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ABSTRACT: Introduction Chronic obstructive pulmonary disease (COPD) may cause some psychiatric disorders such as depression and anxiety, similar to other chronic diseases. Treatment adherence may be affected by worsening of cognitive functions. We aimed to show whether the symptoms of anxiety and depression affect treatment adherence by patients. Method Seventy-eight COPD patients were analysed at the first visit. The use of bronchodilator therapy was revised for standardization before they attended a second visit after six months. Hospital Anxiety and Depression Scale (HADS), Anxiety Sensitivity Index-3 (ASI-3) and SF-36 Questionnaire were carried out at that visit. 'National Guide of Turkish Thoracic Society for Asthma' was used for scoring method of use of the bronchodilator and evaluating treatment adherence (including maintenance therapy). RESULTS: Sixty-two of 78 patients, 53 (85.5%) men and nine (14.5%) women with a mean age of 64.9 ± 9.9 joined the second visit. Thirty-three patients (53.2%) had a high-treatment adherence (HTA), whereas 29 (46.8%) had a low-treatment adherence (LTA). There were high scores of anxiety in 18 (29%) and depression in 11 (17.7%) patients. There was no statistical difference between the HTA and LTA groups in means of age, gender, educational level, presence of comorbidity, classification of COPD, high anxiety scores according to HADS and ASI-3 scores. Of the patients, 41.4% in the LTA group were still smoking, whereas it was only 12.1% in the HTA group (P = 0.009). The LTA group had higher depression scores (P = 0.004) than the HTA group. Dyspnea was found more frequent in LTA patients (P = 0.047); vitality score was also statistically low in this group (P = 0.01). CONCLUSION: As a result, continuing smoking and the presence of depression symptoms may decrease adherence to treatment. Therefore, to increase the adherence to treatment and reduce symptoms such as dyspnea, it is important to treat any depressive symptoms that are present and to help patients cease smoking.
Primary Health Care Research & Development 04/2013;
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ABSTRACT: Introduction: The aim of this study is to assess the opinions of relatives about telling the lung cancer diagnosis to the patient and evaluate the implementation in our hospital. Materials and Methods: A survey questionnaire was designed, and applied on nurses and physicians working in oncology care units, 4th-6th grade medical students, and relatives of cancer and non-cancer patients. Results: Totally 347 (228 males, 119 females) participants (64 physicians, 100 nurses, 61 medical students, and 122 relatives of patients) with a mean age of 28 were enrolled in the study. 62.5% of doctors, 53.2% of nurses, 59.5% of medical students and 45.9% of relatives of lung cancer patients thought that the patient should be informed about his/her cancer diagnosis. 29.5% of the physicians told their patients about their diagnosis of cancer. Gender, age, abroad experience, academic career, speciality, and period of professional experience were not determined to have any impact on physician's opinion and clinical practices. Conclusion: It was determined that physicians care more about patients' right to be informed than other participating groups. Generally, although physicians agree that the diagnosis of cancer should be told to the patient, their routine clinical practices do not reflect this viewpoint.
Tuberkuloz ve toraks 12/2012; 60(4):336-43.
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ABSTRACT: Left ventricular diastolic dysfunction (LVDD) develops in the early stages of acromegaly. The purpose of this study was to identify LVDD analyzing by new echocardiograpic criteria as well as to evaluate determinants of the LVDD in acromegaly. This cross-sectional study examined 42 patients with acromegaly; 16 in active disease (AA) and 26 cured/ well controlled (CA), and compared them with 30 healthy controls (CG). Ventricular systolic and diastolic functions were studied by conventional and tissue Doppler imaging based on the E/Em ratio and myocardial performance index (MPI). Other clinical parameters possibly contributing to LVDD in acromegaly were also investigated. The prevalence of LV hypertrophy (33%) and LVDD (35.7%) were increased in acromegaly, however, there were no differences between the AA and CA groups. Acromegalic patients had higher LV volumes and LV mass, and septal E/Em ratio compared to CG, whereas LV ejection fraction and MPI were not different. The presence of acromegaly (r = 0.29, P = 0.013), diabetes mellitus (DM) (r = 0.41, P < 0.001), hypertension (r = 0.35, P = 0.002), and sleep apnea (r = 0.56, P = 0.003) were found to be correlated with LVDD, whereas duration and activity of acromegaly were not. In regression analysis, advanced age (OR: 8.53, P = 0.006) and DM (OR: 25.9, P = 0.007) were found to be independent risk factors for LVDD. The risk of LVDD according to new criteria increases in acromegaly. However, it seems to be related to the presence of DM and advanced age and is independent of disease duration and activity.
