Researcher: Tabak, Levent
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Tabak, Levent
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Publication Metadata only A rare case of right sided pulmonary artery agenesis associated with congenital mitral valve prolapse(Turkish Assoc Tuberculosis & Thorax, 2016) N/A; N/A; İliaz, Sinem; Aslan, Gamze; Öztürk, Ayşe Bilge; Özyiğit, Sabiha Leyla Pur; Tabak, Levent; Doctor; Doctor; Faculty Member; Doctor; Faculty Member; N/A; N/A; School of Medicine; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; N/A; Koç University Hospital; N/A; N/A; N/A; 147629; 214687; N/AN/APublication Metadata only Palliative care needs of the cancer patients receiving active therapy(Springer, 2022) Bağçivan, Gülcan; Seven, Memnun; Selçukbiricik, Fatih; Paşalak, Şeyma İnciser; Bilmiç, Ezgi; Tabak, Levent; Faculty Member; Faculty Member; Faculty Member; PhD Student; Master Student; N/A; N/A; Faculty Member; School of Nursing; School of Nursing; School of Medicine; Graduate School of Health Sciences; Graduate School of Health Sciences; N/A; N/A; School of Medicine; 261422; 32470; 202015; 125009; N/A; N/A; N/A; 167625Purpose To identify cancer patients' palliative care needs with problem burden, problem intensity, and felt needs related to these problems while receiving cancer treatment. Methods This is a descriptive survey study conducted at a tertiary hospital with no palliative care services in Istanbul, Turkey, from September 2019 to February 2020. Data were collected using the Patient Information Form and the Three Levels of Needs Questionnaire (3LNQ). Descriptive statistics (frequency and percentage) were used to present data. Results The mean age of patients was 60.2 +/- 13.0, and the mean duration since the diagnosis was 11.6 +/- 21.4 months. Of the patients, 40.4% were diagnosed with gastrointestinal (GI) cancer, and 34.4% had stage 4 cancer. Patients mostly received help for their pain (85.7%), lack of appetite (64.8%), and nausea (73/7%). The most frequent unmet needs were problems with concentration (70%), worrying (68%), difficulties with sex life (63.6%), problems with being limited in work and daily activities (61.4%), and being depressed (58.5%) among patients who reported to have these symptoms. Conclusion This study shows that patients with cancer require supportive and palliative care along with medical treatment for cancer and its treatment-induced physical and psychological symptoms. The study results have the potential to guide the development of palliative care services, especially for outpatient oncology settings in countries where palliative care services mostly focus on the end-of-life care. Further studies are also needed to focus on interventions to meet cancer patients' palliative care needs during the medical cancer treatment process with tailored palliative care delivery models.Publication Metadata only The role of atopy in the pathogenesis of bleomycin pulmonary toxicity(W B Saunders Co Ltd, 2019) Atas, Esin Cetin; Deniz, Gunnur; N/A; Özyiğit, Sabiha Leyla Pur; Şenbaş, Zarif Asucan; Öztürk, Ayşe Bilge; Öztürk, Erman; Ergönül, Önder; Tabak, Levent; Ferhanoğlu, Ahmet Burhan; Çetiner, Mustafa; Doctor; Undergraduate Student; Faculty Member; Doctor; Faculty Member; Faculty Member; Faculty Member; Faculty Member; N/A; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; Koç University Hospital; N/A; N/A; N/A; N/A; 214687; N/A; 147629; N/A; 110398; 167625; 18320; N/AIntroduction: Bleomycin pulmonary toxicity (BPT) is a potentially life-threatening consequence of bleomycin usage in patients. An overproduction of epithelium-derived cytokines, habitually linked to allergic inflammation, has been recently revealed in experimental models of BPT. Methods: We assessed retrospectively our cohort of patients with Hodgkin Lymphoma treated with bleomycin between 2014 and 2016 for their demographic, clinical features, including BPT development, atopy status and risk factors for BPT. Then they were invited for allergy testing and blood sample collection. The samples were stimulated with different stimuli (Bleomycin, IL-33, TSLP) for 24 h on cell culture. The culture supernatants were analysed for TGF-beta, Galectin3, Arginin, Amphiregulin, Eotaxin, IFN gamma, TNF alpha, IL1 beta, 4, 5, 6, 10, 13, 17, MIP-1 alpha, and bleomycin hydrolase (BLH) levels. Results: