Sedat Altin

Yedikule Hospital for Chest Disease and Thoracic Surgery, İstanbul, Istanbul, Turkey

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Publications (55)36.14 Total impact

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    ABSTRACT: 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. 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. 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). 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. Copyright © 2015. Published by Elsevier Ltd.
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    ABSTRACT: Objective Patients undergoing haemodialysis for chronic renal failure-hemodialysis (CRF-HD) are at risk of latent tuberculosis infection (LTBI). The effectiveness of using blood IP-10 production capacity to diagnose LTBI in CRF-HD patients was analysed. Methods The study enrolled 50 CRF-HD patients. Interferon-γ release assay (IGRA) was done using QuantiFERON-TB Gold In Tube (QFG-IT) system. Blood IP-10 production capacity was measured using the QFG-IT system tubes. Tuberculin skin testing (TST) was performed on the same day and the test results were compared. Results TST turned out to be positive in 36.4% of the patients and QFG-IT in 54% of them. After stimulation with specific tuberculosis antigens, blood IP-10 levels increased noticeably. The antigen-stimulated blood IP-10 level was significantly higher in patients who were either TST or QFG-IT positive than in patients whose tests were negative (p=0.0001). Using 4.02 pg/mL as the threshold for stimulated blood log-transformed IP-10 level, good agreement was observed between IP-10 and QFG-IT results (κ=1). Conclusion Blood IP-10 level, which can be measured simply, provides results equivalent to IGRAs for the diagnosis of LTBI in CRF-HD patients.
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    ABSTRACT: Background: The differential diagnostic utilities of the levels of soluble interleukin (IL)-12p40 and the IL-2 receptor in sera and pleural effusions were evaluated in patients with exudative pleural effusions. Methods: We enrolled a total of 120 patients with exudative pleural effusions. The clinical, radiological, and histopathological diagnoses were tuberculous pleurisy in 52, malignant pleurisy in 39, and parapneumonic effusions in 29 patients. Results: We measured serum IL-12p40 and adenosine deaminase (ADA) levels in patients with tuberculous pleurisy and in a control group treated for pleural effusion to determine if such levels were useful in the diagnosis of pleural effusion (p < 0.005). Definite microbiological or histopathological diagnoses of tuberculous pleurisy or pleural effusion were recorded, and we found that ADA and serum soluble IL-2 receptor levels aided in diagnosis (p < 0.001). The levels of ADA and soluble IL-2 in pleural effusions afforded sensitivities and specificities of 84.62% and 82.69% and of 70.59% and 80.88%, respectively. The soluble IL-2 receptor level afforded a sensitivity and specificity of 82.69% and 52.9%. IL-12p40 levels in pleural effusions and sera afforded sensitivities and specificities of 80.77% and 80.77% and of 60.29% and 39.71%, respectively. Conclusion: Soluble IL-2 receptor levels in patients with tuberculous pleurisy serve as markers of disease in non-endemic countries, similarly to ADA levels.
    Scandinavian Journal of Infectious Diseases 12/2014; 47(3):1-6. DOI:10.3109/00365548.2014.975278 · 1.64 Impact Factor
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    ABSTRACT: Synovial sarcoma (SS) is a rare tumor originating from mesenchymal tissue and accounting for approximately 5-10% of all soft tissue sarcomas. A rare case of primary pulmonary SS in an asymptomatic 18-year-old man admitted to our hospital for investigation of a 6 × 6.5 cm, oval-shaped, well-delineated pleural based peripheral mass in the left lower lobe in his thorax CT is presented. Left lower lobectomy was done. Immunohistochemically, tumor cells were positive for cytokeratin, epithelial membrane antigen (EMA), and vimentin so that the histopathological diagnosis was compatible with biphasic spindle cell type SS in the lung.
    08/2014; 2014:537618. DOI:10.1155/2014/537618
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    The West Indian medical journal 04/2014; 63(2):213-215. DOI:10.7727/wimj.2013.045 · 0.28 Impact Factor
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    ABSTRACT: One of the obstacles to organ donation and transplantation in Turkey is that of religious beliefs and, at this point, religious officials constitute a key aspect of this problem. Positive or negative viewpoints held by religious officials regarding organ donation and transplantation are influential in guiding the public. This descriptive study was conducted for the purpose of describing religious officials' viewpoints on this subject. To determine the opinions of 40 religious officials from among the imams and muezzins working in Zeytinburnu District Mufti (Religious Officials Superior) Station who participated in a normal meeting in April and who fully completed the survey. A 27-question survey form was used that consisted of open-ended and closed questions, 5 of which were on socio-demographic characteristics, 13 on viewpoints on organ donation and transplantation, and 9 on the Islamic viewpoint regarding organ donation and transplantation. For the analysis of the results, Student's t test and one-way ANOVA tests were used. It was found that all of the religious officials believed in the importance of organ donation, 80 % considered donating their organs, and 5 % had made an organ donation. Of the religious officials who had not donated organs, 35 % gave an answer that there was no specific reason and 27.5 % stated that they had never considered the subject. While the number of those stating that they would donate the organs of a close associate who had died, 77.5 % of them who did not want to donate gave as their reason the idea that if it were him, he would perhaps not want to give his organs after death. Of the religious officials questioned, 92.5 % asserted that the religion of Islam looked positively on organ donation and transplantation, 55 % stated that the knowledge of religious officials in the country was inadequate regarding this subject, and 65 % said that for interest in organ donation to increase, religious officials should make speeches and raise the issue with the public in conversations, meetings, and sermons. Fully 85 % asserted that for interest in organ donation in Turkey to increase, religious officials have to lead on the subject. Of those questioned, 52.5 % considered their knowledge on organ donation and transplantation to be adequate and that they had obtained 52.5 % of such information from seminars/conferences, 50 % from television/radio, and 45 % from Directorate of Religious Affairs publications. However, 40 % expressed that they did not know where organ donations were made. One reason for inadequate organ donation in Turkey is that of incorrect religious beliefs. Thus, it is necessary that informative efforts are made by the Directorate of Religious Affairs through in-house training programs, and that healthcare, religious, and legal officials work jointly to inform the public about organ donation, organ transplantation, and brain death. Additionally, religious officials should donate organs by the way of example and, to increase their sensitivity, healthcare professionals should go more frequently to mosques and Mufti Stations.