International Heart Journal 01/2012; 53(5):299-305. · 1.16 Impact Factor
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ABSTRACT: The aim of the study was to assess the effect of breathing and physical exercise on pulmonary functions, apnea-hypopnea index (AHI), and quality of life in patients with obstructive sleep apnea syndrome (OSAS).
Twenty patients with mild to moderate OSAS were included in the study either as exercise or control group. The control group did not receive any treatment, whereas the exercise group received exercise training. Exercise program consisting of breathing and aerobic exercises was applied for 1.5 h 3 days weekly for 12 weeks. Two groups were assessed through clinical and laboratory measurements after 12 weeks. In the evaluations, bicycle ergometer test was used for exercise capacity, pulmonary function test, maximal inspiratory-expiratory pressure for pulmonary functions, polysomnography for AHI, sleep parameters, Functional Outcomes of Sleep Questionnaire (FOSQ), Short Form-36 (SF-36) for quality of sleep and health-related quality of health, Epworth Sleepiness Scale for daytime sleepiness, and anthropometric measurements for anthropometric characteristics.
In the control group, the outcomes prior to and following 12-weeks follow-up period were found to be similar. In the exercise group, no change was found in the anthropometric and respiratory measurements (P > 0.05), whereas significant improvements were found in exercise capacity, AHI, and FOSQ and SF-36 (P < 0.05). After the follow-up period, it was shown that improvement in the experimental group did not lead to a statistically significant difference between the two groups (P > 0.05).
Exercise appears not to change anthropometric characteristics and respiratory functions while it improves AHI, health-related quality of life, quality of sleep, and exercise capacity in the patients with mild to moderate OSAS.
Sleep And Breathing 11/2009; 15(1):49-56. · 1.84 Impact Factor
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07/2009; 26(3):279-280.
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ABSTRACT: To determine the predominant pulmonary function abnormality in overweight and moderately obese subjects and to evaluate the correlation between the severity of lung function impairment and the degree of obesity.
Fifty-three volunteers underwent physical examination, skin fold measurements, and standardized pulmonary function tests. Thirty-one women and 22 men with a mean age of 40.2 (18-66) years were studied.
The reduction in functional residual capacity (FRC) and expiratory reserve volume (ERV) were the most common abnormalities in overweight and obese subjects. The reduction in static lung volume was correlated with the degree of obesity in women and men. Stepwise multiple regression coefficients were obtained separately for women and men. Subscapular skinfold was the best predictor in women for FRC and waist-to-hip ratio (WHR) and BMI were found the best for ERV. WHR was found predictive for forced vital capacity, total lung capacity, and FRC in men.
The lung volumes are substantially affected in our overweight and obese subjects. This influence is focused on different parameters of respiratory functions in men and women in relation to body fat distribution.
Southern medical journal 01/2009; 102(1):30-5. · 0.92 Impact Factor
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ABSTRACT: Since 1939, it has been known that, silicosis and extrinsic allergic alveolitis can be seen among dental technicians. The interstitial disease caused by the exposure to complex substances used by dental technicians is classified as a special group called dental technician's pneumoconiosis. A 36-year-old man, who has no smoking history, presented with severe dyspnea. He had worked in different dental laboratories for 22 years, but he did not have respiratory symptoms until five years ago. After that date, he had hospitalized and had been examined for respiratory pathologies for many times. He had came to our clinic, because of the progression of his dyspnea. Diffuse pulmonary parenchymal infiltrates which can be related with pneumoconiosis and chronic type 1 respiratory deficiency had been diagnosed as the result of the examinations. While he has no history of smoking or any other risk factors or diseases in his medical history, the case was accepted as dental technician's pneumoconiosis. The factors related with the pathogenesis of dental technician's pneumoconiosis are; the complex compound of the substances (metal dusts, silica, plaster, wax and resins, chemical liquids, methyl methacrylate) used in this sector and their effects on the lung parenchyma. Extrinsic allergic alveolitis related with methyl methacrylate has been reported. The most important factor to acquire an occupational lung disease is a complex occupational exposure. The insufficient workplace airing and the lack of preventive measures added on this exposure, the risks become much more greater.
Tuberkuloz ve toraks 05/2008; 56(2):204-9.