The cohort consisted of 51 patients showed that atopy was the only significant risk factor for BPT occurrence (OR: 7.2, p=0.007). Fourteen subjects were included for blood analysis. The analysis of supernatants at the unstimulated condition revealed that BLH and Amphiregulin were significantly lower in patients who had BPT than controls. The BLH cut-off that best identified a history of BPT was 175.31 (Sensitivity: 62.5%, specificity: 100%). Following the stimulation, BLH reduced compared to the unstimulated condition and the difference between groups remained significant (p < 0.05). Conclusion: Our study is the first to report that low levels of bleomycin hydrolase in allergic individuals may be predisposing to a possible pathway of fibrosis.Publication Metadata only Characteristics of the patients with sarcoidosis diagnosed by labial biopsy(European Respiratory Soc Journals Ltd, 2013) Okumuş, Gülfer; Akbay, Nilay Orak; Bingöl, Züleyha; Özlük, Yasemin; Yılmazbayhan, Dilek; Erkan, Feyza; Cağatay, Tülin; Kılıçaslan, Zeki; Kıyan, Esen; Tabak, Levent; Faculty Member; School of Medicine; Koç University Hospital; 167625Introduction: The labial biopsy is a minimal invasive method which is used for the diagnosis of sarcoidosis. A few studies reported that labial biopsy is an important diagnostic method for differantiating sarcoidosis from tuberculosis or Sjogren’s syndrome. However, characteristics of the patients who were diagnosed sarcoidosis by labial biopsy have not been clearly defined. The aim of this study was to identify the characteristics of the sarcoidosis patients who diagnosed with labial biopsy. Material and Method: This retrospective study included 32 patients (25F,7M, age=44years). While 40% of them were asymptomatic, the most common symptoms were cough, weakness and weight loss. According to the radiology 62% of the patients had stage II, 31% stage I, 7% stage III. Pulmonary function tests and DLCO were normal at 70% of the patients (mean FVC=3040ml). There was no extrapulmonary involvement in 43% of the patients. The most common extrapulmonary involvement was eye (28%). Diagnosis was based on clinical, radiological findings and labial biopsy in 65% of the patients. The other organ biopsies (liver, skin, lung, abdominal and mediastinal lymphadenopathy) had also been positive in addition to the labial biopsy in 11 patients. Bronchoscopy performed to ten patients. Five of them had diagnostic biopsy and the others diagnosed by labial biopsy. Corticosteroids were given to 31% of the patients with the mean duration of 6-12 months. Conclusion: Labial biopsy is a minimal invasive, easy attainable method and this method should be used for the diagnosis of stage I and II sarcoidosis with clinical and radiological correlation.Publication Metadata only Human metapneumovirus infection: diagnostic impact of radiologic imaging(Wiley, 2019) Keske, Şiran; Gümüş, Terman; Koymen, Tamer; Sandikci, Sunay; N/A; Tabak, Levent; Ergönül, Önder; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 167625; 110398Background: Human metapneumovirus (hMPV) is a recently detected virus, which can cause mild to severe respiratory tract infections. Through this study, we aimed to detail the outcomes of hMPV infections. Materials/methods: Between January 2012 and November 2017, patients who had hMPV detected in nasopharyngeal or bronchoalveolar lavage by molecular respiratory pathogen tests were evaluated. The Food and Drug Administration cleared multiplexed-polymerase chain reaction system (Idaho Technology, Salt Lake City, UT) was used for diagnosis. Chest radiography (CR) and computed tomography (CT) were evaluated by an expert radiologist. Results: In total 100 patients were included, the mean age was 22.9 (0-87) years, and 50% were male. The hospitalization rate was 52%. Lower respiratory system infection (LRTI) was diagnosed in 44 patients with clinical findings, and in 31 patients out of 44 the radiological findings supported the diagnosis. The LRTI rate was significantly higher in adults than children (66.7%-32.8%; P = 0.001). In CR, peribronchovascular infiltration (PI) was the most common feature seen in 14 out of 18 patients and was generally bilateral (13 out of 18 patients). In CT imaging, ground-glass opacity was the most common finding seen in 11 out of 16 patients and nodular consolidation in five