    Journal of Religion and Health 03/2014; DOI:10.1007/s10943-014-9851-1 · 1.02 Impact Factor
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    ABSTRACT: Mean Platelet Volume (MPV) reflects the size of platelets. It has been shown to be inversely correlated with inflammation in some chronic inflammatory diseases. This prospective study aimed at showing the usability of MPV as an inflammation marker in patients with active pulmonary tuberculosis (PTB) by comparing them to healthy controls. Additionally, its relationship with other inflammatory markers such as C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR) as well as with radiological extent of disease was examined. The study included 82 patients with active PTB and 95 healthy subjects (the control group). A whole blood count was done; CRP and ESR levels were compared; and in the PTB group, the relationship of radiological extent of disease with MPV and other inflammation markers was investigated. MPV was 7.74+/-1.33 /muL in the PTB group and 8.2+/-1.13 /muL in the healthy group (p=0.005). The blood platelet count, and the CRP and ESR values were significantly higher in the active PTB group than in the control group (p<0.0001). While radiologic disease extent and MPV had no correlation (p=0.80), the CRP (r=0.26, p=0.003) and ESR levels (r=0.39, p=0.003) were significantly correlated with radiologic disease extent. MPV was found lower in PTB patients than in healthy controls. MPV does not reflect the severity of the disease. Using MPV as an inflammation marker in PTB and assessing it as a negative acute phase reactant do not seem very reliable.
    Multidisciplinary respiratory medicine 02/2014; 9(1):11. DOI:10.1186/2049-6958-9-11 · 0.15 Impact Factor
  • 01/2014; 3(1):21-26. DOI:10.5505/abantmedj.2014.95867
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    ABSTRACT: AIM: Obstructive sleep apnea syndrome (OSAS) may promote hyperglycemia and insulin resistance. Our aim is to investigate the effect of OSAS on the fasting plasma glucose, glycosylated hemoglobin (HbA1c), and C reactive protein (CRP) in nondiabetic patients. MATERIAL AND METHODS: Blood parameters of consecutive 90 non diabetic patients whom polysomnografic evaluations were done in our sleep laboratory was evaluated. Among these 61 patients with normal fasting blood glucose were classified due to their apne-hipopnea index (AHI) as mild (n=16, 26.2%), moderate (n=18, 29.5%) and severe (n=27, 44.2%) OSAS. The fasting plasma glucose, HbA1c and CRP were measured. RESULTS: Mean age of the patients was 47.7±11.2 years, 72% male. HbA1c, fasting glucose levels show positive correlation with BMI (r=.503, P=.00; r=.258, P=.045). No relation of HbA1c to apnea index nor AHI was detected while positive corelation of fasting glucose and CRP was detected (r=.262, P=.042; r=.258, P=.045). HbA1c, fasting glucose and CRP levels show negative correlation with minimum SpO2 levels (by order of r=-.302, P=.018; r=-.368, P=.004; r=-.365, P=.004). HbA1c, fasting glucose levels and CRP levels show positive correlation with mean desaturation index (time duration in which SpO2<90% by pulse oxymeter) (r=.263, P=.041; r=.311, P=.015; r=.283, P=.027). CONCLUSIONS: Although no relation in between increased HbA1c or glucose levels and severity of OSAS was detected in nondiabetic OSAS patients, the correlation with the night hypoxia was detected. This could also show the effect of night time hypoxia on glucose metabolism in OSAS patients.
    Archivos de Bronconeumología 05/2013; 49(8). DOI:10.1016/j.arbres.2013.01.006 · 2.17 Impact Factor
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    ABSTRACT: Angiosarcoma is a rare soft tissue tumour and constitutes less than 1% of all soft tissue cancers. Pleural angiosarcomas are extremely rare and have an aggressive course. We report the case of a 79-year-old female patient who presented with complaints of increasing dyspnoea on exertion and homogeneous opacification of the left hemithorax on chest radiograph. Epithelioid angiosarcoma was determined on pleural tissue obtained by video-assisted thoracoscopic surgery (VATS).
