?

Infections, such as tuberculosis, measles and diphtheria, may decrease the risk of developing atopic allergic disorders. Patients with pulmonary TB having similar allergic skin prick test sensitivity as healthy controls but unable to show vigorous atopic phenotype in their healthy period might be a sign for Th1–Th2 immune interaction.

The significance of histopathologic patterns in positive tuberculin skin test site

Backgrounds:  The histologic features of tuberculin skin test site is not uniform. It may be related to status of tuberculosis.

A case of Behcet's disease with pulmonary artery aneurysm and thrombosis

A 22 year old patient with dyspnea, cough, chest pain, fatigue, mild fever and swelling of the lower extremities was hospitalized. Physical examination revealed bilateral decrease in respiratory sounds and end-inspiratory fine rales at the left posterobasal area. Circumferences of both legs were increased. During hospitalization period, oral aphthous and scrotal ulceration were appeared. Bilateral multiple peripheral and central pulmonary artery aneurysms at middle zones were found with dynamic computerized tomography of thorax and magnetic resonance angiography of the lungs. Patient was diagnosed as Behcets disease with lung involvement. Magnetic resonance angiography performed at the sixth month of the treatment revealed a significant regression in aneurysmatic changes, whereas a right ventricular thrombosis had been developed.

Serum prohepcidin in pulmonary tuberculosis.

Abstract Aim: Anemia of chronic disease is the second most encountered anemia following iron deficiency in patients who develop acute or chronic immune activation. Pulmonary tuberculosis is an infectious disease which results in an inflammatory response frequently causing anemia. We investigated whether prohepcidin can be used successfully to disclose the cause of anemia and to monitor the result of the therapy in patients with pulmonary tuberculosis. Material and methods: The study was performed in 40 male patients and 15 healthy controls that had a diagnosis of tuberculosis with a positive sputum smear and did not receive any previous treatment. They were treated for 6 months. Results: The study revealed a significant elevation of prohepcidin in patients with tuberculosis in comparison to those of healthy control subjects. Additionally, prohepcidin levels significantly decreased after treatment in the patient group but remained high in comparison to control group. Conclusion: We conclude that prohepcidin is high in pulmonary tuberculosis and might be a marker for monitoring the response to treatment.

Angiopoietin 2 levels in serum and bronchial lavage fluids and their relationship with cancer stages in lung cancer patients

Background:  Angiopoietin 2 (Ang‐2) has an important role in tumor angiogenesis. In this study, Ang‐2 levels of serum and bronchioloalveolar lavage fluids (BALF) in patients with lung cancer were measured and correlated with clinical and biochemical parameters.

The tuberculosis case fatality rate and the treatment results of the young adult male patients of the last 9 years (2002-2010)

Tuberculosis (TB) remains as the second leading infectious disease causing death following human immunodeficiency virus (HIV) worldwide (1). In 2010, 8.8 million (range, 8.5-9.2 million) new TB cases have been defined. According to the 2011 Global Tuberculosis Control Report of the World Health Organization (WHO), the incidence and prevalence of TB were 128/100,000 and 178/100,000, respectively, and the mortality associated with TB was 20/100,000 worldwide (1). In 2010, TB-related death was determined in 1.1 million (range, 0.9-1.2 million) HIV-negative patients and in 0.35 million (range, 0.32-0.39 million) HIV-positive patients worldwide (1). The incidence of TB has been decreasing since 2002 and the number of definite TB cases has been decreasing since 2006. Within the frame of global TB control strategy of WHO, namely “The Stop TB Strategy”, one of the aims is to reduce the prevalence and mortality rates of TB in 1990 by 50% until 2015 (2). This goal was achieved in America and was nearly achieved in the Western Pacific Region.

Danger Awaiting the Dental Technicians (Search Results of 6 Dental Laboratories in Istanbul)

Dental technicianship is a common health-related occupation especially in metropolitan areas of Turkey. Dental technicians are exposed to ceramic, metal and similar dusts which might lead to pneumoconiosis in occupational environment. The aim of this study was to investigate the incidence and factors related with developing of pneumoconiosis among dental technicians. All of 31 dental technicians employed in six laboratories in Istanbul were enrolled into the study. Detailed medical history, physical examination, chest x-ray, high resolution computed tomography (HRCT) was performed in all participants. HRCT findings were scored and investigated for relation with duration of practice. Mean age and male/female ratio of the study population were 43,2 ? 9,6 years and 27/4 respectively. Mean duration of practice of the technicians was 25,2 ? 9,4 years. Eight subjects complained of dyspnea and cough and out of whom 4 (13%) had HRCT findings compatible with pneumoconiosis. Additionally, four technicians had pulmonary tuberculosis their occupational practice. We have concluded that dental technicianship might be a significant risk factor for pneumoconiosis. The problem might be greater than thought and preventive measures against dust exposure and pneumoconiosis should be revised in dental laboratories.