patients. Ribavirin was given to four patients, three of whom were severe and required respiratory support. None of the patients died of hMPV infection. Conclusions: The ground-glass opacity in CT was similar to other respiratory virus infections, and PI in CR was very common and typical; however, nodular consolidation that may mimic bacterial infection was seen in one-fourth of CT.Publication Metadata only A case of uncontrolled severe asthma patient with coexisting carcinoid tumor presenting as pneumomediastinum(Taylor & Francis Ltd, 2015) N/A; N/A; N/A; N/A; N/A; N/A; N/A; Biçer, Elifnur; Öztürk, Ayşe Bilge; Özyiğit, Sabiha Leyla Pur; Erus, Suat; Tanju, Serhan; Dilege, Şükrü; Tabak, Levent; Undergraduate Student; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; 147629; 214687; 175565; 214690; 122573; 167625Introduction: Patients with inadequately controlled or uncontrolled asthma are at a greater risk of attacks for asthma requiring emergency room visits or hospital admissions. There is a significant correlation between the severity of the disease and the severity of exacerbations. Patients with poorly controlled asthma are at a higher risk for complications. Case study: We present a 24-year-old aspirin-intolerant, uncontrolled asthma patient with the complication of pneumomediastinum. Results: Severe symptoms persisted after the resolution of the pneumomediastinum despite intense anti-inflammatory and anti-obstructive therapy. A bronchoscopy revealed an endobronchial lesion and she was diagnosed with a carcinoid tumor. Conclusion: This case is an example of the importance of re-evaluating asthma patients who do not respond to standard medical treatment. Clinicians should be aware of the complications associated with asthma attacks such as pneumomediastinum and the possibility of a differential diagnosis that worsen asthma symptoms such as a carcinoid tumor.Publication Metadata only Reporting adverse drug reactions in a Tertiary Care Hospital in Istanbul(Bilimsel Tip Publishing House, 2018) Şener, Ülker; Özyıldırım, Aslı; N/A; Öztürk, Ayşe Bilge; Özyiğit, Sabiha Leyla Pur; İliaz, Sinem; Çağlayan, Benan Niku; Tabak, Levent; Faculty Member; Doctor; Doctor; Faculty Member; Faculty Member; School of Medicine; N/A; N/A; School of Medicine; School of Medicine; N/A; Koç University Hospital; Koç University Hospital; N/A; N/A; 147629; 214687; 230719; N/AN/APublication Open Access Isolated omental metastasis of renal cell carcinoma after extraperitoneal open partial nephrectomy : a case report(Elsevier, 2016) Sağlıcan, Yeşim; N/A; N/A; N/A; N/A; Acar, Ömer; Sağ, Alan Alper; Falay, Fikri Okan; Selçukbiricik, Fatih; Tabak, Levent; Esen, Tarık; Faculty Member; Faculty Member; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; School of Medicine; 237530; N/A; N/A; N/A; N/A; N/A; 50536INTRODUCTION: Metachronous metastatic spread of clinically localized renal cell carcinoma (RCC) affects almost 1/3 of the patients. They occur most frequently in lung, liver, bone and brain. Isolated omental metastasis of RCC has not been reported so far. CASE PRESENTATION: A 62-year-old patient previously diagnosed and treated due to pulmonary sarcoidosis has developed an omental metastatic lesion 13 years after having undergone open extraperitoneal partial nephrectomy for T1 clear-cell RCC. Constitutional symptoms and imaging findings that were attributed to the presence of a sarcomatoid paraneoplastic syndrome triggered by the development this metastatic focus complicated the diagnostic work-up. Biopsy of the [18F]-fluorodeoxyglucose (+) lesions confirmed the diagnosis of metastatic RCC and the patient was managed by the resection of the omental mass via near-total omentectomy followed by targeted therapy with a tyrosine kinase inhibitor. DISCUSSION: Late recurrence of RCC has been reported to occur in 10-20% of the patients within 20 years. Therefore lifelong follow up of RCC has been advocated by some authors. Diffuse peritoneal metastases have been reported in certain RCC subtypes with adverse histopathological features. However, isolated omental metastasis without any sign of peritoneal involvement is an extremely rare condition. CONCLUSION: To our knowledge, this is the first reported case of metachronously developed, isolated omental metastasis of an initially T1 clear-cell RCC. Constitutional symptoms, despite a