    Journal of the Pakistan Medical Association 02/2013; 63(2):265-7. · 0.40 Impact Factor
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    ABSTRACT: Postintubation stenosis is the most frequent cause of benign tracheal stenosis and may cause reintubation and delay in weaning of intensive care unit patients. This case study describes typical patients with tracheal stenosis and the management of these patients. Five patients requiring reintubation and mechanical ventilation due to early intubation-related stenosis are discussed. Stridor developed in three cases after extubation. In these cases, bronchoscopy revealed tracheal stenosis. Dilatation and silicone stent placement were performed using rigid bronchoscopy. The other two patients were on ventilators when they were admitted to the intensive care unit and their stenoses were also treated by rigid bronchoscopy. Hypercapnia and hypoxia resolved after intervention in three cases. Of the remaining two patients, one had the tracheostomy closed and in the other patient ventilation was stopped but the tracheostomy was maintained. Tracheal stenosis developing in the subglottic region after extubation, especially after exposure to cuff pressure, may lead to reintubation. A tracheostomy may hinder the diagnosis of progressive stenosis and may lead to unnecessary maintenance of ventilator treatment. Early intubation-related tracheal stenosis should therefore be considered in cases of weaning or extubation failure and prompt appropriate investigation and treatment.
    Anaesthesia and intensive care 01/2013; 41(1):108-12. · 1.47 Impact Factor
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    01/2013; 2(1):27-31. DOI:10.5505/respircase.2013.66376
  • 01/2013; 2(1):35-38. DOI:10.5505/respircase.2013.35744
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    ABSTRACT: Tuberculosis may be complicated with empyema and fistula in patients with cellular immune deficiency. The case presented was a 39-year-old male patient with diagnosis of rheumatoid arthritis developed hydropneumothorax while taking steroid and immunosuppressive treatment and examination of pleural fluid revealed acid-fast bacilli. The patient was admitted to the intensive care unit due to respiratory failure and underwent bronchoscopic examination due to air leakage. The right middle lobe was obliterated by using an endobronchial Watanabe Spigot (EWS), and the amount of leakage decreased considerably after the procedure. On day 7, chest tube drainage was removed, and empyema was drained with a Pezzer drain. On day 50, upon the cessation of empyema drainage, spigots were removed with rigid and flexible bronchoscope. In conclusion, EWS use in the treatment of bronchopleural fistula is an effective, safe and a reversible procedure.
    06/2012; 19(2). DOI:10.5761/atcs.cr.11.01760
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    ABSTRACT: ZET Mounier-Kuhn sendromlu olguda malign fibröz histiyositom metastazına bağlı ana hava yolu obstrüksiyonu Malign SUMMARY Central airway obstruction due to malignant fibrous histiocytoma metastasis in a case with Mounier-Kuhn syndrome
    Tuberkuloz ve toraks 06/2012; DOI:10.5578/tt.2458
  • 06/2012; 13(2):79-82. DOI:10.5152/ttd.2012.19
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    ABSTRACT: Cellular immunity abnormalities are associated with sarcoidosis. Normal cellular immunity is required for adequate humoral immunity; therefore, a decreased humoral immune response is possible in patients with sarcoidosis. We evaluated humoral immunity by vaccinating patients with sarcoidosis against tetanus. We screened 60 patients with sarcoidosis (42 females, average age 39 +/- 11 years) and 40 healthy subjects as a control (23 females, average age 38 +/- 9 years). Of the 51 sarcoidosis patients and 33 controls that did not have sufficient tetanus antibody titers, 48 patients and 31 controls agreed to be vaccinated and were included in the vaccination program. Blood serum samples were collected from the subjects before and after vaccination and evaluated for tetanus toxoid IgG antibodies with an enzyme-linked immunosorbent assay (ELISA). As a result of the vaccination, 24 of the sarcoidosis patients (50%) and 7 of the controls (23%) had insufficient antibody responses (p = 0.019). No relationship was found in sarcoidosis patients between the rate of having sufficient antibody levels and disease duration, activation state, and radiographic staging of the disease. Conversely, mean lymphocyte numbers were significantly lower in patients with insufficient tetanus antibody levels (p = 0.013). Tetanus vaccinations in sarcoidosis patients are less effective than in healthy controls, suggesting that patients with sarcoidosis have a hyporesponsive humoral immune system.
    Sarcoidosis, vasculitis, and diffuse lung diseases: official journal of WASOG / World Association of Sarcoidosis and Other Granulomatous Disorders 03/2012; 29(1):3-10. · 1.74 Impact Factor
  • 01/2012; 1(2):37-41. DOI:10.5505/respircase.2012.92485
  • 01/2012; 14(2):84-92. DOI:10.5505/solunum.2012.05902
  • 01/2012; 14(1):14-17. DOI:10.5505/solunum.2012.68736