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2 results on '"Nart D"'

1. Hiler ve mediastinal lenfadenopatilerde nonpalpabl skalen lenf düğümü biyopsisi sonuçları (46 olguluk bir dizi)

Author

SAMANCILAR, Ö., ÇAKAN, A.n., TURHAN, K., ÇAĞIRICI, U., NART, D., and ÖZHAN, M.

Subjects
Hilar,mediastinal,lymph node biopsy, Hiler,mediastinal,lenf düğümü biyopsisi
Abstract

Objective: The purpose of this study is to evaluate the diagnostic value of scalene lymph node biopsy performed in patients with hilar and/or mediastinal lymphadenopathy and/or bilateral parenchymal lesions which could not be diagnosed by other invasive or noninvasive diagnostic procedures during their hospitalization in Department of Chest Diseases. Patients and methods: Between the years 1998-2004, scalene lymph node biopsy was performed under local anesthesia by the same surgical team in 46 patients (28 women, 18 men) with a mean age of 48.72 + 16.40 (2078) and the results are evaluated retrospectively. Results: Histopathological examination results of the specimens obtained by biopsy were as follows: 22 patients (47.9%) had non-caseating granulomatous lymphadenitis, 1 patient (2.1%) had caseating granulomatous lymphadenitis, 1 patient (2.1%) had Hodgkin’s disease and 22 patients (47.9%) had reactive lymph nodes. No complications occured related to the procedure. Conclusion: The diagnostic yield of scalene lymph node biopsy, which can be performed under local anesthesia before more invasive procedures such as mediastinoscopy and videothoracoscopy, was found to be 52.1%. Scalene lymph node biopsy can be performed with almost no morbidity and with less cost but also with a less diagnostic yield when compared to mediastinoscopy and videothoracoscopy, Giriş ve amaç: Göğüs hastalıkları kliniğinde yatmaktayken, uygulanan noninvaziv ve invaziv tanısal yöntemlere karşın tanı konamamış, bilateral parankimal lezyonu ile hiler ya da mediastinal lenfadenopatisi bulunan olgulara uygulanmış skalen lenf düğümü biyopsisinin tanısal verimliliğinin değerlendirilmesi amaçlandı. Gereç ve yöntem: 1998-2004 yılları arasında, 28’i kadın 18’i erkek toplam 46 olguya (yaş aralığı 20-78, ortalama yaş 48.72 ± 16.40), aynı cerrahi ekip tarafından lokal anestezi ile uygulanan skalen lenf düğümü biyopsisi sonuçları retrospektif olarak incelendi. Bulgular: Biyopsi sonucu elde edilen materyallerin histopatolojik incelenmesi sonucunda, olguların 22’sine (% 47.9) nonkazeifiye granülomatöz lenfadenit, 1’ine (% 2.1) kazeifiye granülomatöz lenfadenit, 1’ine (% 2.1) Hodgkin lenfoma tanısı konurken, 22 olguda (% 47.9) sonuç reaktif lenf düğümü olarak rapor edildi. İşlem sonrası olguların hiçbirinde komplikasyon gözlenmedi. Sonuç: Genel anestezi altında uygulanması gereken mediastinoskopi veya videotorakoskopik akciğer biyopsilerinden önce, tanısal incelemeleri süren olgulara, lokal anestezi ile uygulanabilen skalen lenf düğümü biyopsisinin tanısal verimliliği % 52.1 bulundu. Skalen lenf düğümü biyopsisi mediastinoskopi ya da videotorakosopik parankim biyopsilerinden önce uygulanabilecek, maliyeti oldukça düşük, morbiditesi bulunmayan, ancak tanısal verimliliği yukarıda tanımlanan invaziv yöntemlerle kıyaslandığında daha düşük olan bir tanı yöntemidir

Published
2015

2. [The role of endotracheal aspiration in the diagnosis of ventilator associated pneumonia].

Author

Gürgün A, Korkmaz Ekren P, Bacakoğlu F, Başoğlu OK, Dirican N, Aydemir Ş, Nart D, and Sayıner A

Subjects
Aged, Biopsy, Needle, Bronchoalveolar Lavage Fluid microbiology, Female, Humans, Intensive Care Units, Male, Pneumonia, Ventilator-Associated etiology, Pneumonia, Ventilator-Associated microbiology, Retrospective Studies, Suction adverse effects, Pneumonia, Ventilator-Associated diagnosis, Respiration, Artificial adverse effects, Respiratory Aspiration complications
Abstract

Introduction: Ventilator associated pneumonia (VAP) is one of the most important causes of mortality in patients treated with invasive mechanical ventilation (IMV) in intensive care unit (ICU). Microbiological examinations are required as clinical and radiological findings are usually insufficient in the diagnosis., Materials and Methods: Twenty four patients who were receiving IMV because of respiratory failure, had a Clinical Pulmonary Infection Score (CPIS) of ≥ 6 in the follow-up and died with the suspicion of VAP were enrolled in our study. Six patients were excluded as post-mortem biopsy could not be performed. The patients who had pre-mortem CPIS ≥ 6, in whom a causative organism was identified from the culture of post-mortem lung biopsy and/or histopathological examination of lung biopsy was compatible with pneumonia were diagnosed as VAP. In the 18 patients in whom a post-mortem lung biopsy was performed, quantitative culture results of endotracheal aspirate performed 48 hours prior to death were compared with microbiological and histopathological results of post-mortem lung biopsy specimens, and the role of endotracheal aspirate in the diagnosis of VAP was evaluated retrospectively., Results: Out of 18 patients (12 men, mean age 67.0 ± 13.0 years) included in the study, 11 (61.1%) were diagnosed as VAP. The quantitative culture of endotracheal aspirate was positive in 9 (81.8%) out of 11 patients diagnosed as VAP. The sensitivity, specificity, positive and negative predictive values of endotracheal aspirate culture for identifying VAP were found to be 81.8%, 14.3%, 60.0% and 33.3%, respectively., Conclusion: Our study shown that quantitative culture of endotracheal aspirate is a practical and reliable method that can be used for the diagnosis of VAP in patients receiving IMV in ICU and having CPIS ≥ 6.

Published
2013
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