long interval since nephrectomy, should raise the possibility of a paraneoplastic syndrome being associated with metastatic RCC. Morphological and molecular imaging studies together with histopathological documentation will be diagnosticPublication Open Access Appropriate use of tocilizumab in COVID-19 infection(Elsevier, 2020) Keske, Şiran; Sait, Bilgin; Çimen, Cansu; Çelebi, İrfan; Palaoğlu, Erhan; N/A; Tekin, Süda; İrkören, Pelin; Kapmaz, Mahir; Ergönül, Önder; Uğur, Semra; Şentürk, Evren; Çakar, Nahit; Çağlayan, Benan Niku; Tabak, Levent; Bakır, Veli Oğuzalp; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; Graduate School of Sciences and Engineering; N/A; N/A; N/A; 110398; N/A; 48359; N/A; 230719; N/A; N/AObjective: this study aimed to describe the effectiveness and optimum use of tocilizumab (TCZ) treatment by the support of clinical, laboratory and radiologic observations. Methods: all patients were followed up in the hospital with daily interleukin-6 (IL-6), C-reactive protein (CRP), ferritin, D-dimer, full blood count, and procalcitonin. Thoracic computed tomography (CT) was performed on admission, when oxygen support was necessary, and seven days after TCZ started. Disease course of the patients was grouped as severe or critical, according to their clinical, laboratory and radiologic evaluations. Results: forty-three patients were included: 70% were male; the median age was 64 years (minimum– maximum: 27–94); and six (14%) patients died. The median duration of oxygen support before the onset of TCZ was shorter among the severe patient group than the critical patient group (1 vs. 4 days, p < 0.001). Three cases of 21 (14%) who received TCZ in the ward were transferred to ICU, and none of them died. The levels of IL-6, CRP, ferritin, D-dimer, and procalcitonin were significantly lower in the severe cases group than the critical cases group (p = 0.025, p = 0.002, p = 0.008, p = 0.002, and p = 0.001, respectively). Radiological improvement was observed in severe cases on the seventh day of TCZ. Secondary bacterial infection was detected in 41% of critical cases, but none of the severe ones. Conclusion: earlier use of TCZ in COVID-19 infection was beneficial for survival, length of hospitalization and duration of oxygen support. The recommendation for administration of TCZ was based on an increase in requirement of oxygen support, progression in thoracic CT, and elevation of inflammation markers, including IL-6, CRP, ferritin, and D-dimer, and decrease in % lymphocytes.Publication Open Access Bortezomib induced pulmonary toxicity: a case report and review of the literature(e-Century Publishing Corporation, 2020) Kalyon, Hakan; Özbalak, Murat; Örnek, Serdar; Keske, Şiran; Zeren, Handan; Kurtoğlu, Burçin Sağlam; Tabak, Levent; Çakar, Nahit; Aytekin, Saide; Bölükbaşı, Yasemin; Ferhanoğlu, Ahmet Burhan; Faculty Member; Faculty Member; Doctor; Faculty Member; Faculty Member; School of Medicine; Koç University Hospital; N/A; N/A; 198906; N/A; 216814; 18320Bortezomib is widely used in the treatment of Multiple Myeloma. While the most common side effects are neurological and gastrointestinal related complications, severe pulmonary problems are rarely described. The present case is a 72-year old male with multiple myeloma, who received Lenalidomide, Bortezomib, and Dexamethasone (RVD) combination regimen. He underwent 30 Gy palliative radiotherapy to the thoracic 5-9 and lumbar L1-3 vertebra due to pain and fracture risk. During the third cycle, he was admitted to hospital with dyspnea and dizziness. The thoracic CT revealed bilateral pleural effusions, a diffuse reticular pattern on the parenchyma, and ground-glass opacities that were compatible with drug-induced lung injury. The microbiological and molecular analysis excluded infectious disease, and lung biopsy confirmed the diagnosis of Bortezomib Lung Injury. The time from the first dose of Bortezomib to the lung injury was 57 days, and it was five days from the last dose of Bortezomib. His symptoms were refractory to IV steroids and supportive care. Our patient was lost despite steroids and intensive care support. Even Bortezomib induced lung injury is a rare adverse effect, based on high mortality rate, we would like to emphasize the clinical importance of this clinical scenario in light of the published literature and our presented case.