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ABSTRACT: Several co-morbid diseases have been shown to affect sexual functions in both genders. In the literature, sexual function status in men with obstructive sleep apnea syndrome (OSAS) has been studied; however, sexual functions in women with OSAS have not yet been studied.
In this prospective study, we aimed to determine sexual function status in women with OSAS and its relationship with the disease parameters of OSAS.
Women, who were diagnosed with OSAS with polysomnography performed in the sleep center of our university hospital, formed the study population. Women with any genital deformity, postmenopausal women, and women without a regular partner were excluded from the study. General demographic properties, medical histories, polysomnography parameters, and frequency of intercourse per month were noted for each patient. Patients completed the Sexual Function Questionnaire Version 2 (SFQ-V2) and Epworth Sleepiness Scale. The patients were grouped as mild, moderate, and severe OSAS according to the level of respiratory disturbance index (RDI).
Scores of sexual function domains were determined from SFQ, and their relationships with parameters of polysomnography and demographics were studied.
Twenty-five patients were included in the study. Mean age was 48.1 +/- 2.7 years. All were married with a mean marriage duration of 25.6 +/- 3.3 years. Mean frequency of intercourse per month was 3.3 +/- 1.8. All domains of sexual functions except pain and enjoyment significantly decreased with increasing severity of OSAS. When we controlled for factors of age and co-morbid diseases, correlation analyses showed significant negative correlation between levels of RDI and all domains of sexual functions except pain and enjoyment (P < 0.05).
Obstructive sleep apnea syndrome negatively impacts sexual function in women independent of age and associated co-morbid diseases.
Journal of Sexual Medicine 10/2007; 4(5):1352-7. · 3.55 Impact Factor
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Can Sevinç,
Sibel Sahbaz,
Ulker Uysal,
Oğuz Kilinç,
Hülya Ellidokuz, Oya Itil,
Zeynep Gülay,
Sedat Yunusoğlu,
Serdar Sargun,
Kürşat Kaan Akkoyun,
Eyüp Sabri Uçan
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ABSTRACT: Nosocomial infections are an important cause of preventable morbidity and mortality; they also result in significant socioeconomic cost. Nosocomial pneumonia (NCP) is defined as pneumonia, which occurs 48 hours after hospitalization or after discharge from the hospital. It is the second or third most frequent infection among all hospital acquired infections, and the mortality of NCP is higher than the other hospital acquired infections. Patients, diagnosed as NCP were retrospectively analyzed in order to detect microbiological agent and prognostic factors. We evaluated 173 patients, 67.0% of them were male and 33.0% female. Comorbid diseases were present in 94.2% and a medical procedure had been applied in 75.1% of cases. A single agent was isolated in 79.2% of the cases while a mixt infection was present in 13.3%. In 7.5% of the cases, cultures were negative. Endotracheal aspirates were the most common materials (38.9%) used for detected microorganism and sputum cultures were used in 16.8% of the cases. Most commonly encountered microorganism were Pseudomonas aeruginosa, Acinetobacter spp. and Staphylococcus aureus respectively. NCP developed on approximately 18th day of hospitalization. Overall mortality rate was 45.2%. The effects of diabetes mellitus and chronic pulmonary diseases on mortality rate were analized by logistic regression analysis and it's evaluated that the mortality rates increase 3.7 times with diabetes mellitus and 2.4 times with chronic pulmonary diseases. There was no effect of mechanical ventilation history on mortality.
Tuberkuloz ve toraks 02/2007; 55(2):153-9.
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ABSTRACT: This study was carried out with 127 asthmatic patients and 127 controls, which aimed to compare and evaluate the environmental conditions in the homes of asthmatic patients and the control group. Air samples were obtained by using an air sampler and the mean mould colony counts were established. Aspergillus and Penicillium were the most common isolated species. No significant difference was observed with regard to various house conditions and the mean mould colony counts between the houses of patients and controls. The mould colony counts were found to be lower in houses with wooden parquet flooring. The odds ratio for stone floors vs. wood floors was 2.3 (95% CI 1.08-4.98) for mould growth.
Journal of Asthma 01/2007; 43(10):789-94. · 1.52 Impact Factor
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ABSTRACT: Task-based learning (TBL) is an educational strategy recommended for the later years of the medical education programme. The TBL programme was adopted for clinical years in the 2000-2001 academic year in Dokuz Eylul University School of Medicine (DEUSM).
The aim of this paper is to describe the TBL programme of DEUSM.