Quantiferon-tb Gold Test May Be More Advantageous Than Tuberculin Skin Test For Screening Latent Tuberculosis Infection In Psychiatry Clinics

Tüberküloz (TB) kontrol programlarında, yüksek riskli grupların tanımlanması ve takibi vazgeçilemez unsurlardandır. TB açısından yüksek riskli gruplar ≥100/100.000 ve üzeri insidans gösteren topluluklar olarak tanımlanmaktadır (1). Psikiyatri hastalarının da TB açısından yüksek riskli grup olduğu yapılan değişik çalışmalarda gösterilmiştir (2, 3). Latent tüberküloz enfeksiyonu (LTBE) tanısı yüzyıldan uzun bir süredir tüberkülin deri testi (TDT) ile konulmaktadır. Son yıllarda LTBE teşhisi için hem TDT’den daha özgül hem de sonuçları Bacillus-Calmette-Guerin (BCG) aşısından etkilenmeyen yeni diyagnostik testlerin kullanımı özellikle tüberkülozun sık görüldüğü ülkeler için önem kazanmıştır (4). Risk grupları ve temaslılarının araştırılmasında standart yöntem olarak TDT kullanılmakla birlikte bazı kısıtlanmalar bulunmaktadır. TDT’nin yanlış pozitiflik veya negatiflik vermesi ve yorumlama farklılıkları nedeniyle tanı ve yorumunda zorluklarla karşılaşılmaktadır (5). Pozitif TDT sonucu, M. tuberculosis, M. bovis, (BCG) ve pek çok tüberküloz dışı mikobakterilere (NTM) maruz kalma sonucu ortaya çıkabilmektedir. Ayrıca bağışıklığı baskılanmış olgularda yeterli immün yanıt oluşamadığından TDT testi yalancı negatiflik verebilmektedir (6). Son yıllarda LTBE teşhisi için hem TDT’den daha özgül hem de sonuçları BCG aşısından etkilenmeyen yeni diyagnostik testlerin kullanımı özellikle tüberkülozun sık görüldüğü ülkeler için önem kazanmıştır (7). Mikobakteri genomuna yönelik çalışmalar sonunda M. tuberculosis genomunda bulunan fakat BCG suşu ve NTM’lerin çoğunda bulunmayan farklılık bölgesi-1 (Region of Difference-1) (RD-1) tanımlanmıştır. Bu bölgede kodlanan ‘Early Secretory Antigenic Target-6’ (ESAT6) ve ‘Culture Filtrat Protein-10’ (CFP-10) antijenleri kullanılarak TB enfeksiyon teşhisi için T hücre yanıtına dayalı testler geliştirilmiştir (8). Ayrıca interferon-gamma (IFN-γ) salınım testleri aktif tüberkülozlu hastaların teşhisinde daha hassas bir yöntemdir ve test sonuçları LTBE olduğu düşünülen M. tuberculosis temaslı bireylerde daha iyi korelasyon sağladığını göstermektedir. Çalışmamızda uzun süreli kronik servislerde yatan ve tüberküloz salgını için yüksek risk grubu oluşturan 166 şizofreni hastasında LTBE sıklığı ile TDT ve QuantiFERON-TB Gold (QFT-G) testinin tanısal etkinliğinin karşılaştırılması hedeflenmiştir. Çalışmaya dahil olma kriterleri olarak daha önce aktif tüberküloz geçirmemiş, immünosupresif ilaç kullanmayan, antipsikotik tedavisi altında uzun süredir serviste yatan hastalar seçilmiştir. TDT ve QFT-G test sonuçları arasındaki uyumluluk k sabiti kullanılarak değerlendirilmiş ve her iki test sonuçlarının karşılaştırılması dört gözlü tablo kullanılarak yapılmıştır. Bu amaçla QFT-G ve TDT testi kullanılmış, TDT pozitifliği 99/166 (%59.63), QFT-G pozitifliği ise 88/166 (%53.01) olarak tespit edilmiş ve her iki test birbiriyle düşük derecede