DEUSM outlined 50 clinical tasks for fourth-year students and 37 for fifth-year students. The tasks were grouped into four and five blocks. Interdisciplinary practicals, lectures and patient visits were organised in each task's schedule. The tasks were the focus of learning and each discipline contributed its own learning opportunities to the attached tasks. Formative and summative methods were used to evaluate the programme.
Based on the experience and feedback provided by the students and trainers, the authors considered TBL an applicable and advisable approach for the clinical years of medical education.
Education for Health 04/2006; 19(1):32-42.
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Aylin Gülcü,
Can Sevinç,
Nuran Esen,
Oğuz Kilinç,
Eyüp Sabri Uçan, Oya Itil,
Arif Hikmet Cimrin,
Nuray Kömüs,
Gülper Sener,
Atila Akkoçlu,
Zeynep Gülay,
Mine Yücesoy
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ABSTRACT: Between 2001-2002; in 62 cases, 33 (53%) male, 29 (47%) female, mean age 51.4 +/- 18.1 years) bronchoalveolar lavage (BAL) was performed for diagnosis of opportunistic pulmonary infection and specimens were evaluated for results of microbiological examinations. There was hematological malignancy in 18 (29%) and solid organ malignancy in 13 (21%) cases. Thirty-one (50%) cases were immunocompromised for reasons other than malignancy. By endoscopic evaluation endobronchial lesion was seen in 2 (3%) cases, indirect tumor signs were seen in 2 (3%) cases and signs of infection were seen in 11 (18%) cases. Forty-even (76%) cases were endoscopically normal. Acid-fast bacilli (AFB) direct examination was positive in 3 (5%) cases. In 4 (6%) cases mycobacterial culture was positive, Mycobacterium tuberculosis-polymerase chain reaction (PCR) was also positive in these four cases. Examination of gram-stained smears for bacteria was associated with infection in 14 (23%) cases. Bacteriologic cultures were positive for single potential pathogen in 10 (16%) cases, and for mixed pathogens in 7 (11%) cases for a total number of 17 (27%). Fungal cultures were positive in 3 (5%) cases all of which had hematological malignancy. As a result in 24 (39%) cases microbiological agent of infection is determined: in four mycobacteria, in 17 bacteria other than mycobacteria and in three fungi.
Tuberkuloz ve toraks 02/2006; 54(3):249-53.
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ABSTRACT: Endobronchial metastases (EBM) from extrapulmonary malignant tumors are rare. The most common extrathoracic malignancies associated
with EBM are breast, renal and colorectal carcinomas. In this study, we aimed to evaluate the clinical, radiographic and bronchoscopic
aspects of patients with EBM who were diagnosed between 1992 and 2002. Data about patients’ clinical conditions, symptoms,
radiographic and endoscopic findings, and histopathological examination results were investigated. EBM was defined as bronchoscopically
visible lesions histopathologically identical to the primary tumor in patients with extrapulmonary malignancies. We found
15 cases with EBM. Primary tumors included breast (3), colorectal (3), and renal (2) carcinomas; Malignant Melanoma (2); synovial
sarcoma (1), ampulla of Vater adenocarcinoma (1), pheochromocytoma (1), hypernephroma (1), and Hodgkin’s Disease (1). The
most common symptoms were dyspnea (80%), cough (66.6%) and hemoptysis (33.3%). Multiple (40%) or single (13.3%) pulmonary
nodules, mediastinal or hilar lymphadenopathy (40%), and effusion (40%) were the most common radiographic findings. The mean
interval from initial diagnosis to diagnosis of EBM was 32.8months (range, 0–96months) and median survival time was 18months
(range, 4–84). As a conclusion, various extrapulmonary tumors can metastasize to the bronchus. Symptoms and radiographic findings
are similar with those in primary lung cancer. Therefore, EBM should be discriminated from primary lung cancer histopathologically.
Although mean survival time is usually short, long-term survivors were reported. Consequently, treatment must be planned according
to the histology of the primary tumor, evidence of metastasis to other sites and medical status of the patient.
Clinical and Experimental Metastasis 10/2005; 22(7):587-591. · 3.52 Impact Factor
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Tuncay Goksel,
Osman Nuri Hatipoglu,
Can Ozturk,
Metin Gorguner,
Murat Kiyik,
Ugur Yilmaz,
Asuman Guzelant,
Sezai Tasbakan,
Erhan Tabakoglu,
Hikmet Firat,
Umit Tutar,
Sadettin Cikrikicioglu,
Atila Akkoclu,
Serdar Soyer,
Ebru Cakir, Oya Itil,
Salahattin Sanal
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ABSTRACT: Cisplatin-gemcitabine (PG) and cisplatin-etoposide (PE) combinations are active regimens for non-small cell lung cancer (NSCLC). The present study aimed to compare PG with PE in the treatment of patients with stage IIIB and IV NSCLC.
We conducted a prospective, multicentre trial. A total of 166 patients were enrolled into the study and received either gemcitabine (1,000 mg/m(2)) on days 1, 8 and 15 plus cisplatin (80 mg/m(2)) on day 2 every 4 weeks, or etoposide (100 mg/m(2)) on days 1, 2 and 3 plus cisplatin (80 mg/m(2)) on day 1 every 3 weeks.
The overall response rate was superior in the PG group (54.8%vs 39.0%, P=0.045). There was no significant difference in survival between the two groups, with respective median and 1-year survival of 38 weeks and 33.3% for the PG group, and 34 weeks and 23.2% for the PE group. There was also no statistical difference for time to progression between the two groups. Neutropenia and thrombocytopenia were seen more frequently in the PG group (grade 3 neutropenia, 33.3%vs 15.9%, P=0.012; grade 3 thrombocytopenia, 27.4%vs 3.7%, P<0.001 and grade 4 thrombocytopenia, 10.7%vs 1.2%, P=0.018).
PG is an active chemotherapy regimen and has a better response rate than PE in advanced NSCLC, although there was no difference in time to progression and overall survival. A higher incidence of haematological toxicity was seen with PG than with PE.
Respirology 09/2005; 10(4):456-63. · 2.42 Impact Factor
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ABSTRACT: Endobronchial metastases (EBM) from extrapulmonary malignant tumors are rare. The most common extrathoracic malignancies associated with EBM are breast, renal and colorectal carcinomas. In this study, we aimed to evaluate the clinical, radiographic and bronchoscopic aspects of patients with EBM who were diagnosed between 1992 and 2002. Data about patients' clinical conditions, symptoms, radiographic and endoscopic findings, and histopathological examination results were investigated. EBM was defined as bronchoscopically visible lesions histopathologically identical to the primary tumor in patients with extrapulmonary malignancies. We found 15 cases with EBM. Primary tumors included breast (3), colorectal (3), and renal (2) carcinomas; Malignant Melanoma (2); synovial sarcoma (1), ampulla of Vater adenocarcinoma (1), pheochromocytoma (1), hypernephroma (1), and Hodgkin's Disease (1). The most common symptoms were dyspnea (80%), cough (66.6%) and hemoptysis (33.3%). Multiple (40%) or single (13.3%) pulmonary nodules, mediastinal or hilar lymphadenopathy (40%), and effusion (40%) were the most common radiographic findings. The mean interval from initial diagnosis to diagnosis of EBM was 32.8 months (range, 0-96 months) and median survival time was 18 months (range, 4-84). As a conclusion, various extrapulmonary tumors can metastasize to the bronchus. Symptoms and radiographic findings are similar with those in primary lung cancer. Therefore, EBM should be discriminated from primary lung cancer histopathologically. Although mean survival time is usually short, long-term survivors were reported. Consequently, treatment must be planned according to the histology of the primary tumor, evidence of metastasis to other sites and medical status of the patient.
Clinical and Experimental Metastasis 02/2005; 22(7):587-91. · 3.52 Impact Factor
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ABSTRACT: The ratio of cardiac involvement of Echinoccocus granulosus is 0.02-2% and although seen rarely, involvement of the interatrial septum has also been reported in the published literature. The present case was a 19-year-old male university student admitted to hospital with complaints of headache and dizziness. Computerized tomography of the cranium revealed a cystic mass located at the frontal region and enucleation of the cyst was performed during surgery. A cystic lesion 5 x 4 cm in size was detected within the interatrial septum on two-dimensional transthoracic echocardiography during the postoperative period and the patient was referred to our clinic. Open heart surgery was performed and a hydatid cyst that involved the interatrial septum was enucleated. The cyst wall was sutured to the interatrial septum. No complications developed during the postoperative period. The patient was discharged on the fifth day of hospitalization and medical therapy was started with albendazole.
Japanese Heart Journal 08/2004; 45(4):703-7. · 0.40 Impact Factor
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Medical Teacher 06/2004; 26(3):279-80. · 1.22 Impact Factor
